Recommendations

Document Overview

Design and created by Guideline Central in participation with the Centers for Disease Control and Prevention.

Prescribing Opioids for Chronic Pain

Centers for Disease Control and Prevention

Publication Date: Mar 18, 2016

Page Last Updated: May 5, 2026

Grading System

Category of Recommendation		Evidence Type
1	Applies to all persons; most patients should receive the recommended course of action.	1	Randomized clinical trials or overwhelming evidence from observational studies.
2	Individual decision making needed; different choices will be appropriate for different patients. Clinicians help patients arrive at a decision consistent with patient values and preferences and specific clinical situations.	2	Randomized clinical trials with important limitations, or exceptionally strong evidence from observational studies.
		3	Observational studies or randomized clinical trials with notable limitations.
		4	Clinical experience and observations, observational studies with important limitations, or randomized clinical trials with several major limitations.

Document Overview

Document Title: Prescribing Opioids for Chronic Pain

Authoring Society: Centers for Disease Control and Prevention

Endorsing Society: United States Department of Health and Human Services

Document Publication Date: Mar 18, 2016

Page Last Reviewed/Updated: May 5, 2026

Document Type: Guideline

Country of Publication: United States

Full Text Freely Available: Yes

Full Text Guideline: www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F65%2Frr%2Frr6501e1er.htm

Source Citation: Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49. DOI: http://dx.doi.org/10.15585/mmwr.rr6501e1

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Scope: Assessment and Screening, Management, Prevention, Treatment

Diseases/Conditions (MeSH)

D059350 - Chronic Pain

Keywords: Opioid, Pain Management, chronic pain

Target Patient Population: patients with chronic pain

Target Provider Population: primary care clinicians

Inclusion Criteria: Female, Male, Adult, Older Adult

Health Care Settings: Ambulatory, Emergency Care, Hospital, Outpatient

Intended Users: Nurse, Nurse Practitioner, Physician, Physician Assistant

Recommendation Development Processes & Methodology

Supplemental Methodology Resource: Data Supplement

Number of Source Documents: 223

Includes peer/external review process?: Yes

Includes public comment process?: Yes

Methodologist involvement?: Yes

Patient involvement?: No

Includes multi-disciplinary group?: Yes

Includes systematic review?: Yes

Grades quality of strength of evidence?: Yes

Grades quality of strength of recommendation?: Yes

Discloses funding source?: Yes

Discloses conflicts of interest?: Yes

Includes benefits/harms analysis with recommendations?: Yes

Prescribing Opioids for Chronic Pain

Recommendations

Determining When to Initiate or Continue Opioids for Chronic Pain

Opioid Selection, Dosage, Duration, Follow-Up, and Discontinuation

Assessing Risk and Addressing Harms of Opioid Use

Grading System

Document Overview

Supplemental Implementation Resources

Document Scope, Criteria, and Use Cases

Recommendation Development Processes & Methodology