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In an effort to curb what many consider the worst public health drug crisis in decades, the federal government on Tuesday published the first national standards for prescription painkillers, recommending that doctors try pain relievers like ibuprofen before prescribing the highly addictive pills, and that they give most patients only a few days’ supply. The release of the new guidelines by the Centers for Disease Control and Prevention ends months of arguments with pain doctors and drug industry groups, which had bitterly opposed the recommendations on the grounds that they would create unfair hurdles for patients who legitimately have long-term pain. (Tavernise, 3/15)

Prescription painkillers should not be a first choice for treating common ailments like back pain and arthritis, according to new federal guidelines designed to reshape how doctors prescribe drugs like OxyContin and Vicodin. Amid an epidemic of addiction and abuse tied to these powerful opioids drugs, the Centers for Disease Control and Prevention is urging primary care doctors to try physical therapy, exercise and over-the-counter pain medications before turning to painkillers for chronic pain. Opioid drugs include medications like morphine and oxycodone as well as illegal narcotics like heroin. (3/15)

Many state lawmakers have responded to the crisis by introducing bills to restrict prescribing. And the Food and Drug Administration is pushing drug makers to develop more tamper-resistant products. But the CDC guidelines, while voluntary, arguably represent the most sweeping effort to address the problem. (Silverman, 3/15)

This first national guidance on the subject is nonbinding, and doctors cannot be punished for failing to comply. But the head of the Centers for Disease Control and Prevention, which issued the guidelines, said the effort was critical to bringing about “a culture shift for patients and doctors.” “We are waking up as a society to the fact that these are dangerous drugs,” Director Tom Frieden said in an interview. “Starting a patient on opiates is a momentous decision, and it should only be done if the patient and the doctor have a full understanding of the substantial risks involved.” (Demirjian and Bernstein, 3/15)

The CDC also recommends limiting opioid prescriptions for patients suffering short-term, acute pain to three days or less in most conditions, and says that more than seven days’ worth of opioid drugs “will rarely be needed.” “If you’re prescribing an opiate to a patient for the first time, that’s a momentous decision,” CDC Director Tom Frieden said in an interview. “That may change that patient’s life for the worse forever. So you’ve really got to think carefully before doing it.” (McKay, 3/15)

"We know of no other medication routinely used for a nonfatal condition that kills so frequently," CDC Director Tom Frieden said. More than 40 Americans die each day from prescription opioid overdoses, he said. "We must act now," Frieden said. "Overprescribing opioid, largely for chronic pain, is a key driver of America's drug-overdose epidemic." (Fauber and Stephenson, 3/15)

Prescriptions and sales of opium-derived painkillers have quadrupled since 1999. In 2014, U.S. doctors wrote nearly 200 million prescriptions for opioid painkillers, while deaths linked to the drugs climbed to a record of roughly 19,000. (McCoppin, 3/15)

The 12 guidelines, which the CDC has worked on for two years, are voluntary and have been opposed by pharmaceutical companies and doctors who say they could interfere with the treatment of patients with chronic pain. (Radelat, 3/15)

In long-awaited final guidelines for prescribing opioid pain medications, federal health officials mostly kept in place recommendations that were criticized by some as restricting access to pain relieving drugs. And so the effort to change opioid prescribing practices among primary-care physicians, who prescribe nearly half of all opioid prescriptions, is likely to face challenges. (Ross Johnson, 3/15)

The action from the CDC comes after years of study within the organization, and in the middle of a presidential race where opioid abuse has become a major issue. (Sullivan, 3/15)