Pain Management Guidelines: Facing Criticism Over Process and Content, Agency Announces Additional Review

In a decision announced last Friday, the Centers for Disease Control (CDC) will delay implementation of a new set of opioid prescribing guidelines that were drafted and unveiled to a limited audience in September. CDC will extend the period for public comment on the guidelines until January 13, 2016. Additionally, the guidelines themselves have been posted to the Federal Register for widespread review. The decision comes in the face of critical commentary, and threatened lawsuits, from patients, clinicians, and other federal agencies, both over the guideline content, and the process used to construct the draft document. The guidelines would discourage primary care clinicians from prescribing opioids for chronic noncancer pain, instead recommending nonpharmacological therapies as the preferred treatment approach.

The process that CDC used in developing the guidelines has been criticized as unusually secretive and one-sided, with an advisory team dominated by special interest groups and addiction treatment specialists, most of whom were determined to rein in opioid prescribing. Few patient advocates and pain physicians were included in the process. In its decision to reopen the public comment period, CDC additionally stated that the draft guidelines themselves will now be reviewed by a scientific advisory panel, which will appoint a new work group to consider changes, a process that could take several months or more. Commenting on this latest announcement, PAINWeek faculty member Jeffrey Fudin, PharmD, FCCP, said, “It seems to me that CDC is forming more committees and more layers to shield liability and hide behind their transgressions. Rather than do this, I’d like to see a committee formed to examine how CDC’s actions around the guidelines happened in the first place, including but not limited to the choice of committee members and all potential conflicts and alliances among participants.”

Read more about pain management guidelines, here.

Read a news story about the CDC decision, with link to the draft guidelines, here.

Additional commentary on the issue may be read here.





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