Coincidentally, the month of September is both “Pain Awareness Month” and “Suicide Prevention Month”.
Judging from all the articles I’ve found discussing the link between pain and suicide, the juxtaposition of these two awareness campaigns is a fortuitous coincidence, a chance to raise awareness of the potentially deadly consequences of poor pain control.
Perhaps it can start some necessary conversations about how the withdrawal of opioid pain management could exacerbate suicidal impulses. Continue reading
This is a Twitter discussion thread from one of our favorite advocates: Dr. Stefan Kertesz from Sept 7, 2018. He makes an excellent argument, with links to his previous articles, about the wrong-headedness of restricting prescription opioids.
1/New study shows US #opioid prescribing is down 35.5% overall and 48% for high dose in particular (2012-2017, per capita figures) http://annals.org/aim/fullarticle/2698111/opioid-prescribing-united-states-before-after-centers-disease-control-prevention Continue reading
Opioid crisis not helped by panic – Jeffery A. Singer – Sept. 2, 2018
The opioid crisis that gets the most attention is the growing rate of opioid-related overdose deaths in non-medical users.
How refreshing to see the “opioid overdoses” qualified like this, making it clear that these are from *non-medical* users.
According to the National Survey on Drug Use and Health, less than 25 percent of non-medical users of prescription opioids ever get them from a doctor — they get them from a friend, relative, or drug dealer. Continue reading
These two high profile defenders of pain patients’ access to opioids both responded to Oregon’s proposal to force the taper all pain patients off opioids.
I’ve captured their reasonable objections in a series of comments from their Twitter accounts:
Stefan Kertesz – @StefanKertesz – 29 August
1/An unknowing defense: Oregon Medicaid Director responds to our critique of his plan to force-taper all #opioid receiving patients in WSJ, and reveals to all that he is unaware of what’s unique about the plan he’s defending https://www.wsj.com/articles/oregon-opioid-abuse-policy-is-the-right-one-1535469847 https://twitter.com/StefanKertesz/status/1034849416195190784/photo/1 Continue reading
U.S. Chronic Pain Practitioners and Scientists Comment on Oregon Forced Taper Proposal – National Pain Report – July 31, 2018
Editor’s Note—This letter was submitted to the Oregon Health Evidence Review Commission (HERC) in advance of its August 9 meeting to consider opioid forced taper guidelines.
People outside of Oregon are free to comment. To submit your comment of 1000 words or less, email them to firstname.lastname@example.org as soon as possible.)
OTHER SIDE OF THE EPIDEMIC: Chronic pain patients says they’re ‘treated like criminals’ – by Cathy Dyson – Aug 2018
When the former nonprofit director—a woman with a master’s degree in social work—moved from North Carolina to Spotsylvania County last fall, she brought detailed medical records about her chronic pain and the opioids she takes to treat them.
As she searched for a pain management doctor in the Fredericksburg area, she called at least eight different offices. Before she could even describe her situation, the receptionist would cut her off, saying: “We don’t prescribe opiates.”
The woman, whose first name is Becky, was shocked, then scared. Continue reading
Opinion: The Battle Against Opioids Could Mean Misery for Patients in Pain – By Heather Wargo – August 16, 2018
While the United States is distracted by politics, a human rights battle to the virtual death is being played out in Oregon and no mainstream media outlet is covering it.
The ramifications of ending Medicaid coverage of prescribed pain medication for chronic illness except for a very narrowly defined list in Oregon will affect every American whether they realize it or not within the next decade. The effects will be disastrous if it goes the way the bipartisan players desire.
And here Ms. Wargo has arrived at an near-perfect analogy that makes our plight obvious: Continue reading
Oregon Overshoots on Opioids – WSJ – By Sally Satel and Stefan Kertesz – Aug. 16, 2018
The Oregon Health Authority is contemplating a radical plan to end opioid coverage for many chronic-pain patients enrolled in the state’s Medicaid program.
Beginning in 2020, physicians would have one year to fully taper off doses of medications such as Percocet, Vicodin and OxyContin. OHA’s chief medical officer says the agency believes “pain patients have been put at higher risk with regard to overprescribing.”
But the available evidence does not show a safety benefit from mandatory, across-the-board opioid tapers. Instead of targeting those most at risk of overdose, the mandate would needlessly exacerbate suffering for thousands of patients. Continue reading
Oregon Medicaid program could cut off chronic pain patients from opioids – STAT – By Lev Facher @levfacher – August 15, 2018
There is little Laura Dolph has not tried to escape her physical pain. Tylenol, occupational therapy, oxycodone. A chiropractor. Transcutaneous electric nerve stimulation. Methadone, Advil, physical therapy, Tylenol with codeine. A prescription fentanyl patch that didn’t work because its adhesive made her break out in hives.
For almost two years, heroin. Twice, in the mid-1990s, suicide.
But after decades of drugs and appointments and surgeries, mercifully, Dolph says she has found pain management that works, that keeps her stable. When she first wakes up, a methadone pill. When the pain wells up in her lower back and begins its creep down to her legs — left, then right — an oxycodone pill, and sometimes another as needed. Continue reading
Opioid laws hit physicians, patients in unintended ways | Crain’s Detroit Business July 29, 2018 – By JAY GREENE
New state laws on opioids intended to save lives have physicians complaining about unintended consequences.
None of the doctors interviewed by Crain’s objected to the laws’ intent: Reducing misuse of the powerful painkillers that have contributed to rising deaths and addictions.
But they say regulations have
- added unnecessary administrative headaches,
- led to a climate of fear for doctors and
- left patients unable to get medications when they really need them. Continue reading