The Centers for Disease Control (CDC) is currently working to update or expand its 2016 Guidelines for Prescribing Opioids for Chronic Pain. The federal agency is calling on patients, caregivers, and health care providers to supply information to assist with this work.
Stephanie Nichols, Pharm.D., BCPS, BCPP, FCCP, associate professor of pharmacy practice, was recently selected by the CDC to take part as a stakeholder with expertise in treatment of patients with pain and opioid use disorder (OUD).
“I was very honored to be selected,” Nichols stated. “It is a huge opportunity for me to speak on behalf of my patients, my students, and fellow pharmacists and on behalf of the other healthcare professionals that I work with on a day-to-day basis. It is really meaningful that UNE’s School of Pharmacy has the opportunity to weigh-in and be a stakeholder on such an important issue.”
Part of the CDC’s work is to address the opioid crisis. Nichols says there is belief that some people may have misinterpreted the original guidelines to mean that they should never use opioids in the treatment of chronic pain.
“In some cases, people who developed opioid use disorder were abruptly stopped on their opioids and many of them ended up using heroin,” she said. “Unfortunately, people did overdose and pass away.”
Nichols says she discussed the need for new guidelines that emphasize the compassionate tapering off of opioids, reduction of stigma around OUD, and keeping patients engaged in care.
“It is so critical to do a compassionate taper,” she explained. “What that means is a slow taper with a lot of support and reassurance that the patient is not in trouble, that they are still going to receive care, just in a different way. Telling patients that they will no longer be able to receive any sort of treatment for their chronic pain is not compassionate and does not set people up for success.”
Nichols also discussed the role of mental health in opioid use.
“There is data that shows more than half of opioid prescriptions are prescribed to people with mental illness,” she stated. “I don’t think opioids treat mental illness, but they can acutely mask the symptoms. We are under-treating mental illness and sometimes treating it with opioids. That is not really appropriate for many reasons.”
The CDC is specifically interested in learning more about experiences involved in making pain management decisions. It is also looking for information about experiences in managing pain, which may include the benefits, risks, and harms of opioid pain medications, non-opioid medications, or non-pharmacological treatments.
The CDC is planning to release an update of previous guidelines in 2022.