2016 Cdc Guidelines For Prescribing Opioids For Chronic Pain

Hey all fellow patients out there, did you know the CDC has published a list of their proposed 2016 guidelines for doctors who prescribe opioids for chronic pain? That includes oxycodone, lortab, percocet, hydrocodone, opana, suboxone, morphine, and any other drug that has an opiate ingredient in it that so many of us count on to lead normal lives!

This affects all of us and the comment period ends on January 13 2016! That's about a week from now! You know the doctors are going to have to follow whatever federal rules pass so if you are worried that you might not get the care you need please go to the gov web site for the office of the Federal Register and submit your comments to them before it's too late!

"The Centers for Disease Control and Prevention (CDC) in the Department of Health and Human Services (HHS) announces the opening of a docket to obtain public comment on the draft CDC Guideline for Prescribing Opioids for Chronic Pain (Guideline). The Guideline provides recommendations regarding initiation or continuation of opioids for chronic pain; opioid selection, dosage, duration, follow-up, and discontinuation; and assessment of risk and addressing harms of opioid use. The Guideline is intended to be used by primary care providers (e.g., family physicians or internists) who are treating patients with chronic pain (i.e., pain lasting longer than 3 months or past the time of normal tissue healing) in outpatient settings."

https:/­/­federalregister.gov/­a/­2015-31375

Editor's note: Please note that the above statement "You know the doctors are going to have to follow whatever federal rules pass" is technically correct but may be misleading in this case because the CDC draft says that it is "not a federal regulation" and that "adherence to the Guideline will be voluntary."

Editor's note # 2: The title for this discussion thread has been updated to reflect the topic most effectively.

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I had a tough time finding what to do on that federal page so I finally figured it out. In case any one wants to know what is going on that page basically links to a pdf file with info on it if you wonder what they are specifically looking to do. See page 1 only. I found a paragraph where it says "The Guideline is not a federal regulation; adherence to the Guideline will be voluntary." So that is a bit of good news as far as this not being laws or anything but i can't say how many doctors will choose to "voluntarily" follow any new guidelines???

But we all know how that kind of thing starts. First it gains a bunch of attention and then all of a sudden the feds and dea decide it is time to make these "voluntary" guidelines into law, am i right? So I am submitting my comments to them and I think as many of us need to do this NOW before much else happens. I think doctors are nervous now and I don't blame them, but ultimately I don't think the lawmakers know how many legitimate patients suffer when changes are made to how and when we can get our meds. Silence is the only bad action we can take at this point.

So when you get to that government page near the top it says "This document has a comment period that ends in 7 days (01/13/2016)" and so you just click on "SUBMIT A FORMAL COMMENT". Just click on that button so you can fill out and send them a message. Tell them your story and that certain medicine lets you lead a quality of life.

Editor's note: Enabled live link to the pdf file above and also pasted the related paragraph which this user is referring to down below:

" CDC developed the draft Guideline to provide recommendations about opioid prescribing for primary care providers who are treating adult patients with chronic pain in outpatient settings, outside of active cancer treatment, palliative care, and end-of-life care. The draft Guideline summarizes scientific knowledge about the effectiveness and risks of long-term opioid therapy, and provides recommendations for when to initiate or continue opioids for chronic pain; opioid selection, dosage, duration, follow-up, and discontinuation; and assessing risk and addressing harms of opioid use. The draft Guideline identifies important gaps in the literature where further research is needed.

To develop the recommendations, CDC conducted a systematic review on benefits and harms of opioids and developed the draft Guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. CDC drafted recommendations and consulted with experts on the evidence to inform the recommendations. CDC hosted webinars in September 2015 and also provided opportunities for stakeholder and peer review of the draft Guideline. The Guideline is not a federal regulation; adherence to the Guideline will be voluntary. "

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THEY ARE HOLDING A CONFERENCE CALL OPEN TO THE PUBLIC TOMORROW MORNING!! It doesnt say the timezone but i assume east coast?

Time and Date: 9:00 a.m.-1:00 p.m., January 7, 2016 (OPEN).
Place: Teleconference Dial-In Number:
1-888-395-7561, Participant Code: 3954121.

Matters for Discussion: The Board of Scientific Counselors will discuss the background for development of the CDC Guideline for Prescribing Opioids for Chronic Pain (Guideline) and the formation of the Prescribing Opioids for Chronic Pain Workgroup (Opioid Guideline Workgroup). We will be accepting public comments only related to the formation of the Opioid Guideline Workgroup. There will be 30 minutes allotted for public comments at the end of the session. All public comments will be limited to two-minutes per speaker.

