EDITORIAL: CDC guidelines for opioid use a good step toward controlling problem

Abuse of prescription painkillers has been skyrocketing. Last week’s guidelines on the use of opioids in treating chronic pain from the Centers for Disease Control and Prevention are a step in the right direction.

Under the voluntary guidelines, primary care physicians, who write about half of the scripts for the powerful painkillers, are being told that they should look to other suitable pain control medications such as acetaminophen and ibuprofen instead of the addictive class of medicines.

Dr. Tom Frieden, CDC director, says that sales of opioids have quadrupled in just over a decade and a half, resulting in 165,000 fatal overdoses. The CDC says more than 40 Americans a day are dying from opioid overdoses.

“Overprescribing opioids, largely for chronic pain, is a key driver of America’s drug-overdose epidemic,” he said.

Importantly, the new guidelines are not for illnesses where powerful painkillers are needed, such as cancer and end-of-life care. Those are situations where the benefits of the drugs far outweigh other considerations.

Patients need the guidance because often they are under the impression that a prescription must be “safe” to use. Generally, they are when used under specific guidelines and conditions. Long-term use of opioids, however, can be addictive, with the patient developing a need for the medication. Those addicted to opioids have been known to doctor- and pharmacy-shop in attempts to mask the quantity of the drug they are getting, and many die not specifically from a drug overdose, but from damage they do to their heart and other vital organs from overuse of the medication.

One Georgia public official who has been a proponent of cracking down on opioid has been state Attorney General Sam Olens, who has spoken about its dangers to students in our area. He was one of 37 state attorneys general who asked the CDC to adopt these kinds of guidelines.

In reaction to their release, he said the CDC guidelines will help primary care providers ensure the safest and most effective treatment for their patients. “By better informing and guiding prescribers, these guidelines will not only provide a strong framework for providers, but they will also improve the access to opioids for patients for whom they are the best choice,” Olens said.

In the dozen guidelines, Olens said there were three principles that he felt were key to improving patient care:

— Making non-opioid therapy preferred for chronic pain outside of active cancer, palliative and end-of-life care;

— Use of the lowest possible effective dosage to reduce risks of opioid use disorder and overdose;

— Exercise of caution when prescribing opioids and the close monitoring of the patient.

The idea that prescription medication addiction is somehow not as bad as addiction to illegal drugs is a falsehood. Prescription painkillers that are misused or used by those for whom they haven’t been prescribed are every bit as destructive. While we believe that vast majority of family practice physicians are conscientious of the issues that have developed with opioids, the CDC guidelines keep the issue front-of-mind. And in some cases, that may be a lifesaver.

— The Albany Herald Editorial Board