Congress Questions CDC: Who Drafted Controversial Opioid Guidelines?

Congress Questions CDC: Who Drafted Controversial Opioid Guidelines?

The scrutiny of the CDC decision-making in developing its opioid guidelines has now spread to Congress.

In a letter to CDC Director, Thomas Frieden, the U.S. House Committee on Oversight and Government Reform writes it is investigating whether CDC’s “Core Expert Group,” which was responsible for drafting controversial guidelines for prescribing opioids, is compliant with the Federal Advisory Committee Act (FACA).

“CDC has not provided clear information regarding the ‘Core Expert Group’s’ role,” the letter stated. “To date, CDC has not identified the group’s 17 members.”

“In its draft ‘Guideline for Prescribing Opioids for Chronic Pain’ the CDC notes that it ‘recruited a Core Expert Group … to assist in interpreting the evidence and translating the evidence into recommendations.  CDC also stated that Core Expert Group “members provided individual consultation and were not part of a designated Federal Advisory Committee,” the letter continued.

“We expect CDC’s guideline drafting process to seek an appropriate balance between the risk of addiction and the need to address chronic pain. The CDC has utilized a ‘Core Expert Group’ in the drafting and development of opioid prescribing guidelines, raising questions whether CDC is complying with FACA,” wrote Representatives Jason Chaffetz (R-UT), Elijah Cummings (D-MD), Jim Jordan (R-OH), Matt Cartwright (D-PA), Mark Meadows (R-NC), and Gerry Connolly (D-VA).

CDC has until January 5, 2016 to produce the following information to the House Committee on Oversight and Government Reform:

  • Documents related to the selection process CDC used to identify its Core Expert Group to “include the identity and affiliation of group members and efforts of CDC to ensure that the composition of the Core Expert Group was balanced in terms of points of view expressed by members of the group.”
  • All documents related to its behind-closed-doors meeting in Atlanta
  • All documents given to CDC by members of the Group
  • All documents related to CDC’s compliance with FACA
  • A description of the process CDC used in getting input on the guidelines

CDC has also been asked to provide a briefing to the Committee by January 8, 2016.

CDC recently opened its Draft Guidelines for a second public comment after mounting criticism by chronic pain advocacy groups, as we reported. You can find tips and instructions on how to comment on the CDC Draft Guidelines here.

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Authored by: Staff

There are 11 comments for this article
  1. Karen S at 4:40 pm

    There are good comments here. I am thankful, though skeptical, that we have a mouse in the ear of Congress.
    All I can add is this…what good has it done the people, citizens of our United States, whether legitimate pain patients (you can have acute or short term pain, now, and the ER will send you home with ibuprofen), or, much less, those of us in chronic pain, or a real addict…how have these laws helped any if us?

    We cannot get medicine, are treated worse than criminals on probation (I have to pee in a cup more often than they do) and endure hurtful, sarcastic, burning remarks from doctors. Even family members strain to understand our pain and are stressed and burdened by constantly doing for us. With medication, I can do my own housekeeping, shopping, even exercise. Without medication, I lie in bed in order to keep down my pain level. I am rotting away in bed.

    Real drug addicts…how have you helped them? By letting heroin become the most plentiful, cheap, dangerous street drug to flood our cities and towns? Along with the illegal element, the drug runners, the gang wars, the shootouts in the street, these human beings are overdosing and dying at an embarrassing rate for the “greatest country in the world.” They deserve treatment, also. But, they are seen as less than human, of no value or worth to the crusty elite.

    The Drug War is a business, just like your real wars. But, since you, the government, cannot stop it, like prohibition was a failure, would it not be healthier and less dangerous to take the criminal element out if the equation? Isn’t it better to have prescription pharmaceuticals on the street, than heroin and gangs? I know our soldiers are guarding the poppy fields in Afghanistan. It’s time they came home.

    The government, politicians, have hijacked the doctor/patient relationship. You have cut the legs right out from under the MDs…when Kentucky passed their version, HB1, I had 4 Primary Care Physicians close up shop. Not because they were bad doctors, because you took away all the rights and the sanctity of the doctor/patient relationship, and the doctors’ own rights of practice.

    Here is a section of the AMA’s Code of Ethics…it concerns putting a patient’s suffering above the doctor’s own welfare. In other words, you’ve scared the bejesus out of them.

