RICHMOND, Va. (WRIC) — Attorney General Jason Miyares joined ten other states in sending a letter to the CDC, expressing concern over the CDC’s proposed opioid prescription guidelines.

“The opioid epidemic has touched the lives of Virginians in every corner of the Commonwealth. To defeat and prevent it, we must address each way individuals can fall into addiction,” Miyares said. “Diverted drugs are a low risk and convenient way individuals access opioids.”

CDC’s National Center for Injury Prevention and Control announced in February that it was in the process of updating the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. 

On February 10, the new draft was made available for public comment in the Federal Register. The public comment period was for 60 days and ended on April 11.

The 200-page document features a number of results from research studies and recommends amendments to the 2016 guidelines.

The concerns of Miyares and the other Attorneys General are specifically focused on “diverted drugs.”

Diverted drugs are drugs that are sold legally but come into the possession of users without a prescription. Such as an individual taking leftover opiates from a friend or family member that was prescribed them due to a recent surgery.

Diverted drugs play a massive role in the opioid epidemic. According to Miyares, a 2016 study found that 71% of Americans who abused opioids received their drugs through diversion.

The Attorneys General letter suggests:

  • Opioids should not be considered as a first-line treatment.
  • The CDC should recommend that prescribers administer toxicology tests for patients with long-term opioid prescriptions.
    • These tests would help to prevent overdoses and identify patients that are not taking their medication, risking diversion.
    • The CDC concedes these tests are inexpensive.
    • These tests could be recommended in areas where the opioid crisis, and therefore the risk of diversion, is particularly severe.
  • In addition to recommending physicians prescribe the “lowest effective dosage,” the guidelines should consider the physical quantity of pills prescribed.
  • Previous guidelines issued in 2016 explicitly recommended time limits on opioid use for the treatment of acute pain.

Some of these suggestions — such as toxicology tests and diverted drugs — are addressed in the CDC’s draft document.

In the letter from the Attorneys General, they concede that “overall, many of the CDC’s practice guidelines reflect reasonable medical judgments about opioid use that reflect a serious approach on the CDC’s part, too. Still, we believe that the Proposed Guidelines are insufficient to prevent abuse and diversion.”