Pubdate: Wed, 21 Oct 2015
Source: Washington Post (DC)
Copyright: 2015 The Washington Post Company


The CDC Is Right to Advise Doctors on Opioid Prescriptions.

HORRIFIC AS it is for the victims, drug addiction's impact 
reverberates beyond them, to include families, friends, whole 
communities. Thanks to a new Washington Post-University of Maryland 
poll, we can begin to quantify those wider consequences in our area. 
Nearly 3 in 10 Marylanders say they have a close friend or family 
member who was or is addicted to opiates such as prescription pain 
pills or heroin.

The figures range from 4 in 10 in Baltimore to 1 in 6 in Montgomery 
County; but whether in the city or the suburbs, these numbers are far 
too high and fully warrant Gov. Larry Hogan's (R) promise to focus on 
the problem.

More treatment is necessary, as is prevention; yet preventing opioid 
addiction has been devilishly difficult due to the fact that people's 
first contact with the drugs often comes not through illicit channels 
but in a doctor's office, where they are prescribed opioids by a 
licensed physician who, in turn, had been told that medications such 
as OxyContin or Vicodin convey powerful relief with little or no 
addiction risk. In 2012, providers wrote 259 million prescriptions 
for opioids, enough for every American adult to have a bottle of 
pills. Opioid sales increased 300 percent since 1999. Almost 2 
million people abused these drugs in 2013, and more than 16,000 died 
from overdoses.

Now the Centers for Disease Control and Prevention (the source of 
these data) has a plan that could make a major dent in the 
overprescription of opioids.

The CDC is preparing opioid prescribing guidelines for primary-care 
physicians - the first of their kind from a federal agency.

The guidelines are not finished, but early indications are that they 
will urge physicians to discuss risks with patients, pursue 
non-opioid alternatives as "preferred" options and limit initial 
prescriptions to a three-day supply at "the lowest effective dose." 
If finalized by the CDC and embraced by doctors, the guidelines 
promise to turn medical practice in an appropriately more cautious direction.

As is often the case with suggestions to curb pain prescriptions, the 
CDC's proposals are being met with opposition: some from people 
concerned about the impact on patients, some from a pharmaceutical 
industry concerned about the impact on profits.

The American Cancer Society's lobbying arm has urged the CDC to 
suspend work on its guidelines, arguing in an Oct. 1 letter to the 
agency that cancer patients could be denied pain relief.

Though understandable, these concerns are overstated; the CDC has 
said publicly its focus is not oncology but primary care, "outside 
end-oflife care."

It's true, as the cancer society letter notes, that the CDC 
guidelines are more than mere suggestions and will influence "state 
health departments, professional licensing bodies or insurers." That 
is precisely why they can be so beneficial; until now, government, 
medicine and the private sector have too often underestimated the 
risks, individual and societal, of widespread opioid prescription. 
The CDC has the prestige and authority to correct the balance.

After incorporating valid comments from the cancer society and other 
interested parties, the CDC plans to publish in early 2016, and we 
see no reason to delay.
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