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
A More Sensible Surge: Ending DOJ’s Indiscriminate Raids of Healthcare Providers – by Michael C. Barnes DCBA Law & Policy, email@example.com
This is a “Legislation & Policy Brief” I found that echoes what we’ve been trying to explain. This brief specifically mentions well-known doctors that have been prosecuted (and persecuted) by federal law enforcement for simply doing their jobs: treating their patients’ pain with opioids when nothing else gave relief.
Mr. Barnes understands and agrees with our position, urging that federal raids of doctors’ offices be halted.
He also points out that the overdose crisis is not about opioids specifically, that the deaths are from increasing numbers of people ingesting various combinations of illicit drugs. Continue reading
National Imperative to Align Practice and Policy with the Actual CDC Opioid Guideline – by Beth Darnall, PhD – July 23, 2019
Here’s another article by Dr. Darnall arguing against the rigid anti-opioid sentiment she previously seemed to support when she claimed that much of chronic pain was due to “catastrophizing”.
This year (2019) she has completely reversed course to push back against the fallout from her previous stance. I admire her courage in so publicly attacking the anti-opioid sentiment that was encouraged by her previous stance.
Although the national focus on opioid reduction preceded the CDC guideline [2016 CDC Guideline for Prescribing Opioids for Chronic Pain], its issuance emboldened opioid reduction practices and policies in ways that its authors never intended. Continue reading
Opioid discontinuation as an institutional mandate: Questions and answers on why we wrote to the Centers for Disease Control and Prevention: Substance Abuse: Vol 40, No 1 – Stefan Kertesz, MD – May 2019
This article explains what the HP3 group wanted to accomplish with their letter “protesting” the CDC guideline. It looks like it worked!
On March 6, 2019, a self-designated committee (Health Professionals for Patients in Pain, HP3, a group that is not incorporated and accepts no contributions) sent a public letter to the Centers for Disease Control and Prevention (CDC), urging the agency to address the widespread misapplication of its 2016 guideline on prescribing opioids.
318 health care professionals and three former directors of the White House Office of National Drug Control Policy (“Drug Czars”) signed the letter, as did the parent organization for Substance Abuse, the Association for Multidisciplinary Education and Research on Substance use and Addiction. Continue reading
Amid a reckoning on opioids, a doctor crusades for caution in cutting back – By Andrew Joseph @DrewQJoseph – May 2019
About four years ago, Dr. Stefan Kertesz started hearing that patients who had been taking opioid painkillers for years were being taken off their medications. Sometimes it was an aggressive reduction they weren’t on board with, sometimes it was all at once.
Clinicians told patients they no longer felt comfortable treating them.
Pardon me for not being terribly concerned about physicians “discomfort” in prescribing me opioids for my much greater “discomfort” (and which I don’t have a choice about) with chronic pain. Continue reading
Rep. Amore bill that excludes chronic intractable pain from medication prescribing guidelines passed by House – Press release – June 2019
Finally, a state government (which does have the authority to regulate medical practice, unlike the federal government) is proposing a bill to allow chronic intractable pain patients to continue taking opioids if they are the only effective treatment.
This legislation is remarkably reasonable, realistic, and would be a huge relief to pain patients.
Rep. Gregg Amore’s (D-Dist. 65, East Providence) legislation (2019-H 5434A) that would exclude chronic intractable pain from the definition of “acute pain management” for the purposes of prescribing opioid medication was passed by the House of Representatives. Continue reading
A Mea Culpa on CDC Opioid Guideline – Pain Medicine News – by Nikki Kean – Jul 2019
This article focuses on the flaws with how the guideline has been interpreted and applied. I’m starting to see more articles that are critical of the current overriding fear of opioids appearing in medical publications.
Almost from the day it was released in 2016, the “CDC Guideline for Prescribing Opioids for Chronic Pain” has triggered criticism from many patients and providers.
Nearly three years later, the agency finally seems to be listening, with two publications in April that take a hard look at the guideline and how it is being applied in clinical practice. Continue reading