    “Opinion 10.015 – The Patient-Physician Relationship

    The practice of medicine, and its embodiment in the clinical encounter between a patient and a physician, is fundamentally a moral activity that arises from the imperative to care for patients and to alleviate suffering.

    A patient-physician relationship exists when a physician serves a patient’s medical needs, generally by mutual consent between physician and patient (or surrogate). In some instances the agreement is implied, such as in emergency care or when physicians provide services at the request of the treating physician. In rare instances, treatment without consent may be provided under court order (see Opinion 2.065, “Court-Initiated Medical Treatments in Criminal Cases”). Nevertheless, the physician’s obligations to the patient remain intact.

    The relationship between patient and physician is based on trust and gives rise to physicians’ ethical obligations to place patients’ welfare above their own self-interest and above obligations to other groups, and to advocate for their patients’ welfare.

    Within the patient-physician relationship, a physician is ethically required to use sound medical judgment, holding the best interests of the patient as paramount. (I, II, VI, VIII)

    Issued December 2001 based on the report “The Patient-Physician Relationship,”PDF FIle adopted June 2001.”

    I have lost count of the doctors who refuse to treat me, because injections are of no help to me. Well, all the money is in surgery and injections. A urine drug scan at my clinic is nearly $400…each month, until recently… I think Medicare must have got on them for excessive testing…or the Clinic thought they would catch people off guard. They have the prescriptions written out a day ahead…before the exam, NO consultation, minds made up before patient walks thru the door!!!
    Is this what my hard earned Medicare dollars are paying for? $350 office visits, $400 urine tests, and who knows how much the injections cost.

    Please! Get the snake back in the jar.

  2. Kathy Cooper at 11:59 am

    I just want to put my 2 cents in here. I have been bored and following different Stories online. This current CDC thing is just another in a series of non scientific, and Industry guided attempts to undermine Health Care, and increase profits for Insurance Companies. This also undermines our Rights, allows Acute and Chronic Pain to be Ignored “for our own good”. The mistreatment of Chronic Pain, and the current “misunderstanding” and failure to apply Science based, solutions, Facts, and even relevant statistics is just another ploy to increase profits for the Insurers, avoid responsibility by the Medical Industry and alienate another group of people.
    I have been following some diverse stories, from the Workers Comp party in Las Vegas, to the the Classification of Chronic Pain as a Psychological Condition in the DSMV, The Bible of Psychiatrists. There are also Articles about the Millions of Americans who have drunk themselves to death, and a staggering number of people who have died due to Suicide or Drug overdoses. The Political Attacks against Health Care reform where they claimed there were would be “Death Panels” if the U.S. adopted Universal Health Care. Even the Movement for “Tort Reform” which was to limit the amount of damages in Lawsuits, which was a well funded false “Grassroots Movement”, where they took a Non issue and blew it out of proportion, in order to limit the liability of Corporations. The Media has been misleading us, Playing a False Narrative of what we should be concerned about.

    The mainstream Media has been Sensationalizing the “Opiate Epidemic” and failing to do any kind of Investigative Journalism.. Nearly every one of the Mainstream Media Articles and Opinions has linked Chronic Pain and Addiction. They have a basic Narrative about the Horrors of Opiate addiction and then Blame it somehow on Chronic Pain Patients. They use misleading and false Data and Statistics to make it appear they are reporting the “Facts”.
    This Narrative has led to people with real pain that has been diagnosed to be the targets of anger, and contempt. The fear of prescribing and “addiction” has led to the failure to even diagnose pain. Pain Patients are referred to Steroid Shot Clinics ( which are very Profitable, yet there is no evidence that they are helped while there is evidence they are harmed). Pain patients are also told to seek Psychological Help, instead of Pain treatment. This is to postpone any kind of treatment. The implication is that pain is a Psychological issue, or the expected depression treatment will magically remove the pain. This process can take years, and the pain untreated can become worse. While this is going on and the pain is untreated. In the meantime the person with the Pain often loses nearly everything. The can’t work at the level they did before the pain, and their savings are spent pursuing treatments that Insurance does not cover. They lose their income, their friends, and even family. The pain isolates them from social activities. People just don’t understand when a Pain patient has to cancel plans, avoid situations, pace themselves and ration their time because of pain. It becomes a subject to be avoided, because a pain Patient learns to avoid mentioning it, because that will open them up to well meaning but misguided “Advice”, Judgement and even anger. The Pain Patient can no longer participate in life the way they did. They lose their dignity, because they have to try to find treatment, and often they are ignored, trivialized and misdirected. The mainstream media tells us people who don’t work are moochers, and attacking our way of life. No one would chose this life. We are bombarded with negative stereotypes, Sensationalized stories of people gaming the system, drug addicts, and malingerers. The Medias false narrative can trigger hatred for an innocent toddler, so it is not a stretch to see the anger directed at Pain Patients.

