The CDC's opioid prescribing guideline has failed to reduce addiction and overdoses, significantly worsened the quality of pain care in the United States and should be revoked, according to a large new survey of patients and healthcare providers by Pain News Network, an independent, non-profit news organization.
Nearly 4,200 patients and providers participated in the online survey, which was conducted as the Centers for Disease Control and Prevention prepares to update and possibly expand its 2016 guideline, which discourages doctors from prescribing opioid pain medication.
Most survey respondents - nearly 75% -- believe the guideline should be withdrawn or revoked. Less than one in four (23%) believe changes can be made to make its recommendations more effective.
Although voluntary and only intended for primary care physicians, the guideline has become the standard of care for pain management in the U.S., with many doctors, insurers, pharmacies and regulators adopting its recommendations as policy. The goal of the guideline was to "improve the safety and effectiveness of pain treatment" and reduce the risk of opioid addiction and overdose.
But survey respondents overwhelmingly believe the CDC has failed to achieve its goals. Nearly 97% said the guideline has not improved the quality of pain care, and 92% believe it has not reduced opioid addiction and overdoses.
Opioid prescriptions were declining before the CDC guideline was released and now stand at their lowest level in 20 years. Most overdoses in the U.S. involve illicit fentanyl and other street drugs, not prescription opioids, yet many patients have been cut off from opioids or had their doses reduced.
"They have done immeasurable damage to chronic intractable pain patients all across America. There have been suicides, people have lost their jobs and their entire quality of life because of them," one patient said.
"In 40 years as a pain specialist, I have never seen patients with pain so mistreated, abandoned and unable to access pain treatment as a direct result of the CDC guidelines," a doctor wrote.
"Due to inadequate pain control many chronic pain patients, including myself, attempted suicide to get relief of intolerable pain. I wish I had succeeded," another patient wrote.
Other survey findings:
- 59% of patients were taken off opioids or tapered to a lower dose against their wishes
- 42% had trouble getting an opioid prescription filled at a pharmacy
- 36% were unable to find a doctor to treat their pain
- 29% were abandoned or discharged by a doctor
- 27% had a doctor who stopped prescribing opioids
- 35% have considered or attempted suicide due to poorly treat pain
- 10% have obtained prescription opioids from family, friends or the black market
- 9% have used illegal drugs for pain relief
"This is the fourth survey we've done on the CDC guideline. Each year the findings grow more disturbing, with patients desperate for pain relief or simply giving up on life," said Pat Anson, founder and editor of Pain News Network. "Nine out of ten patients say their pain levels and quality of life have grown worse since the guideline came out. Many of their stories are heartbreaking. Pain patients are the unrecognized victims of the opioid crisis and are being blamed for something they did not cause."
The CDC is currently in the process of updating and possibly expanding the guideline to include recommendations for treating short-term acute pain, migraine and other pain conditions such as fibromyalgia and low back pain. A draft version of the updated guideline is not expected until late this year.
(The survey was conducted online and through social media from March 15 to April 17. A total of 4,185 people in the United States participated, including 3,926 who identified themselves as chronic, acute or intractable pain patients; 92 doctors or healthcare providers; and 167 people who said they were a caretaker, spouse, loved one or friend of a patient. To see the full survey results, click here.)