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
"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 guidelines add.