Blumenthal, Five Senate Colleagues Urge CDC to Release Delayed Opioid Prescribing Guidelines

(Washington, D.C.) – U.S. Senators Richard Blumenthal (D-Conn.), Joe Manchin (D-WV), Edward J. Markey (D-Mass.), Dianne Feinstein (D-Calif.), Richard Durbin (D-Ill.), and Tim Kaine (D-VA) today urged the Centers for Disease Control and Prevention (CDC) to release delayed opioid prescribing guidelines. Over-prescription of opioid painkillers puts patients at risk of abuse, misuse and addiction, and is closely linked to an escalating heroin crisis.

The Senators wrote: “The United States is in the midst of the worst prescription opioid epidemic in our history, which has claimed the lives of nearly 19,000 in 2014 alone. One critical step we must take to address this national, public health crisis is to ensure the responsible prescribing of opioids.” 

“We have seen firsthand the devastating effects of prescription drug abuse on individuals, families, and communities in our states, and we believe that encouraging the responsible prescribing of opioids is critical to stopping this epidemic. These guidelines will help the United States reduce opioid addiction and diversion and save lives without compromising access to needed treatment. We hope that CDC will advocate for the strongest possible set of recommendations to help end prescription drug abuse and overdose deaths and finalize these guidelines as soon as possible”

The complete text of the letter is below, and it is available in pdf format here.

January 27, 2016

The Honorable Sylvia Matthews Burwell
Secretary
U.S. Department of Health and Human Services
200 Independence Avenue SW
Washington, DC 20201

Thomas Frieden, MD, MPH
Director
Centers for Disease Control and Prevention
1600 Clifton Rd
Atlanta, GA 30333 

Dear Secretary Burwell and Dr. Frieden, 

Many of us wrote you this past November expressing our strong support of the Centers for Disease Control and Prevention’s (CDC) recently released Draft Guidelines for Opioid Prescribing, which were expected to be finalized in January 2016. To our great dismay, we have learned that these guidelines have been delayed. We appreciate CDC’s desire for strong stakeholder input and concerns about patient access, but we are troubled by reports that this delay occurred after opposition from companies that have a significant financial stake in the sale of opioid painkillers.[1]The United States is in the midst of the worst prescription opioid and heroin epidemics in our history, which has claimed the lives of nearly 29,000 in 2014 alone. One critical step we must take to address these national, co-occurring public health crises is to ensure the responsible prescribing of opioids.

The over-prescribing of opioid painkillers has made the United States the epicenter of the prescription opioid epidemic. Although the United States makes up only 4.6 percent of the world’s population, it consumes approximately 81 percent of the global supply of oxycodone products and almost 100 percent of the world’s hydrocodone.[2] In 2012, health care providers wrote 259 million prescriptions for painkillers – enough for every American adult to have a bottle of pills.[3] The skyrocketing use of opioids in America is also contributing to the rising heroin crisis, particularly among populations with historically low rates of heroin use. The heroin epidemic reached new heights this year with over ten thousand people dying from a heroin related overdose in 2014 – double the rate from 2011.[4] As experts note, many painkiller and heroin addicts start abusing opioids after receiving a legitimate prescription for pain-related medical issues.[5] 

Irresponsible, uninformed and harmful prescribing practices put patients at risk of addiction, abuse and misuse. The CDC recently released alarming statistics showing that there was a 16 percent increase in the number of prescription opioid deaths between 2013 and 2014. More than six in ten drug overdose deaths were caused by opioids in 2014, leading to 18,893 deaths.[6] The United States urgently needs CDC’s opioid prescribing guidelines so the country can reverse this dangerous trend. The immediate release of the proposed guidelines will help to ensure that more lives are not lost to this scourge.

We support CDC’s effort to reshape how primary care doctors use opioids painkillers for chronic pain, which would result in fewer prescriptions, and ultimately fewer deaths. CDC’s draft guidelines represent a reasonable, commonsense approach to help doctors take into account the very real and prevalent danger of dependency, addiction and overdose when prescribing opioids. Of note, the CDC has stated clearly that its recommendations for more cautious opioid use apply to primary care practices and do not pertain to cancer patients, palliative care or end-of-life conditions. 

As you know, under CDC’s guidelines, physicians would be encouraged to recommend non-pharmacological therapy as the preferred treatment for chronic, non-cancer pain, prescribe the lowest dose and the fewest number of pills considered effective for the patient, and regularly evaluate the risks to the patient from the prescription opioids they are taking. Furthermore, physicians overwhelmingly support the guidelines according to a recent survey. Of the over 1,600 physicians surveyed, 87 percent support the CDC’s opioid prescribing guidelines and would use them in practice.[7]

We have seen firsthand the devastating effects of prescription drug and heroin abuse on individuals, families, and communities in our states, and we believe that encouraging the responsible prescribing of opioids is critical to stopping these epidemics. These guidelines will help the United States reduce opioid addiction and diversion and save lives without compromising access to needed treatment. We hope that CDC will advocate for the strongest possible set of recommendations as set forth in the original draft guidelines to help end prescription drug abuse and fervently urge that the guidelines be finalized and implemented without further delay.

Sincerely,

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