Prescription painkillers should not be a first-choice for treating common ailments like back pain and arthritis, according to new federal guidelines designed to reshape how doctors prescribe drugs like OxyContin and Vicodin. Amid an epidemic of addiction and abuse tied to these powerful opioids drugs, the Centers for Disease Control and Prevention is urging primary care doctors to try physical therapy, exercise, and over-the-counter pain medications before turning to painkillers for chronic pain. Opioid drugs include medications like morphine and oxycodone as well as illegal narcotics like heroin. Under the new guidelines, doctors would prescribe painkillers only after considering non-addictive pain relievers, behavioral changes, and other options. The CDC also wants doctors to prescribe the lowest effective dose possible. And doctors should only continue prescribing the drugs if patients show significant improvement.
The new recommendations—which doctors do not have to follow—represent an effort to reverse nearly two decades of rising painkiller use, which public health officials blame for a more than four-fold increase in overdose deaths tied to the drugs. In 2014, US doctors wrote nearly 200 million prescriptions for opioid painkillers, while deaths linked to the drugs climbed to roughly 19,000—the highest number on record. "We're trying to chart a safer and more effective course for dealing with chronic pain," Dr. Tom Frieden, the CDC's director, said in an interview with the AP. "The risks of addiction and death are very well documented for these medications." More than 40 Americans die every day from painkiller overdoses, a staggering rate that Frieden said is "doctor driven." Though the guidelines are voluntary (and do not apply to doctors who specialize in treating severe pain due to cancer and other debilitating diseases), they could be widely adopted by hospitals, insurers, and state and federal health systems.