CDC's bold clarification gets wider audience

We  warmly commend the three authors of the CDC Guideline for publishing a  lead Perspective in today's New England Journal of Medicine, "No  Shortcuts to Safer Opioid Prescribing". The authors make clear that the  Guideline did not urge, and does not support policies and practices  that mandate dose reduction or discontinuation, even though it does  support individualized assessment of the potential value of tapering  doses.  Judiciously, Drs. Dowell, Hagerich and Chou write, "Policies  should allow clinicians to account for each patient's unique  circumstances. " Their article underscores the need for careful,  individualized decisions, a value inherent in the original Guideline,  and yet - as the authors note-- frequently not upheld in policies in  practice. Their statement sets the table for a necessary revision to  policies instituted across the country that utilize mandates, strong  incentives and implied threats in ways that have been harmful to  patients.

The  Guideline authors' response has our admiration and support. It responds  thoroughly and with the highest standards of medical practice to the  concerns we raised to the CDC on March 6, 2019, with the support of 318  clinicians and 3 former United States Drug Czars.


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