Are Federal Guidelines for Prescribing Opioids Hurting Patients With Chronic Pain?



As Oklahoma and Purdue Pharma reach a landmark settlement, we look at an underreported result of the opioid crisis: the underprescribing of opioids for …

34 Comments

  1. That this happened was completely predictable because from the beginning this campaign against overprescription would never touch on the fact that the majority of doctors don’t over prescribe and the majority of patients have no interest to overdose. Corruption and criminal ignorance exists but the amount of it can easily be blown out of proportion. This debate about over prescription of pain medicine had also negative effects on the discussion about other drugs that have little to do with pain medicine, for example anti-depressions and medication for the treatment of ADHD. There is a very vocal American cotton industry of snake oil sales people among those who call themselves alternative health experts, and some of them like to present the entirety of conventional medicine and the pharmaceutical industry as one big criminal syndicate that has no other purpose than pushing bad pills that make everyone sicker than they are. And they promote this overgeneralisation so they have a better chance to sell their placebo sugar pills, their self-help-books, and their miracle diets. As usual the topic was overly politicised and actual experts, good doctors, and patient advocates where ignored. Instead, also as usual, the various media channels tried to outdo each other with sensational outrage stories, and the truth was again the first victim. Even DN participated in these exaggerations to some less severe extent. Gladly they now – for the first time perhaps (?) – talk about the other side of the story.

  2. I'm about to fly off the handle. I am SO SICK OF PEOPLE who can sit and talk about people like myself but have never ever experienced the pain I (and so many others) live with every d*mn day.
    They don't have a clue as to our living conditions. Do they know how difficult it is to get out of bed, wash a few dishes, sweep a floor, make a sandwich, walk to the mail box, take garbage cans to the street? My hair is dirty. No, my entire body is. So is my house.
    Do I like to be this way? NO I don't but I have degenerative disc disease. There is NO cure only pain relief with strong narcotics which I'm being denied an increase after being decreased because my pc doc is scared after another doctor was terminated for writing 2 scripts.
    And that's just the beginning of a painful existence and they wonder WHY people suicide?

    This is part of their game plan folks! If we don't suicide they will use another method. We are called "useless eaters" by the super rich evil satanists who have put themselves in charge of eliminating people. At this moment they are still destroying the food we eat and the land upon which it grows, the water we drink and the air we breathe.
    Never in my life did I think I would be almost totally abandoned and in so much pain. My husband left me after almost 30 years because he had "no feelings" for me. My country has abandoned me too.
    My daughter does my laundry, and grocery shops, makes doctor appts. and takes me to them and many other things too but she can't do it all.
    Are there people addicted to these drugs? Of course there are but many are out on the street using illegal drugs and I don't doubt those drugs are being brought in by means other than across the Mexico border! Does anyone care? Obviously not because no one goes after the other suppliers nor those on the street using them.
    The truth is they just want to be rid of those who are genuine pain patients and not looking for a "fix" to get "high". Pain patients don't experience a "high" only pain relief.

  3. I am a disabled firefighter that was injured on the job; I was exposed to a virus that has caused me to suffer with chronic pancreatitis which last year I was admitted to hospital 9 different times. I went to a pain specialist and they started treatment and yes after nothing else worked I was prescribed opiates. But since their treatment started I have been able to treat my extreme pain at home vs going to the hospital and being admitted anywhere from 5 to 9 days. Until they can find a cure, I’m stuck and yes at times those of us with legitimate medical conditions that require pain management are getting left out of the conversation. New laws make it difficult at times and increase the hoops we need to jump through. So far it hasn’t been a problem, but with all the extreme measures it seems our government likes to do, I am just waiting until the time comes where I will be back to going to the hospital when my disease flares up.

  4. Yeah Amy I live in Seattle I have degenerative disc disease in my spine my entire neck diffuse from top to bottom with titanium and they are dragging their heels on doing the lumbar so they don't leave me on pain management will now they're telling me Oh sorry this government. It says we have to take away this much of your medication well I'll be going out to the street tomorrow to buy heroin to supplement what they taken away for my pain medication so governor of Washington state on Ensley you can kiss my motherfucking ass you ignorant dumb son of a bitch.

  5. Chronic pain is not treated with opioids, unless it is from cancer. Tai- chi, Yoga, prayer and exercise are more helpful than heroin for chronic pain. This whole debate is stirred up by heroin addicts who want heroin subsidized by the insurance companies.

  6. My friend has chronic pain yet his pain needs vary. If he has a good week with little pain he's still required to still take the same amount of medication or they will stop it altogether. They draw blood to make sure. Helluva solution.

