On January 13, 2016, ASA and the American Society of Regional Anesthesia and Pain Medicine (ASRA) submitted formal recommendations to the Centers for Disease Control and Prevention (CDC) offering support for the proposed 2016 Guideline for Prescribing Opioids for Chronic Pain while expressing caution on its impact on therapies used to treat acute and chronic pain. The Guideline provides recommendations for primary care providers who are prescribing opioids for chronic pain and addresses: 1) when to initiate or continue opioids for chronic pain; 2) opioid selection, dosage, duration, follow-up, and discontinuation; and 3) assessing risk and addressing harms of opioid use.
In the letter, ASA and ASRA offered support for the federal government’s efforts to reduce opioid overdose deaths, and support for the majority of recommendations in the Guideline. However, the societies expressed concern that the Guideline would curtail perioperative physicians’ ability to treat patients’ acute pain after surgery. In addition, ASA and ASRA explained that the Guideline inaccurately portrays the effectiveness and risks of interventional procedures, which is particularly concerning since interventional pain procedures are a key non-opioid therapy to treat chronic pain. As a result, the societies recommended specific changes to the Guideline that support perioperative physicians’ imperative to treat post-surgical pain and access to interventional pain medicine therapies.
This letter follows several formal communications from ASA to the CDC about the Guideline. In the fall of 2015, ASA served as a member of CDC’s Stakeholder Review Group and offered formal recommendations to the CDC on an earlier version of the Guideline. In addition, in January 2016, Richard Rosenquist, M.D. and Asokumar Buvanendran, M.D., the Chair and Vice Chair of the ASA Committee on Pain Medicine, held a conference call with the CDC to discuss ASA’s recommendations.
ASA looks forward to continue working with the CDC and stakeholders on the Guideline and on other efforts that encourage safe and effective prescribing of opioids.