At the end of 2022, the CDC released new prescribing guideline for opioids, replacing their last set from 2016. Excluding patients with cancer and other terminal illnesses, this guideline strongly emphasizes alternatives to opioids and urges extreme caution for physicians considering new opioid prescriptions, while also recommending how to appropriately care for chronic pain patients with long-term opioid treatment.
Notably however, is how the new guideline answers the failures of the past. According to the CDC, many laws, regulations and policies were “notably inconsistent and have gone well beyond its clinical recommendation.” This led to rapid tapers, abrupt discontinuation, treating MOUDs like buprenorphine as opioids for pain that needed to be stopped as quickly as possible, setting arbitrary limits on prescriptions by insurers and pharmacies, and even patient dismissal and abandonment. The fallout from this is “patient harm, including untreated and under-treated pain, serious withdrawal symptoms, worsening pain outcomes, psychological distress, overdose, and suicidal ideation and behavior.”
Dr. Clay Jackson, a board certified pain specialist from West Tennessee who also serves on the Tennessee Opioid Abatement Council, speaks with Jeremy about the new CDC guideline for the prescription of opioids for acute and chronic pain. Dr. Jackson uses his extensive and first-hand knowledge of the subject to dive deep into the story of how we got here in the first place, and taking us through some of the broader philosophical considerations of the treatment of pain and the future of the field. This conversation also touches on the FDA, fentanyl, non-opioid treatments and medications, and other topics that are strongly impacted by this still young history of prescription opioid pain treatment.
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