When Pain Becomes Government Regulated

When Pain Becomes Government Regulated, We Are All Potential Victims – May 20, 2018 –  Janice Barlow

No one should doubt that we’re still in the midst of an opioid crisis and have been for the better part of a decade. The nature of the crisis, however, is not what you have been led to believe by mass media reports and federal authorities.

Opioid medications have been part of treatment regimens for several decades. But in recent years, the line between who needs them to alleviate chronic or acute pain and who wants them because of the pleasant side effects, has become blurred.  

Or at least it has, according to the government.

Instead of creating a simple and organized process by which these medications, which are Schedule II opioid painkillers, including oxycodone, hydrocodone, oxymorphone, hydromorphone, morphine, codeine, and fentanyl, can be dispensed to those who truly require them – each state has developed a convoluted process that keeps these medications away from the people who need them the most, just so it can claim it is keeping them out of the hands of  abusers.

The Center for Disease Control has developed guidelines that make it very difficult for someone with a chronic and verifiable condition to receive a new prescription or an increased dose of a regulated medication.

That tells it like it is in reality.

If you are a doctor who has a patient suffering from acute pain and you prescribe anything over 90 mg. of this class of substances (based on the daily equivalent dosage of morphine) – you will be exposed to a higher degree of scrutiny from authorities. This produces a chilling effect on the very medical providers that know and understand the circumstances and medical history of the patient best.

You might be asking, “but aren’t doctors massively over-prescribing pain relievers?” The answer runs contrary to many popular media narratives – and the answer is no.

There was a statistical uptick in prescriptions during the last 30 years – that is true. But what is not understood, is that the increase in prescriptions was due to the severe underprescription of opioids prior to the 1980s. Prior to that, people who had severe pain were often denied drugs that provided meaningful relief.

This is a valid point I haven’t seen mentioned before. All those horrible statistics about climbing opioid prescriptions are listed as though the opioid was an independent entity in itself, and not tied directly to pain.

This is how all the opioid studies are done too. They look only at opioid milligrams and make predictions based on that amount, like “people prescribed higher amounts of opioids are still taking them 90 days later”.

Does it occur to no one that opioids are prescribed for severe pain? If you use the amount of opioid as a function of the amount of pain, this and all the other “outcomes of opioid prescriptions” make perfect sense.

The prescription end of the opioid crisis is not the prime focus of the epidemic.

German Lopez, writing in Vox, outlines the dangerous unintended consequences of these policies of government overreach:

“When it comes to cracking down on opioids, just going after the drug’s supply isn’t enough. If you go after opioid painkillers, people will eventually go to heroin. If you go after heroin, they’ll eventually go to fentanyl. And if you go after fentanyl, they might resort to some of its analogs, like carfentanil.

This drug crisis, then, likely requires a response that also tackles the existing demand for these drugs, particularly through new forms of drug prevention and treatment that can get people off these dangerous substances altogether.”

It seems that in the run for cover over reaction to the serious crisis of misuse of these controlled substances, federal and state authorities have drawn the overarching conclusion that anyone taking these medications will automatically become addicted to them and require rehabilitation. This is not the case in reality.

What is happening instead is that people who are truly suffering and in need of the relief that can only be attained with some of these medications, are being denied because there is a segment of the population that abuses them.

It is odd that fentanyl is grouped in with the oral medication as it is a patch, and it’s very strong.  Fentanyl is very deadly if used improperly. Some people have stupidly chewed them and died as a result.

The D.E.A. (Drug Enforcement Agency), the arm of government that has been perpetually administrating the failed “War On Drugs”, has produced new restrictions that are having a detrimental impact on chronic pain sufferers.  T

he National Fibromyalgia and Chronic Pain Association (NFMCPA) released a survey assessing the first 100 days after the regulatory change. The results include:

  • 88 percent of patients responding that the changes denied their rights to access pain medication.
  • 71 percent report being switched to less effective medications by their doctors, who are fearful of legal                               issues.
  • 52 percent perceiving an increase sense of stigma as a patient receiving hydrocodone.
  • 27 percent of patients even reported suicidal thoughts when unable to access their prescription.

Among the comments received by the sponsors of this study, was the following.

“The one person I know who says the recent guidelines have helped (is) my neighbor who is a heroin dealer. He says business has quadrupled since doctors have started becoming too afraid to help people in pain.”

I found it easier to get medications through the black market than through my doctor. I spend about $1,000 per month in medications through the black market, but in the end that is less than the deductible on my insurance. And they deliver to my house!”

Giving a nineteen-year-old 30 hydrocodone (Vicodin) tablets because he had four wisdom teeth pulled is irresponsible.

Conversely, denying someone ten days of hydrocodone who had a knee replacement to recover from post-surgical pain is also irresponsible.

The protocol now however, is often no more than three to five days of pain medication following major surgery, including heart surgery!

Taking people off the medication that has helped alleviate pain for years has caused severe depression, return of chronic pain, and even suicidal thoughts.

And more than merely suicidal thoughts – real deaths of people driven to desperation by being deprived of adequate dosages of pain relieving medication, have been documented to be widespread.

Unfortunately, the government’s efforts in cracking down on bad players – rogue clinics and irresponsible, profit driven distribution networks, has bled over into the rights of individuals legitimately needing opioids

When government agencies acting with the acquiescence of Congress, take a sledgehammer to a nail, scores of innocent people suffer.

Remarkably, the very government official who spearheaded the new CDC guidelines that are putting millions of Americans at risk, acknowledges that prescription opioids are not driving the public health crisis.

Debra Houry, MD, Director of the CDC’s National Center for Injury Prevention and Control, admitted to House members in a Congressional hearing last year that:           

“Although prescription opioids were driving the increase in overdose deaths for many years, more recently, the large increase in overdose deaths has been due mainly to increases in heroin and synthetic opioid overdose deaths, not prescription opioids. Importantly, the available data indicate these increases are largely due to illicitly manufactured fentanyl.”

Despite knowing the reality, Houry steadfastly refuses to reverse course.

It’s almost the same as saying that no diabetic should be allowed access to candy bars because some diabetics just eat too many of them and cause severe damage to their health.

Other people affected by the revised regulations, include people in the Medicare system who have had their prescriptions cut back, or been denied effective pain relief prescriptions for documented chronic conditions.

On September 18th, 2018, there will be a nationwide protest rally against the over regulation of pain medications.

“We are protesting to have our voices heard regarding the neglect the chronically ill community/pain patients have experienced due to the new CDC guidelines, the DEA, and the FDA’s involvement.”

Interested parties can check get more information on the Facebook group, Don’t Punish Pain Rally, and search for their individual states in the Files section.

Original article: When Pain Becomes Government Regulated, We Are All Potential Victims

From the Facebook group:

We are protesting in all major cities on September 18th, 2018. We are protesting to have our voices heard regarding the neglect the chronically ill community/pain patients have experienced due to the new CDC guidelines, the DEA and the FDAs involvement.

2 thoughts on “When Pain Becomes Government Regulated

  1. Laura P. Schulman, MD, MA

    Unfortunately, the mindset of physicians denying relief to pain patients seems to be crossing over to other medications and conditions. My new primary care physician just decided unilaterally that I don’t get my estrogen (originally prescribed by a gynecologist for severe hormone deficiency) or my maintenance asthma medications that I’ve relied on to not get pneumonia every year like I did for the first 35 years of my life.

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