Treating Pain in an Established Patient: Sifting Through the Guidelines

摘要

The CDC Guideline for Prescribing Opioids for ChronicPain, published last March, provided major steps towardbringing the medical community together to addressthe opioid epidemic in the U.S. However, the Guidelinefocuses primarily on treatment of new inductions intoopioid therapy for pain. Physicians may have difficultyfiguring out how to apply the CDC’s recommendationsto patients who are already receiving opioid maintenancetherapy for chronic pain. Patients already maintainedon opioids for chronic pain should not be subjected toabrupt cessation or rapid tapers, and the CDC’s Guidelineconfirms this. Physicians should not balk from treatingopioid-dependent patients with chronic pain, and theCDC’s recommendations do contain helpful informationif one reads through them carefully. This article attemptsto distill the major points from the Guideline for thetreatment of chronic-pain patients already on long-termopioid therapy.