Connections Quarterly

In the wake of an increasingly expanding epidemic of opioid overdoses in the United States, the Centers for Disease Control and Prevention (CDC) has issued a new “Guideline for Prescribing Opioids for Chronic Pain.”

These recommendations aim to assist primary care physicians treating adult patients with chronic pain in outpatient settings, excluding patients undergoing cancer treatment, palliative care, or end-of-life care.

Currently, primary care physicians account for nearly half of all opioid prescriptions. The guidelines are aimed to curtail these opioid prescriptions when other treatment options may be available and to ensure the safest treatments for all patients.

“The opioid overdose problem is huge in America. More people die from overdoses than from car accidents,” says Dr. Adam Rubinstein, an internal medicine and addiction medicine physician at Advocate Condell Medical Center in Libertyville, IL, and physician adviser to Live4Lali and Soft Landing Therapeutics. “The problem is multifactorial and is not just about doctors prescribing, however, helping doctors do a better job with prescriptions is a good step in the right direction.”

The CDC guideline includes 12 recommendations for primary care physicians including to encourage the use of non-opioid therapies, to prescribe only the lowest effective dosage amount of an opioid if needed and to always monitor patients closely.

While Dr. Rubinstein commends the guidelines as a move in the right direction, he would like to see additional changes rolled out to combat the epidemic such as:

• Medical schools should provide more robust education on addiction and overdose.
• More physician education opportunities should be offered online and in person.
• Federal laws should give physicians access to patients’ complete drug records.
• Better communication needs to exist amongst physicians and with pharmacists.
• Mental health care needs to be more accessible.