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.
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.
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.
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).
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.
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.
- 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”.