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Unintended consequences of United States chronic pain guidelines

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Abstract

In 2015, the United States of America (USA) Department of Health and Human Services (HHS) released an issue brief that addressed opioid addiction, opioid overdoses, and opioid-related deaths as a public health concern within the country. After collaboration with state and stakeholder organizations, the HHS identified three target initiatives aimed to mitigate the negative consequences of opioid use within the USA. One initiative included implementation of guidelines to help reduce inappropriate opioid prescribing with a goal to reduce morbidity and mortality. The aim of this commentary is to discuss the misapplication and unintended consequences of the USA CDC Guideline for Prescribing Opioids for Chronic Pain.

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References

  1. Opioid Abuse in the U.S. and HHS Actions to address opioid-drug related overdoses and deaths. Department of Health & Human Services USA. https://aspe.hhs.gov/system/files/pdf/107956/ib_OpioidInitiative.pdf. March 26, 2015. Accessed February 25, 2020.

  2. Information about Medication-Assisted Treatment (MAT). US food and drug administration. https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat. February 14, 2019. Accessed April 14, 2020.

  3. Franklin GM, Mai J, Turner J, Sullivan M, Wickizer T, Fulton-Kehoe D. Bending the prescription opioid dosing and mortality curves: impactof the Washington State opioid dosing guideline. Am J Ind Med. 2012;55(4):325–31.

    Article  Google Scholar 

  4. Dowell D, Haegerich TM, Chou R. 2016 CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. MMWR Recomm Rep 65(No. RR-1):1–49. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm. Accessed April 14, 2020.

  5. Bonnie R, Schumacher M. Pain management and opioid regulation: continuing public health challenges. Am J Public Health. 2019;109(1):31–4.

    Article  Google Scholar 

  6. Pergolizzi JV, Rosenblatt M, Lequang JA. Three years down the road: the aftermath of the cdc guideline for prescribing opioids for chronic pain. Adv Ther. 2019;36(6):1235–40.

    Article  Google Scholar 

  7. Clinical Evidence Review for the CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. CDC Stacks Public Health Publications. https://stacks.cdc.gov/view/cdc/38026. Accessed April 14, 2020.

  8. Kroenke K, Alford DP, Argoff C, Canlas B, Covington E, Frank JW, et al. Challenges with implementing the centers for disease control and prevention opioid guideline: a consensus panel report. Pain Med. 2019;20(4):724–35.

    Article  Google Scholar 

  9. Davis CS, Lieberman AJ, Hernandez-delgado H, Suba C. Laws limiting the prescribing or dispensing of opioids for acute pain in the United States: a national systematic legal review. Drug Alcohol Depend. 2019;194:166–72.

    Article  Google Scholar 

  10. FDA Drug Safety Communication: FDA Identified harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering. Available at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes. May 9, 2019. Accessed on November 25, 2019.

  11. Fenton JJ, Agnoli AL, Xing G, Hang L, Altan AE, Tancredi DJ et al. Trends and rapidity of dose tapering among patients prescribed long-term opioid therapy, 2008–2017. JAMA Netw Open. 2019;2(11):e1916271.

    Article  Google Scholar 

  12. CDC Warns of Misapplication of its Opioid Guideline. American Academy of Family Physicians. https://www.aafp.org/news/health-of-the-public/20190509cdcopioidgdln.html. May 9, 2019. Accessed February 25, 2020.

  13. Pedersen CA, Schneider PJ, Scheckelhoff DJ. ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing-2016. Am J Health Syst Pharm. 2017;74(17):1336–522.

    Article  Google Scholar 

  14. Connelly TP, Korvek SJ. Computer Provider Order Entry (CPOE) [Updated 2020 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470273/

  15. The Epic Problem with the CDC Opioid Guideline. Orthopedics This Week. https://ryortho.com/breaking/the-epic-problem-with-the-cdc-opioid-guideline/. November 21, 2018. Accessed April 14, 2020.

  16. Overton HN, Hanna MN, Bruhn WE, Hutfless S, Bicket MC, Makary MA et al. Opioid-prescribing guidelines for common surgical procedures: an expert panel consensus. J Am Coll Surg. 2018;227(4):411–8.

    Article  Google Scholar 

  17. Linder BJ, Occhino JA, Wiest SR, Klingele CJ, Trabuco EC, Gebhart JB. Assessing the impact of procedure-specific opioid prescribing recommendations on opioid stewardship following pelvic organ prolapse surgery. Am J Obstet Gynecol. 2019;221(5):515.e1–.e8.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pharmacy Practice, University of Connecticut, Storrs, CT, USA

    Kathleen Adams

  2. Department of Pharmacy, Yale New Haven Hospital, New Haven, Connecticut, USA

    Michael Guerra

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  1. Kathleen Adams
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  2. Michael Guerra
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Correspondence to Kathleen Adams.

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Author Kathleen Adams, PharmD, BCPS and Michael Guerra, PharmD, BCPS declare that they have no conflict of interest.

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Adams, K., Guerra, M. Unintended consequences of United States chronic pain guidelines. Int J Clin Pharm 43, 313–317 (2021). https://doi.org/10.1007/s11096-020-01129-7

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  • DOI: https://doi.org/10.1007/s11096-020-01129-7

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