ASH Statement on New Opioid Prescribing Guidelines

The Society applauds the CDC for highlighting the need for special considerations for severe and chronic pain management in sickle cell disease and blood cancers

(WASHINGTON, Apr. 8, 2022) — Today, ASH submitted feedback to the Centers for Disease Control and Prevention (CDC) on the agency’s proposed new guidelines for prescribing opioid painkillers. The draft recommendations would reverse some prescribing limits outlined in earlier CDC guidelines and encourage health care providers to use their best judgment in opioid prescription. Additionally, the U.S. Food and Drug Administration (FDA) released draft guidance to support research and development of non-opioid pain therapies.

ASH President Jane N. Winter, MD, of the Robert H. Lurie Comprehensive Cancer Center at Northwestern University’s Feinberg School of Medicine issued the following statement:

“ASH is pleased to see attention paid to this issue once again, as people with hematologic disorders such as sickle cell disease (SCD) and blood cancers require access to all options for pain control so they can make appropriate pain management decisions with their providers.

In 2019, to address the opioid crisis, the CDC updated its guidelines on chronic and acute pain management to include recommendations limiting opioid prescriptions. In the guidance, there was a provision excluding individuals with SCD, blood cancers, and other blood disorders from the opioid prescribing restrictions. ASH and other medical societies partnered with CDC leaders to make this crucial provision clearer so that patients suffering acute or chronic pain from these conditions would not be inadvertently denied clinically appropriate opioid therapy.

It is very encouraging to see that this special consideration is not only preserved, but highlighted, in the new draft guidance. As a Society, we have long held the belief that every patient should have access to the pain treatment approaches recommended by their physician, and we applaud the CDC for returning the patient-clinician relationship to the forefront.

ASH believes that in the treatment decision-making process, patients and providers should be able to develop an individualized approach to pain management, including consideration of opioid and non-opioid therapies, without restriction, delay, or interference.

We have long advocated for more research into pain management strategies and options for hematologic conditions, from medications to behavioral health strategies and other multi-modality approaches. We are encouraged to see the FDA’s call for more research into non-opioid therapies, as we believe that these approaches can be important components of comprehensive pain management strategies.

ASH has created several resources to guide the development of these strategies and ensure proper care for individuals living with SCD, including a point-of-care tool for managing SCD in the emergency department and a series of SCD clinical practice guidelines. The SCD guideline on pain management includes recommendations for pain management approaches beyond and in addition to prescription medicines.

We look forward to continuing to partner with federal agencies to make sure their guidance includes considerations for the patients our members treat.”

Resources

• ASH Statement on Opioid Use in Patients with Hematologic Diseases and Disorders
• Benign Hematology Curriculum: Sickle Cell Disease (ASH Academy on Demand)
• ASH Sickle Cell Disease Clinical Practice Guidelines
• Joint ASH-ACEP Tool on Managing Sickle Cell Disease in the Emergency Department

The American Society of Hematology (ASH) (www.hematology.org) is the world’s largest professional society of hematologists dedicated to furthering the understanding, diagnosis, treatment, and prevention of disorders affecting the blood. For more than 60 years, the Society has led the development of hematology as a discipline by promoting research, patient care, education, training, and advocacy in hematology. ASH publishes Blood (www.bloodjournal.org), the most cited peer-reviewed publication in the field, and Blood Advances (www.bloodadvances.org), an online, peer-reviewed open-access journal.

Contact:
Leah Enser, American Society of Hematology
lenser@hematology.org, 202-552-4927