Waiting for CDC Decision: Anger, Nausea, and Fear
I’ve been living with the constant slight nausea of anger and fear since September 16, 2015. On that day, the CDC suddenly leaped to the lead of the campaign against opioid pain relief.
Totally out of character and out of the blue, these bureaucrats hastily cobbled together an unreasonably strict set of guidelines for prescribing opioids and, only after the fact, gave a limited audience a quick peek at the harsh and draconian rules.
What a shock that was.
This highly regarded, influential agency single-handedly released premature, unscientific, and biased rules about opioid prescribing without any of the required public announcements or reviews. News of this audacity was met with a combination of disbelief and fear; disbelief that the CDC would so suddenly, without any prior notice, inflict such arbitrary rules on doctors, and fear that doctors would actually be forced to follow them.
It was later determined that PROP (Physicians for Responsible Opioid Prescribing, an anti-opioid group of doctors) had suggested and initiated these guidelines, and the CDC just went along. The content of the guideline was at least partly written by PROP, with parts lifted directly from their own propaganda.
The CDC is supposed to warn me of dangers and give me non-partisan advice to help me avoid them, not just sit back and let a special interest group first prod them into action, and then take over the process.
These guidelines force doctors first to delay giving opioid pain relief and then to adhere to an arbitrary universal dose limit, as though all patients and all pain were the same.
Despite all the real-life variables, patients are to be treated generically. The dose limit and 3-day prescribing limit apply equally to a tooth extraction or a crushed pelvis, a broken nose or a broken spine.
There is no urging to tailor opioid treatment to an individual, even though this is the most effective (for pain) and safe (from addiction) approach to the wide variety of chronic pain and diversity of patients.
The evidence given to support the guidelines is blatantly distorted, statistically incorrect, and exclusively focused on addiction, even though the guidelines apply only to prescribers who are trying to help their patients with pain. Promulgated by PROP, the addiction model insists that anyone taking opioids for any reason is addicted to them.
If this were true, every one of the millions of people who receive post-surgical opioids would be addicted, and thus, according to all the scary propaganda, on their way to being destitute, homeless, and dying in the streets. There are millions of people who take opioids for a while and then stop without giving it much thought, but PROP’s president and founder gleefully ignores all evidence contrary to his dogma.
PROP has its fingers in everything having to do with opioids these days, steering guidelines, influencing rules, spreading false propaganda, and even enticing a federal agency to break government rules of conduct. (CDC was reprimanded by Congress) PROP cleverly gained control of the opioid conversation early on and has managed to limit its focus to opioid addiction, barely acknowledging opioids’ role in pain relief.
PROP supporters disparage those of us that use opioids to treat our pain, which they preemptively dismiss as insignificant. This utter indifference to my pain infuriates me.
I’m angry that there are so many people out there that that don’t believe my pain is intolerable without opioids, that they truly believe “it’s not that bad” and that I should “get over it” and that I should be “used to it”, oblivious to their own cruelty in so casually dismissing my pain
We are urged to swap the opioids we’ve been depending on to make our lives worth all the painful trouble, for treatments like psychotherapy. In the recommended CBT sessions, I’m taught that my thoughts are the source of my pain and that by controlling my thoughts I can gain control over my pain. Ha! If only it were that simple.
In the end, already squirming in pain, thinking that I’m in pain, thinking painful thoughts, thinking about thinking painful thoughts… and then I realize it’s just another way of blaming me for my pain, implying I should be mentally strong enough to control my pain with my thoughts.
And that sends me into a whirlwind of rage. I (and all other patients) know that, if it were the pain of our critics, they would feel so very differently.
I’m so tired of being angry about my situation as a pain patient. Angry that I need opioids to retain some quality of life, angry at being dismissed as a drug addict, angry that some people are trying to force me to abandon all hope for relief.
I’m angry, furious and frustrated about the guidelines, the idiocy they represent, the wild media distortions of the topic, the prideful ignorance of people who have undue influence in our society.
I’m exhausted from the frightened thoughts swirling around in my head all the time, wrung out from trying to untangle knots of specious arguments, worn out by attempts to use logic and reason with those that resist it.
So here I sit, waiting for “the last word” from the CDC, nauseated, with a rising tide of anger and fear.