Source: https:/­/­www.gpo.gov/­fdsys/­pkg/­FR-2015-12-14/­html/­2015-31367.htm

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Roy, THANK YOU for starting a brand new, current thread re: CDC'S 2016 Opioid Guideline for Doctors as it was sorely needed.

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I have antiphospholipid syndrome (APS). The pain started when i was about 8. I would get horrible headaches (ha). I figured out when i was 16 that aspirin, an antiinflammatory worked very well at controlling the pain. I would buy bottles of 500 norwich aspirin (325 mg each) at the dime store which at 6-8 a day would last 3 months. I mentioned the ha to my doctor when i was 8 and he ignored me. I even took aspirin during all 3 pregnancies unaware that ASA were banned during pregnancy. Thank god for ASA because i was unwittingly anticoagulating myself and all 3 kids born healthy. All went well until i was 39 when the pain became unbearable. The pain had morphed into trigeminal neuralgia. The only drug that helped at all was oxycodone combined with ASA. It is now known that APS, due to microvascular clotting , causes ischemia in various parts of the body. In my case it was my brain initially and as it progressed, avascular necrosis of the jaw bone which compresses the trigeminal nerve. I had the equivalent of a tooth ache for many years. Trigeminal neuralgia is known as the suicide disease. Ask Dr Jerry Bouquot in Morgantown, WV. He is one of the doctors who first identified the jaw ischemia. WV should be very proud of him, an oral pathologist trained at MayoClinic and former chief of WV Dental School. I know he saved my life. Also speak with dr ronald brownfield. He practices at HIMG on 5170 route 60 east in Huntington. He continues treating me with multiple drugs, including oxycodone. He is a saint, even now I rrquire about 3 oxycodone(5mg) and 6 ASA per day. This does not always control my pain, but helps tremendously. Dont penalize me and others with chronic pain due to those who abuse it.

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How dare US it is against turture to terrorist when they have taken away medication needed for end of life inhumane murdring pain. I have had 4 people die in my niegborhood not from over dosing but becuse they were cut off needed medication in their last days. Well their last days were inhumane what used to be criminal pain.I keep getting told im going to have a stroke my blood pressure is so high becuse of murdering pain at the end of my life and no the end of my life was not supposed to be tonight but it could be becuse the only way to control my BP is with my pain med that took 8 years of suffing to finally get diognosis n treatment the only thing that can be done is control pain. no more surgery

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Thanks Roy for the information. My doctor about a month or so ago told me about the new prescribing guidelines and told me that I would be one of the last patients he would ever reduce my level of medication on because he could easily justify my level of Medicine.
I had a really bad epidural abcess 27+ years ago after a back surgery and while I had the infection they had me on IV steroids for 10 days which made the infection a super bug. It scared the dural sac really bad at 2 levels, scared the nerve sheaths really bad at 2 levels and basically created a scar tissue pocket the size of 2 softballs from L4 to S1.
I guess by now you get the picture of how much nerve irritation I have going on. I have a multi-lead spinal cord stimulator implant (my 7th unit and counting) and have Rhizotomys at 3 levels both sides about every 14 months.
That's basically what someone who doesn't have cancer or end of life care will have to almost have to stay on their current medication regime.
Most doctors will follow the new guidelines because if they don't they could be sued for anything that might happen because of not following the guidelines. They say it's not mandatory, but watch most doctors follow the guidelines unless it's something rare, severe and has a zero surgical fix. Like my unfortunate self :-(
There's exceptions to everything and I definitely fall into the exception category, alot of people in pain management are going to have to get by with less medicine or none at all. Most people I know in pain management where I live have already been told by their doctors if their medicines are going to be reduced or even eliminated all together and have already started months ago doing this.
Chronic Pain patients are the latest victims in our governments failed War On Drugs, sad but true! Drug abusers now have a higher priority than suffering human beings!
Everyone can complain all they want to, but until the politicians are out of office who caused this it won't change. Bless all of you who are going to be victims of our governments out of control over reach playing doctors now...

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Is this a way for the federal government to legalize marijuana as a pain reliever? I really believe the devil is in this issue. Chronic pain in seniors that pain rx helps them to lead an active life should not even be a government involvement. Is this something that Fl. Atty General Pam Bondi started? Does anyone remember the days that cancer patients died in such pain agony because doctors were afraid they would get hooked on drugs while dying or the FDA was fearful that someone would buy paregoric! This is an asinine government involvement that cannot see that Americans could be killed by terrorists ...........not a pain rx!

