A call for caution

Be careful when you decide to prescribe opioids for chronic pain. Start low and go slow. And be sure you monitor your patients very closely, to assure that the drugs are working and not causing problems. That’s what the Centers for Disease Control and Prevention’s (CDC) new guidelines suggest providers do, to help address the opioid overdose epidemic through prevention.

The guidelines were rolled out earlier this week to provide guidance to prescribers and patients, and provide another tool to help address the growing number of deaths and addictions associated with opioid use and abuse.

To highlight the need for their recommendations – the guidelines are voluntary and are not laws or regulatory requirements – the CDC noted that 2012 in health care providers wrote 259 million prescriptions for opioid pain medication. That’s enough for every adult in the U.S. to have their own bottle of pain pills.

The CDC also noted that from 1999 to 2014, more than 165,000 people died from overdose related to opioid pain medication in the U.S. These stats were the groundwork for the CDC’s assessment that the risk of prescribing opioids for the nonfatal condition of pain often outweighs the benefits.

Other organizations (like medical professional societies) have issued opioid prescribing guidelines over the years, but this is the first time the federal government has weighed in on how primary care providers should prescribe opioids for chronic pain. It’s important to note that the guidelines do not encompass pain care for active cancer treatment, palliative care or end-of-life care.

The CDC’s final guidelines can be viewed here. Many of the guidelines follow widely adopted practices such as starting a patient off with baseline pain and function measurement before first prescribing pain medications, and following pain and function over time. But, some of the recommendations are the first time we’ve seen them: suggestions to prescribe opioids for only 3-7 days, for example. As such, there is considerable controversy over the guidelines, and what the role of CDC should be, especially when it comes to prescribing decisions made by doctors.

We founded our business based on the belief that the best way to help patients take opioids safely and as prescribed is through better communication and better information for prescribers for decision-making. One of the ways we do this is to provide a way for prescribers to monitor a patient’s use between visits.

When doctors choose to prescribe opioid medications for pain and feel they are indicated, our product, OpiSafe, can help. Our system is tailored to each provider’s choice of guidelines, whether they be from the CDC, the VA, their professional society (ASAM, AAPM, or AAFP), the AMA, an insurer or worker’s comp plan, or even a combination of these guidelines and their most important elements.   We also make it quick and easy to check the state Prescription Drug Monitoring Program Database, schedule random urinalysis and many other helpful features.

In the end, the decision to prescribe opioids is up to the doctor and the patient. For those who need them, opioids are important tools to help people lead productive, pain free lives. But to avoid problems, we created OpiSafe, so that the benefits can exceed the risks, through careful monitoring, which is what we can all agree is best for our patients.