  7. I think that the problem in lies with the insurance companies…yet again. For years this was allowed to go on and it was perfectly fine to pay out on it, thus creating this epidemic. Now, that has changed and it is ridiculous the hoops that you are forced to jump through now. Like others commenting, am a patient with a chronic incurable disease that requires a level of pain management so I can have some semblance of quality of life. Without relief from pain, I do not move and am unable to help myself because I am literally frozen/crippled with pain. People like me actually are addicted, but in a controlled and deliberate manner it is called dependency. I view it like a diabetic who is dependent on insulin to survive. Pain is not considered a metabolic condition warranting the on going renewable medication tier. This is what needs to change. The coding of chronic incurable conditions which allow for any and all means of pain control to be covered would be ideal.

  8. i have come to the conclusion over the last couple years that they actually want us to die. they treat us like criminals or children or both as well as often treat us with obvious disgust. to top it off, the suicide numbers are hidden

  9. I knew I could count on Amy to cover this even if no one else will ! The general public is being lied to, they still think docs are handing pain pills out like candy whn in reality not even legit suffering patients are able to get the medicine they nd. They're being thrown out on the streets & driven to suicide while ppl like this idiot wanna talk about side effects, cuz we all know constpation is far more serious than debilitating agonizing pain smh. Counterfeit pills, heroin & fentanyl are what's causing all these deaths. Overprescription is NO LONGER the issue ! #EndOpioidHysteriaNow

  10. Thank you, this has been a sentance of torture & lack of quality of life. Leading to loss of muscle mass we've worked hard to keep, losing jobs & ability to care for ourselves & families.
    I'm relieved to here someone finally stand up for the millions of patients that are going through a genocide.

  11. While recuperating from kneecap replacement surgery, a hospital nurse ran through the entire pharmacopia of so-called ''pain killers,'' and ONLY the opiate Dilaudid was effective. An intravenous dose of morphine produced NO EFFECT WHATSOEVER, not even drowsiness. My brother told me I'd make a lousy junkie. Some of us NEED opioids sometimes.

  12. problem is so absurd that many years ago i went without painkillers for the excruciating pain of an exercise injury caused burning pain to the nerve in my arm originating in my neck. i had to wait 2 weeks of misery b4 PT eventually resolved it. the urgent care in metro DC I went to when i had a SECURITY CLEARANCE working for DoD wouldnt give me anything despite my clean-cut appearance and well-spoken manner. Ever since then in 2004 I horde painkillers i am ever prescribed. Ive had 10 year old pills that i use for if and when i eveer get so hurt that i need them bc i cannot depend on the medical world to give me them even when I clearly need them. But they give them out like candy to my now elderly mother, which a burglar loved when he broke into my mom's house. Absurd. This has all happened so they could flood the market w these pills. sell more now, who cares about the mess.

  13. Policy driven by profit and self-interest… the corruption of our government contributed to the "opiod crisis", and the same corrupt politicians are now trying to score points with policies intended to make them look good, and tough, but with NO regard for people. Vote for and support candidates that put the good of the people first.

  14. … that dude 7:40 needs to experience chronic back pain from nerve damage that is so intense that it hurts to breathe and that is so intense that there is nothing -NOTHING that can alleviate that pain except an opioid … until then, he needs to stfu …

  15. That's a question that, unfortunately, is completely ignored by our government and healthcare system.
    Unfortunately, the DEA and policymakers have created a system where chronic pain patients and patients in end of life care are often unable to get treatment (or adequate treatment) for pain and suffering. In an effort to reduce illicit opioid and prescription opioid use, and treat opioid addicts, they've attacked people who are most vulnerable and most in need of opioid pain medications. Chronic pain patients have the lowest rate of addiction among all patient populations, at 0.3%, and yet we're being punished for the negative choices of others. We should all be able to get the medicines we need to function and enjoy life as much as possible. What are the alternatives for those of us who can't get life restoring medication? Suicide and / or illicit drugs. And suicide rates are skyrocketing among those chronic pain patients who are unable to find a doctor willing to help.

    In my case, I was hit by an 18-wheeler and then fractured my spine in a cycling accident. I've been bedridden for years, unable to get any opioid pain medication (after exhausting all allopathic treatments and alternative treatments). My husband has cancer and has also been denied opioid pain medication. Instead, he was told to use distraction, massage, acupuncture magnets, meditation, hypnosis… And if none of those worked, they said he should try "acceptance therapy" and psychotropic medicines.

    The only doctors who have a free pass to prescribe opioids (govt issued waiver) are DATA 2000 addiction medicine doctors AND they can ONLY PRESCRIBE OPIOIDS TO OPIOID ADDICTS. Other doctors who would like to treat their patients who are suffering risk DEA raids, loss of livelihood, and even incarceration. It's ludicrous.

