National Academies outlines new guidelines for opioid prescribing – By Andrew Joseph @DrewQJoseph – Dec 2019
A new report issued Thursday by the National Academies of Sciences, Engineering, and Medicine outlines a framework for prescribers and others to develop their own plans for acute pain, without offering any direct recommendations itself.
Here is finally a sensible “guideline” that essentially says to ignore specific “rules” and work with individual patients to find what works best for them.
But I expect the simplistic anti-opioid rules fabricated by non-medical “experts” will continue to override any thoughtful guidance from respected scientific groups like the National Academies of Sciences, Engineering, and Medicine.
After all, what could scientists possibly know that PROPagandists don’t? Continue reading
Trends in prescription opioid use and dose trajectories before opioid use disorder or overdose in US adults from 2006 to 2016: A cross-sectional study – Nov 2019
I’m not going to pretend to be impartial and scientific anymore – this obscene charade of drug-warriors fighting what they call an “opioid epidemic” has gone to such ridiculous extremes (no opioids after cutting open a woman’s abdomen to pull her baby out) that I can no longer restrain my outrage.
With governments’ increasing efforts to curb opioid prescription use and limit dose below the Centers for Disease Control and Prevention (CDC)-recommended threshold of 90 morphine milligram equivalents per day, little is known about prescription opioid patterns preceding opioid use disorder (OUD) or overdose.
Limiting opioid prescriptions never worked in the past, isn’t working now, and never will work. It cannot work because legitimate opioid prescriptions are not related to opioid overdoses. How long will it take these bureaucrats to figure this out? Continue reading
Opioid Dose Tapering, Opioid Dependence, and Indications for Buprenorphine | Annals of Internal Medicine | American College of Physicians – September 2019
This article is significant only because its authors are all founding members of PROP, the group that initiated, escalated, inflamed, and essentially fabricated the whole issue with prescribed opioid medication:
- Roger Chou, MD;
- Jane Ballantyne, MD;
- Anna Lembke, MD.
I’m delighted to see even a tiny crack in the seemingly invincible force of opioid prohibition.
HHS Guide for Clinicians on the Appropriate Dosage Reduction or Discontinuation of Opioid Analgesics – Oct 2019
I’m furious that throughout this detailed 8-page document, the assumption is always that tapers must happen, one way or another. I couldn’t find a single sentence suggesting it may be best to leave patients on some dose of opioids for their pain because, for most of us, opioids are the ONLY effective means of pain control.
More judicious opioid analgesic prescribing can benefit individual patients as well as public health when opioid analgesic use is limited to situations where benefits of opioids are likely to outweigh risks.
Yet they never again mention this case of the benefit being greater than risks, even though that’s the case for so many of us. Continue reading
Health Officials Urge Caution in Reducing Opioids for Pain Patients – The New York Times – By Abby Goodnough – Oct 2019
In a newly published guide, federal health officials say doctors “should never abandon” pain patients and warn of acute withdrawal and other risks.
The Trump administration on Thursday instructed doctors to use more caution when taking chronic pain patients off opioid medications, a response to reports that many have been cutting off prescriptions too quickly, in some cases even dismissing patients from their practice.
Question: Why did we have to wait 3 1/2 years for this?
Answer: because no one wanted to know the results. Continue reading
How Did We Come to Abandon America’s Pain Patients? – Filter Magazine – Alison Knopf – July 2019
Overdoses—not those involving prescription opioids, but of heroin and illicit fentanyl, often combined with benzodiazepines—continue to go up. But
And many physicians, caught in the middle, have stopped prescribing because they don’t want to get in trouble and possibly lose their livelihood. Continue reading
Coincidentally, the month of September is “Pain Awareness Month” and its 2nd week is also “Suicide Prevention Week”. I believe pain awareness *is* suicide prevention, so here is my yearly post about the unintended serendipity of these two awareness campaigns going on at the same time.
By now we have direct evidence that a lack of pain awareness, as demonstrated by all the politicians and healthcare “experts” enshrining the CDC “guideline” prescription opioid restrictions as law, is leading to suicides of patients with uncontrolled pain.
Can the connection become any more obvious? Continue reading
Outcomes After Opioid Dose Reductions and Stoppage: It’s Time to Start Counting – Stefan G. Kertesz, MD, MSc – Aug 2019
As clinicians reconsidered the value of a muchoversold drug class [opioids], the institutions that govern, regulate, pay, and police health care pushed for reductions.
The unanswered question[s] would be
- how such reductions would be carried out,
- who might measure the outcomes, and
- whether those outcomes included benefits, harms, or both.
And into that chasm of deliberate blindness are falling the suicides of pain patients who cannot live with their pain untreated.
Pain patients left in anguish by doctors ‘terrified’ of opioid addiction, despite CDC change – Ken Alltucker and Jayne O’Donnell, USA TODAY – June 2019
I’m encouraged to see this article in such a mainstream publication where it will be seen by more than just patients and their doctors.
The Centers for Disease Control and Prevention issued guidelines in 2016 to cut back prescriptions after years of liberal opioid dispensing contributed to addiction and overdose deaths.
Those guidelines influenced more than doctors: State regulators, health insurers and even disability administrators have cited the federal guidelines to justify policies that limit pain pill prescriptions. Continue reading
The authors of the CDC’s opioid guidelines say they’ve been misapplied – By ANDREW JOSEPH @DrewQJoseph and ED SILVERMAN @Pharmalot – Apr 2019
The authors of influential federal guidelines for opioid prescriptions for chronic pain said Wednesday that doctors and others in the health care system had wrongly implemented their recommendations and cut off patients who should have received pain medication.
They said some health care players had used the guidelines to justify an “inflexible application of recommended dosage and duration thresholds and policies that encourage hard limits and abrupt tapering of drug dosages,” when the guidelines did not actually endorse those policies.
The new paper comes three years [of unrelieved agony and suicides] after the Centers for Disease Control and Prevention published the prescribing guideline. Continue reading