Pain Patients to Congress: CDC’s Opioid Guideline Is Hurting Us – by Shannon Firth – Med Page Today – Feb 2019
Now we just have to hope Congress really listened and “heard” what pain patients are trying to make clear.
Patients with chronic pain are suffering from ham-handed efforts to curb opioid overdoses, a series of witnesses told the Senate Health, Education, Labor and Pensions (HELP) Committee on Tuesday.
In particular, the CDC’s 2016 guidelines for opioid prescribing came under heavy fire, as even a self-described supporter of its recommendations admitted the evidence base was weak.
About 50 million Americans suffer from chronic pain and almost 20 million have high-impact chronic pain. Continue reading
Draft Report on Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations – PPM Editorial – Authors of this commentary are: Richard A Lawhern, PhD and Stephen E Nadeau, MD – Feb 2019
Here is a great example of an excellent commentary on the Draft Report from the HHS. We can all use this as a template for how to organize our own comments.
The following review comments were submitted in response to the draft report, Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations, published by the HHS Pain Management Best Practices Inter-Agency Task Force.
To Be Praised
I urge everyone to start with the positive to make our later criticism more palatable. We have to remember the person reading our comments and try to be what they would regard as “reasonable”. Otherwise, I fear our commentary will be left unread and disregarded. Continue reading
60 Minutes Segment on Opioids Draws Ire of Chronic Pain Community – National Pain Report – by Ed Coghlan – Feb 2019
On Sunday night, CBS 60 Minutes aired a segment that has raised the ire of many chronic pain advocates.
It asked “Did the FDA Ignite the Opioid Epidemic” and asserted a label change in 2001 by the FDA expanded the use of opioids without what 60 Minutes said was “any evidence”.
Cindy Steinberg, Policy Advocate for the U.S. Pain Foundation, tweeted:
“Shame on @60minutes for its 1-sided coverage: https://cbsn.ws/2IvwL7B that somehow forgot about the 20 million Americans living with hi-impact #chronicpain” Continue reading
Cancer and Opioids: Patient Experiences with Stigma (COPES) – a Pilot Study. – PubMed – J Pain Symptom Manage. – Jan 2019
It should be obvious even to laypeople that not allowing opioids for cancer patients is just plain wrong. I hope this will make people think twice about supporting these blanket restrictions of opioids.
Cancer-related pain is a common symptom that is often treated with opioids. However, legislation aimed at containing the opioid crisis, coupled with public fears about opioid risks, may contribute to opioid stigma in cancer patients.
How has the CDC opioid guideline affected you? – a survey conducted by Pain News Network
At the time of its release, the CDC said it was “committed to evaluating the guideline to identify the impact of the recommendations on clinician and patient outcomes” and would revise the guideline “as new evidence becomes available.”
The CDC has not taken one tiny step toward evaluating the disaster their guideline caused. For me, such selective support of their own guideline indicates strong bias, undue outside influence, and corruption of the guideline process.
Opiophobia: The Irrational Fear of Opioids – by Dr. Jeffrey Grolig – National Pain Report – Feb 2019
The irrational fear of opioids, opiophobia, has plagued our country before. Prior to 2000, especially in the 1980s and 1990s, opiophobia ruled the medical community.
The fear was that opioids used for more than a short time would cause overdose, death and addiction. The War on Drugs from the Nixon era caused non-opiophobic doctors to be targeted, arrested and disciplined.
But then Dr. Russell Portenoy conducted research showing that chronic pain patients actually did well on these opioids, achieving an excellent quality of life with vanishingly few developing problems. Continue reading
A few weeks ago, I posted the revealing study in question (Study: Limiting opioid Rx won’t reduce overdose deaths) which finally proves that all the policies to limit the use of legitimate opioid pain medication are doomed to failure.
Here are two more articles from respected publications that expose this travesty:
Researchers Predict Opioid Epidemic Will Grow by Jennifer Nessel – Pharmacy Times – Feb 2019
Researchers at the Massachusetts General Hospital Institute for Technology Assessments (MGH-ITA) estimate that restricting access to prescription opioids will have minimal effects on the opioid overdose epidemic, which they project to increase in the future. Continue reading
Performance of CMS’ opioid overutilization criteria for classifying OUD or overdose – Feb 2019
Researchers investigated whether the criteria underpinning CMS’ opioid Overutilization Monitoring System could effectively pinpoint Medicare subscribers with opioid use disorder (OUD) or at high risk for overdose.
The program, launched in 2013, asks that plan sponsors take action—such as utilization review, case management, and dose-dependent safety alerts or reimbursement denials—when they do identify high-risk beneficiaries.
Here CMS is finally looking at outcomes of their policy. Meanwhile, the CDC, which even included a requirement to evaluate outcomes in its own guideline, has refused to do so.
I’m almost certain they fear that any outcome measurements will show how ineffective their guideline has been at stemming overdoses and how perversely effective it has been in harming pain patients. Continue reading
California Doctors Alarmed As State Links Their Opioid Prescriptions to Deaths – Heard on All Things Considered – Jan 2019
Of all the hare-brained ideas states have implemented to clamp down on legal and medically appropriate opioids, California has come up with the worst:
Comb through the state’s PDMP for the last three years to find a link from someone who recently died from an overdose of illegal drugs to a doctor who prescribed them opioids up to three years ago, and threaten them with prosecution if the CA medical board doesn’t agree with some aspect of this long-ago prescription.
About a year ago, Dr. Ako Jacintho of San Francisco returned home from traveling to find a letter from the state medical board waiting for him. Continue reading
“Like being put on an ice floe and shoved away”: A qualitative study of the impacts of opioid-related policy changes on people who take opioids – ScienceDirect – Apr 2019
This is the study that the CDC should have been running all along, to find and evaluate the outcomes of their opioid policy. They said they would do this, but we’re still waiting, so other groups are stepping in, probably because of the damage they see accumulating.
To characterize the impacts of policies intended to improve opioid prescribing and prevent opioid-related overdose and death on individuals who take opioids.