HHS and CDC on Opioids
On March 18, 2016, the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Health released a National Pain Strategy that outlines actions for improving pain care in America. According to an agency press release, the Strategy is a roadmap toward achieving a system of care in which all people receive appropriate, high quality and evidence-based care for pain. The plan was developed by the HHS Interagency Pain Research Coordinating Committee (IPRCC), which is composed of representatives from the Department of Defense, Department of Veterans Affairs, Agency for Healthcare Research and Quality, Centers for Disease Control and Prevention (CDC), Food and Drug Administration, National Institutes of Health and members of the public, including scientists and patient advocates.
Specifically, the Strategy calls for:
- Developing methods and metrics to monitor and improve the prevention and management of pain.
- Supporting the development of a system of patient-centered integrated pain management practices based on a biopsychosocial model of care that enables providers and patients to access the full spectrum of pain treatment options.
- Taking steps to reduce barriers to pain care and improve the quality of pain care for vulnerable, stigmatized and underserved populations.
- Increasing public awareness of pain, increasing patient knowledge of treatment options and risks, and helping to develop a better informed health care workforce with regard to pain management.
“Chronic pain is a significant public health problem, affecting millions of Americans and incurring significant economic costs to our society,” said Karen B. DeSalvo, MD, MPH, the HHS acting assistant secretary for health. “This report identifies the key steps we can take to improve how we prevent, assess and treat pain.”
The National Pain Strategy was released just four days after publication of guidelines issued by the CDC calling on primary care physicians to restrict prescribing of opioid pain medicine. In releasing the guidelines, CDC Director Tom Frieden called the rise in deaths from opioids a “doctor-driven” epidemic. The CDC guidelines would limit most initial opioid prescriptions for acute pain to three days, noting that seven days or more “will rarely be needed.” CDC acknowledged that evidence to support the guidelines was weak because relatively little research has been done on using opioids to treat pain for longer than three months.
Sen. Ed Markey (D-MA, who had been pressing CDC to release the guidelines, said that the next step would be to require pain management training for physicians who prescribe the drugs.
“While [the CDC recommendations] are important measures we need prescribers to take, they are just guidelines and we need requirements to ensure all prescribers of opioid painkillers are educated in safe prescribing practices and the identification of possible substance use disorders,” Markey said in a statement. “I will continue to work with my congressional colleagues to pass legislation that ensures all prescribers of opioid pain medication get the education needed to help prevent addiction before it takes any more lives of our friends, families and loved ones.”
Read the full statement online here.