Proposed guidelines for physicians prescribing opioids raise concerns

In 2012, health care providers wrote 259 million prescriptions for opioid pain relievers, according to information cited on the Centers for Disease Control and Prevention website.

That’s enough for every American adult to have a bottle of pills.

In an effort to give physicians better guidance when it comes to prescribing opioids, the CDC released a draft of proposed guidelines and allowed for public comment through Jan. 13.

Pennsylvania physicians published their comments about the proposed guidelines last week, addressing a topic that hits home for them. Pennsylvania is one of 14 states to see a significant increase in overdose deaths in 2014.

The state saw a 12.9 percent increase from the previous year, which translated into nearly 2,500 reported deaths.

In a letter to the CDC, David Talenti, chairman of the Pennsylvania Medical Society, raised concerns about the draft guidelines, the main one being that the issue won’t be fixed by a one-size-fits-all approach.

“We are afraid that a well-meaning guideline requiring physicians and patients to follow a rigid, one-size-fits-all protocol, may be detrimental to patient care by impeding the individualized treatment that is the hallmark of the physician-patient relationship,” Talenti wrote in a letter.

Other items PAMED highlighted include a lack of input from pain-management physicians, and that the draft doesn’t address patient referrals to the emergency department.

The letter suggested adding a recommendation that would caution primary care providers not to refer patients receiving chronic opioid therapy to the emergency department for their opioid prescriptions.  

The guidelines specifically addressed prescribing opioids to patients ages 18 and older in primary care settings, and focused on treating chronic pain, which is a treatment plan that lasts longer than three months but is not considered end-of-life care.

Pennsylvania physicians weren’t the only ones to raise concerns over the proposed guidelines.

The CDC opened the draft for public review due to complaints from other industry leaders that the guidelines had been written behind closed doors, according to reports by The Associated Press.

Although the guidelines wouldn’t be binding, they would be the strongest government effort to date in addressing the rise in overdoses tied to opioids.

The Food and Drug Administration is typically the organization to advise physicians on medications.

The heroin and opioid epidemic has reached a national level, and it was one of the first items President Barack Obama addressed as a bipartisan priority during the State of the Union last week.

Lenay Ruhl

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