Terri Lewis: CDC Guideline – Not Patient Focused

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.  

 

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3 thoughts on “Terri Lewis: CDC Guideline – Not Patient Focused

  1. J K

    As a long time chronic pain sufferer (33 years), I am appalled at the “science” as practiced by the CDC.
    Their conclusion is that if I don’t have cancer, my life is not worthy of the quality that opioid meds can give me.
    Excuse me? Because I am “lucky” that I have chronic pain, because slow torture is so preferable, I have no right to meds that could be helpful?
    The CDC has no business in my doctor’s office–and no business telling a trained physician how to treat a patient with severe chronic intractable pain with legal meds.
    My doctor should be able to make that decision without the CDC, the DEA, or any other government agency’s intervention.
    She is the one who knows my case: she knows what causes the pain, and what works best to dampen it. Not the CDC.
    And she has the credentials to make the right decision. She knows that I am not a drug-seeker; I am a relief-seeker. There’s a world of difference.
    The CDC is intruding into a doctor-patient relationship. Into the world of medicine, where every patient is different, and the doctor who knows that patient, should be the best person to choose that patient’s meds.

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      I agree 100% – these new rules are irrational and will not even address the intended problem of addiction and overdoses. Only effective addiction treatment can do that.

      It’s truly unbelievable that supposedly not ignorant people came up with such nonsense. Then again, if you follow the money it leads to the extremely profitable “recovery industry”, where business is booming despite its lame <15% long term success rate.

      We've been screwed by our country.

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      Reply
  2. S. Crabtree

    I have an incurable, very rare (and painful) disease – Ledderhose disease. Mine is severe, and there is no cure to this progressive disease. Currently, about 175,000 people in the US have this, and I live in a major City and I’ve had this for 30 years. I’ve seen about 20 different kinds of Specialists, etc, and only ONE knew of it. ALL the others have never seen it, heard of it, nothing. I’ve been treated now for over 10 years by several Dr’s. and take Scheduled medication for my chronic pain. But, I had never heard of Neuroplasticity until I discovered I had permanent changes in my brain from unabated, untreated chronic pain. I soon discovered I have ADHD (adult) and some depression from my issue NOT being treated.

    The new CDC Guidelines should come with a warning about Neuroplasticity and how the brain will re-wire itself from untreated Chronic Pain. NOW – a whole epidemic of another kind, brought on by these archaic rules and regulations. Are they not speaking with Psychiatrists? Because I could not find treatment soon enough, I now suffer from my disease AND a host of other mental issues. Chronic pain “of ANY kind needs to be treated correctly” and taking 10 Advil (like I used to do) will only damage you further.

    If the CDC is ‘truly’ trying to help people, they need to speak to ALL Specialists, Dr’s who see this every day. I don’t know what I’ll do, as my mental rewiring came as a shock to me, and I now know that it was because of my rare disease, the issue getting worse, and self-treatment, all of this – causing my situation today. Each person (I’m now disabled) should be evaluated and looked over what they have been thru. I’ve been through every hoop, every test, every MRI to PROVE I had this awful junk on my feet. Progressive – great, nothing to look forward to and nothing short of Radiation Therapy (which I’ve tried and I am part of a Study at OU Oncology). So, CDC? You still want to deny me the ONLY thing that allows me some quality of life – meaning less pain every day – night?? I can only say that if you follow thru with this, you will create even MORE epidemics than you have now – and, as we all know, the ‘EPIDEMIC’ is with people taking, buying, selling these medications that “WERE NOT MEANT for them!!!” Look at the O.D. and deaths from these horrible drugs. People in Grandma’s medicine cabinet looking to get high or sell these drugs that are STOLEN!! It’s the bad apples that are going to ruin the entire crop of apples, then NO ONE gets any relief because of irresponsible people, not the disabled or ones dealing with Chronic Pain – AND the good possibility of Neuroplasticity if not treated. This is just not good enough.

    Liked by 1 person

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