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The Federal Government has published new opioid prescribing guidelines. They're aimed at helping doctors to manage chronic pain patients. The guidelines say there is no mandate to get all patients off these drugs. NPR's Allison Aubrey reports that the recommendations come at this moment of confusion over how best to stem the opioid epidemic while still making opioids available to patients who can benefit from them.
ALLISON AUBREY, BYLINE: There is no doubt that opioids have been overprescribed, but in the haste to reduce the number of people who get addicted, some chronic pain patients have been forced to abruptly taper or stop using them. Now the new guidelines say doctors need to consider each patient individually and consider the risks of cutting people off too quickly. Here's Admiral Brett Giroir of the U.S. Department of Health and Human Services.
BRETT GIROIR: There is a very large body of data that would say that abrupt discontinuation or abrupt reduction in dosage can be harmful to patients.
AUBREY: He says people with chronic pain who've used these drugs a while become physically dependent.
GIROIR: And withdrawal leads to all kinds of bad things - cardiovascular symptoms, gastrointestinal symptoms, very difficult psychological symptoms.
AUBREY: Back in 2016, the CDC released guidelines aimed at helping doctors taper patients off the drugs, but in some cases, these guidelines have been misinterpreted as a mandate to get people off the drugs quickly. Now there's a recognition that, for some patients, the benefits of long-term use of opioids at the lowest possible dose can outweigh the harms. So tapering is still a goal.
GIROIR: A majority of patients can have a reduction in opioids and improve pain control at the same time.
AUBREY: But he says easing people off the medications or to a significantly lower dose needs to be done in a coordinated, compassionate way.
GIROIR: Usually with full patient collaboration. It must be done slowly and carefully, and there's no easy way around that.
AUBREY: Ideally, patients with chronic pain would also get help from health care providers to access alternative therapies that can be beneficial, too - everything from help with diet and lifestyle changes, exercise, physical therapy and counselling.
Allison Aubrey, NPR News.
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