The California Medical Association (CMA) has submitted written comments on the Centers for Disease Control and Prevention (CDC) draft guidelines that provide clinical practice recommendations on the prescribing of opioids for treatment of chronic pain. CMA previously submitted comments on the CDC guidelines that raised concerns regarding the lack of transparency and public input involved in developing the guidelines.

While the CDC guidelines claim to be advisory recommendations for use by primary care providers who are treating patients with chronic pain in outpatient settings, CMA is concerned that the CDC guidelines are mandating the standard of care by including definitive prohibitions and treatment directives. As drafted, the CDC guidelines would limit a physician’s ability to provide medical care that is reflective of the individual needs of the patient, instead imposing a “one-size-fits-all” solution for pain management. This approach fails to recognize the complexities involved in pain management, which could result in the ineffective or inefficient treatment of chronic pain.

CMA has been supportive of efforts to address the complicated issues related to prescription opioid misuse and overdose, and has supported a well-balanced approach to opioid prescribing and treatment that considers the unique needs of individual patients.  For example, in 2014, after an extensive public process that included feedback from health care practitioners who treat pain in diverse settings, the Medical Board of California (MBC) released its revised “Guidelines for Prescribing Controlled Substances for Pain.”

These detailed MBC guidelines reflect the realities of patient care and need for flexibility in order to arrive at the best patient-appropriate treatment decision. The MBC guidelines also include an extensive discussion about the nature of pain and the treatment of pain, neither of which are reflected in the CDC recommendations.

Click here to read CMA’s submitted written comments on the CDC guidelines.

Read the CDC guidelines here.

Contact: Samantha Pellon, (916) 551-2887 or spellon@cmadocs.org.