Evidence map›Paper›PMID 42236086›Full record

ArticleBMJ open2026

Effects of the 2016 CDC opioid prescribing guideline: a scoping review.

Katherine E Warren, Sooyeon Kho, Carol Mita, Molly F Franke, Shelly F Greenfield, Scott G Weiner

Abstract readScoping Review
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Katherine E WarrenUniversity of Washington, Seattle, Washington, USA.ORCID http://orcid.org/0000-0001-6016-5315
Sooyeon KhoMetroWest Medical Center, Framingham, Massachusetts, USA.
Carol MitaHarvard Countway Library, Harvard Medical School, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0003-3059-1369
Molly F FrankeHarvard Medical School, Boston, Massachusetts, USA.
Shelly F GreenfieldHarvard Medical School, Boston, Massachusetts, USA.
Scott G WeinerBrigham and Women's Hospital, Boston, Massachusetts, USA sweiner@bwh.harvard.edu.ORCID http://orcid.org/0000-0002-4672-5184

Funding

Opioid Prescribing and Chronic Pain in the Primary Care SettingF30DA052116 · NIDA · HARVARD MEDICAL SCHOOL · PI WARREN, KATHERINE ELIDA · 2021 to 2023
$145k
NIDA NIH HHS F30 DA052116
6 · The paper itself

Abstract

objectivesIn March 2016, the Centers for Disease Control and Prevention (CDC) released the

methodsA scoping review was conducted with a preregistered protocol. Comprehensive searches of PubMed, Embase and Cumulative Index of Nursing and Allied Health Literature were conducted in April 2025. Reports published between 2016 and 2025 that explored the effects of the CDC guideline were included. No restrictions on language or country of study origin were applied, though all retrieved reports were published in the USA and in English. Two authors independently screened titles, abstracts and full-text reports. Data were extracted by healthcare setting, study aims and design, sample size, study population, participant characteristics and study findings and outcomes. Reports were characterised as empirical studies that evaluated guideline effects or implementation studies that assessed uptake. Study findings were presented descriptively and by evidence maps.

resultsNinety-four studies met the inclusion criteria: 75 empirical studies and 19 implementation studies. Eighty-eight per cent measured changes in opioid prescribing; all but one found significant reductions in at least one prescribing measure, often among people receiving ≥50-90 morphine mg equivalents per day. Effects occurred across specialties and populations, including groups not targeted by the guideline. Studies found increased rates of tapering, with mixed findings on opioid-benzodiazepine coprescription. Legal analyses showed widespread policy adoption at the state level. Implementation studies described expanded risk-mitigation strategies, sometimes beyond guideline text. Few studies reported patient-centred outcomes, participant race or ethnicity or equity measures.

conclusionsThis voluntary federal guideline had significant intended and unintended effects. The guideline was associated with reductions in opioid prescribing among groups targeted and not targeted by its design, with limited evidence on patient outcomes. Future work should prioritise equity-focused patient outcomes to inform implementation of the 2022 CDC guideline.

Indexed as

Analgesics, OpioidChronic PainPractice Guidelines as TopicPractice Patterns, Physicians'Centers for Disease Control and Prevention, U.S.Guideline AdherenceHumansUnited StatesAnalgesics, OpioidChronic PainHealth policyPAIN MANAGEMENT

Identifiers

PMID42236086
PMCPMC13239533

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.