No Shortcuts to Safer Opioid Prescribing
Open accessAbstract
No Shortcuts to Safer Opioid Prescribing The CDC’s 2016 Guideline for Prescribing Opioids for Chronic Pain has largely been embraced by the medical and health policy communities. Unfortunately, some policies and practices purportedly derived from the guideline have been inconsistent with its recommendations.
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Tapering opioids can have unintended consequences including acute opioid withdrawal, uncontrolled pain, and even suicide.
“Clinicians should also be aware of unintended conse quences of tapering opioids - including acute opioid withdrawal, uncontrolled pain, and even suicide - and balance the risks and benefits of continued opioid use 303 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [303]
In “No Shortcuts to Safer Opioid Prescribing” (page not provided), the authors warn that tapering may bring withdrawal symptoms and increased pain, particularly if dosages are reduced abruptly. They discuss adverse psychological outcomes but do not identify suicide as a consequence. (LLM, conf=0.87)
Experimental — accuracy not yet measuredIncautious tapering can do harm, shaking patient confidence and reducing the chance of successful deprescribing, and should not be imposed.
“In order for the process to be successful, patients require a clear commitment to stop opioids and need considerable support; 5 incautious tapering can do harm, shaking patient confidence and reducing the chance of successful deprescribing and should not be imposed.12,13”
From Tapering and withdrawing opioids: guidance informed by fundamental principles to minimise withdrawal symptoms (2025) · cites this paper as [13]
The paper’s main text (page unavailable) warns that abrupt tapering can cause psychological and physical harm and recommends collaborating with patients who agree to taper. It does not specifically say that incautious tapering shakes patient confidence or reduces the chance of successful deprescribing. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe time taken for patients to taper off opioids is highly variable.
“There is also consensus on the observation that the time taken for patients to taper off opioids is highly variable, with some patients requiring months or years to successfully stop opioids, especially when use has been prolonged.5,13”
From Tapering and withdrawing opioids: guidance informed by fundamental principles to minimise withdrawal symptoms (2025) · cites this paper as [13]
Some patients require months or years to successfully stop opioids, especially when use has been prolonged.
“There is also consensus on the observation that the time taken for patients to taper off opioids is highly variable, with some patients requiring months or years to successfully stop opioids, especially when use has been prolonged.5,13”
From Tapering and withdrawing opioids: guidance informed by fundamental principles to minimise withdrawal symptoms (2025) · cites this paper as [13]
The CDC guideline calls for maximizing use of physical, psychological, and multimodal pain treatments, which have not been available, used, or reimbursed sufficiently.
“In 2019, Dowel et al published a commentary that re-emphasized that the CDC guideline calls for maximizing use of physical, psychological, and multimodal pain treatments, which have not been available, used, or reimbursed sufficiently. 7”
From Overview and Feasibility of a Novel Transdisciplinary Integrative Approach to High Impact Chronic Pain in Vermont (2024) · cites this paper as [7]
The PATH program maximizes the use of physical, psychological, and integrative pain treatments within a transdisciplinary model accessible to patients and is consistent with the CDC 2019 statement and call to action.
“The PATH program maximizes the use of physical, psychological, and integrative pain treatments within a transdisciplinary model accessible to patients and is consistent with the CDC 2019 statement and call to action. 7”
From Overview and Feasibility of a Novel Transdisciplinary Integrative Approach to High Impact Chronic Pain in Vermont (2024) · cites this paper as [7]
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Opioid-free anesthesia in oncologic surgery: the rules of the game
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- Authors
- Dowell, D., Haegerich, T., & Chou, R.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2019-06-13
- Volume
- 380
- Issue
- 24
- Pages
- 2285-2287
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC6573011
- OpenAlex
- W2941323238
- Cited by
- 408
- References
- 5
- Citations by year
- 2026: 18 · 2025: 31 · 2024: 31 · 2023: 52 · 2022: 54 · 2021: 71 · 2020: 113 · 2019: 38
- FWCI
- 63.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- opioid prescribing, chronic pain, guideline implementation, opioid safety, prescription drug monitoring programs
- MeSH terms
- Analgesics, Opioid, Centers for Disease Control and Prevention, U.S., Consensus Statements as Topic, Humans, Opioid-Related Disorders, Practice Patterns, Physicians', United States, Practice Guidelines as Topic, Pain Management
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