The Risks of Non-adherence to CDC Guidelines
By Tolu Ajiboye
Constituting efforts to end the ongoing opioid epidemic, the Centers for Disease Control and Prevention (CDC) in 2016, released some guidelines to help physicians safely prescribe opioids and monitor its use. Some of the top recommendations in the Guideline for Prescribing Opioids for Chronic Pain include:
- Opioids should not be the first resort for chronic pain management. And in all cases, they should only be prescribed when the patient stands to benefit more than he/she risks from their usage.
- Physicians should organize and carry out routine urine drug tests to check for prescribed opioids and other illicit substances in the patient’s bloodstream. These tests should also be carried out periodically- annually at a minimum.
- Physicians should use data from state prescription drug monitoring programs to periodically assess a patient’s prescription medication history.
Risks of non-adherence to the guidelines
While the CDC guidelines aren’t laws and are therefore not legally enforceable, there are some personal and patient-related risks that physicians take by not following them:
- Opioid use disorders: If you’re not conscientious about the prescription and monitoring of opioids, you risk your patients developing opioid use disorders. Opioid use disorder is a chronic condition that has far-reaching consequences including but not limited to disability, constant relapses and death. In 2017 alone, ⦁ more than 1.7 million Americans developed substance use disorders that were tied to prescription opioids. Further, there’s a risk that such patients could develop other disorders like heroin use disorders
- Opioid overdose and death: Patients overdosing and dying are very possible results of the indiscriminate or unmonitored prescription of opioids. According to the National Institute on Drug abuse, more than 130 people die every day from overdosing on opioids.
- Criminal prosecution and civil lawsuits: As a physician, you can actually be sued and/or held criminally liable for overprescribing opioids. This is particularly so when such prescriptions have led to a substance use disorder or death from overdose. A notable case is that of Dr. Hsiu-Ying “Lisa” Tseng, who became the first doctor to be convicted of murder for overprescribing opioids. She received a sentence of 30 years to life in prison. While criminal convictions of this kind are still very rare, this case was not an isolated one. The number of physicians that the US Drug Enforcement Administration takes action against yearly is on the rise. In 2011, the number was 88, but in 2016, 479 doctors were penalized by the agency. Civil wrong suits brought by private citizens for wrongful death are also becoming increasingly common.
Bearing all this in mind, the solution is not to stop prescribing opioids. In a recent media release, the CDC warns against abrupt tapering or sudden discontinuation of opioids and states that doing so is a misapplication of the Guideline for Prescribing Opioids for Chronic Pain. Instead, adhering to the essence of the recommendations and monitoring prescription opioid use through routine urine drug tests is the preferable route to take.
How ASAP Lab Can Help
To help you stay In line with the CDC recommendation of routine urine drug tests, ASAP Lab offers urinalysis tests that can give information on prescription opioid levels in a patient’s system. The test can also detect other illegal drugs like heroin, oxycodone, amphetamine, and ecstasy which are commonly abused alongside opioids.
Reach out to see how we can assist you as you help your patients deal with their pain ethically.