Medicare to restrict opioid RXs – doctors predict danger

Medicare wants to restrict opioid RXs, but hundreds of doctors predict dangerous results – March 28, 2018 – By Allison Maass

I’m happy to see that the media seems to be noticing that these restrictions are brutally damaging to patients.

Chronic pain patients receiving opioids through Medicare and Medicaid might soon be cut off, and hundreds of doctors are warning the agency that doing so could have dangerous consequences.  

The Center for Medicare and Medicaid (CMS) announced plans to restrict opioid prescriptions to a maximum dose equal to 90 milligrams of morphine a day. For a popular opioid like hydrocodone, that would be about nine pills.

“This is just a knee-jerk reaction,” Dr. Ajay Manhapra, an addiction medicine fellow at Yale University, said. “One thing is assured, a lot of people on long-term opioids are going to suffer quite a bit.”

Dr. Manhapra helped write a letter to CMS outlining the possible negative effects the new policy could have on chronic pain patients who are already prescribed more than the restricted amount, which according to CMS data is over 500,000 people.

That’s half a million people, enough that if every one of them could protest, there would be a tsunami of opposition.

People with these complex set of problems will be abandoned, and they’ll be either bed-ridden, or a lot of them will likely have adverse medical outcomes. They will have adverse psychiatric outcomes. There will be increased suicide among them,” Dr. Manhapra said.

Now, the letter has received at least 220 signatures, including eight officials who helped develop the 2016 Center for Disease Control guidelines on prescribing opioids.

It doesn’t seem plausible that the group of supposedly smart people who wrote the guidelines didn’t know they would be used to make hard rules.

They must have known how America would react by simply doing more of what didn’t work before: prohibition.

If this anti-opioid reaction was truly unintended, the guideline would have explicitly specified that this document was NOT to be used for “standard rules”.

If they really didn’t know what would happen, they are grossly ignorant or stupid. If they did know (which I strongly suspect, considering PROP’s influence), they are grossly malicious.

One of those officials is Dr. Jane Ballantyne, and she said the proposed CMS policies are “too ruthless” for those patients who are already dependent on opioids, which is something the CDC guidelines had factored in.

The CDC guideline does make note that if somebody is already taking opioids that those rules don’t really apply because they already are taking opiates, and therefore they are already opiate dependent, and you can’t just cut them off if you wouldn’t have given them opiates in the first place,” Dr. Ballantyne said.

She acts like she couldn’t have predicted this misuse of the guideline, but I doubt that because she has made her career from opposing opioids.

“If we just tried to reduce everyone who is already on high doses of opiates to the dose level that the CDC is recommending, you would have an awful lot of people who are either suffering a lot or going to the street to get heroin, neither of which is a very good result,” Dr. Ballantyne said.

Her professed ignorance about how the guideline would be used to torture pain patients, even as she was a central player in their development.

In 2016, one-third of Medicare Part D patients had been prescribed an opioid, according to a Health Department Inspector General report published in 2017.

Dr. Manhapra said nobody in the letter is denying the widespread abuse of opioids and the harm it has caused, but since many states have already enacted laws meant to reduce the number of opioid prescriptions, so the new CMS policy would only take pain killers away from people who actually benefit from them.

People who are going to use heroin and fentanyl are gonna go ahead and use it.

Why do they know and say this now, not while the guideline was being developed, and not when it was first used as a “standard” for all patients?

People who are really dependent on opioids, because there is no access to treatment, they are gonna move on to heroin.

The only set of people this is going to affect those who are stable on this medications,” he said.

Since 2012, the number of opioids prescribed in the U.S,. has steadily decreased while the number of fatal drug overdoses has continued to increase.

I read about this fact several times each day in the articles I peruse, yet no one in authority seems able or willing to act on it.

We need that guideline to be annulled, recalled, revoked… shredded.

4 thoughts on “Medicare to restrict opioid RXs – doctors predict danger

    1. Zyp Czyk Post author

      Her backtracking is a glimmer of hope that reason may start breaking down the wall of “real pain” denial and drug-war fantasies at the CDC


  1. Kathleen Harrington

    Why in the world are they not going after the illegal drugs, heroin/fentanyl/carfentanyl like they are doing to legally prescribed medications for chronic pain patients? Something is very, very wrong here……

    Liked by 1 person

    1. Zyp Czyk Post author

      Well, street drug dealers are criminals with guns and hired “protection”, while pain doctors and patients are generally peaceful law-abiding citizens – which would you rather face in a showdown?

      DEA are a bunch of cowards looking for easy targets.



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