By Pat Anson, Editor

The Centers for Disease Control and Prevention won’t disclose how much it is paying a Seattle-based public relations firm to provide research and analysis of the agency’s image in the pain community.

Nor will the CDC say why it hired the company – called PRR – as an image consultant.

“After consulting with our procurement and grants office, CDC isn’t able to discuss the specifics of this contract because it is an active procurement,” said CDC spokesperson Courtney Leland in an email to Pain News Network.

A spokesperson for PRR also declined to say why the firm was hired. But a source at the company indicated the primary reason was to analyze why the CDC’s opioid prescribing guidelines were so poorly received in the pain community and to find out "where they’ve gone wrong.”

“They’ve heard a lot of outrage about this,” the source said. “And so they hired our firm to gauge those perceptions and talk to people and come back to them with an analysis of what those perceptions are.”

In recent weeks, PRR has been contacting “thought leaders” in the pain community to gauge their reaction to the CDC guidelines. This reporter was among those contacted and participated in a short telephone survey involving 10 questions, such as these:

“What about these guideline recommendations are worrisome to you and what about them are encouraging to you?” 

“Are these guideline recommendations a step in the right direction, in your opinion, or do you think the CDC is panicking?"

"Are these recommendations going to help solve the prescription opioid addiction problem?”

We gave PRR the names and contact information for about a dozen activists in the pain community who also wanted to participate in the survey. But we were later informed by PRR that the company “completed the required number of interviews, so we will not interview these individuals at this time.”

PRR handles communications, marketing and public relations for dozens of public and private organizations, including Starbucks, the Environmental Protection Agency, Waste Management, Nike, and the University of Washington. With offices in Seattle, Washington DC, Austin, TX, Norfolk, VA and Portland, OR, its services probably don’t come cheaply.

“To advance your vision and deliver meaningful results, we develop strategic marketing plans that can transform the marketplace, or an individual’s behavior. With multiple disciplines at our disposal, we can gather market intelligence and create strategic plans to achieve your goals,” PRR says on its website.

The CDC has been roundly criticized for its secrecy and lack of transparency in developing the opioid guidelines – which discourage primary care physicians from prescribing opioids for chronic pain. Since the guidelines were released in March, many pain patients have been taken off opioids or weaned to lower doses by their doctors. Others have been discharged by their doctors or coerced into more invasive pain treatments, such as spinal cord stimulators or epidural injections. 

A survey of pain patients released this week found that three out of four believe their pain is not being adequately controlled. Over half said they have contemplated suicide since the guidelines were released.

Virtually all of the nearly 2,000 patients surveyed – 97 percent – said they have never been addicted or required treatment for drug abuse. Reducing abuse and addiction are the primary goals of the CDC guidelines.  

Guidelines Webinar

The CDC also isn’t saying much about its decision to hire the University of Washington to help the agency conduct a series of training webinars this summer for healthcare providers to learn about the  guidelines. The agency did not say how much it is paying the university.

“Faculty and clinicians from the University of Washington School of Medicine were contracted to provide didactic and case-based training content and demonstrate and instruct providers on application of the Guideline in clinical settings,” Leland said. “University of Washington has had prior experience developing and disseminating clinical case studies to facilitate learning among clinicians on pain management for patients.”

Three of the four faculty members who have participated in the webinars are affiliated with Physicians for Responsible Opioid Prescribing (PROP), an organization that has lobbied the federal government for years to reduce opioid prescribing.

Jane Ballantyne, MD, is PROP’s president, and Mark Sullivan, MD, and David Tauben, MD, are PROP board members.

The fourth faculty member is James Robinson, MD, a professor of rehabilitation medicine who appears to have no association with PROP.  

“I believe in a rehabilitative approach to chronic pain,” Robinson is quoted as saying on the university’s website. “Key elements of this are empowering patients to optimize self-management of chronic pain disorders and encouraging them to take as much responsibility for self-management as is feasible.”

The University of Washington Medical Center received over $17.2 million last year for research, consulting, and grants from dozens of drug and medical device makers, many of which are involved in the field of pain management. Ballantyne, Sullivan and other faculty members at the university have previously played key roles in developing opioid regulations in the state of Washington, which has some of the toughest prescribing laws in the nation.

Since everyone chosen for the webinars appears to have a bias against opioid prescribing, we asked CDC why the agency was either unwilling or unable to have a more diverse panel of speakers. We were told CDC provides “timely, accurate, and credible information to clinicians.”     

“This webinar series was developed to be a continuing education training opportunity to increase clinicians’ knowledge and competencies on prescription drug overdose and offer evaluation and management strategies to help address the issue,” Leland said.

During a webinar held on Wednesday, the primary advice given to physicians was not to prescribe opioids for chronic pain and to taper patients off opioids if they’ve already started.

“A successful taper makes a patient much better able to function. And generally their experience is the pain level either doesn’t change or is actually improved,” Ballantyne said.