Resource Location: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm
This guideline provides recommendations for clinicians providing pain care, including those prescribing opioids, for outpatients aged ≥18 years. It updates the CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 (MMWR Recomm Rep 2016;65[No. RR-1]:1–49) and includes recommendations for managing acute (duration of <1 month), subacute (duration of 1–3 months), and chronic (duration of >3 months) pain.
The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care.
The guideline addresses the following four areas:
1) determining whether or not to initiate opioids for pain,
2) selecting opioids and determining opioid dosages,
3) deciding duration of initial opioid prescription and conducting follow-up, and
4) assessing risk and addressing potential harms of opioid use.
CDC developed the guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Recommendations are based on systematic reviews of the scientific evidence and reflect considerations of benefits and harms, patient and clinician values and preferences, and resource allocation.
CDC obtained input from the Board of Scientific Counselors of the National Center for Injury Prevention and Control (a federally chartered advisory committee), the public, and peer reviewers.
CDC recommends that persons with pain receive appropriate pain treatment, with careful consideration of the benefits and risks of all treatment options in the context of the patient’s circumstances.