Tag Archives: rules

CDC Guideline Harms Pain Patients

CDC Guideline Harms Pain Patients, Panel Saysby Judy George, Contributing Writer, MedPage Today – March 11, 2019

The CDC’s 2016 opioid guideline is being implemented in ways that harm chronic pain patients, a panel of physicians said here.

I agree that the problem isn’t with the guidelines themselves.  They were just

1) suggestions,
2) for primary care providers and
3) first-time opioid prescriptions.

The problem is that they have been weaponized by anti-opioid crusaders to make laws and rules that force opioid tapers even when not medically indicated.  Continue reading

Were Consequences of CDC Guideline Unintended?

CDC Opioid Prescribing Guideline: Unintended Consequences? – July 2018 – an angry essay by yours truly, Angelika Byczkowski (Zyp Czyk)

I’m sick and tired of reading over and over how all the entirely predictable consequences of the CDC Opioid Prescribing Guideline were “unintended” and “unforeseeable”.

The broad misinterpretation of the guideline as establishing fixed limits on opioid prescribing has stranded hundreds of thousands of pain patients in agony without the effective relief they had achieved with opioids.

Yet we are expected to believe that these consequences were “unintended” and “unforeseeable” by the guideline authors. Most pain patients realized right away that the guideline’s suggestions would become codified rules, no matter how little evidence supported them.

And we were right – more than we ever imagined…  Continue reading

Medical guidelines may be biased, overly aggressive

Medical guidelines may be biased, overly aggressive in USCornell University – Apr 2019

Dr. Sunita Sah practiced general medicine for several years in the United Kingdom’s National Health Service. When she came to the United States, she noticed something strange.

The U.K. guidelines for tests such as mammograms and colon cancer screenings drastically differed from those in the U.S…

…even though they were based on the same medical evidence.   Continue reading

CDC Issues Key Clarification on Guideline

CDC Issues Key Clarification on Guideline for Prescribing Opioids for Chronic Pain | ASCO – April 9, 2019

I’m angry that the CDC issued this clarification for only three discreet conditions

  • cancer patients,
  • cancer survivors, and
  • individuals with sickle cell disease.   

Because it so carefully carves out these three very specific conditions for special notice, it seems to imply that any other conditions not listed are currently being understood and implemented as intended, and I’m afraid it could become even harder for chronic pain patients to get opioid relief. Continue reading

Inconsistent Definitions of Opioid Use Disorder

Agreement between definitions of pharmaceutical opioid use disorders and dependence in people taking opioids for chronic non-cancer pain (POINT): a cohort study – The Lancet Psychiatry – free full-text – Mar 2015

Background

Classification of patients with pharmaceutical opioid use disorder and dependence varies depending on which definition is used.

I find it outrageous that OUD can be diagnosed on a whim just by using the fitting definition in one of the several classification systems.

The DSM-5 is the worst, thanks to its “spectrum” of Opioid Use Disorder (OUD), which always places us pain patients, with our regularly prescribed opioids, into the low end of this spectrum.  Continue reading

Over-Prescribing Did Not Cause the Opioid Crisis

Over-Prescribing Did Not Cause America’s Opioid Crisis – By Richard A. Lawhern, Ph.D. –  Mar 2019

A central assertion in many articles is that the crisis began with physicians over-prescribing to their patients in the 1990s and early 2000s, in an era of “Pain as the Fifth Vital Sign.”

Almost the entirety of present U.S. public policy on opioid pain relievers at Federal and State levels is founded upon this false claim.

Governments are engaged in a vast exercise in regulatory over-reach, seeking to “solve” our opioid crisis by restricting dose levels and duration of treatment for both acute and chronic pain.   Continue reading

Paraplegic Drug User Victim of Involuntary Commitment

How a Paraplegic Drug User Became a Victim of Involuntary Commitment by Christopher Moraff – Feb 2019

New laws make it easy for anyone accused of having an addiction problem to be committed if they don’t agree to whatever treatment is recommended for them.

Involuntary commitment for people accused of having an addiction and not actively participating in treatment for it is becoming more common as more laws are being passed to make this legal.

Barely a day passes on my beat without my meeting someone with a harrowing story about the impact of zero-tolerance drug policies on their lives. But few of these stories have impacted me personally as much as that of a young man I’ll call “Jay.”

Continue reading

Opioid Crisis: No Easy Fix to Social and Economic Causes

Opioid Crisis: No Easy Fix to Its Social and Economic Determinants – Feb 2018

The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector.

I don’t see how this wrong idea can be called “accepted wisdom” when it is much more akin to “accepted nonsense” and “urban legend”.

Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness.   Continue reading

Opiophobia: The Irrational Fear of Opioids

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

CA Links Past Opioid Rx by Doctors to Deaths

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