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, an expert in overdose and addiction management and Chair of Emergency Medicine, Rutgers New Jersey Medical School is available to discuss why the Centers for Disease Control and Prevention’s proposed new guidelines to remove the recommended dosage caps on opioids for acute and chronic pain could have dangerous consequences for patients seeking care.  

“This is a dramatic change from the 2016 guidelines, which recommended to physicians a 90 morphine milligram equivalents [MME] cap for new patients,” said Nelson, a former panelist for the creation of the 2016 guidelines. 

“There are good data to support that there is an inflection point at 90 MME. It’s clear that high-dose chronic opioid therapy is associated with a number of adverse consequences—including addiction, unintentional overdose and potentially death. In a way, it’s a race to the bottom in pain management, because if you’re not getting better with a reasonable dose of an opioid, there’s nothing to support that additional opioid is going to carry significant benefit and is known to markedly increase the risk. It is not a good idea to rapidly lower a patient’s opioid dose to 90 MME either, which has been an unintended outcome of the original guideline. The key was to avoid escalation beyond this on the way up.”