    I try to ask the question, Who Benefits? Workman’s Comp would make millions from denying Chronic pain, they have millions of dollars for Lobbying, and have been at this for the long haul. Pharmaceutical Companies also benefit, the alternative medications they are pushing for pain, are newly Patented and very expensive. Of course the Insurance companies, if they deny the Medications and treatments that allow chronic pain patients to function, they stand to make Billions. Government Agencies that depend on sensationalism for their funding, like the DEA, the CDC gain by denying basic rights to people, while getting grants to fight an imaginary problem. The Media does not mention the industry ties to lobbyists, and their companies. The recent CDC “Guidelines” are another attempt by big business to undermine aspects of healthcare for profit. The CDC has had some enormous failure lately. The failure to use accurate statistics for other Health Concerns. Going after Chronic Pain patients that have already been vilified, and blamed for the “opiate epidemic” will make it appear they are protecting our health. The So called “Opiate Epidemic” is due to failed drug Policies, corruption, and a significant number of people who have no hope. These are social problems, due to years of economic disparity, lack of opportunity, and a failed system. These issues are too broad to fit in a sensationalized, and simplified mainstream news Article.

    I wish i had more energy to write a more cohesive response. I saw my Surgeon yesterday, and he told me that another operation on my spine for the current pain and nerve issues, would have a high failure rate. The surgery has a 20 percent chance of making the pain worse. He referred me back to pain management instead of surgery. Only when the pain and nerve compression in my left arm become worse, basically when I can’t use my left arm anymore, should I consider surgery. I have already had 2 spinal surgeries, but the Pain persists. He can’t magically do any surgery to fix this. All i can do is avoid stress and activities that aggravate the pain. Due to the area I live in and the current lack of Pain Physicians I have to drive nearly 200 mile round trip for any treatment. I know people form other States that have to travel further. The State I live in has already placed Guidelines, and requirements which led to a lot of Physicians no longer treating Pain. My Pain Physician already follows strict guidelines, very stringent documentation rules, and State Regulations. The problems is not in the Strict Guidelines, it is the misinterpretation and ignorance.

    Many Chronic Pain Patients are subjected to this

  3. John S at 11:16 pm

    Kerry, 29 years of pain, humiliation, lies, fear, Dr’s that refused to even give me an examination and a society that looks at us like cry babies that can’t handle some discomfort

    Most all of my adult life has been pure torture but I was fortunate to find a Dr. that makes me comfortable with medicine. I want no one to feel sorry for me, all I want is for my Dr to be permitted to treat me in the future in the same manner he is today. This so called Epedemic won’t change over night. Yes we do need to reach out to our elected officials so they know the effect any new Guidlines will have on our life. Just keep in mind – their will be changes and they won’t be what we all want / to be given the proper medical treatment along with the medication that has worked for us in the past. After 12 operations I have a pretty good idea about how pain has affected my life and the thought of my future treatment being left in the hands of politically correct politicians scares the hell out of me.

  4. Kerry at 10:30 pm

    John, for anyone who has gone through the hell of pain and the insults that those in high places have heaped upon them understands, this in no way is a celebration of the completion of anything. It is very simply an opportunity to express to those who may now finally be just a little more open to hearing from us than usual. That is all that it is. What we do with this opportunity and the results thereof are entirely left up to us, the suffering pain patients.

  5. John S at 8:31 pm

    Its a nice article and its good to hear that somebody is paying attention to the CDC.

    Before we uncork the champagne and light the fireworks lets wait to hear just exactly what it is congress is looking for from the CDC and the next version of the guidelines. FACA might just be a step the CDC didn’t take when the first draft was written and submitted.

    Yes, they are giving folks like us a chance to voice our position on their website ( please do not forget to pass your thoughts along ) and there will be another version of the guidelines. Lets wait till the egg has hatched before we call it a chicken and remember; when was the last time the government was there to make sure the people that need opioids get them ?

    Does anyone think the CDC will ‘ reverse or water down ‘ what was in the first draft ?

