CDC Releases UPDATED Clinical Practice Guideline for Prescribing Opioids for Pain

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

Thursday, November 3, 2022, the CDC posted this Press Release to announce the updated CDC Clinical Practice Guideline for Prescribing Opioids for Pain:

Pain affects the lives of millions of Americans every day and improving pain care and the lives of patients with pain is a public health imperative. The Centers for Disease Control and Prevention (CDC) is releasing updated and expanded recommendations for clinicians providing pain care for adult outpatients with short- and long-term pain. These clinical recommendations, published in the CDC Clinical Practice Guideline for Prescribing Opioids for Pain, will help clinicians work with their patients to ensure the safest and most effective pain care is provided. The publication updates and replaces the CDC Guideline for Prescribing Opioids for Chronic Pain released in 2016.

“Patients with pain should receive compassionate, safe, and effective pain care. We want clinicians and patients to have the information they need to weigh the benefits of different approaches to pain care, with the goal of helping people reduce their pain and improve their quality of life,” said Christopher M. Jones, PharmD, DrPH, MPH, Acting Director of CDC’s National Center for Injury Prevention and Control.

The 2022 Clinical Practice Guideline addresses the following areas: 1) determining whether to initiate opioids for pain, 2) selecting opioids and determining opioid dosages, 3) deciding duration of initial opioid prescription and conducting follow-up, and 4) assessing risk and addressing potential harms of opioid use.  The Clinical Practice Guideline supports the primary prevention pillar of theHHS Overdose Prevention Strategy – supporting the development and promotion of evidence-based treatments to effectively manage pain.

The guideline is a clinical tool to improve communication between clinicians and patients and empower them to make informed decisions about safe and effective pain care. The recommendations are voluntary and provide flexibility to clinicians and patients to support individualized, patient-centered care. They should not be used as an inflexible, one-size-fits-all policy or law or applied as a rigid standard of care or to replace clinical judgement about personalized treatment.

CDC followed a rigorous scientific process using the best available evidence and expert consultation to develop the 2022 Clinical Practice Guideline. An independent federal advisory committee, four peer reviewers, and members of the public reviewed the draft updated guideline, and CDC revised it in response to this feedback to foster a collaborative and transparent process. CDC also engaged with patients with pain, caregivers, and clinicians to gain insights and gather feedback from people directly impacted by the guideline. The expanded guideline aims to ensure equitable access to effective, informed, individualized, and safe pain care.

“The science on pain care has advanced over the past six years,” said Debbie Dowell, MD, MPH, chief clinical research officer for CDC’s Division of Overdose Prevention. “During this time, CDC has also learned more from people living with pain, their caregivers, and their clinicians. We’ve been able to improve and expand our recommendations by incorporating new data with a better understanding of people’s lived experiences and the challenges they face when managing pain and pain care.”

CDC will continue to work to improve patient safety and outcomes by equipping health care professionals and patients with data, tools, and guidance they need to make informed treatment decisions. The 2022 Clinical Practice Guideline supports patients and clinicians working together to make informed, individualized decisions about safe and effective pain care.

Additional materials associated with the guideline are available for patients and clinicians.

The New England Journal of Medicine also posted Perspective: Prescribing Opioids for Pain — The New CDC Clinical Practice Guideline that same day.

“The 2022 guideline aims to promote equitable access to effective, informed, individualized, and safe pain management that improves patients’ function and quality of life, while clarifying and reducing the risks associated with opioid use. Ideally, new recommendations should result in greater and more equitable access to the full range of evidence-based treatments for pain, more judicious initial use of opioids, and more careful consideration and management of benefits and risks associated with continuing, tapering, or discontinuing opioids in patients who are already receiving them long term.

The CDC will monitor for these intended effects as well as for unintended effects and will work with public and private payers and share evidence that can be used to inform decisions regarding coverage for a broader range of pain therapies. Evidence to guide the best achievable pain management remains limited, and research should address critical remaining gaps, including long-term comparative effectiveness of therapies for pain. Patient–clinician communication about benefits and risks associated with opioids remains central to treatment decisions. The 2022 guideline can help inform those decisions and assist clinicians in meeting patients’ unique needs.”