With opioids as the number one cause of drug overdose deaths in the US, the spotlight has been on reducing the overprescribing of opioids for those facing chronic or intermittent pain. Those efforts have paid off with a reduction, since 2012, in the overall amount of opioid prescriptions being dispensed. Seeing more patients who can benefit from alternative pain management approaches and bypass the need to take opioids is certainly a positive result of these efforts, yet focus has been lacking on patients who have been taking opioids for a long time and who experience harm when they are abruptly taken off these medications.
The new Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics (the Guide) from the US Department of Health and Human Services (DHHS) aims to remind health care providers that each patient is different and care must always remain patient-centered. The Guide offers resources and best practices from the literature on how to safely modify pain management regimens and make the decision – jointly with the patient – on when and how to discontinue opioid treatment.
This action by the DHHS follows up and clarifies previous recommendations issued by the US Centers for Disease Control and Prevention (CDC) which in response to the rise of opioid-related injuries and deaths recommended a reduction in opioid prescriptions in favor of other approaches. As spotlighted in a recent NPR podcast, in response to this CDC guidance, some providers started abruptly stopping the medications instead of gradually reducing the dose. This rapid stopping can cause acute withdrawal symptoms and suicidal thoughts – leading patients to find alternative means of obtaining opioids. By recommending and providing guidance for a more gradual approach, DHHS hopes to stem the tide of this issue that is endangering patient health.
Guidance for the health care community as it relates to opioid use and addiction will continue to evolve as the needs of individuals and communities change. CSIP and partners will continue to provide updates and resources to support those in need.
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About the Center for Safe Internet Pharmacies (CSIP)
The Center for Safe Internet Pharmacies (CSIP), a non-profit organization founded in 2011 by the White House, represents the technology sector and commerce intermediaries including Google, Microsoft, Facebook, Oath, UPS, PayPal, MasterCard, Discover, American Express, and .Health. CSIP’s mission is to promote industry best practices as it relates to illegal online pharmacies, and educating consumers about safe purchasing of prescription drugs.