The American Academy of Pain Medicine cautiously supports the efforts of the CDC to address the challenges that often accompany prescribing opioids for chronic non-cancer pain. AAPM has long emphasized safety and effectiveness in pain treatment, and the CDC guideline echoes many of its recommendations.
"We know that doctors – primary care and pain medicine specialists – are integral in treating pain wisely and carefully monitoring for signs of substance abuse. Abuse and diversion of prescription opioids must be addressed. Opioids are not the usual first choice for treating chronic non-cancer pain, but they are an important option—as part of a comprehensive multidisciplinary approach—that must remain available to physicians and appropriately selected patients," said Dan Carr, MD, President of the American Academy of Pain Medicine and Professor of Public Health and Community Medicine at Tufts University.
"We need to address both chronic pain and its treatment as public health challenges. This view is endorsed by the National Academy of Medicine and outlined in the draft National Pain Strategy from the NIH. Public health problems are typically complex; well-meaning, but narrowly targeted, interventions often provoke unanticipated consequences. We share concerns voiced by patient and professional groups, and other Federal agencies, that the CDC guideline makes disproportionately strong recommendations based upon a narrowly selected portion of the available clinical evidence. It is incumbent upon us all to monitor the deployment of the guideline to ensure that it does not inadvertently encourage under-treatment, marginalization, and stigmatization of the many patients with chronic pain that are using opioids appropriately."