The CDC on Feb. 10 proposed new guidelines for prescribing opioids painkillers that remove previously recommended ceilings for chronic pain patients, leaving physicians to call the shots.
Daniel Guy, MD, president of the American Academy of Orthopedic Surgeons said the AAOS has always believed that physicians should have the flexibility to treat patients based on their individual needs, while continually weighing the benefits and risks of opioids for pain alleviation.
"The proposed guidelines are a step in the right direction, and we look forward to reviewing them in greater detail, as we continue to advocate for a comprehensive multimodal approach utilizing the adoption and research of nonopioid and nonpharmacological interventions," Dr. Guy said.
Still, the AAOS and practices continue to be cautious about handling opioids in postoperative care.
Long before the CDC updated its recommendations, an orthopedic practice in Indiana took charge of its own opioid prescribing protocols. South Bend Orthopedics implemented measures to limit the amount of opioids that can be prescribed to patients who have surgery. The action is aimed to make sure unused pills aren't "floating around," one surgeon told a local news station.
Recent research has found that orthopedic surgeons are overprescribing opioids. A study in the January/February 2022 edition of the Journal of Orthopaedics found total joint replacement patients on average took less than half of their prescribed opioids.
"These data can be used to educate patients regarding pain expectations following surgery and develop evidence-based opioid tapering guidelines to effectively manage postoperative pain while limiting opioid use," the study concluded.
The CDC's new recommendations acknowledge the dangers of opioids, but the agency also notes their benefits. And if opioids are prescribed, the CDC advises physicians to begin pain management plans with the lowest effective dose and to choose immediate-release pills over long-acting ones.