Six years ago, the Centers for Disease Control and Prevention (CDC) issued guidelines that discouraged doctors from prescribing opioids for pain and encouraged legislators to restrict the medical use of such drugs, based on the assumption that overprescribing was responsible for rising drug-related deaths:
Using data for 2010 through 2019, Aubry and Carr looked at the relationship between prescription opioid sales, measured by morphine milligram equivalents (MME) per capita, and four outcomes: total drug-related deaths, total opioid-related deaths, deaths tied specifically to prescription opioids, and “opioid use disorder” treatment admissions. “The analyses revealed that the direct correlations (i.e., significant, positive slopes) reported by the CDC based on data from 1999 to 2010 no longer exist,” they write. “The relationships between [the outcome variables] and Annual Prescription Opioid Sales (i.e., MME per Capita) are either non-existent or significantly negative/inverse.”
Those findings held true in “a strong majority of states,” Aubry and Carr report. From 2010 through 2019, “there was a statistically significant negative correlation (95% confidence level) between [opioid deaths] and Annual Prescription Opioid Sales in 38 states, with significant positive correlations occurring in only 2 states. Ten states did not exhibit significant (95% confidence level) relationships between overdose deaths and prescription opioid sales during the 2010–2019 time period.”
During that period, MME per capita dropped precipitously, falling by nearly 50 percent between 2009 and 2019. By 2021, prescription opioid sales had fallen to the lowest level in two decades.
Policies and practices inspired by the CDC’s 2016 guidelines contributed to that downward trend. Aubry and Carr note that “forty-seven states and the District of Columbia” now “have laws that set time or dosage limits for controlled substances.” In a 2019 survey by the American Board of Pain Medicine, the American Medical Association reports, “72 percent of pain medicine specialists” said they had been “been required to reduce the quantity or dose of medication” they prescribed as a result of the CDC guidelines.
The consequences for patients have not been pretty. They include undertreatment, reckless “tapering” of pain medication, and outright denial of care.
“The consequences for patients have not been pretty. They include undertreatment, reckless ‘tapering’ of pain medication, and outright denial of care.”
Correct. Doctors are even hesitant to prescribe mildly strong medication such as cough medicine with codeine. You might become a junkie.
Negative correlation? Sounds like patients are getting their pain meds on the streets instead.
I wonder how far the CDC was honestly mistaken and how far it was a corrupt power grab. Like with Covid.