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"The AMA appreciates that the CDC recognizes that patients in pain require individualized care and that the agency's 2016 guidelines on opioids have been widely misapplied. The guidelines have been treated as hard and fast rules, leaving physicians unable to offer the best care for their patients.

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"The CDC's clarification underscores that patients with acute or chronic pain can benefit from taking prescription opioid analgesics at doses that may be greater than the guidelines or thresholds put forward by federal agencies, state governments, health insurance companies, pharmacy chains, pharmacy benefit managers and other advisory or regulatory bodies.

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"The AMA continues to urge physicians to make judicious and informed prescribing decisions to reduce the risk of opioid-related harms. Physicians began taking steps to reduce opioid prescribing even before the CDC released its guidelines. There has been a 22 percent nationwide decrease in prescription opioid prescriptions between 2013 and 2017, and indicators point to continued decreases.

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"The guidelines have been misapplied so widely that it will be a challenge to undo the damage. The AMA is urging a detailed regulatory review of formulary and benefit design by payers and PBMs to ensure that patients have affordable, timely access to medically appropriate treatment, pharmacologic and non-pharmacologic. The nation's physicians will work with CDC so our patients receive comprehensive, multidisciplinary, multimodal pain care based on medical science and effective clinical practice."