Patients -- Protect Yourself By Reading New Clinical Guidelines for Prescription Opioids



The Centers for Disease Control has just set clinical practice guidelines to improve the way opioids are prescribed. Now, it is up to the medical profession to practice these steps to ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these drugs.

The recommendations focus on the use of opioids in treating chronic pain (pain lasting longer than 3 months or past the time of normal tissue healing) outside of active cancer treatment, palliative care, and end-of-life care.

You, the reader, must understand the risks of taking opioid pain medications. You have the ultimate responsibility to decide what substances -- in safe doses and in safe applications --  benefit you. Decisions include opioid selection, dosage, duration, follow-up, and discontinuation.

Today I decided to focus upon the new guidelines and how they apply to the patient's health. The text of this entry can be found at the CDC website in greater detail. Please click here to access all the information: http://www.cdc.gov/drugoverdose/prescribing/guideline.html . I am sharing what I consider to be very important for pain patients; however, I encourage you to conduct a thorough study for your own safety.

A list of common opioid drugs

Some types of opioid drugs include:

• codeine (only available in generic form)
• fentanyl (Actiq, Duragesic, Fentora)
• hydrocodone (Hysingla ER, Zohydro ER) 
• hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
• hydromorphone (Dilaudid, Exalgo)
• meperidine (Demerol)
• methadone (Dolophine, Methadose)
• morphine (Astramorph, Avinza, Kadian, MS Contin, Ora-Morph SR)
• oxycodone (OxyContin, Oxecta, Roxicodone)
• oxycodone and acetaminophen (Percocet, Endocet, Roxicet)
• oxycodone and naloxone (Targiniq ER)





What is the new opioid prescribing guideline and how will it affect me?

CDC developed the new Guideline for Prescribing Opioids for Chronic Pain to help primary care providers make informed prescribing decisions and improve patient care for those who suffer from chronic pain (pain lasting more than 3 months) in outpatient settings. The guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

If you have chronic pain and are prescribed opioids as part of your treatment, your doctor should monitor you regularly. This might include extra assessments, a pain treatment plan, more frequent office visits, and urine testing. Prescription opioids can be very dangerous if not used properly. Make sure to follow all of your doctor’s recommendations.



If you are prescribed opioids

• Use them only as instructed by your doctor. Never take opioids in greater amounts or more often than prescribed.
• Avoid these other drugs while taking this medication:
  • Alcohol
  • Benzodiazepines (such as Xanax and Valium), unless specifically advised by your doctor
  • Muscle relaxants (such as Soma or Flexeril), unless specifically advised by your doctor
  • Hypnotics (such as Ambien or Lunesta), unless specifically advised by your doctor
  • Other prescription opioid pain relievers
• Work with your doctor to create a plan on how to manage your pain, and consider non-opioid options.
• Follow up regularly with your doctor.
• Talk to your doctor about any and all side effects and concerns.
• Store opioid pain relievers in a safe place and out of reach of others.
  • Help prevent misuse and abuse by not selling or sharing prescription opioid pain relievers. Never use another person's prescription opioids.
  • Find your community drug take-back program or your pharmacy mail-back program to safely dispose of unused prescription opioids pain relievers.

Know your options

Talk to your doctor about ways to manage your pain that don’t involve prescription opioids. Some of these options may actually work better and have fewer risks and side effects. Options may include:

• Acetaminophen (Tylenol®) or ibuprofen (Advil®)
• Cognitive behavioral therapy
• Physical therapy and exercise
• Medications for depression or for seizures
• Interventional therapies (injections)

Where can I get help?
If you or someone close to you needs help for substance abuse problems, talk to your doctor or call SAMHSA’s National Helpline at 1-800-662-HELP or go to SAMHSA’s Behavioral Health Treatment Services Locator.  Click here to access: https://findtreatment.samhsa.gov/
If you have questions about any medicines, call the U.S. Department of Health and Human Services Poison Help Hotline at 1-800-222-1222.

Tools and resources for patients:

• Pregnancy and Opioid Pain Medications (PDF - 1 MB)(http://www.cdc.gov/drugoverdose/pdf/pregnancy_opioid_pain_factsheet-a.pdf)
  Women who take opioid pain relievers should be aware of the possible risks during pregnancy.
• Guidelines Patient Poster: manage Your Pain, Minimize Your Risk (PDF - 720 KB) (http://www.cdc.gov/drugoverdose/pdf/guidelines_patients_poster-a.pdf)
• JAMA Patient Page: Opioids for Chronic Pain  Click here a access: http://jama.jamanetwork.com/article.aspx?articleid=2503507