How Would Opioid Prescription Guidelines Read if Pain Patients Wrote Them? – National Pain Report – April 10, 2017 – By Richard A. Lawhern, Ph.D.
A CDC Guideline for prescribing opioids in chronic pain was published in March 2016. It has become clear that this Guideline is generating horrendously negative results for both chronic pain patients and their doctors.
Many doctors are choosing to leave pain management rather than face possible prosecution by State or Drug Enforcement Agency authorities for over-prescription of pain relieving opioids. Tens (if not hundreds) of thousands of patients are being summarily discharged without referral and sometimes without management of opioid withdrawal.
There are increasing reports of patient suicides. Continue reading
Should CDC’s Opioid Guidelines Be Revised? — Pain News Network – March 17, 2017/ Pat Anson
Suicidal patients. Illegal drug use. Hoarding of pain pills. Pharmacists refusing to fill prescriptions. Doctors worried about going to jail. Chronic pain going untreated.
Those are some of the many problems uncovered in a PNN survey of nearly 3,400 pain patients, doctors and healthcare providers, one year after the release of opioid prescribing guidelines by the Centers for Disease Control and Prevention (see “Survey Finds CDC Opioid Guidelines Harming Patients”).
The guidelines were meant to be voluntary and are only intended for primary care doctors, but they’re being widely implemented throughout the U.S. healthcare system – often with negative consequences for the patients they were intended to help. Continue reading
An Epiphany – March 2017 – by Lynn Webster, MD
Myra Christopher is the PAINS Director and someone I’m proud to call a friend. She has given me permission to re-post her blog, An Epiphany, here. It was first published at PainsProject.org.
This morning I was a guest on Central Standard, a program which airs on the local Kansas City NPR station. The program’s focus was chronic pain. Over the weekend the host’s producer called to do a “pre-interview.” One of the questions he asked me was about the relationship between efforts to improve chronic pain care and the opioid epidemic.
Although I am agnostic about opioids, on more than one occasion, I have been the victim of what a colleague calls “hit and run journalism” and alleged to be an “agent of big pharma” because of the position I take. I think we have overused opioids. Continue reading
CDC Guideline on Prescribing Opioids: Some Major Concerns – March 18, 2017
In his presentation at the 2017 annual meeting of the American Academy of Pain Medicine (AAPM), Jeffrey Fudin, PharmD, DAAPM, FCCP, FASHP, adjunct associate professor at Western New England University College of Pharmacy, highlighted some of the major concerns he has regarding the guidelines established by the Centers for Disease Control and Prevention (CDC) for prescribing opioid for chronic pain
As Dr Fudin mentioned during his talk, despite the fact that these guidelines were based on either case series or expert opinion, they were assigned a grade A recommendation, a grading which usually requires a minimum of 2 class I studies.
Dr Fudin cited a study published in January 2016, which states: Continue reading
Though not particularly long, this comment took me several days to compose and edit (and edit again). I have only one chance to influence all these various agencies trying to restrict our opioid use, so I want to make my comment compelling enough to make someone think twice.
I intend to point out various issues the reader may have overlooked, the unfairness of the restrictions, the personal harm I will suffer, and end it with a strong question or statement that might resonate with the reader.
==== COMMENT ====
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. Continue reading
Strict limits on opioid prescribing risks ‘inhumane treatment’ of pain patients
By Stephan G. Kertesz and Adam J. Gordon – Feb 24, 2017
Here is another article from Dr. Kertesz, pointing out how the CDC Guidelines are NOT VALD as STANDARDS for pain treatment. He and Dr. Gordon both practice Addiction Medicine, so this article shows that the problems with the CDC guideline are visible to unbiased addiction specialists.
Amid a rising toll of opioid overdoses, recommendations discouraging their use to treat pain seem to make sense. Yet the devil is in the details: how recommendations play out in real life can harm the very patients they purport to protect.
A new proposal from the Centers for Medicare and Medicaid Services to enforce hard limits on opioid dosing is a dangerous case in point.
Here is the latest (as of 2/24/17) collection of posts that explain the many serious flaws in these guidelines:
4 articles with the best evidence
against the legitimacy of CDC Guidelines
- By far the most comprehensive:
Opioids, Addiction, and Pain: Briefing for Policy Leaders
- CDC Manipulated Data to Deceive
- CDC Guidelines Refuted with Scientific Evidence
- The Changing Opioid Epidemic: Not from Rx
This excellent summary of the points of our argument against the CDC Guidelines was created by Stefan G Kertesz, MD, who also wrote the thoroughly researched paper, The Changing Opioid Epidemic: Not from Rx, proving that our opioid prescriptions are NOT the problem.
Opioids, Addiction, and Pain:
Message Clarity to Prevent Harm and Save Lives
Briefing for Policy Leaders
Prepared by: Stefan G Kertesz, MD. Associate Professor, U. Alabama at Birmingham, with review by two physicians expert in opioid use disorders and pain. Continue reading
Seedy Sea or CDC? by Jeffrey Fudin – January 12, 2016
This review of the guidelines was written by a professional pharmacist together with his students.
Upon review of the Proposed 2016 CDC Guideline for Prescribing Opioids for Chronic Pain we find various contradicting statements based on the presented evidence and the recommendation strength
According to the National Guideline Clearinghouse, “level A rating requires at least two consistent Class I studies”.
However, all of the 12 recommendations provided are based on case series (level 3 evidence) or expert opinion (level 4 evidence) yet assigned a grade A recommendation. Continue reading
This advocacy advice comes from Richard Lawhern, a tireless advocate for pain patients. He was a headline speaker at the “Stop the War on Chronic Pain Patients” rally in Wash DC last fall (See Making Ourselves Heard) and has personally contacted both journalists and legislators to fight the flood of anti-opioid articles and legislation.
I thought I would share some tactics that may help others be more effective in this kind of advocacy. Some of this is things I’ve heard. Some is what I’ve experienced myself.
- Physically visiting your own Senator’s office with an appointment to see a staff member by name is the most effective lobbying you can do without a checkbook and deep pockets. Senator’s constituents will always get priority over a non-resident. Continue reading