CDC Opioid Prescribing Guideline: Unintentional Consequences?

CDC Opioid Prescribing Guideline: Unintentional Consequences?

By Angelika Byczkowski.

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

The broad misinterpretation of the CDC’s Opioid Prescribing 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 “unintentional” and “unforeseeable” by the guideline authors. Most pain patients realized right away that these “suggestions” would become codified rules, no matter how little evidence supported them–and we were even more right than we ever imagined.

Angelika Byczkowski

Considering the public positions of the carefully selected people who were allowed to write the guideline, their intentions were clear to anyone familiar with their fervent anti-opioid beliefs and opinions.

When the guideline so strongly discourages opioid prescribing and insinuates a risk threshold at 90MEDD, was it “unintentional” that it would lead to the conclusion that opioids are unacceptably dangerous and should never be prescribed over 90MEDD?

The use of this guideline to standardize doses of medication for all Americans is a radical retreat from the modern trend toward individualized medicine. It makes no sense to stipulate standard doses to treat such an ill-defined and variable symptom as pain.

Legitimate opioids doses can vary by a factor of 100 (yes, literally) between individual patients in their individual situations, with their individual body chemistry, individual metabolic abilities, and individual health histories. It is for this reason that the medical literature has rightfully abstained from identifying standard dosing or an upper dose limit for opioids.

Was it unintentional to insinuate a significantly higher categorical risk at a certain number of milligrams?

In the otherwise ambiguous and indeterminant realm of pain and its relief, the guideline writers did what researchers and doctors have never been able to justify with current evidence. The guideline specified a standard number of milligrams, a mostly fabricated but measurable data point, for risk ranking.

Was it unforeseeable that bureaucrats, politicians, and even doctors would immediately latch onto this number to use as an upper limit of permissible opioid prescribing?

~~~~~~~~

It was PROP, Physicians for Responsible (and restrictive and punitive) Opioid Prescribing, that instigated and lobbied for the writing of the CDC’s guideline, portions of which were cribbed right from the PROP organization’s own PROPaganda, anti-opioid to the extreme, and without sufficient evidence.

PROP’s leader, A. Kolodny, equates our best and sometimes only option for true pain relief with an illegal street drug, calling our pain medications “heroin pills”. His position is that opioids are not effective for chronic pain, that we are taking them only to avoid opioid withdrawal symptoms, not to treat the pain that started us taking them.

Therefore, he advocates for forced opioid dose reductions across the board, ideally to zero, but at least to below the 90MME “magic number” mentioned in the guideline as requiring more careful consideration. This number has been widely, and wrongly, interpreted as conferring a threshold of increased risk for overdose.

Mr. Kolodny sees no value in opioids for long-lasting pain, only for acute pain of at most a few weeks, so he cannot begin to comprehend the reality that chronic pain patients live in.

~~~~~~~~

Misled and inflamed by the flood of anti-opioid hysteria in the media, most of the public believes the crisis of overdoses is from opioid medications, possibly diverted or scammed, but prescribed by doctors.

Thus, the anti-opioid crusaders are convinced they must reduce the amounts of opioids prescribed. They firmly ignore all other possibilities, deaf to our cries of agony and blind to our subsequent suicides, as they doggedly pursue their drug-warrior fantasy: pain management without opioids, except very rarely, very briefly, and very reluctantly.

Even today, there is little mention of the real culprit in the rapidly rising number of overdoses: illicitly manufactured fentanyl.

Cheap, ultra-potent, and deadly even in tiny amounts, fentanyl has already contaminated much of the black market drug supply. Drug users purchase what they believe to be their “normal drug and dose” but the concentrated power of added fentanyl sends them into respiratory depression and death.

That’s what’s causing the overdoses, not prescribed medications. Overdoses are still increasing while opioid prescriptions are at 10-year low.

