Dangerously Rapid Opioid Tapers

Opioid medication discontinuation and risk of adverse opioid-related health care events. – PubMed 2019 May

Here’s a recent study from the NIH showing that sudden tapers are a disaster for patients. If you showed them this study (link in title), with documented harm to patients, any doctor who still honestly cares for their patients would not force sudden tapers like this.

BACKGROUND:

Between 2012 and 2017, the United States dramatically reduced opioid prescribing rates.

While this may be an appropriate given the opioid epidemic, there has been little research to guide the clinical practice of discontinuing patients from opioid medications and opioid death rates have continued to increase.   

OBJECTIVE:

To determine the relationship between time to opioid discontinuation and the risk of an opioid-related emergency department visit or hospitalization among high dose opioid users.

PARTICIPANTS:

Medicaid beneficiaries in Vermont who filled prescription opioids at high daily doses (at least 120 morphine milligram equivalents) for 90 or more consecutive days and who subsequently discontinued opioid prescriptions (n = 494).

MAIN MEASURES:

The outcome was an opioid-related adverse event defined as an emergency department visit or hospitalization with a primary or secondary diagnosis of opioid poisoning or substance use disorder.

KEY RESULTS:

The median length of time to discontinuation was 1 day indicating that half of patients had no dose reduction prior to discontinuation.

…making this a damning indictment of so many doctors who suddenly decided it was in their best interest to stop prescribing opioids at all.  Some wrote one more 30-day prescription, but others just disappeared and just left a note, saying basically:

“I’m more terrified of the DEA than concerned about my patient’s welfare”.

Considering how the DEA has gone after doctors who are most compassionate and treating the most complicated and severe pain, their fears are well-founded, but still…

When their whole career is focused on helping people, rescuing them from horrible accidents, finding the right therapies to allow them to live with deadly chronic conditions like heart failure, kidney disease, or diabetes, how can they categorize the “chronic condition” of constant pain as any less worthy of effective medication?

When they see a patient whose pain has left them physically disabled, mentally debilitated, and emotionally desperate, how can they say “I’m no longer going to prescribe the only medication that has effectively relieved your suffering” and believe they are anything more than minions of the latest governmental decrees?

  • 86% of patients discontinued within 21 days (considered rapid tapering in recent clinical guidelines)
  • 49% of members had an opioid-related hospitalization or emergency department visit.

After controlling for sociodemographic and clinical factors, each additional week of discontinuation time was associated with a 7% reduction in the probability of having opioid related adverse event (p < 0.01)

Although 60% of members had a diagnosed substance use disorder prior to tapering, <1% of beneficiaries were transitioned onto an opioid use disorder medication.

CONCLUSIONS:

  • Faster rates of opioid tapering were associated with a greater probability of adverse events and
  • many patients discontinued opioids suddenly, with no dose reduction.

Additional clinical guidance, research, and interventions are needed to ensure that patients’ opioid prescriptions are discontinued safely.

So here’s the evidence they say is lacking about the use of opioids. They instituted a policy that is causing documented damage to millions and claim it’s for “harm prevention”.

Beware of those that claim that they’re making you suffer “for your own good”.

2 thoughts on “Dangerously Rapid Opioid Tapers

  1. peter jasz

    Government don’t care, nor do a boat-load of physician’s don’t give a crap -other than to serve/save their income and ass’s.
    (Professionals/physicians didn’t evencare to form a (legal) defense for either themselves -their patients nor to defend the rule of law.)

    pj
    ( Don’t shoot the messenger )

    Liked by 2 people

    Reply
  2. Kathy C

    They all went along with it mindlessly. The few physicians or researchers who challenged this were ignored. They ran a false narrative in the media too. It was clear that people would die, or suffer, but they mindlessly went along with it. They knew there were a lot of people who were addicted, so they sent them to illegal drugs. It could be described as Genocidal.

    They knew there was a problem in 2000, yet they ignored the pharma companies and went after sick people, and physicians. When they did cut the amount of opioids there was no treatment for the addicted. Most states had a few 12 step programs, which have been proven not to be effective. Our government was undermined by the industries that all profited from this.

    They deliberately stigmatized people with chronic pain, it was easier and more profitable than going after the corporations. There were plenty of journalists happy to jump in on attacking sick people demonizing the addicted and undermining physicians. All we have to do is look at who profited. Plenty of psychologists seeking industry funding, questioned the every existence of pain. The media conflated pain patient with addicts, even though the addicted were taking stolen or black market opioids.

    They found the dead body of a child with Meth in her system, it was in the paper today. In our state the denial runs deep, instead of asking why so many people are turning to drugs, to alleviate their despair they chose to ignore it an go after people with pain. They can’t have all of these people getting medical treatment, they had to create doubt. They used this public health crisis to market everything from marijuana, new age medicine and faulty medical devices and dangerous surgeries.

    We should not blame the government, we should blame the corporations that infiltrated it. They took funding away from regulatory agencies to increase the profits for industry. At the same time the media ran a false narrative that benefited the corporate takeover of our government. We are all being exposed to lies and propaganda, promoted by our mass media. It was no accident they targeted pain patients, the industries found them inconvenient. At the same time it was a great marketing gimmick. Health providers needed a way to discredit and demean the people they could not help, and cover for their mistakes. It was no accident that nearly every mass media article about opioids demonized and blamed the pain patients or physicians.

    People with cancer were doubted if they reported pain to a doctor. No research was done on that by design. They misled the public, while practitioners and academics were silenced. The so called academics that created an industry friendly narrative got funding and media amplification. The local media in my state, lied and distorted the facts. They ran articles about how well our state was doing as people died. One well funded “researcher” who is also on the state “Opioid Board” advertised quack cures for research dollars in the newspaper. They advertised that they did alternative pain cures, while at the same time they were selling defective implants for pain, they lied about that. As long as they were making money, and getting media attention the facts did not matter.

    No media covered the protest at the CDC, that kind of stuff is effectively censored. Most physicians work for the big Insurance companies and health providers, so they have been silenced, unless they come out demonizing opioid or pain patients. After 20 years the rising rates of addiction, and suicide might indicate that they are doing something wrong, yet they are still trying to make a profit on the despair.

    Liked by 1 person

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