    The CDC had admitted to inflating the numbers of prescription opioid related deaths, illicit drug related overdose and deaths used in combination with other substances, and how numbers are derived. For example, if someone dies with any opioid in their system, it's counted as an opioid related death. If an 80 year old dies from cancer and has any opioid onboard, it's a prescription opioid related death. If someone, like Prince, dies with illicit fentanyl onboard (not to mention high doses of 5 other substances) it's counted as an opioid related death because illicit fentanyl is an analogue of prescription Fentanyl. If a person dies with alcohol, benzodiazipines, illicit fentanyl, heroin, in their system, it's counted as a prescription opioid death.Again because illicit fentanyl is an analogue of prescription Fentanyl. These faulty reporting methods on which
    policy-makers are basing all the insane laws and guidelines. Obviously, it hasn't been working. How long will it take for them to come to their senses? With the ignorant, old white guy, reefer madness mentality among our policy-makers, I'm not holding my breath.

    For a common sense approach see: http://www.drcarlhart.com

  16. Finally the discussion is starting. Get the government out of Healthcare and allow doctors to work with their patients. Most chronic pain patients have already been through the spectrum of "other" treatments… Now chronic pain patients are being left with no help, no care, and insurance companies and the government dictating their medications. The current situation is killing people. People who were stable on their prior medications, who have been force-tapered off their meds and are now unable to tolerate the pain they are in. Take an aspirin? How cold hearted can you be?

  17. Democracy Now! raises the question that has been completely absent from all other (significant) media sources – or from anyone in Washington for that matter. The people who have extreme pain and/or unrelenting chronic pain are the ignored victims of the opiate crisis/epidemic/scam.Every single person in the Pharma industry (as well as the politicians and the people at the FDA who played along with the scam) should be in prison. The inadequate and impotent response to the opioid crisis is a manifestation of the same kind of short-sighted, incompetent and ignorant thinking that got us here in the first place. Why hasn't this aspect of those in extreme pain been a focal point by other media outlets? Maybe (partly) because journalistic ethics are dead, as mass media outlets have been bowing down to the endless wave of Pharma commercials and ads and the profits they bring in.

  18. The 2013 MED(Morphine Equivalency Dosage) is what caused me to be let go from the pain clinic I had been going to, seeing the same doctor and complying with everything that was required of me for over 10 years. Before that I was prescribed lower dose pain medication like Vicodin and Ultram by my family physician. I never was prescribed Oxycontin. I was on time release morphine(old and cheap).
    I cannot function without pain medication, no longer work without it.
    I nearly died going through withdrawals. I believe I would be dead if not for cannabis. Which the damn government decided is illegal.
    I disagree with that man(and Jeff Sessions)….it depends on what your back pain is caused by as to whether you should suck it up. A sprained muscle can heal and is helped by physical therapy. Bone and neurological disease needs medication among other treatment.

  19. Thank you for finally being unbiased in your reporting about this!! I have left comments previously and have been advocating for patients everywhere. Besides the thousands of patients speaking out and sharing horror story after story and the escalation to denying even cancer & hospice patients pain medication, this was also addressed at the Senate Hearing Committee on Pain Management During the Opioid Crisis.
    The CDC has publicly admitted they used misleading & inflated numbers of overdose deaths in their 2016 Guidelines. he way deaths are recorded can mean someone took one pain pill after a doctor visit, died in a car accident on the way home and their death is listed under "opioid related".

    Now Gillibrand & Gardner are trying to force every one to be capped at 7 days only for acute pain! These types of laws have already been passed in over 25 states already and are not working well. Some states make patients go back, in person, to the doctor for more pain meds every 3 days/ We have more and more nurses joining the CPP community and explaining how being forced to move around so soon after surgery increases healing time, possibility of infection, possible tearing of sutures and are describing the terrible pain patients are going through .

    Acute pain is an amputation from a car accident, it is a compound fracture from a skateboard accident, it is emergency surgery; acute pain is not just from getting a tooth pulled.

    It's also not supposed to effect CPPs (Chronic Pain Patients) but neither were the CDC guidelines.

    My profile pic is an xray of my back. I was injured at work in 2003. I've already gone through the stigma of trying to get acute pain meds while already receiving maintenance pain medicine. for my already daily pain. Pain medication doesn't magically work better to cover an increase in pain from major surgeries. Having your bones cut with saws and metal hammered into place causes an increase in pain for well over 7 days.

    There are many qualified individuals ready, able and willing to speak up on our behalf, I hope to see more stories of the unintended consequences in the futre. We've already lost 7 people this month alone to complications caused by severe un or undertreated pain.
    It causes release of cortisol, tachycardia, increased blood pressure, strokes and heart attacks.

