CDC Guidelines on Prescription of Opioids – More and Less Than Meets the Eye

Abstract

On February 10, 2022, the US Centers For Disease Control and Prevention (National Center for Injury Prevention and Control) circulated a draft revised and expanded “2022 CDC Clinical Practice Guideline for Prescribing Opioids”. This proposal incorporates major expansions of scope and revisions of recommendations in the earlier 2016 CDC Guideline on prescription of opioids to adults with chronic non-cancer pain. Mainstream press articles have described the 2022 Guideline as a major improvement over the 2016 predecessor document in that it emphasizes the need for clinicians to exercise their own judgment on behalf of patients and to tailor treatment to individuals. However, deeper reading of the proposed 2022 Guideline calls the impressions of press reporters into serious question. In the opinion of the author and many others, the 2016 CDC Guideline has already wrecked the practice of pain medicine in the US, and proposed 2022 “revisions” may continue the destruction. The only ethically sound courses of action now open to the CDC are either to repudiate and withdraw both 2016 and draft 2022 guidelines without replacement, or to burn them to the ground and start over with condensation and correction of gross errors and policy mis-directions under a new, unbiased and clinically qualified writers group.