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CDC calls for new guidelines on opioids to reduce risks

JAN. 18, 2013 PHOTO.Rich Pedroncelli/ASSOCIATED PRESS

Some of the opioids on the market which the government wants doctors to drastically curtail giving to patients because 40 Americans die every day from overdoses.

The CDC is telling doctors to knock it off with all the painkiller prescriptions.

In issuing new guidelines for treatment involving opioids, the Centers for Disease Control Tuesday stressed the need to look for alternative therapies. The aim: stem the epidemic of deaths from opioid painkillers.

At the heart of the recommendations came twin pleas — asking doctors to find alternative therapies and asking patients to be honest with their doctors.

Patients need to understand the risks, the report argued.

Doctors, for their part, need to ensure that simple methods such as ibuprofen, acetaminophen, exercise therapy, weight loss and behavioral treatments are also considered before doctors write prescriptions for stronger stuff.

According to CDC Director Tom Frieden, it’s not uncommon for a student-athlete to suffer an injury, take prescribed opioids, become addicted and wind up overdosing.

Frieden stressed that, for most patients, the risks of taking opioids — high-powered but addictive painkillers — far outweigh the benefits.

Among the guidelines:

– Opioids should not be first-line therapy.

– When opioids are prescribed for chronic pain, doctors should prescribe immediate-release instead of extended-release drugs.

– Use the lowest effective dose.

– Prescribe for very short periods of time and only for acute pain.

“Three days or less will often be sufficient; more than seven days will rarely be needed,” the CDC guidelines state.

The 12 recommendations are just that — the CDC has no power to force doctors to do anything. The voluntary measures ask doctors to stay in communication with their patients and regularly assess how a patient is faring.

The CDC wants a drastic reduction in the use of painkillers which are prescribed to deal with acute and chronic pain.Education Images/UIG via Getty Images

The CDC wants a drastic reduction in the use of painkillers which are prescribed to deal with acute and chronic pain.

Frieden recalled that back when he was in medical school, the thinking was that if someone was in pain, doctors should give the patient an opiate; the patient would not become addicted.

“The prescription overdose epidemic is doctor-driven and can be reversed, partly, by doctor actions,” Frieden said in a press conference.

The new guidelines are not intended for cancer patients or those managing severe pain as they are dying. The guidelines are, though, intended to reel in doctors who write too many prescriptions.

Forty Americans die every day from overdosing on opioids, Frieden said.

“We know of no other medication routinely used for a nonfatal condition that kills patients so routinely,” Frieden said. “It is so important that doctors understand that any one of those prescriptions could potentially end a patient’s life.”

Nearly 2 million Americans age 12 or older were dependent on prescription opioids in 2014. Since 1999, the amount of opioids prescribed in the U.S. has quadrupled, though the amount of pain reported by Americans has not changed.

Some health care providers were already worried about the eventual effect these guidelines will have.

Responding, the American Medical Association applauded efforts to stop the deaths, but expressed concern over limiting doctors in how much and for how long they prescribe painkillers.

“We know this is a difficult issue and doesn’t have easy solutions and if these guidelines help reduce the deaths resulting from opioids, they will prove to be valuable,” Dr. Patrice A. Harris, chair of the AMA Task Force to Reduce Opioid Abuse, said in a statement.

If these guidelines, “produce unintended consequences, we will need to mitigate them. They are not the final word. More needs to be done, and we plan to continue working at the state and federal level to engage policy makers to take steps that will help end this epidemic.”

Even though the guidelines are advisory, Robert Twillman, executive director of the American Academy of Pain Management, a non-profit group of 4,200 physicians and other health care providers, expects these guidelines will become law.

The guidelines are only advisory “until groups like state legislatures and licensing boards get their hands on it and then they will start making it mandatory,” Twillman said.

jcutler@nydailynews.com

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