We, the undersigned patients, would like to take this opportunity to provide input to the CDC as it relates to the proposed opioid guidelines for the treatment of chronic pain. As people living with chronic pain we know better than anyone what works, what doesn’t, and what the barriers are to receiving effective treatment. The 2016 CDC opioid prescribing guidelines failed to recognize one of the most important therapies for patients like us - interventional pain procedures. While conservative treatments such as physical therapy, chiropractic care, and acupuncture can help some patients, many of us require more specific and sophisticated treatments. We understand the issues inherent in using opioids better than the individuals who crafted the 2016 guidelines. The majority of us prefer to avoid using opioids if at all possible and just want to be able to function on a daily basis.

Over the years we have tried many treatments for pain management and have received significant relief from the interventional treatments by my pain management physician. Many of us have also benefited from such procedures and injections and blocks, radiofrequency procedures, implantable medication pumps or implanted neuromodulation devices when simpler measures did not work. Without these interventional treatments from my pain physician we would not be able to function and would be forced to take higher dosages of opioids.

We also understand the value of the expertise a specialist pain physician and bring to a chronic patient’s treatment team. We urge the CDC to recommend in the next guidelines that patients who are suffering in pain for more than 3 months be referred to an expert pain specialist for evaluation and possible treatment.

One of the biggest problems we face as chronic pain patients, is insurance denials for doctor-recommended treatments, which leave us to try to find ways to cover the cost ourselves or to suffer in needless pain. We urge the CDC to not overlook this important set of treatments as you develop the next version of these guidelines. The CDC guidelines are very influential and have the power to help us advocate for the many Americans who suffer from chronic pain. By including an evaluation of these safe and effective interventional treatments as an alternative to opioids in the next guidelines, the CDC can help ensure that patients in pain have better access to these opioid-sparing therapies.

Thank-you for considering our comments,