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I just posted my comments. I also included the fact that Suboxone, which is a prescription medication for withdrawal of opiates, is completely out of reach for even patients with insurance can not afford. Those that want to get off pain medication stay on it just do to the fact that pain medication is much cheaper than Suboxone!!

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Tourture n murder used to be criminal. We all know CDC being paid off by ins. Co. so they can get away with inhumane murder. No secret severe chronic pain causes High Blood pressure, strokes, n inability to live any kind of healthy life. i just get by thanking God. alll u thieves r going to have enterity of pain in Hell u hypocrite , discriminating murderes.

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These Guidelines will not be Federal Law and will be Voluntary and they also state that they are for Primary Care Physicians. The FDA Guidelines 120 mg Morphine/120 mg Morphine Equivalent Daily that came out a while back are the same way, they are not Law, they are voluntary and they aren't aimed at Pain Management Drs, but the vast majority of pain managment drs are going by them now.

The CDC Guidelines contain much more than the decrease to 90 mg Morphine/90 mg Morphine Equivalent Daily.

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Recently, i have had a very bad spell of scattica with contant excruciating.pain,.i went to my pcp whp refused to give me ANYTHING, SO I left totally upset & went to the er where i was prescribed. Percocet, flexiril & predisone pak which helped greatly. My pcp still would not put me on percocet from chronic pain although she told me that was the only thing that would help.she did give me tramadol , which was about as good as chewing m&ms, i ended up going to a pain management dr.over 70 miles from where i live. he gave me percocet to last until an appt to get an injection in my back, which thank the goddess was immediate pain relief,my question is Why are ALL the drs. so reluctant to give out narcotic pain killers when they are clearly needed? My pain management. Dr.was even reluctant to give me percocet to have on hand in case the pain came back!!!! What. CAN I DO ABOUT THIS RIDICULOUS NEW RULING THAT I CANT EVEN GET PAIN MEDS WHEN I NEED THEM!!!##!!!????

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Does anyone know what time zone the call later today is in? I'd like to give them a piece of my mind because they need to know what is going on with real patients like us.

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Nancy and all: Thank you for your comments and sorry to hear about your struggling too. BL you are right that they are guidelines and not really a written law but I think you can agree and none of us can ignore that doctors are less and less willing to prescribe like they once were. Why do you think that is? Were lots of them getting in trouble? Feels like having to jump through flaming hoops in the circus to get the proper care sometimes. What else can be done?

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Where can I see the guidelines? I need to read them before I comment on them! I've just read reams of text asking for a response to the proposed guidelines. I can't find the guidelines anywhere. Where can I see them?

Editor's note: This comment was moved in from a related discussion thread in order to keep all information consolidated.

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http:/­/­www.regulations.gov/­#!docketDetail;D=CDC-2015-0112

Editor's note: This comment was moved in from a related discussion thread in order to keep all information consolidated.

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Ok the CDC call is going on as I type this. When I first called in a lady came on the phone and gave me a NEW number to use. So if anyone is trying to call in here are the new details:

9am - 1pm EASTERN TIME

1-888-469-1243, enter the code 4709506 then press # (pound)

It is being recorded and I hope they make the recording available afterwards.

So far they are placing A LOT of emphasis on how much research and evidence is going towards developing these guidelines. So it seems like they are prepared to back their statements up with research studies from the sound of it.

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The research/studies were paid for by the taxpayers and the government agency involved will always get the exact results they want to promote. In other words backup their BS with their fingers on the scale and we're paying for it... I've never seen a government study yet that wasn't severely biased toward the outcome the government wants to promote, this won't be the first one that's not biased either.
No Severe Chronic Pain patient needs a study to tell them what they need to control their pain and how much is needed. You can't lump all injures and diseases into a single category and treat them all the same! That's just complete insanity! But the best part is yet to come! A severe increase in street drug abuse which will have a severe increase in crime of all types. The terrorists are licking their lips in anticipation of all the opium they'll be putting on the streets of America after this huge American Government blunder... Funny how our government rarely if ever looks at the big picture of their actions. Welcome to our next nightmare courtesy of Odumbo! The government will now tell you how you feel and exactly what you need because your doctor and you are to dumb to think for yourselves! Don't you just love Odumbo socialism?

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I dialed the conference number and got the message: "there are two parties in conference including you"--that means me and only one other person, so I guess it was either a hoax or nobody else gives a damn

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I called a few moments ago and me and another party were the only ones there. It at 10:15 central time. I kept saying "hello? Hello?" I didn't get a reply

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Thank you for the number update! LOL The other one was empty.....

