Arguments Against Opioid Restrictions

Below is an argument/comment that itemizes the reasons NOT to implement standard restrictions on opioid prescriptions as proposed by the CDC Opioid Prescribing Guideline.I hope this can be used by others too as a basis for comments on media articles proposing such restrictions.

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I’m writing to urge you to not let the government set standard medication dosages for individual patients, which will happen if this agency adopts policies based on the scientifically flawed CDC Opioid Prescribing Guidelines.

I inherited a permanently painful and disabling disorder, Ehlers-Danlos Syndrome, and have been taking high doses of opioids for the last 20 years. I was able to maintain employment for 10 of those years before the pain became too great.

Countless other treatments, therapies, and medications, were ineffective or far too expensive. For me and many others, only opioids provide effective pain relief, so enforcing arbitrary opioid limits is cruel and unusual punishment for pain patients.

Thanks to opioids I’m still functional enough to write you this letter, even though it took me several days to complete. Below are 5 egregious flaws I see in the CDC Guidelines, which stipulate arbitrary (not backed by research) dose limits for individuals.

  1. The Guideline opioid restrictions unfairly discriminate against people with permanent pain.

A standard limit for pain-relieving medication unfairly targets patients who have painful diseases or genetic flaws, people who suffered terrible accidents, or those who were gravely wounded in the military.

All these people will be condemned to a life of constant pain through no fault of their own.

  1. The Guideline has too many flaws and inconsistencies: it is biased, based on admittedly manipulated data, and overlooks essential facts about opioid prescribing.

The CDC guideline was created by a group of addiction specialists. No pain management needs were considered by this group.

The evidence used for the guideline was cherry-picked in an unusual pattern which excluded evidence in favor of opioids for pain relief.

The CDC made its strong recommendations based on weak evidence.

  1. Standard dosages imposed by the government are inappropriate for medical practice.

This same government is committed to “Individualized Medicine” with the Precision Medicine Initiative, which recognizes that the most effective treatments must be tailored to the genetics of each individual.

  1. The “opioid overdose” numbers were created by adding together very different drugs, users, and motivations.

There is little overlap between legitimate prescriptions used for pain relief and illegal heroin used for recreation, so this confuses the motives of people in pain with those looking for a recreational high or staving off withdrawal.

Limits intended for one problematic population (people with less severe pain, people with acute pain, recreational users) will strongly impact a different and innocent population.

  1. The “crisis” is one of addiction and not any particular drug, and is more related to psychological, social, and economic factors than prescriptions.

Most tragic consequences come from street drugs mixed with fentanyl, definitely NOT a prescription opioid.

When OxyContin was made abuse-resistant, the recreational users switched to heroin because it’s cheaper, but pain patients need legal, measured, and quality assured medication so they cannot switch.

Results so far?

Prescriptions have been declining since 2011 but heroin/fentanyl overdoses continue to increase, so the argument that these prescription restrictions will reduce opioid overdoses is FALSE.

It’s not my fault that I need opioids because I inherited a painful condition.

It’s not my fault that some people lie and steal to get opioids.

It’s not my fault that people are using illegal opioids like heroin/fentanyl recreationally or addictively and overdosing.

Why do I have to suffer
for the destructive behavior of others?