b'Medicine & ResearchUUppddaatteessttootthheeCCDDCCPPaaiinnGGuuiiddeelliinneessRevisions set to x opioid prescription problemsBy Adrienne DeBerryChronic pain is one of the most commonmisinterpretations of the guidelines. In reasons patients seek medical attention.February 2022, the CDC called for public Approximately 20.4 percent of Americancomments on the practice guideline draft adults report chronic pain, which is denedbefore its nal release.as pain lasting more than three months. TheCritics of the 2016 guideline argue that prevalence of pain in patients with multiplethe guideline was misconstrued to act as a sclerosis is estimated to range from 29 to 86regulatory requirement. The previous guideline percent based on clinical studies. There are aincluded recommendations for primary care host of medications that can be used to treatand general practitioners to place maximum chronic pain with each class carrying its owndaily limits on opioid prescriptions to be of no set of benets and risks. When it comes timemore than 90mg of morphine milliequivalents for clinicians to consider opioid treatment for chronic pain, there is a delicate balance thatper day. Patients receiving daily opioid clinicians must tread lightly. The goal is to ndprescriptions higher than this threshold may have the balance between helping and upholdingbeen perceived to be receiving unnecessary, the oath of do no harm. One of the mostexcessive, or improper amounts of opioids.notable and public examples of this Catch 22Ramications from the prescriptive limit is the 2016 CDC Guidelines for Prescribingrecommendations were felt by patients at the Opioids in Chronic Pain.pharmacycounterandthroughinsurance This guideline was developed to helpplans. Patients in some cases were turned clinicians navigate safe prescribing practicesaway from pharmacies and some pharmacies concerning opioids, but it led to a lot of controversy.instilled policies requiring a call to the prescriber Normally, clinical practice guidelines are meantto alert them that a prescription was written to be used as recommendations. However,for more than 90 MME per day. Some insurance the 2016 guideline was misapplied as a legalplans also changed their formularies to require requirement. Various healthcare stakeholdersprior authorizations for opioid prescriptions including payers, prescribers, pharmacies,that were greater than 90 MME per day.and, most importantly, patients were facedThese barriers to medication access did withdifficultcircumstancesasaresultofnot take into account that some patients may misapplication. A needed update benet from opioid dosing greater than 90 MME per day. Prescribers who wrote prescriptions The CDC has recognized this issue and infor opioids greater than this threshold could theforthcomingrevisedClinicalPracticebe mislabeled as a bad doc based on how Guideline for Prescribing Opioids, the authorsrmly the 90 MME limit was being emphasized point out these previous misapplications andin the guideline.msfocusmagazine.org 44'