CDC Clinical Practice Guideline for Prescribing Opioids for Pain, 2022: Key Messages for Decision-Makers

July 28, 2023

The CDC Clinical Practice Guideline for Prescribing Opioids for Pain, 2022 (2022 Clinical Practice Guideline) is a clinical tool intended to help clinicians and patients make shared, informed, patient-centered decisions about pain care. The 2022 Clinical Practice Guideline provides voluntary recommendations that are intended to be flexible to support, not supplant, individualized patient-centered care. This resource is intended to summarize key takeaways from the Guideline and educate decision-makers on its scope and purpose.

WHAT is the purpose of the 2022 Clinical Practice Guideline?

• The 2022 Clinical Practice Guideline is voluntary guidance for clinicians, created to inform clinical decision-making.
• It does not replace clinical judgment and individualized, patient-centered decision-making.
• The voluntary recommendations are not intended to be interpreted as absolute limits for policy or practice across populations by organizations, healthcare systems, or government entities.

WHO is the intended audience?

The audience for the 2022 Clinical Practice Guideline is clinicians who provide pain care for outpatients aged 18 years or older with acute pain, subacute pain, or chronic pain. It is not applicable to:

• Management of pain related to sickle cell disease.
• Management of cancer-related pain.
• Palliative care.
• End-of-life care.

The 2022 Clinical Practice Guideline updates and replaces the 2016 Guideline for Prescribing Opioids for Pain (2016 Guideline) to include recommendations for primary care clinicians, as well as clinicians managing pain in other outpatient settings, including:

• Clarification for non-clinical decision-makers regarding the proper application and intended audience for the 2022 Clinical Practice Guideline (e.g., urging against use of the Guideline to justify inflexible standards of practice or dictating clinical practice through legislation and regulation).
• New and emerging evidence on the benefits and risks of prescription opioids for pain.
• Updated guidance on non-opioid pain treatments, dosing strategies, risk mitigation strategies, and opioid tapering and discontinuation.
• More details of additions and changes from the 2016 Guideline can be found on CDC's Clinical Practice Guideline What’s Different webpage.

HOW was the 2022 Clinical Practice Guideline developed?

• The 2022 Clinical Practice Guideline was developed using the best available scientific evidence and followed a rigorous scientific process.
• Sources of input used to inform the 2022 Clinical Practice Guideline included:
• Systematic literature reviews.
• Listening sessions with patients, caregivers, clinicians, and the public.
• Federal Advisory Committee and federal partner engagement.
• Peer review by external subject matter experts.
• More details on the process to develop the 2022 Clinical Practice Guideline can be found on CDC's Process for the Development of the 2022 Clinical Practice Guideline for Prescribing Opioids for Pain webpage.

References

Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC clinical practice guideline for prescribing opioids for pain—United States, 2022. MMWR Recommendations and Reports. (2022). 71(3), 1-95. doi: 10.15585/mmwr.rr7103a1.

Key Definitions

• Patient-Centered Care: Clinicians working collaboratively with patients and healthcare providers to create a care plan that is personalized, comprehensive, and coordinated care that is characterized by dignity, compassion, and respect that leverages patients’ strengths to help them achieve an optimal quality of life.
• Acute Pain: Pain lasting less than one month.
• Subacute Pain: Pain lasting between one and three months.
• Chronic Pain: Pain lasting longer than three months.
• Palliative Care: Specialized medical care for people living with serious illnesses.