US authorities are softening their recommendations on opioid prescriptions – Science et Avenir

On Thursday, U.S. health officials released new guidelines aimed at helping doctors prescribe opioids for pain despite the risk of addiction.

The Centers for Disease Control (CDC) has revised guidelines adopted in 2016 to try to stop the opioid overdose epidemic in the United States.

Unlike the previous document, the new guidelines are careful not to set thresholds in terms of dosage or duration of administration.

If interpreted harshly, this has led doctors to suddenly cut or drastically reduce the doses of patients taking opiates. Governments and insurance companies have also been inspired to set their own limits.

Patients suffering from chronic pain complained that they no longer had access to medications to enable them to lead normal lives and warned of an increased risk of suicide in their ranks.

The new recommendations, collected in the 200-page report, aim to strike a balance.

One in five Americans suffer from chronic pain, and “opioids may be the go-to medications” to relieve their suffering, “but they pose a significant risk,” the paper’s authors note from the outset.

To weigh this benefit versus risk, nothing beats doctors’ judgment based on a personalized clinical examination of patients, they say. The new guidelines “should not be used as a rigid standard,” the CDC emphasizes.

However, health authorities remain cautious. Opioids should only be considered after other pain medications have proven ineffective, and physicians should discuss this with their patients at every stage.

And if they decide to use opiates, they should first “prescribe the lowest effective dose” and then closely monitor the effects of the treatment.

In the event of a problem, physicians must also “avoid abrupt discontinuation of opiate prescribing” and must ensure that people “with a problem using use get the care they need.”

As a precautionary measure, “we recommend that long-term opiate use be offered naloxone,” an antidote that can save a person from overdosing, Christopher Jones, a senior official, said during a CDC press briefing.

Opiate prescriptions quadrupled in the United States between 1999 and 2010. Although this trend has reversed since 2016, they have created addiction and pushed some patients to turn to drugs such as heroin and fentanyl.

Last year, the United States recorded a record 107,000 overdose deaths, more than 70% of which were from illegal synthetic opiates.

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