The American Medical Association (AMA) today urged advisers to the Centers for Disease Control and Prevention (CDC) Injury Center to recommend an overhaul of the CDC’s problematic guideline on opioid prescriptions that has proved devastating for patients with pain.
The AMA comments mirror those of the Opioid Workgroup, which was established for the purpose of reviewing draft revisions to the CDC’s 2016 guideline for prescribing opioids. The resulting Opioid Workgroup report outlines the foreseeable misapplication of the guidelines and points to more productive ways to move forward. The report was just presented to the Board of Scientific Counselors, which voted Friday to endorse it with few amendments.
The AMA is urging the CDC to remove arbitrary thresholds, restore balance and support comprehensive, compassionate care as it revises the guideline. In comments to the CDC Injury Center’s Board of Scientific Counselors, AMA Board of Trustees Chairman Bobby Mukkamala, M.D., pointed out that the opioid epidemic is becoming more lethal despite the CDC restrictive guideline due to illicitly manufactured fentanyl, fentanyl analogs, heroin, methamphetamine and cocaine. At the same time, patients are suffering from the undertreatment of pain and the stigma of having pain.
Mukkamala, who also is chair of the AMA task force focused on pain management and the drug overdose epidemic, wrote, “CDC’s threshold recommendations continue to be used against patients with pain to deny care. We know that this has harmed patients with cancer, sickle cell disease, and those in hospice. The restrictive policies also fail patients who are stable on long-term opioid therapy.”
States and insurers have turned the guideline into laws and unbending regulations, preventing physicians from treating patients as individuals with specific needs. The AMA outlined its concerns and recommendations last year in a letter to the CDC.
According to the CDC, it is anticipated that a revised guideline will be posted for public comment in late 2021.