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State Attorneys General Believe New Opioid Guidelines are Too Relaxed


— April 18, 2019

The National Association of Attorneys General has sent a letter to the federal government indicating the report recently drafted is far too relaxed and deviates from CDC guidelines.


The National Association of Attorneys General has sent a letter to the federal government objecting to parts of a recent draft report on pain management that it’s calling “incomprehensible” for deviating from the Centers for Disease Control and Prevention (CDC) guidelines aimed at decreasing the risk of opioid misuse.

The bipartisan National Association of Attorneys General, whose members have been battling the opioid crisis, has sent a letter to the federal government objecting to parts of a recent draft report on pain management.  The plan was devised by a panel of experts appointed by the U.S. Department of Health and Human Services and called the Pain Management Best Practices Inter-Agency Task Force.

The attorneys general letter says, “it’s incomprehensible that the draft report weakens and deviates from guidelines published by the Centers for Disease Control and Prevention that are aimed at decreasing the risk of opioid misuse.”  It was signed by 39 bipartisan state and territory attorneys general, showing a significant number of states are objecting to the plan.

State Attorneys General Believe New Opioid Guidelines are Too Relaxed
Photo by Samuel Zeller on Unsplash

“As a matter of public safety, there is simply no justification to move away from the guidelines to encourage more liberal use of an ineffective treatment that causes nearly 50,000 deaths annually,” the letter states.  The organization received an acknowledgment that the letter was received, “but we haven’t received any additional official response at this point,” Allison Gilmore, chief communications officer for the group, said.

The new analysis would leave it up to a provider’s judgment to determine the exact dose prescribed and duration of opioid use.  This was drafted despite the agency’s guidelines call for documentation, monitoring, and consultation with a pain management expert to determine dosage and duration.  Many experts in the field have specified that opioids should not be prescribed for more than seven days at a time in order to limit abuse.  However, allowing physicians who are not soliciting the help of pain management experts to determine how much to prescribe may mean that larger doses will still be issued.

“As attorneys general, we have witnessed the devastating effect of unfettered opioid manufacturing, distribution and prescribing on our public health, social services and criminal justice systems.  The well-established risks associated with higher doses of opioids, prescriptions of longer duration, and concurrent prescriptions of opioids and benzodiazepines demand continued constraints,” the letter contends.

The report also does not offer a reason for departing from the evidence-based guidelines, and it does not explicitly state that there is no completely safe opioid dosage.  Both are concerns addressed in the letter, which states, “Moving away from the guidelines at this critical time would undermine ongoing legislative initiatives, as well as refinements to standards of medical care.”  The main purpose of the attorneys general is to push for more definitive guidelines rather than allowing lawmakers to make them more relaxed.

A department representative who is unnamed said the task force “is in the process of reviewing the comments it received on its draft recommendations, which it will take into consideration as it drafts its final recommendations.  The task force plans to release its final recommendations in May.”

Sources:

SC Attorney General concerned about draft report on opioids

State Attorneys General Criticize Draft Report Weakening Opioid Guidelines

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