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In 2016 as part of the urgent response to the epidemic of opioid overdose deaths, the CDC issued new recommendations for prescribing opioid medications for chronic pain, excluding cancer, palliative, and end-of-life care. While not law or regulations which carry the weight of law, the CDC guidelines have been widely adopted by state medical boards and implemented by regulation with the force of law. The word guideline(s) is used 173 times throughout the publication. the word recommend or recommendation is used 237 times, the word should 227 times, and the word taper or tapering 58 times.

Despite these cautionary words, practitioners, hospitals, and clinics abruptly terminated patient medications resulting in a rash of suicides across the U.S. with the last reported count being in excess 1,500 deaths in 2018, and they experimented in performing surgeries without the use of opioids for post-op pain management. Due to these rash actions, the CDC had to issue an erratum revision of the guidelines stressing that the guidelines were for general practitioners treating chronic pain not acute pain. The erratum provided guidelines for a staged reduction with frequent reassessments of the patient's condition. As of 2020 it's estimated that more than 1,000,000 individuals are no longer employed, forced into lower-paying jobs, onto welfare rolls, or into early retirement on reduced Social Security Benefits do to these actions. With the number of prescriptions written now down by more than 33% the overdose death rate continues to climb.

The CDC routinely archives publications, for this reason, the entire publication has been copied here.

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Dr. Stefan Kertesz, in this Tedx Talks, "We need to measure the opioid crisis differently."https://youtu.be/gMXHAPutGJA

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Mbabazi Kariisa, PhD1; Lawrence Scholl, PhD1; Nana Wilson, PhD1; Puja Seth, PhD1; Brooke Hoots, PhD1 (View author affiliations)

Summary

What is already known about this topic?

Overdose deaths involving cocaine and psychostimulants continue to increase. During 2015–2016, age-adjusted cocaine-involved and psychostimulant-involved death rates increased by 52.4% and 33.3%, respectively.

What is added by this report?

From 2016 to 2017, death rates involving cocaine and psychostimulants increased across age groups, racial/ethnic groups, county urbanization levels, and multiple states. Death rates involving cocaine and psychostimulants, with and without opioids, have increased. Synthetic opioids appear to be the primary driver of cocaine-involved death rate increases, and recent data point to increasing synthetic opioid involvement in psychostimulant-involved deaths.

What are the implications for public health practice?

Continued increases in stimulant-involved deaths require expanded surveillance and comprehensive, evidence-based public health and public safety interventions.

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