CDC delays guidelines on painkiller prescribing, says it wants more input

CDC Director Dr. Tom Frieden

The Center for Disease Control (CDC) stepped into the middle of the raging debate over opioid use in the U.S. when it said it would establish prescribing guidelines to help curb their soaring use and the overdose deaths that have come with them. Now, the agency is stepping back.

The CDC has delayed a January deadline to issue the guidelines. It instead will give another 30 days for comment and will then use that to freshen up its proposals, the Associated Press reports. The move follows intense criticism from the pharma industry and advocacy groups for people with chronic pain who say there has been no transparency into the CDC's process.

CDC Director Dr. Tom Frieden told the AP, however, that it was prudence not politics that led it change of plans. "We want to make sure we don't go so fast that there are questions about our process, but we certainly don't want to see any further delay," Frieden told the news service.

Anti-addiction organizations sense the beginning of a total retreat in the CDC's move. "This is a big win for the opioid lobby," said Dr. Andrew Kolodny, co-founder of Physicians for Responsible Opioid Prescribing, a group that wants to see less use of painkillers by doctors, according to the AP.

The CDC has proposed that doctors prescribe the meds only as a last choice for chronic pain, after first trying non-opioid pain relievers, physical therapy and other options. It also suggested they only prescribe the smallest supply of the drugs possible, usually three days or less for acute pain, the AP points out.

It was unusual for the CDC to step into an area that has been in province of the FDA and in doing so, it inserted itself into the middle of a very contentious debate. On the one hand are drugmakers who make about $9 billion a year in the U.S. off of the drugs, supported by patient groups who worry they will lose access to the meds that help them deal with often terrible and chronic pain. On the other side have been lawmakers and prosecutors and some physicians who point to what they consider epidemic growth in painkiller use and crime and overdoses that have come with that. They say heroin use has spiked in the country as addicts move to the cheaper alternative.

Two California counties and the City of Chicago have both sued a handful of drugmakers, trying to force them to pay for some of the costs they say the addiction problems have saddled them with. And last year, some lawmakers called for the resignation of former FDA Director Margaret Hamburg when the FDA approved a new opioid-based drug that didn't include anti-tampering technology.

The furor over the problem had died down some but then in August, the FDA approved Purdue's powerful painkiller, OxyContin, for children ages 11 to 16. The agency said it was a step needed for children with pain connected to cancer and other conditions but critics called it a terrible mistake.

- read the Associated Press story

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