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Abstract: 

On March 18, 2016, The Centers for Disease Control (CDC) issued a comprehensive set of guidelines intended for primary care health providers—physicians, nurses, and physician’s assistants—prescribing opioids for painful conditions that may or have become chronic. The guidelines come at a time when opioid addiction and abuse have reached epidemic levels in many areas of the United States. Health providers are torn in two opposing directions when it comes to prescribing opioids. On one hand, when used appropriately, opioids are highly effective in managing pain. For certain types of severe pain, there is simply no substitute that provides the same level of relief. On the other hand, opioids are highly addictive and can have debilitating side effects; dependency can outlive the acute condition that made them necessary in the first place; and a vast black market in opioids threatens families and communities, and would not be possible without the illegal diversion of opioids prescribed by primary care providers. Knowing the dangers of opioid dependency and the high risk of criminal misuse, many doctors are reluctant to prescribe opioids even in cases where their use is clearly called for. At the other extreme, many prescribers, motivated by compassion or frustration or simply indifferent to the risks, too readily write scrips for opioids. This issue of Correctional Health Care Report reproduces those sections of the guidelines most useful to jail and prison practitioners. We have reproduced the CDC’s “Background and Rationale” (beginning on page 33) and the heart of the guidelines, the “Recommendations” (beginning on page 35). We have omitted several other sections of the guidelines not strictly relevant to prisons and jails; these can be accessed at http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm.

Keywords: The Centers for Disease Control (CDC); Guidelines for Prescribing Opioids for Chronic Pain

Affiliations:  1: Correctional Health Care Report.