The U.S. Department of Health and Human Services (HHS) has issued new guidelines that say what pain physicians and patients have been saying for the past four years: Abrupt changes to a patient’s opioid prescriptions could harm them.
“Care must be a patient-centered experience. We need to treat people with compassion and emphasize personalized care tailored to the specific circumstance and unique needs of each patient,” said Admiral Brett Giroir, assistance secretary for health.
HHS does not recommend that opioids be tapered rapidly or discontinued suddenly due to what it called “the specific risks of opioid withdrawal.”
Issues the HHS says should be considered when making a change in chronic pain therapy include shared decision making with the patient to stop the arbitrary stoppages that doctors have been prescribing.
As Stanford pain psychologist Beth Darnall noted, the HHS also said integrating behavioral care before & during a taper can help manage pain & strengthen the therapeutic relationship
The new directive is entitled Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Opioid Analgesics.
There has been considerable pressure on doctors to reduce the amount of opioid prescriptions they write. What has also happened is that patients have been forced to taper or discontinue their usage—which has put patients at risk and has raised the ire of many pain physicians, psychologists and patient advocacy organizations. The CDC and the FDA both put out statements this year citing the danger of forced tapering.
The opioid guidelines from the CDC were intended to strike back at the so-called addiction epidemic that that the agency believe was caused by over-prescription. Those who live with the chronic pain in the U.S. began to protest almost immediately at what they believed to be an overreaction to a voluntary guideline.
It also increasing the suffering of millions of chronic pain patients and led some to suicide.
Will this HHS proclamation change prescribing behaviors of doctors? Most of the people we’ve talked with think it will take much more than this.
Here’s the HHS Press release and a link to the guideline.
HHS Moderates Opioid Prescribing Guideline – National Pain Report