This is not an “opioid crisis” – it’s a heroin and fentanyl crisis. And to make matters even worse, the CDC recently admitted that it has been over-counting prescription opioid overdose deaths by erroneously categorizing street fentanyl as a “prescription opioid”.

~~~~~~~~

It is as though the anti-opioid crusaders cannot quite believe that “real” chronic pain exists, leading them to conclude that patients are complaining of intractable pain only to get the drugs we need to feed the inevitable addiction we’ve developed.

By denying patients this effective treatment of last resort, the only one that makes our painful lives bearable and worth living, they believe they are rescuing us, setting us free from the nightmare of addiction.

And when we are finally forced “off” opioids and established in one of the unregulated and insanely profitable addiction recovery centers sprouting all over the country, we will see “the truth” and finally recognize them as the virtuous heroes they believe themselves to be. I think not.

Because the prevailing winds of the cultural “war on opioids (and pain patients)” have been blowing into their sails for so long, these anti-opioid crusaders are unaware that their driving cause is only hot air and based on popular click-bait memes, not reality.

~~~~~~~~

To correct the errors and gross bias of the CDC Opioid Prescribing Guidelines, which would only heap more convoluted and imprecise conditions onto what is already scientific garbage, let’s throw them out and start over.

As they say:

“Adding a spoonful of wine to a barrel of sewage makes more sewage, but

Adding just a spoonful of sewage to a barrel of wine still makes sewage.”

Until she was disabled by progressive pain and fatigue from Ehlers-Danlos Syndrome and Fibromyalgia, Angelika was a high tech IT maven at Apple and Yahoo, and a competitive endurance athlete. She lives in a rustic cabin in the redwood forests of the Santa Cruz Mountains just up the hill from Silicon Valley with her husband and various 4-legged kids.

When her pain allows, she spends her limited energy researching, writing, and blogging about Chronic Pain, EDS, and Fibromyalgia at http://EDSinfo.wordpress.com and writes poetry to sustain her sanity.

Subscribe to our blog via email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Authored by: Angelika Byczkowski

129
Leave a Reply

2000
129 Comment threads
0 Thread replies
1 Followers
 
Most reacted comment
Hottest comment thread
117 Comment authors
  Subscribe  
newest oldest
Notify of
Lynne

I’m 71. In pain. Suicide is my option. They will never fis this. Look at the whole mesh. Think they care about you. Desperate, just torture. Like I’m some kind of street person.

@Justice

*If * A.K./prop, CDC & whoever else; take your pick, is correct & intractable pain patients are just trying to avoid withdrawal (hypothetically) : then WHY after 1 – 2 yrs [thousands] of patients being cut-off their meds- are STILL suffering & most likely bed-ridden? ..& even committing suicide. I’d like them to answer to that.

Their “theories” & assumptions have failed misserably. The proof is in the pudding so to speak. One thing is for sure though: they are single handedly responsible for:
1) quotas = medication shortages
2) profiling of the sick
3) suicides
4) under treated pain in some cancer pts
5) gov/police state dictates care
6) insurance dictating medical outcomes & regimens like never before
7) job loss (increased disability)
8) •experiments•/surgeries With inadequate pain control in hospital setting
9) medical careers eradicated
(Re:pain management)
10. patient abandonment
….the list goes on….

—NOT TO MENTION turning medical practitioners into eternal sceptics looking at every patient as a potential drug-seeker! They have forever changed the landscape of medicine & the sanctity of Dr/patient relationships
— Are “they” proud of themselves now?…For saving humanity *jest*

**now explain to me why anyone THOUGHT this was a great plan? “What a disgrace & mess this has caused!”

C Dix

I’m confused…..if it’s all fake news, how come POTUS said that people going into the hospital for a broken arm will be addicted to opioids when they leave? (Sarcasm)

ITGIRL273

This is why the media needs to be held accountable for this mess. News is supposed to be VERIFIED by fact checking and source verification. These standards are no longer required and ther fore not being practiced anymore. It makes me absolutely sick that stories of completely fiction and bias are spread to every network without 1 person fact checking. And in the end, when the truth finally comes out, nothing is done! Lives are being ruined by tis control they have and I blame not just our government, but those who actually watch and believe this garbage. We haven’t had a news channel on in my house in years. Who can you actually trust for the truth anymore?

