Tag Archives: CDC-Guidelines

Will Pill Control “Fix” Our Problem?

Here is a video of Dr. Kertesz’ criticism of how the CDC guidelines have been turned into regulations in various health care settings:

Will Pill Control “Fix” Our Problem?: The Allure of Simple Solutions

Sound medical decision-making and
how propaganda is hurting otherwise stable patients

Three points:

  1. The CDC guideline was a serious response to a serious problem
  2. Emerging practices don’t respect it and people are being hurt
  3. How did we get here? Continue reading

Opioids, Evidence Based Medicine, and Public Policy

Opioids, Evidence Based Medicine, and Public Policy; The Art of Creating an Unnecessary Public Health Crisis – National Pain Report – by David Nagel, MD – May 25, 2017

Dr. Nagel demonstrates how low-quality evidence, like that used by the CDC for their guidelines, is normally not used clinically.

He compares how such poor evidence is handled in the case of the prostate-specific antigen (PSA) test (rejected) versus the CDC guidelines (recommended).

A few days ago I met with my doctor for my annual physical

We talked a great deal about the utility of the prostate specific antigen (PSA) test which has been used for a few decades to predict and, hopefully, prevent prostate cancer.  It came as a bit of a surprise to me that this widely touted test was no longer recommended.   Continue reading

Opioid crisis: Pain patients pushed to the brink

Opioid crisis: Pain patients pushed to the brink; Overdose prevention efforts have had unintended — and dire — consequences By Markian Hawryluk, The Bulletin, @markianhawryluk – Jun 5, 2017

Three weeks after her last appointment, Sonja Mae Jonsson got a call from her doctor’s office in Waldport, telling her she needed to come in. Her urine drug screen had tested positive for a drug she hadn’t been prescribed.

The doctor would no longer prescribe her any pain medication.

Linda Jonsson, a registered nurse, had taken over her daughter’s care after a traumatic brain injury when she was 32, and carefully monitored her daughter’s medications. She pleaded with the clinic they had made a mistake.

Without the pain medications, they would be condemning her daughter to a life of pain.   Continue reading

Warning to the FDA: Beware of “Simple” Solutions

Warning to the FDA: Beware of “Simple” Solutions in Chronic Pain and Addiction – Face Facts – by Richard Lawhern –  May 2017

On May 9-10, 2017, the US FDA held a workshop titled “Training Health Care Providers on Pain Management and Safe Use of Opioid Analgesics—Exploring the Path Forward.” I attended that Workshop in person to offer public comment on behalf of chronic pain patients. This paper is an expansion on the same theme.

“… If you are truly concerned with the safety of patients who are prescribed opioid analgesics, then your first duty may be to adjourn this conference with a public acknowledgment that you aren’t ready to train doctors because you have no viable or safe standard of medical care in which to train them.

This is true because the March 2016 CDC Guidelines on prescription of opioids are fundamentally incomplete, desperately flawed, and actively dangerous to the lives and health of hundreds of thousands of people.” 1   Continue reading

Patient-Focused Guideline for Prescription Opioids

The CDC’s Fictitious Opioid Epidemic, Part 2 | Journal of Medicine | Medical Journals | National College of Physicians – 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 [CDC] 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

Why the CDC Needs to Recognize Palliative Care

Why the CDC Needs to Recognize Palliative Care — Pain News Network – March 28, 2017 – By Barbara Nelson, PhD, Guest Columnist

A little over a year ago, the Centers for Disease Control and Prevention released its “Guideline for Prescribing Opioids for Chronic Pain.” Its goal is to help reduce the raging and heartbreaking overdose epidemic in the U.S.

Unexpectedly, the guideline has exposed the extraordinary need for palliative care for millions of patients who may live for decades with intractable pain.

These patients now face enormous obstacles getting medically-needed opioids for effective pain control, especially when the dose exceeds the highest recommendation made in the guideline of 90 morphine milligram equivalents (MME) per day.  Continue reading

Opioid Guidelines By Patients For Patients

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

CDC’s Opioid Guidelines Need Revision

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

CDC Guideline appropriate for acute, not chornic pain

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

Some Major Concerns about the CDC Guideline

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