Increased Rates of Non-Opioid Prescription Following CDC Guidelines

A recent article published in JAMA analyzed patterns in prescribing non-opioid pain medication. The study found an increased number of non-opioid pain medications prescribed after the CDC’s 2016 guidelines on prescribing opioids for chronic pain.  

Since the late 1900s, opioid prescription has led to an opioid epidemic, with many patients who are prescribed opioids developing opioid use disorder. Based on a Nature article, deaths related to drug overdose tripled between 1999 and 2017.  

According to the CDC, approximately 75% of drug overdoses involve an opioid. Furthermore, data in a StatPearls textbook found that 18% of the 16 million people have or have had opioid use disorder were in the United States.  

Misinformation by pharmaceutical companies is the major contributing factor to the opioid epidemic. As stated in a Nature article, “Purdue Pharma knew that it was addictive, as it admitted in a 2007 lawsuit that resulted in a $635 million fine for the company. But doctors and patients were unaware of that at the time.” 

Despite this fact, prescribers also played a hand in exacerbating the crisis. A publication in the Journal of Neuroscience states, “in 2012, physicians in the United States wrote greater than 259 million opioid prescriptions, which equates to one bottle of pills for every adult American.” 

To combat this issue, in 2016, the CDC put forth guidelines for physicians on prescribing opioids for chronic pain management. These guidelines highlighted when to prescribe, management strategies, and risk analysis information.  

The hope of this guideline was to reduce prescription rates and opioid use disorder.  

The researchers in the JAMA publication found that, in the first year following the guidance, the non-opioid pain management prescription rate increased by 3%. By 2018, that number had risen to 9.7%.  

In the publication, researchers concluded that “this study showed increases in non-opioid pain medication prescribing after the release of the 2016 CDC guideline, suggesting that the guideline may be associated with an increase in guideline-concordant care.” 

While this data implies that CDC guidelines have helped inform physician decisions and increase vigilance around opioid prescriptions, further research must be done, and more statistics must be collected to properly evaluate the guidance's effectiveness.  

As noted by the researchers in the publication, studies on additional aspects of pain management and its treatment may further advance this field.  

The researchers wrote, “multimodal and multidisciplinary approaches to pain management that address the biological, psychological, and social characteristics of each person are a critical part of a comprehensive treatment protocol.”