ArticleJAMA network open2025
The 2016 CDC Opioid Guideline and Analgesic Prescribing Patterns in Older Adults With Cancer.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Guideline for Medication Management of Distressing Symptoms in Older Patients Receiving End-of-Life Palliative Care.Journal of evidence-based medicine · 2026Guideline
- Geographic Variation of Gabapentinoids and Opioids in US Nursing Homes.Journal of the American Medical Directors Association · 2026Article
- Substitution Patterns After Discontinuation of CNS-Active Medications in Older Adults in Primary Care.Journal of the American Geriatrics Society · 2026Article
- Initiation of Gabapentin with Opioids and Risk of Respiratory Cardiovascular and Opioid-Related Adverse Events Following Surgery for Breast Cancer.Clinical pharmacology and therapeutics · 2026Article
- Article
- Impact of Hydrocodone Rescheduling on Pharmaceutical Pain Management in End-of-Life Lung Cancer Patients.Journal of palliative care · 2026Article
- Trends in Co-Prescribing Opioids and Gabapentinoids Among Medicare Beneficiaries, 2017 to 2022.Medical sciences (Basel, Switzerland) · 2026Article
- The impact of opioid prescribing guidelines on opioid dispensation: A systematic review and meta-analysis.Canadian journal of pain = Revue canadienne de la douleur · 2026Review
- Preexisting Psychiatric Risk Factors and Any and Long-Term Opioid Use in Head and Neck Cancer.JAMA otolaryngology-- head & neck surgery · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
Importance: In 2016, the Centers for Disease Control and Prevention (CDC) published guidelines cautioning against prescribing opioids for chronic noncancer pain. Little is known about unintended outcomes of this guideline on analgesic prescribing for older adults with cancer, who commonly require opioids as first-line pain treatment. Objective: To determine whether the 2016 CDC guideline was associated with altered analgesic prescribing among older adults with cancer. Design, Setting, and Participants: Interrupted time series analysis of a longitudinal cohort using Medicare Current Beneficiary Survey (MCBS) dataset (2010-2020), a nationally representative longitudinal survey of Medicare beneficiaries linked to Medicare claims. MCBS participants older than 65 years who reported a non-skin cancer diagnosis were followed up for up to 4 years. Subgroup analysis conducted for those with poor prognosis cancer or a cancer-related pain encounter (advanced cancer/cancer pain). Data were analyzed from January 2023 to February 2025. Exposure: CDC Guideline for Prescribing Opioids for Chronic Pain publication in March 2016. Main Outcomes and Measures: Quarterly prescribing rates of opioids (typical opioids, tramadol, and buprenorphine) and gabapentinoids (gabapentin and pregabalin). For each time series analysis outcome, a level change estimated immediate change and trend (ie, slope) change estimated ongoing change following the guideline. Results: The cohort included 11 903 older adults with cancer (mean [IQR] age, 79.4 [73-85] years, 6504 [54.6%] women), including 1283 with advanced cancer or cancer pain. Compared with preguideline trends, we observed the following changes after the guideline release: the slope of opioid prescribing decreased (typical opioids: -0.47; 95% CI, -0.63 to -0.30 percentage points [pp]/quarter; tramadol: -0.27; 95% CI, -0.36 to -0.17 pp/quarter; buprenorphine: -0.01; 95% CI, -0.02 to -0.01 pp/quarter), though tramadol prescribing rose by 11.5% overall; and gabapentinoid prescribing increased by 24.9% (slope change, -0.03; 95% CI, -0.09 to 0.02 pp/quarter). Conclusions and Relevance: In this cohort study of older adults with cancer, the 2016 CDC guideline was associated with a decline in opioid prescribing that was less pronounced for tramadol compared with typical opioids and was followed by a 25% increase in gabapentinoid prescribing. This may reflect a shift in cancer pain management from first-line opioids to tramadol, which is less safe, and gabapentinoids, which have been shown to be less effective for cancer pain treatment.
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