August 15, 2019
ASA Makes Formal Recommendations to CDC on Guideline for Prescribing Opioids for Chronic Pain
On August 13, the American Society of Anesthesiologists (ASA) sent a formal communication to the Centers for Disease Control and Prevention (CDC) to convey concerns related to the misapplication of the CDC Guideline for Prescribing Opioids for Chronic Pain by state medical and disciplinary boards, public and private payers, pharmacies and others.
ASA believes the CDC Guideline has been misapplied in many settings; it was intended as a guidance for primary care providers and not for its recommendations to be applied across-the-board to all patients. ASA is concerned about this misapplication and the negative impact such a broad policy is having on patient care.
In the formal letter, ASA recommended that the CDC review and revise the Guideline to provide the most up-to-date scientific evidence available and to clarify its intent to ensure it is clearly understood and utilized appropriately. ASA recognizes the value of the CDC Guideline at a time when the nation is facing an opioid epidemic. However, individualized patient care and safety is the utmost priority throughout chronic pain treatment. The treating physician and the patient should jointly decide on a treatment plan and modality after discussing options, weighing benefits and risks, as well as expectations. In some cases, the best treatment for the patient does not fall within the purview of the Guideline and ASA urged the CDC to clarify its intent to ensure patients continue to receive compassionate pain care.
ASA is concerned that the CDC Guideline lacks scientific evidence and high-quality data on the duration of opioid effectiveness for chronic pain. ASA believes this can be addressed and expressed support for recommendations developed by the HHS Pain Management Best Practices Inter-Agency Task Force which encourage building the applicable evidence. The recommendations were released in a report recognizing the misinterpretation of the Guideline and the consequences of unintended adverse outcomes.
ASA looks forward to continue working with the CDC to ensure an updated and revised Guideline is best for patient care and appropriate for physician practice.