RALEIGH, N.C. — A Raleigh doctor and an activist who works to bring awareness to opioid addiction have expressed mixed feelings about the Centers for Disease Control and Prevention's updated guidelines for prescribing opioids.

Dr. Douglas Briggs, the chief medical officer at Raleigh's Neighborhealth Center, says that added flexibility for physicians could help patients but that the changes announced in November could go further.

What You Need To Know

  • About 1 in 5 adults in the U.S. had chronic pain in 2019, according to the Centers for Disease Control and Prevention

  • Clinicians say opioids can limit that pain

  • A Raleigh doctor says updated CDC guidelines should give doctors more autonomy 

  • A Raleigh activist raising awareness of opioid addiction says the new CDC guidance is a double-edged sword

He notes three main changes to the CDC guidance.

He says there is a softer stance on prescribing opioids for acute pain, which was previously limited to three days. Briggs says the softer language implies an increased flexibility in the amount of opioids that can be given to patients. And there is also a new caution for clinicians to avoid abruptly stopping opioids in patients taking the medication chronically.

In 2016, Briggs said, the CDC's guidance was treated as hard and fast rules.

"I don't think they go far enough in some areas as far as giving doctors a little bit more autonomy in how they deal with their own patients that they know and they know their backgrounds and whether or not someone has had problems with addiction to opioids or whether they have legitimate pain," Briggs said.

Briggs says there are a lot of patients whose acute pain doesn’t go away in three to five days. He believes that the more clinicians can regulate the use of opioids without people turning to street drugs, the better.

According to the CDC, roughly 1 in 5 adults in the U.S. had chronic pain in 2019. Clinicians say opioids can limit that pain.

But opioid addiction is what killed one mother's son and countless others. She is putting their names up on billboards across our state to raise awareness.

Freida MacDonald says the new guidance is a double-edged sword.

MacDonald spends hours a day in her Raleigh home office looking at the names of strangers. She says people reach out to her nearly every week with the name of a loved one gone too soon.

The average age, she says, is 24. The youngest she's seen is 12.

"Their lifestyle, whether they are in any particular kind of job, none of it matters. It does not discriminate," MacDonald said.

Michael Powell is MacDonald's latest submission. He was 55 when he died.

"It's his wife that sent this in. And she said sending love and prayers to all grieving and those still struggling," she said.

One of MacDonald's sons, Stephen, was killed during a robbery.

"He passed away Jan. 26, 2012, and it was gun violence. It was a robbery and he ended up getting shot. It had a huge impact on his younger brother," MacDonald said.

MacDonald says her other son, Michael, was never the same, looking for a way to alleviate his pain.

"[Michael] then became an IV user for heroin and he ended up dying in a recovery house in Wilmington from fentanyl," she said.

From MacDonald's pain and grief, her nonprofit Know Hope North Carolina was born.

"You have to keep going, one foot in front of the other, and hope will do that for you. Hope that there's a silver lining in the midst of your storm. Hope that you can help someone that may be experiencing something like you are," she said.

To reach others struggling, MacDonald puts up billboards with the names of 100 people lost to the opioid epidemic. She has 11 of them up across North Carolina and counting.

"I have had someone as recently as last week talk to me about their inspiration they felt. To go look for sobriety, to change it up, to do something different. That they couldn't get the picture of it out of their mind," she said.

Despite all of her efforts, MacDonald is conflicted about how to solve this crisis, especially after learning the CDC updated its guidelines.

"​It has its advantages, and harm reduction is one of those advantages because if people can't get what they need and they go to the streets and there's fentanyl on the streets, we're losing lives," MacDonald said.

The tricky part, she says, is making sure opioids don't get abused, because the last thing MacDonald wants is for more names to end up on her billboards.

"We have made improvements since I lost my son and I think it is so important to not give up because there is always hope," she said.

The North Carolina Department of Health and Human Services provides information on drug addiction support and referrals.