In March of 2016, the Centers for Disease Control took a historic step to address our country’s opioid epidemic: They released their first-ever guide aimed at improving the way opioids are prescribed through clinical practice.
The CDC Guideline for Prescribing Opioids for Chronic Pain is a set of recommendations, ensuring patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from opioids.
"Put simply, the risks of opioids are overdose and death, and the benefits are transient and generally unproven," CDC director Tom Frieden has said. "The epidemic of opioid overdose deaths is doctor-driven, and it can be reversed in part by doctors' actions."
The CDC Guide for Patients
What are opioids?
Opioids are natural or synthetic chemicals that reduce feelings of pain. Common prescription opioid pain relievers include:
- Hydrocodone (Vicodin)
- Oxycodone (OxyContin)
- Oxymorphone (Opana)
Are opioids safe?
Prescription opioids can help with some types of pain in the short term, but they are highly addictive and have serious risks. For active cancer or end-of-life pain, opioids can be an important part of treatment. But for chronic pain, there just isn’t evidence that opioids are effective when used long-term.
Before taking opioid medication for your chronic pain:
- Discuss pain treatment options, including ones that do not involve prescription drugs.
- Tell your doctor about past or current drug and alcohol use.
- Discuss all of the risks and benefits of taking prescription opioids.
What are the risks?
One out of four people receiving long-term opioid therapy in a primary care setting struggles with addiction. In addition to the serious risks of addiction and overdose, the use of prescription opioid pain relievers can have a number of side effects, even when taken as directed. These include:
- Tolerance: meaning you might need to take more of the medication for the same pain relief
- Physical dependence: meaning you have symptoms of withdrawal when the medication is stopped
- Increased sensitivity to pain
- And more, like nausea, depression, and constipation
What should I do if I’m prescribed opioids?
Talk to your doctor, and follow up regularly
Remember that your doctor is your partner in your treatment plan. Always discuss any side effects or other concerns with your physician. Don’t be afraid to speak up and ask questions about your care plan.
Consider non-opioid options
Other options may in fact work better, with fewer risks and side effects. These include:
- Acetaminophen (Tylenol) or ibuprofen (Advil)
- Cognitive behavioral therapy
- Physical therapy and exercise
- Medications for depression or for seizures
- Interventional therapies (injections)
Avoid concurrently using benzodiazepines, like Xanax
Unless specifically advised by your doctor. Combining opioids and benzodiazepines increases risk of overdose. Muscle relaxants, hypnotics (like Ambien), and alcohol should also be avoided.
Store opioids in a safe place, out of reach of others
Don’t sell or share your prescription opioids. Never use an opioid that was not specifically prescribed for you. Seek out a community drug take-back program to safely dispose of unused opioids.
The CDC Guide for Prescribers
Recommendations for clinicians are outlined in this infographic. (Click on image for larger view.)