NEW YORK –
The top public health agency in the United States has proposed changing — and in some cases loosening — guidelines for prescribing oxycodone and other opioid pain relievers.
The previous guideline from the Centers for Disease Control and Prevention (CDC), issued six years ago, helped stem the rush of prescriptions that sparked the worst overdose epidemic in US history.
But it also made many doctors too quick to withdraw pain relievers from patients and too strict in prescribing them to those who might need them, the CDC said.
“We started hearing how the guidelines were being misused and misapplied,” said Christopher Jones of the CDC and co-author of the proposal for new guidelines.
The changes, contained in a 229-page update document in the Federal Register, would remove some suggested limits on drugs. His publication opens a period of 60 days for public comments. CDC will consider comments before finalizing the updated guidance.
The intent is to promote individualized patient care, Jones said. It also offers more options for treating the type of short-term acute pain that follows operations or injuries.
One expert expressed initial caution about the proposed revision.
The 2016 guidelines helped reduce inappropriate and dangerous prescribing, said Dr. Adrienne Fugh-Berman of Georgetown University Medical Center. She said her critics have included pain patients, but also painkiller producers and the groups they fund.
“There’s nothing wrong with the original guidelines,” said Fugh-Berman, who has served as a witness for plaintiffs in cases against drug company marketing practices.
Opioids can be important in treating severe pain from cancer, surgery, and serious injuries. But they can be addictive, even when used under doctor’s instructions.
Beginning in the 1990s, some drug makers and pain specialists promoted more widespread use of pain relievers to treat more common pain such as back pain and arthritis.
That campaign was linked to the marketing of drugs like OxyContin, which were described as less addictive than other opioids.
When overdose deaths in the United States began to skyrocket, prescription painkillers were identified as a central cause.
Governments tried to restrict prescriptions, but the overdose epidemic worsened, with people addicted to pills turning to heroin and then fentanyl.
That type of illegal injection drug is now associated with the majority of overdose deaths in the United States.