February 1, 2022
In July of 2021 the CDC held an all-day meeting about the updated guidelines. In case you missed our e-mail explaining what the meeting was all about, we included some of the information here for you to review.
What was the meeting about?
Last year, an Opioid Work Group (OWG) was formed with the goal of reviewing the draft of the updated guidelines and providing feedback. The OWG report was released on July 15, 2021, and showed comments about each suggested guideline. Also, there is commentary on the evidence rating of each guideline. The evidence rating is done as follows:
Evidence is categorized into four types within the GRADE framework:
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Type 1, or high-quality evidence: Randomized controlled trials (RCTs) or overwhelming evidence from clinical studies
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Type 2, or moderate-quality evidence: RCTs with important limitations, or exceptionally strong evidence from observational studies
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Type 3, or low-quality evidence: Observational studies or RCTs with notable limitations
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Type 4, or very low-quality evidence: Clinical experience and observations, observational studies with important limitations, or RCTs with several major limitations
Each guideline is given either A or B category designation.
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Category A recommendations apply to all patients.
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Category B recommendations require individual decision making where different choices will be appropriate for different patients so that clinicians must help patients arrive at a decision consistent with patient values and preferences and specific clinical situations.
Based on the OWG report, 11/12 recommendations were given a Category A, and 1 was given B. One was given 2, five were given 3. and 6 were given 4. The only one given type 2 evidence rating was about OUD, not pain. In other words, the guidelines have low-quality to very low-quality evidence, yet they recommend they be applied to everyone. This is important for us to understand because they are always referred to as “evidence based guidelines."
What was the outcome of the meeting? The Board of Scientific Counselors (BSC) voted to endorse the OWG report
What did this mean for our community?
Well, it was definitely a good thing, but whether the BSC actually listens to the concerns of the Opioid Work Group remains to be seen. Many of the comments from the OWG reflect our concerns with the guidelines,
If you'd like to read more about the CDC's process for updating these guidelines, click here.
***HERE IS WHERE YOU COME IN***
What can you do to help?
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Comment: We will let you know as soon as the CDC opens up the comment period for the updated guidelines. All we know at the moment is they said the 60-day comment period will begin soon.
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Donate: – Your donations allow us to pay for lobbyists and continue to dedicate our time to get this information out to you!
