I’m encouraged to see this very reasonable article in the New York Times, which has previously published some anti-opioid pieces of questionable accuracy.
Some Americans suffering from chronic pain have recently lost access to medicines that helped them live normal lives.
Other patients have had to turn to invasive and dangerous treatments, like spinal injections.
“Consequently, patients have endured not only unnecessary suffering, but some have turned to suicide or illicit substance use,” more than 300 medical experts, including three former White House drug czars, wrote in a letter this month.
The C.D.C.’s crackdown on the overuse of opioids — though overdue and necessary — is also too uniform.
It has ignored the fact that many people receive huge benefits from opioids and use them safely.
The crackdown, which began with new guidelines for doctors issued in 2016, is denying medications to people who need them.
Clearly, the overuse of opioids is a national emergency, having caused more than 200,000 deaths over the past two decades.
But too much of the discussion about this issue treats opioids as an unalloyed evil, as opposed to a valuable medication that is terribly overused.
It’s the goal of PROP to make everyone believe our medications are actually “heroin pills” and thus instantly addictive. They are relentless in hammering home of the story about “evil opioids”, which shuts down any constructive discussion about using them for intractable pain.
Some pain patients can benefit equally from other treatments, but many do not. They function well on opioids and can barely function without them.
Even worse, the main public health problem today doesn’t appear to be over-prescription of opioids but rather a class of synthetic drugs, including fentanyls, often sold on the street.
Reducing opioid prescriptions is important. But it needs to be done in a smarter way.
If only our government agencies would start exhibiting the same common sense that this New York Times reporter does.
A case study
The Washington Post ran a good op-ed on the subject this week, written by John Heubusch, the executive director of the Ronald Reagan Presidential Foundation and Institute and himself a sufferer of chronic pain
Many doctors, Heubusch writes, “have turned away from their patients in chronic pain.” The real problem, he says, is not excess pills that happen to be prescribed by well-meaning doctors. It is “the illegal trafficking of opioids on the street where you live.”
This fact is becoming more and more obvious, and I don’t understand why most news organizations and publishers refuse to see it.
Those that keep pushing the long disproven and by now indefensible trope that “prescription opioids = addiction” should have to answer for the suicides they indirectly caused by their activism designed to do away with opioids even for pain management.
He continues: “The C.D.C.’s intended audience should have been small; a limited number of bad actors and a minority of doctors overprescribing for short-term pain were the C.D.C.’s real target.
But the guidelines were ambiguous and short-sighted.
That’s the “cover story” that the guideline writers are hiding behind, that the horrific fallout was “unintended and unforeseeable” – I call BS: Were Consequences of CDC Guideline Unintended?
The immediate result:
confusion at major medical conferences, inside hospital boardrooms and, most troubling, in just about every doctor’s office.”
In his own case, Heubusch writes, “I’ve had to undergo countless unsuccessful procedures and near superhuman efforts to be granted barely enough medication to try to live a normal life.
Even those doctors with the courage to prescribe them for chronic pain sufferers are finding the hurdles established by federal and state reporting requirements so onerous that they are simply turning patients away.”
It’s possible to reduce the horrific toll of opioid misuse and overuse without causing so much harm to people like Heubusch. And there are a lot of people like him.
It seems incomplete to say that “it’s possible to reduce the horrific toll” without even a hint at how this might be accomplished.