Comparison of opioids prescribed for patients at risk for opioid misuse before and after publication of CDC’s opioid prescribing guidelines

CDC released its opioid prescribing guideline on March 15, 2016, and researchers with Missouri’s Saint Louis University School of Medicine were curious about the subsequent effect, if any, on orders for Schedule II opioids. A cross-sectional study examined data from 279,435 de-identified adults in a commercial claims database, all of whom had a non-cancer painful condition. Investigators specifically looked at the volume of new prescriptions for Schedule II opioids, which are associated with a high risk of potential abuse, compared with tramadol, a Schedule IV opioid with lower abuse potential, in the 18 months before and after the CDC guidance was issued. Analysis revealed that with the exception of a 14% decrease in the likelihood of patients receiving oxycodone vs. tramadol, the odds of new prescriptions for Schedule II opioids did not change significantly after publication of the CDC recommendations—even among patients at high risk for opioid misuse due to depression, anxiety, substance abuse disorder, or benzodiazepine use.