Earlier this year, a consensus panel report addressing the challenges of implementing the CDC Guideline for Prescribing Opioids for Chronic Pain was published in Pain Medicine. The report, authored by a multidisciplinary panel convened by the American Academy of Pain Medicine Foundation, drew attention to the fact that the CDC Guideline has, in many cases, been misinterpreted as regulation, causing widespread adoption of dosage ceilings and prescription limits, impeded access to multimodal pain care, barriers to the diagnosis and treatment of opioid use disorder, and a critical failure to appreciate the importance of patient involvement in decisions to taper or discontinue opioids.
Yesterday the CDC issued an advisory cautioning against the misapplication of its guideline, following the publication of an editorial in The New England Journal of Medicine. The editorial references the AAPM Foundation consensus panel report and recognizes that some policies and practices derived from the CDC Guideline are inconsistent and go beyond its recommendations, causing undo difficulty for patients and their providers. Furthermore, the editorial acknowledges the need for improved patient access and provider reimbursement for multidisciplinary pain care.
Work to unravel the barriers and burdens imposed on AAPM members and their patients by policies attributed to the CDC Guideline will take time, but this is an important first step. AAPM will continue to serve as the voice for pain clinicians in these national efforts to address the opioid crisis and promote the importance and adoption of patient-centered, multidisciplinary care.
Members of the AAPM Foundation consensus panel discussed their report during the AAPM 35th Annual Meeting on March 8 in Denver. Among the topics discussed were
- Appropriate opioid reduction and tapering
- Difficulty with OUD diagnosis and treatment
- Primary care concerns
- Integrated, comprehensive pain care models
A recording of this session available now in the AAPM Education Center.