Dear Fellow Officers,
Today, the U.S. Department of Health and Human Services (HHS) published a new Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Long-Term Opioid Analgesics. Individual patients, as well as the health of the public, benefit when opioids are prescribed only when the benefit of using opioids outweighs the risks. But once a patient is on opioids for a prolonged duration, any abrupt change in the patient’s regimen may put the patient at risk of harm, and should include a thorough, deliberative case review and discussion with the patient. The HHS Guide provides advice to clinicians who are contemplating or initiating a change in opioid dosage.
The HHS Guide emphasizes that care must be a patient-centered experience. We need to treat people with compassion, and emphasize personalized care tailored to the specific circumstances and unique needs of each patient. This Guide provides more resources for clinicians to best help patients achieve the dual goals of effective pain management and reduction in the risk for addiction.
Compiled from published guidelines and practices endorsed in the peer-reviewed literature, the HHS Guide covers important issues to consider when changing a patient’s chronic pain therapy. It lists issues to consider prior to making a change, which includes shared decision-making with the patient; issues to consider when initiating the change; and issues to consider as a patient’s dosage is being tapered, including the need to treat symptoms of opioid withdrawal and provide behavioral health support.
As public health professionals, all Commissioned Corps officers should be aware that the HHS Guide is a resource for clinicians.
Sincerely,
Brett P. Giroir, M.D.
ADM, U.S. Public Health Service
Assistant Secretary for Health
Senior Adviser, Immediate Office of the Secretary