    Thank you,

    John S

  6. Amy Vallejo at 5:44 pm

    CRPS is the most debilitating pain condition I’ve had the non pleasure of having. It comes with a long list of comorbid conditions to compound the issues. I live 24/7 365 days a year plus leap year because we don’t get a break. I have tried SCS which causes my condition to spread. I’ve tried massage which landed me into the ER because my autonomic system doesn’t work properly anymore. I’ve tried meditation, soothing music, essential oils, change in diet and exercise (only Pilates) to try and ease my pain due to #undertreatedpain
    This war on drugs is going to kill more people than help. To live like this is should be a crime. To purposely not treat my pain as a dr should is torture. I suggest you get to know the CRPS/RSD community and encourage the CDC,DEA and anyone else to help us find a cure so we don’t have to take meds to have any type of quality of life. People can’t live in this much pain without the proper treatment. We are all different an require different meds. Some metabolize quicker others have gastroparesis so meds aren’t absorbed like a normal person taking meds. We need research and pain relief for our community along with other chronic pain conditions (which I have those too)
    The deaths in our community will be on the governments hands and WE will take this to the supreme courts if needed. #painedlivesmatter
    #crps

    PS in our group we have two 12 yr olds, one 16yr old and a 14yrs old who should be able to get medications to help not make CRPS worse. SCS is a 50/50 chance to help or make things worse. Then the need for opioids increases if it is made worse. People talk about cancer pain is worse?? On the McGill pain scale CRPS is more painful than amputation of a digit, untrained natural child birth and non terminal cancer. What would you do if your child or a loved one was in this much pain???? Seriously to what extent would you go to if the Doctors hands are tied to save your child’s life?

    Someone must stop and listen to us!!!!

  7. Kristine (Krissy) at 12:03 pm

    So relieved to hear this. We are breaking through the barriers! I will write to my representatives and mail it by tomorrow, or submit online if I can.

    Thanks, Kerry, for the helpful words. Hope people are reading the comments. It might make a good idea to publish yours and some of the others that come in in a story on NPR.

  8. Heather at 10:11 am

    THANK GOD we have advocates! Please folks, now is the time to advocate for yourself!

    I’m in need of information on the means to comment on the CDC’s guidelines. Is this done online or by mail? I’m eager to do this and have been gathering my thoughts. I also want to send a letter to the state representative. I’ve written to Bernie Sanders because I thought I saw him as a potential advocate or at least a level-headed person on the issue but after the debate on Saturday, I’ve just been reeling.

    The CDC has ALREADY done damage, as has the 60 Minutes reports. We need to work together to try to minimize damage. NPR — give us ALL you’ve got on who we can write to to make a difference now, because we’re going to lose our chances. Please remind us again after the holidays.

  9. Scott michaels at 9:55 am

    I hope people write to these congress people asap. We all mst realize that the CDC AND PROP HAS LIED AND LIED ALREADY. THEYRE NOT GOING TO STOP NOW.
    THE 25 MILLION OF US NEED TO BE HEARD. THE ONLY VOICES BEING HEARD ARE THOSE OF ADDICTION SPECIALISTS AND INSURANCE.COMPANIES THAT BOTH HAVE HUGE FINANCIAL GAINS TO LOOK FORWARD TO IF THESE GUIDELINES.GET PASSED.
    THERE WERE NO VOICES HEARD FROM THE CHRONIC PAIN COMMUNITY. THEY NEED TO KNOW ITS JUST NOT CANCER PATIENTS THAT SUFFER. ITS INJURED WAR VETERANS, ELDERLY AND THOSE WITH.MANY CONDITIONS THAT CAUSE US TO NEED OPIOID THERAPY

  10. Kerry at 9:39 am

    So look, here is what we can do. The CDC is no doubt feeling the heat now from Congress. We need to write our individual congressional representatives and ask for fairness in how we are cared for as chronic pain patients. We need to share our stories of what has happened and ask them to consider fair and honest guidelines that will take into account our needs as patients as well as safeguarding against the misuse of narcotic pain medicine. We need as well to ask them to release the names of the folks who are on the CDC advisory committee which should be done anyway without hesitation. Please folks, let your representatives know of your issues and your story. It seems that a door is cracked right here but we need to not allow our emotions to run rampant in what we are saying. They need to simply know what is happening to us and please reference this story so that even representatives not a part of this meeting can share your story with those representatives involved the decision making. Friends, we can do this. It is an opening that we have wanted and they need to hear our story!!!!