UAB doctor reacts to CDC’s new guidance on opioid prescribing

Published: Nov. 7, 2022 at 7:37 PM CST
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BIRMINGHAM, Ala. (WBRC) - The Centers for Disease Control has changed its guidance on prescribing opioids.

The agency recommending how and when to prescribe the drugs, as well as the pros and cons of them.

The CDC said its new guidance is a recommendation, not a mandate – and it should not be used as a one-size-fits-all solution.

In 2016, the CDC recommended that doctors drastically reduce the dosage of opioid prescriptions for some patients being treated for pain.

“And it emphasized that the dose should not go higher than 90 milligrams of morphine, which is typically a dose that’s only reached in someone that’s been on them long-term,” explained Physician and Professor of Medicine at UAB’s Heersink School of Medicine, Dr. Stefan Kertesz.

He said the CDC’s recommendation did not prohibit the use of opioids for pain treatment, but some doctors and clinicians abruptly changed doses or cut patients off of medications anyway, including some patients who were being treated for cancer, sickle cell, or were recovering from surgeries.

Dr. Kertesz said the CDC’s recommendation prompted some doctors to force doses down in people who were previously stable on high doses of opioids, and said research shows this led to many devastating outcomes including poor quality of life and suicides.

“And these suicides became a pretty prominent issue. The CDC was also aware that a lot of patients were losing access to doctors who are afraid to prescribe, and the CDC came to recognize that a lot of patients who were taken off opioids because of their numbers were turning to the illicit market and were getting drugs that were actually more dangerous,” Dr. Kertesz said.

Dr. Kertesz said the CDC’s new guidance is less rigid and encourages doctors to discuss alternative medications with patients first, as well as offer overdose education for patients who are prescribed daily doses of more than 50 milligrams of morphine.

“If we had one treatment that always worked for chronic pain or for any pain, it would be great, but opioids sometimes really are the thing that is helpful, particularly so when people have severe pain, or when it’s long-term,” Dr. Kertesz explained.

Dr. Kertesz said in order for this new guidance to be effective, other agencies will also need to change their current policies because the guidelines themselves won’t change what doctors do.

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