    An especially heinous death, perpetrated by a doctor too afraid of the DEA to continue to prescribe needed pain medicine, to a double amputee among other issues, who had never abused her meds and followed all the rules, is Dawn Anderson. Please search the article written by Dr. Richard "Red" Lawhern describing her final days after she was found unconscious and rushed to the hospital with a terrible infection and still denied pain meds while in the hospital and then refused dialysis because she was so tried of being in pain. She was then held down against her will and forced to receive injections.

    CPPs are not denying there's a drug/addiction problem in the US and that people with substance abuse issues need treatment as well, but it's due to IMF (Illicit Manufactured Fentanyl) not our prescribed pain medicine. Yes, there was a time, 20 years ago, of pill mills and some diversion, but those days are long past.

    Why, despite a decrease of 30-45% of prescriptions and prescription medications available is the OD rate still climbing?

    Even Human Rights Watch has done an investigation into this issue and found that CPP are suffering greatly, and being forced to choose between street drugs or suicide.

  20. I've been disabled from CFS/ME and Fibromyalgia since 1995 and have tried every therapy suggested since then. Since 2006, I have successfully been treated for my pain and insomnia symptoms with an opioid and a benzodiazepine.  I functioned so well I had more or less forgotten I was ill.  I was able to volunteer and work part-time and was a caregiver to my partner.  That was until 6 months ago when I was totally cut off abruptly from my sleep medication and had my pain medication tapered down by 60% which was (and is) torture.  This was because of my double board certified pain management specialist's fear of being arrested by the DEA due to the 2016 CDC Opioid Guideline's recommended 90 mme (morphine milligram equivalent).  It's NOT working and I have been set back years.  With this lowered pain med. dosage I barely sleep and when I do it is once every 48-72 hours. I am sleep deprived and find it extremely difficult to function (cook, clean, bathe, drive, etc.) because of my pain.  My life is reduced to staring at the walls consciously breathing to get my mind off the pain.  Every chronic pain patient in the country has been adversely affected by these draconian CDC dosage limitations.  Please write your legislators.  No one should have to live in pain.  And I want my life back.

  21. I met today a man who complained that the Veterans Administration Hospitals and doctors can't prescribe marijuana since the federal govt doesn't approve of it. MJ is okay for non-VA doctors in the state of New Mexico and other states to prescribe, and it can be helpful. Maybe one day the feds will catch up with the idea that CBD oil can be of assistance and maybe less addicting than approved opioids.

  22. The trouble with opioids is that first you have Purdue pharma aggressively marketing Oxycontin, giving doctors kickbacks for prescribing Oxy, and so they doled it out like M&Ms. Oxycodone was an old synthetic opioid, which was resurrected in the 1980s for pain management, when doctors finally were convinced pain is't good for you. People used to think that "everybody hurts a little", usually the kinds of people who hadn't experienced serious pain. So now when 10-20 years ago the message was going out that doctors need to be careful with opioids (especially since the FDA figured that Oxy was seriously addictive contrary to Purdue's marketing materials) – and that the DEA would be keeping tabs on Oxy sales and registering doctors who could prescribe them – doctors started avoiding any opioids, sometimes making their patients go cold turkey. So the people go for street drugs, and since most heroin you can buy on the street is 80% unknown, possibly poisonous shit, people get used to an approximate dose estimate. Then they do get the batch of heroin that's been cut with poison – or perhaps they get white powder that is 50% heroin instead of the usual 20%, and they OD by accident.

    Infuriating! Then they think it's the patient's fault! But now the white middle class, nice people are dying of OD, so now they're victims instead of at fault, like the black neighbourhoods were during the crack epidemic, when the victims were mostly black.

    To have arseholes like Jefferson Davis Sessions III make drug policy is an insult to every doctor and every patient!

    I had a friend who for years and years clearly expressed that he didn't understand my chronic pain and my intermittent migraines. I would be taking non-opioid analgesics then, and I was a big upset with his attitude, although otherwise he was a great guy who understood me (I'm HFA or high functioning autistic) . Then he broke his femur in a workplace accident. First of all it didn't heal very fast, and it left a permanent, chronic pain in his femur. I moved away from the city, but we saw each other a few years later, he was on crutches and he said he now understood pain better.

    Jefferson Motherfucker Higgenbottom Sessions III obviously doesn't know about pain. It's great to get pain advise from people who've never experienced pain beyond some cuts or minor sprains or hairline fractures. Because I have lousy coordination, I've had my bones seriously broken at least ten times, not to mention the dozens of sprained ankles, subluxated shoulders, knees and fractured toes, fingers. And there's the chronic neuropathic pain that I've had since I was about 20 years old, so four decades and counting.

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