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Dear Pain Warriors,

You may have heard by now that the CDC released an updated draft version of the Clinical Practice Guideline for Prescribing Opioids – 2022. This new Guideline will take the place of the 2016 version. You can read the full version here.
The document is 200 plus pages which I am currently reviewing and will draft a formal comment to the docket on behalf of the U.S. Pain Foundation that we will share with you when it is ready. However, we wanted to summarize the changes in the new version for you. (Please see below.) We have prepared a head to head comparison of each of the twelve 2022 Guideline statements with the twelve 2016 Guideline statements that you can see here.

We also wanted to let you know that you can and should write into the docket with your views on the revised Guideline. All comments will be read by CDC. The deadline to submit comments is April 11, 2022. To submit your comments, click here

Changes to the Guideline

Overall, this revised Guideline is an improvement over the 2016 version. It is less dogmatic, more balanced and urges a more flexible approach to individual patient needs.  

The greatest change is the removal of dosage cautions and limits in Guideline 5.

The number of days of treatment duration for acute pain have also been removed from Guideline 6.

The newly released Guideline has softened recommendations around patient surveillance advising clinicians to periodically review state PMP data and consider using toxicology. The 2016 version directed clinicians to check the state PMP prior to every script or at least every 3 months and urged urine testing prior to starting opioid therapy and at least annually thereafter.

In this latest version, the CDC has also strengthened warnings to clinicians regarding not abruptly or rapidly reducing opioid dosages.

Again, we urge you to make your views known on this latest version by writing your comments to the docket. After April 11, CDC will review all comments and release the final draft of the updated Guideline later in 2022.


Cindy Steinberg
Director of Policy and Advocacy
U.S. Pain Foundation