Opinion: CDC Guideline – Not Patient Focused – National Pain Report – Terri A Lewis, Ph.D.
These guidelines are predicated on the notion that pain should be addressed differently based on whether it originates in a cancer diagnosis, which then supposes the necessity for palliative care models. That is a faulty heuristic.
There is no functional difference in chronic pain that originates from any source.
I’m so glad a professional finally said this. Cancer isn’t some magic illness that causes a higher degree of pain than other physical injuries. There is no reason it should be treated differently than other pain.
The main difference between cancer pain and chronic pain is that cancer pain *seems* to have an obvious cause but lately, even cancer patients have come under scutiny for opioid abuse – see Risk of opioid misuse among cancer patients is substantial.
Large burns cause the worst possible pain, yet even for that opioids will soon be restricted by law, as these horribly flawed and biased guidelines will probably become the law.
Our biology imposes chronic pain as an organic adaptive response to injury or illness.
Imposing the label gives us permission to withhold palliative treatment from one group over another, which is not ethical. In fact there are almost no conditions of chronic pain that will not be present at the death of the individual; cancer is not the arbiter for length of life.
The damage caused by the politicization of treatment for chronic pain and co-mingling of treatment approaches with addiction models has already been accomplished – the damage is done.
Patient dumping is occurring as we speak.
The guidelines and state laws provide us with directives that have no measures of effectiveness. The evidence for their application is admittedly of low quality
As written, we cannot know whether they will achieve their intended effect for reducing overdose deaths – which seems to be the primary concern. There is no way to determine whether a reduction in prescribing will lead to better patient outcomes except through monitoring and case investigation – which our scientists at CDC are loath to do
So we are still left with the very significant problem of developing evidence for the effectiveness of these regulations.
This is a tremendous opportunity to learn on many levels. The question is whether the risks to patients outweigh the benefits to the public at large. There is almost nothing that is less fruitful or fair than forcing persons who have grave pain related conditions to live without effective care.
Is suicide more publicly acceptable when conducted by methods other than opiates? What about the ongoing family stressors imposed by caring for a loved one who is underrated for their chronic health condition? We already know how family health is negatively magnified by stressors that increase and hasten the onset of stress related disease processes.
Time will tell how we truly value the projected outcomes. It shouldn’t take too long for results of these policies to reveal themselves.