Heightened alarm over opioid use
New guidelines issued in March by the CDC emphasize once again the devastating impact of opioid use, which claimed nearly 29,000 lives in 2014 and more than 165,000 lives over the past 15 years.
Deaths related to drugs have surged across the country, but opioids continue to be used widely. The CDC reports that in
2013 alone, nearly 1.9 million people in the U.S. abused or were dependent on prescribed opioid medication.
More startling yet, opioids were prescribed, and continue
to be prescribed widely, despite the lack of clear evidence they
are superior to other therapies. "It has become increasingly clear
that opioids carry substantial risk but only uncertain benefits -
especially compared with other treatments for chronic pain,"
says CDC director Dr. Thomas Frieden.
The agency's latest guidelines are directed at prescribing
physicians, who are often uneasy about managing patients
with chronic pain and feel they don’t have enough training in
prescribing opioids. "Of primary importance, non-opioid therapy
is preferred for treatment of chronic pain. Opioids should be
used only when benefits for pain and function are expected to
outweigh risks," the guidelines state.
"Before starting opioids, clinicians should establish
treatment goals with patients and consider how opioids will
be discontinued if benefits do not outweigh risks. Clinicians
should prescribe the lowest effective dosage, carefully reassess
benefits and risks when considering increasing dosage to 50
morphine milligram equivalents or more per day, and avoid
concurrent opioids and benzodiazepines whenever possible," the