CHICAGO—The American Medical Association (AMA) is urging the Centers for Disease Control and Prevention (CDC) to make significant revisions to its 2016 Guideline for Prescribing Opioids for Chronic Pain to protect patients with pain from the ongoing unintended consequences and misapplication of the guidance.

“To make meaningful progress toward ending this epidemic, a broad-based public health approach is required,” wrote AMA Executive Vice President and CEO James L. Madara, M.D. “We are now facing an unprecedented, multi-factorial and much more dangerous overdose and drug epidemic driven by heroin and illicitly manufactured fentanyl, fentanyl analogs, and stimulants. We can no longer afford to view increasing drug-related mortality through a prescription opioid-myopic lens.”

Among its recommendations, the AMA called for CDC to remove arbitrary limits or other restrictions on opioid prescribing given the lack of evidence that these limits have improved outcomes for patients with pain. Rather, they have increased stigma for patients with pain and have resulted in legitimate pain care being denied to patients. “Hard thresholds should never be used. Where such thresholds have been implemented based on the previous CDC Guideline, they should be eliminated,” Dr. Madara wrote.

Madara noted the CDC itself cautioned against misapplying the guideline to justify specific dose or quantity restrictions.

The AMA also urged CDC to add to its recommendations that “public and private payer policies must be fundamentally altered and aligned to support payment for non- pharmacologic treatments and multimodal, multidisciplinary pain care,” and to ensure that patients who may have pain and co-occurring opioid use disorder receive effective pain treatment.

 Read the full AMA letter and each recommendations to revise the CDC guideline.