OBJECTIVES: In March 2016, the Centers for Disease Control and Prevention (CDC) released the Guideline for Prescribing Opioids for Chronic Pain to promote safer and more effective use of prescription opioids for adult patients with chronic pain outside of active cancer treatment, palliative care, and end-of-life care. We aimed to synthesize the literature on changes in opioid prescribing and pain management following the publication of the guidelines.

METHODS: We adopted the standard systematic review procedures. Studies that used real-world data to examine the impacts of the guidelines on opioid prescribing or pain management outcomes and were published between March 2016 and May 2023 were searched in five databases, including PubMed and Web of Science. Included studies were categorized based on the study population and reported outcomes.

RESULTS: A total of 23 articles met the inclusion criteria. The studies examined the impacts of the guidelines on various populations, both intended and unintended groups of the guidelines, including those with chronic pain (n=5), acute pain (n=1), any non-cancer pain conditions (n=3), cancer (n=3), surgery (n=2), and opioid-naïve individuals (n=8). The reported opioid prescribing outcomes before and after the guideline release included: the prevalence or incidence of opioid prescriptions, opioid dose, the number of days’ supply, concurrent opioid and benzodiazepine prescriptions, and tapering and rapid discontinuation. Two studies examined the impacts of the guidelines on pain-management outcomes. Except for one study that assessed the likelihood of tapering and rapid discontinuation, all of the included studies reported declines in opioid prescription practices in at least one of the opioid prescription outcomes across different populations.

CONCLUSIONS: The release of the 2016 CDC guidelines was associated with decreases in various opioid prescribing outcomes in both intended and unintended groups of patients. There is a gap in the literature regarding the impacts of the guidelines on pain management outcomes.