Thank you for this article, and thank you for providing the truth!!

A. MacKenzie

Well said, Angelika! Thank you. I believe the opioid “crisis” is a perfect example of how an idea can take off like wildfire, fanned by a complicit media, resulting in possibly unintended consequences, as well as distinct concrete harm to those touched by the frenzy. It is easy to jump on the bandwagon of the latest fad, especially for our politicians , and opioid addiction is an easy one for politicians on both sides of the aisle to get on board with, making them appear to be concerned and “non partisan.” After years of suffering I finally learned about tramadol w/acetaminophen around 2002 and only received this for fibromyalgia pain and stiffness when I read about it in a fibromyalgia newsletter and I asked a rheumatologist if I could try it. NOBODY – no doctor – would ever give me anything for relief, but just scorned me for being over 40 and overweight, and would prescribe a pill for depression and tell me to exercise more. I lived in fear that someday I would be deprived of the one medication that relieved my pain and allowed me to live a more normal life AND that doctors would continue to prescribe for me. I first heard of the “opioid crisis” watching the Democratic Presidential debate when Hillary Clinton railed against opioids in the debate and my heart sank … I thought, “here it goes.” I had NO idea how quickly it would catch fire and how drastically it would complicate my life, cause constant fear, and that I would even be denied seeing a doctor at two different clinics, merely because I was in some database as being prescribed tramadol/apap, and for an entirely unrelated issue. That really scared me. I am just thankful that there is pushback through organizations such as the National Pain Report.

Stacy

I broke my neck in 2011 and have had TWO FAILED surgeries due to an incompetent doctor. Now NO ONE will touch my neck because it “opens them up to a liability.” I have had 7 doctors tell me that. They sent me to pain management. I jave been on the same medication for 6 years and it does not take away the pain but makes the pain manageable. I DO NOT GET HIGH when I take my meds. It makes the “sharp pain” tolerable., as tolerable as it will ever get. I already had EVERYTHING taken away from me with this injury. My husband lost the wife he married. My kids lost the mother who did EVERYTHING with them. I lost my friends. I also lost the ability to provide for my family as I was the higher income so my children didn’t have to be in daycare and could be cared for by their dad. We lost the house I tried so hard to get. I lost both of my vehicles. I went back to school while my kids were very young to finish my Bachelor Degree. I have had. Job since I was 14 years old. I am ONLY 43. We moved to Wyoming from TX so we could afford to live. I only receive social security and my student loan still comes out of that. I spent two years in bed. It makes me sick to see that bed everyday knowing that I will end up in it again. I now have to drive from Wyoming to Montana just to be treated at my pain specialist. He is a great doctor. He follows the rules and so do I. Now he is lowering all patients doses because of this CDC guidleine. It is a “guideline”, not a law but they are still lowering doses. I have NEVER abused my medication. I pass every test when its given and I even offer to take it each and every time I go in.

THE FFA, CDC, DEA, ETC…..YOU ARE DOOMING THE PEOPLE WHO FIGHT EVERYDAY, EVERY HOUR, EVERY MINUTE TO KEEP GOING. YOU ARE KILLING US, AGAIN. WE HAVE A RIGHT TO LIVE AS WELL AS WE POSSIBLY CAN. OUR FAMILIES HAVE ALREADY LOST SO MUCH. THEY SUFFER AS WELL. The powers that be are pushing us to a very dark place and the suicide number will explode!

The “opiod epidemic” and overdose deaths are from heroin laced with fentanyl and carfentanil!

How is this not considered discrimination? How is this not considered a crime? People are indicted if they even support a suicide. This is EXACTLY what the government is doing. This should be concidered a crime!

