CDC Announces New Opioid Prescribing Guidelines

The Centers for Disease Control and Prevention (CDC) have proposed to remove the 2016 recommended dosage caps on opioids for acute and chronic pain, with a final announcement of an improved guidance for physicians expected by the end of 2022.

If approved, the guidance would be a significant change from the 2016 guidelines, which recommended physicians limit a patient’s daily dosage to no more than 90 Mmes, or morphine milligram equivalents.  The proposed CDC action will help to address several misgivings in the 2016 guidelines, including a misinterpretation by states and physicians that the guidelines were mandatory for all physicians. 

The 90 Mme dosage cap in the 2016 guidelines wasn’t meant for all pain medicine prescribers. The recommendations were targeted as guidance to primary care physicians, but they were not targeted at pain medicine specialists. While the CDC brought its recommendations out as a prescribing guide, these suggestions were misinterpreted by physicians and even law enforcement as strict rules. This led the guidance to become an unintended roadblock to appropriate care for some chronic pain patients.

The new 2022 CDC document document stresses the importance of an individualized approach to care and provides a substantial review of opioid treatments, which is an appropriate and critical paradigm shift for many pain physicians and their patients.  The document does need some work, most importantly to add further discussion about non-opioid therapies by year’s end for both pain management and as support for insurance reimbursement.  Insurance companies may be less likely to cover non-opioid pain treatments if they’re not explicitly recommended by the CDC.

In order to assist physicians when they prescribe opioids for pain, they should utilize available telehealth tools to capture key clinical data from their patients and preserve information to help improve compliance with the patient’s medication and care plan.  Physicians should look to such tools as the internationally recognized PainScript physician management platform.   The PainScript approach is specifically designed to augment the physicians’ efforts in making an appropriate and thoughtful decision about their patient’s health and to document those decisions with data supporting the physician’s action.

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