Data Used to Create CDC Guidelines Found to Be “No Longer Present”
CDC opioid prescribing guidelines
In 2016, the United States Centers for Disease Control and Prevention (CDC) released guidelines surrounding the prescription of opioid pain medication for chronic pain treatment. This excludes palliative, cancer and end-of-life care. The intent of the publication was to improve communication with clinicians regarding the risks versus the benefits of opioid use for chronic pain, as well as reduce the number of opioid overdoses and deaths.
Direct correlations no longer present
The guidelines were based on data that the CDC used showing that over prescribing opioids was the cause for the opioid epidemic. The usage of this data was due to a correlation between prescribed opioids and drug-related deaths. However, a new study published in Frontiers in Pain Research states that this is no longer the case. The interrelationship that was found two decades ago is nonexistent today.
The new study shows that opioid prescriptions were declining steadily prior to the release of the CDC guidelines. The decrease became significant after the guidelines were implemented. If over prescribing opioids were to blame for drug-related deaths, the number of overdoses and deaths should have decreased as a result of the guidelines. However, the trend of overdoses related to prescription opioids did not change, and deaths related to drug use increased.
Potential causes of failed guidelines
It is possible that the guidelines were unsuccessful because the opioid epidemic was not the result of over prescribing opioids for chronic pain treatment, but instead was related to use of illegal opioids. In 2020, the five leading causes of drug-related deaths were illicit fentanyl, alcohol, cocaine, methamphetamine, and heroin. Prescription opioids were the sixth leading cause.
The CDC is currently reviewing and revising their opioid guidelines. Final updated guidelines should be available by the end of 2022.