After years and decades in which healthcare providers were freely prescribing opioids for all sorts of painful conditions, the US Centers for Disease Control and Prevention (CDC) published guidelines to help bring down opioid prescription rates and with them, addiction and overdose-related death rates. Though these were not binding, they urged physicians to be cautious in dealing with opioids when prescribing for pain.
The result was predictable: many doctors and patients, as well as advocacy groups, reacted strongly, claiming that many patients with severe chronic pain had been on opioids for years at high doses, yet had not developed addiction. They also claimed that the guidelines had caused many such patients to go without the pain relief they required. Over 300 doctors also formalized their protests in a letter to the CDC in the first part of 2019.
In clarification, the CDC countered by saying that its guidelines were not meant to force patients or healthcare providers to suddenly stop taking opioids or sharply reduce the dosage, and called upon doctors to understand its stance properly before applying the guidelines. The new guide shows potential sources of harm to patients who are abruptly taken off opioids, and describes factors that must be kept in mind when opioid tapering is considered. The CDC has also included several tapering protocols, to reinforce the message that abruptly stopping opioid use patterns could harm the patient.