Balancing research with safe opioid prescribing to reduce pain and improve quality of life

This article is sponsored by the Centers for Disease Control and Prevention.

Pain is a deeply personal experience and one of the most common reasons why individuals seek medical care in the U.S. The Centers for Disease Control and Prevention (CDC) recognizes the challenges both clinicians and patients face with pain management and the risks associated with opioid prescribing.

On November 3, 2022, CDC released the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain (2022 CDC Clinical Practice Guideline) to support clinicians in providing compassionate, safe, and effective pain care. It represents an important milestone in clinicians’ approach to opioid prescribing, offering lived experience and evidence-based recommendations for clinicians navigating the challenging landscape of pain management. The 2022 CDC Clinical Practice Guideline updates and replaces the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain (2016 Guideline) and provides guidance for clinicians providing care for outpatient adults with acute, subacute, and chronic pain.

Balancing research with lived experience in safe opioid prescribing

Living with pain not only affects every aspect of a patient’s daily life but also can impact their families and friends. The process for updating the 2022 CDC Clinical Practice Guideline involved community engagement and a series of public comment periods where CDC had the opportunity to listen to challenges and experiences shared by patients, family members, clinicians, and experts firsthand. In addition, members of the public shared feedback during Board of Scientific Counselors of the CDC National Center for Injury Prevention and Control (BSC/NCIPC) public meetings and participated in the BSC/NCIPC-established Opioid Workgroup.

“The science on pain care has advanced over the past six years,” said Debbie Dowell, MD, MPH, Chief Clinical Research Officer for the CDC’s Division of Overdose Prevention. “During this time, CDC has also learned more from people living with pain, their caregivers, and their clinicians. We’ve been able to improve and expand our recommendations by incorporating new evidence coupled with a better understanding of people’s lived experiences and the challenges they face when managing pain and pain care.”

These recommendations do not replace a clinician’s judgment. The 2022 CDC Clinical Practice Guideline provides voluntary recommendations to enable decision-making that is tailored to each patient. It also considers an individual’s expected health outcomes and well-being so that clinicians have additional guidance to apply on a case-by-case basis.

The 2022 CDC Clinical Practice Guideline’s recommendations do not apply to sickle cell disease, cancer-related pain treatment, palliative care, and end-of-life care. Other clinical guidelines more specifically address the unique considerations of pain management in these specific contexts.

Managing pain and improving quality of life

All patients living with pain deserve safe and effective pain care that provides the greatest benefits relative to the risks. Grant Baldwin, PhD, MPH, director of the Division of Overdose Prevention at the CDC’s National Center for Injury Prevention and Control, wants both clinicians and patients to have the information they need to weigh the benefits of different approaches to pain care, with the goal of helping people reduce their pain and improve their quality of life. “Everyone should receive safe and effective pain care,” said Dr. Baldwin.

To help clinicians provide this care, the 2022 CDC Clinical Practice Guideline accounts for the complexity of providing safe, compassionate, and effective pain care for acute, subacute, and chronic pain. This includes improving communication with patients, safely and effectively mitigating pain, and reducing the risks associated with opioid pain therapy. CDC recommends that clinicians:

maximize the use of nonpharmacologic and nonopioid therapies as appropriate for the specific condition and patient;
consider opioid therapy only if benefits are anticipated to outweigh risks; and
discuss the realistic benefits and known risks with their patients before initiating opioid therapy.

The ultimate goal of the 2022 CDC Clinical Practice Guideline is to help people set and achieve their personal goals to reduce their pain and improve their function and quality of life. Clinicians play a vital role in helping their patients achieve this goal.

The CDC remains committed to supporting clinicians’ efforts to compassionately and safely treat patients who are experiencing pain.

For more information and resources to support implementation of the 2022 CDC Clinical Practice Guideline in your practices and health systems, including self-paced clinician trainings and patient case scenarios, here: CDC’s Clinical Practice Guideline for Prescribing Opioids for Pain. We encourage you to review these materials and share them with colleagues.

The Centers for Disease Control and Prevention is the nation’s leading science-based, data-driven, service organization that protects the public’s health. For more than 70 years, we’ve put science into action to help children stay healthy so they can grow and learn; to help families, businesses, and communities fight disease and stay strong; and to protect the public’s health.