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Re: 2017furtherrestrictionsnyc (# 180)

Yes, I loved when a patient of mine. 93 was told he could begin using a meditation ball...I will spare you his response as it was less than cordial. He forsnt have too much longer, maybe a year, I would guess and they're worried about him getting addicted. This is just going too far.

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Lovw that "voluntary" version....those that dont "voluntarily" go along with this may loose their liscense or be investigated. They're keeping doctors from using their best judgement and causing them to make decisions from fear. This is not how medicine should work!

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Re: some1whoknows (# 118)

Wow. I find your response totally absurd. Working in health care, I work with patients who have chronic pain and need these medications. One that I have worked with was crushed by construction equipment, another is a ear veteran who will.have pain for the rest of his life from an i.e.d. yet another that was recently denied has kidney disease, a recurrent tumor and stage 4 endometriosis. These people arent gettin, "high", they're existing. People that couldn't hold a job. Before being given these meds (the ones I work with anyway), mostly work after. Now some will have to stop. And now, I've had another nurse have a patient who killed herself because she couldn't stay out of pain. By no means am I saying this is everyone, but shame on you for saying cancer patients are the only patients who should get these. What are your qualifications to make that statement? Also, do you realize that many patients now have to keep their meds in a safe if they get any and pay out of their own pocket for naltrexone, on the off chance someone breaks into their house and safe and overdoses? And now they're telling patients to "deal with the pain", after major surgery or giving 5 days of meds. Many of the CDC members who made these guideline are statisticians, not doctors. So glad politicians are making medical decisions they have no education or background to make.

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Re: BL (# 156)

I'd love to see those state and federal "laws" as up till now, being in the health care industry, I've never seen any.

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Audrey, it is still up to each doctor to prescribe what in their professional opinion is best for their patients. Unfortunately doctors lie. They tell patients they are being forced to prescribe a certain way when it is totally their choice.

No state is making doctor prescribe a certain amount. Nor is the federal government. Even when their is a policy, like with CMS Opioid Misuse Strategy, there are exceptions. But, the medical commuinity gas learned that high doses of opiates are not best. It takes a while to adjust to lower doses of opiates, but it will get better.

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Come on...You can say reccomendation but I've had doctors fully admit they're feeling forced into this! They're fearful they will be hurt or their liscenses will be-. I've been on the same regimine for over a decade-i am a productive member of society- now my doctor tells me he "has to reduce" my medications. Can't wait for the rest of my life stuck in bed because of pain! You need some kind of codicils for those of us that have been on these meds for years/decades and have never had problems. Your punishing those of us that do as we're told!

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I have had 2 ACDF C5-C6 AND C6-C7 and now have to have a 3rd back surgery on C4-C5. I also have Lupus and Hashimotos Thyroid! I have been to several pain clinics in the Knoxville TN searching and begging for some help. I have gone from 2/60 mg Oxycontin ER twice a day along with 4/30mg Oxycodone IR per day for breakthrough pain to the unbelievable amount of only 2/20 mg Oxycontin ER and only 3/20 mg Oxycodone IR per day. They are going by the CDC recommendations! Which is exactly that, recommendations ONLY! My question is ARE ALL STATES going by the recommendations are they doing what's right and doing a PATIENT BY PATIENT BASIS? Every one is different, we are not the same and definitely not the same problems. Is anybody else having the same problem or is it just the wonderful state of TN?

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2017furtherrestrictionsnyc , most pain management doctors are also following the CDC Guidelines..

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Dawn,
According to a CBS news affiliate in NYC beginning January 3,2017 tri -state area PHYSCIANS will further be reducing narcotic pain meds in an effort to get what's considered "Excessive " prescribing habits for powerful opiate containing pain meds under control.Citing the Federal guidelines established in January 2016 were insufficient So a further reduction is needed and an emphasis placed on other methods for pain control.I was troubled to hear this and reached out to area physicians in Brooklyn and queens who verified a more holistic approach will be placed on many who practice Family, General, or internal medicine. HOW this effects pain specialists is unknown. Just wanted to share this so folks visiting there medical providers in the new year are prepared. God bless....

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How long ago was this all written down I'm from New Jersey I'm on Oxycodone 10s without Tylenol and they I wear taking 4×s a day they no longer work on me what shall I do YES I've told my doctor I was supposed to see him 2day but he had a EMERGENCY. Any feedback will help, I just need to know what do you think my Doctor will do?? Thank you TRULY DAWN In NJ suffering from Chronic pain in my power back n spine and neck....

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