ArticleAdvances in therapy2019
Three Years Down the Road: The Aftermath of the CDC Guideline for Prescribing Opioids for Chronic Pain.
Article in Advances in therapy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04625283 (The Effect and Contribution of a Perioperative Ketamine Infusion in an Established Enhanced Recovery Pathway), which is not on this map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect and Contribution of a Perioperative Ketamine Infusion in an Established Enhanced Recovery Pathway
Who cites it
15 citing papers in PubMed, 68 citations in OpenAlex.
- Outpatient opioid dispensing during the 2024 floods in Southern Brazil: a population-based ecological time-series analysis.Lancet regional health. Americas · 2026Article
- Pharmacists may facilitate opioid tapering before total hip or knee arthroplasty.Annals of joint · 2026Article
- Prescription Opioid Dose Reductions and Potential Adverse Events: a Multi-site Observational Cohort Study in Diverse US Health Systems.Journal of general internal medicine · 2024Observational
- Association of Opioid Use Disorder Diagnosis With Use of Physical Therapy and Chiropractic Care Among Chronic Low Back Pain Patients: A Group-Based Trajectory Analysis.The journal of pain · 2024Article
- Trends in Antiseizure Medication Prescribing Among Nursing Home Residents With and Without a Seizure Diagnosis.The neurologist · 2023Article
- Associations Between Opioid Prescriptions and Use of Hospital-Based Services Among US Adults with Longstanding Physical Disability or Inflammatory Conditions Compared to Other Adults in the Medical Expenditure Panel Survey, 2010-2015.Journal of pain research · 2023Article
- Trends in Prescriptions for Non-opioid Pain Medications Among U.S. Adults With Moderate or Severe Pain, 2014-2018.The journal of pain · 2022Article
- Downstream Acute Care Utilization Following Initial Prescription of an Opioid Pain Reliever Among Emergency Department Patients With Low-Severity Conditions.The Permanente journal · 2022Article
- Effects of kappa opioid receptor agonists on fentanyl vs. food choice in male and female rats: contingent vs. non-contingent administration.Psychopharmacology · 2021Article
- Unintended consequences of United States chronic pain guidelines.International journal of clinical pharmacy · 2021Article
- Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency.Frontiers in pain research (Lausanne, Switzerland) · 2021Review
- Transforming Prescription Opioid Practices in Primary Care With Change Theory.Health services insights · 2021Article
- Methocinnamox (MCAM) antagonizes the behavioral suppressant effects of morphine without impairing delayed matching-to-sample accuracy in rhesus monkeys.Psychopharmacology · 2020Article
- Association of Obesity With Prescription Opioids for Painful Conditions in Patients Seeking Primary Care in the US.JAMA network open · 2020Article
- Trends in Prescription Analgesic Use Among Adults With Musculoskeletal Conditions in the United States, 1999-2016.JAMA network open · 2019Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The 2016 CDC guidelines for opioid prescribing by primary care physicians have exposed some shortfalls in our thinking about opioid use and stranded many chronic pain patients with inadequate analgesia. Opioid prescribing rates started to decline in 2012, but still remain high. The response from providers to the 2016 guidelines have led to unintended consequences. Some of the CDC guidance seems arbitrary and not supported by evidence (the 90 MME per day cutoff). Patient and prescriber education, the role of buprenorphine (an atypical Schedule III opioid), and abuse-deterrent opioids are not mentioned at all but could play crucial roles in reducing abuse. Opioid use disorder (OUD) is not defined by the guidance which calls on primary care physicians to recognize and treat it. Opioid withdrawal syndrome is not mentioned and tapering plans, although advised, are not described in a practical way. While the morbidity and mortality associated with OUD are public health crises, so is untreated pain. Chronic pain patients deserve consideration, yet emerge as the silent epidemic within the opioid crisis. To be sure, there is much good in the CDC guidance or any guidelines that urge caution and care in opioid prescribing. Pain specialists must speak out to advocate for patients dealing with pain, to educate patients and prescribers about analgesic options, and to make sure that pain is adequately treated particularly in vulnerable populations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.