Centers for Disease Control and Prevention (CDC) 2016 Opioid Prescribing Guidelines Summary
Because of increasing risks of overdose and death of users of opioids, the CDC released its “Guideline for Prescribing Opioids for Chronic Pain”1 in March 2016. The guidelines can be used as a best practice guideline but are not the standard of care at this time.
- Avoid benzodiazepines with opioids (increases risk of overdose and death vs opioid-only use)
- Perform periodic benefit-risk evaluation, including prescription drug monitoring program database review and urine drug screen
- Prescribe nonpharmacologic and nonopioid treatment as first line
- For chronic pain, avoid opioids; risk outweighs benefits for most
- Discuss risk-benefits with patients and document
- Establish realistic goals before opioid therapy starts
- Start with immediate-release opioids; avoid methadone as first line because of higher risk
- Use additional precautions if dose exceeds morphine equivalent dosing (MED) of 50 mg/d
- Generally, avoid increasing the dosage to MED 90 mg/d
- Prescribe a maximum of only 3 days of opioids for acute pain for most nontraumatic, nonsurgical pain.
Concerns regarding the CDC guidelines are that they may limit access to opioids for some patients for whom opioids may benefit.