Ethel Parks

It is disturbing and factual that the Government is placing controls on the people who are in #ChronicPain #Wal-mart and #Fema are teaming up, and #innocent civilians which rely on #prescription drugs will soon be un-able to receive #prescriptions! Look @ closed #Wal-mart ‘s and #FEMA camp’s, this is a disturbing pattern and #AMERICA needs to #WAKE-UP! Don’t be distracted by #CDC this is only a ploy and millions of lives are at risk. MAY GOD HELP US

Troy Gren

The people in Chronic pain to be told by their Doctors they better tell their congressmen ask for protection. Is being a bout as effective as the WW2 era German people telling the Jews to protect themselves!!

Kris Aaron

There is an astounding profit to be made off denying people prescription opioids for pain! Andrew Kolodny, currently head of PROP and a member of the CDC committee that recommended the decrease, was until recently the director for Phoenix House, a string of unregulated drug rehab clinics. Rehab is even more costly than a heroin habit — some clinics charge $1,000 PER DAY and welcome “frequent flyers” (repeat customers) with open arms. The only other business I’m aware of that makes huge profits off its failures is the private prison industry.
The CDC committee that came up with the original 90 MME decision was composed of addiction specialists including Kolodny, family physicians with little pain training, non-medical professionals and ONE pain specialist. No chronic pain patients were included. That may explain why the CDC tried for months to keep the names of committee members from the public.
Where else does the profit motive come in? “Alternatives” to opioids are thick on the ground and waiting for pain patients to discover them. Everything from mindfulness meditation to TENS units, physical therapy, bio-feedback, surgically-implanted electrodes, colored lights, massage, accupuncture, and non-opioid prescription drugs (often with nasty side-effects) are considered “appropriate” treatments. Unfortunately for us, our health insurance rarely covers every alternative our doctors suggest. Pain patients have been bankrupted chasing physician-recommended relief.
While gabapentin and pregabalin (Lyrica) do work for some individuals, others experience unpleasant reactions including personality changes and significant weight gain without the promised relief from suffering.
Some patients have been driven to using illegal drugs. Tragically, pharmaceutical-quality narcotics are nearly impossible to find on the street, but, hey! how ’bout illegal fentanyl from a lab in the Middle East? When the pain becomes unbearable, playing Russian roulette with street drugs becomes a viable alternative.
In the end, an increasing number of chronic pain patients are turning either to the street or to Drs. Smith and Wesson as a way to end a lifetime of uncontrolled suffering.
Meanwhile, our government is laughing at us. Attorney General Jeff Sessions’ comment about pain patients being able to “take two aspirin and tough it out” was beyond cruel. People in power will never have to experience the horror of chronic pain — powerful opioids will always be available to them.

Jill

Such a great article. Straight talk pulling no punches. Wish it could make the front page of any major city newspaper. Or better yet, all of them. Thanks, Angelina. God bless you and keep you strong!

Notasheep

The amount of replies to this article on one website should throw red flags. We are all TIRED, just….tired.

Robert Ivan

To Kelly Howard,
Your story is I’m afraid, far too common. Unbelievable to think such events could take place in the United States of America.

We have more empathy for animals than we do for human beings.
We have more understanding for our enemies. Can you imagine if we allowed a terrorist to suffer agonizing torture without the media having a field day.

The CDC admits they screwed up, inflating the overdose figures by 53% and no reaction from the press.

It is now a unquestionable fact that illegal opioid analogs are the main cause of addiction and overdose and yet nothing from the media.

Several studies have confirmed that true chronic pain patients rarely become addicted (less than 1%) to their pain medication and still nothing but the sound of crickets chirping. It doesn’t matter how much evidence comes forth vindicating the innocence of patients in pain, the narrative continues to persecute the innocent.

I wonder how much will it take for the American public to realize what our government has been doing to the weakest of us. How long will it take for the deliberate torture to stop.

Caregiver 24/7/365

Angelika: Thank you for speaking truth to power. Too many of those who have commented: Thank you for adding the details of your own plight. To those who say “quit the opioids, other things will work”, in the case of my 78 year old wife, a genetics researcher and professor (retired), they will not. None of them, and we have tried them all. You have no idea to what lengths we have gone.

Perhaps you are well-intentioned but I invite you to please leave this up to us and our physicians, who are experts in the particulars of my wife’s malfunctioning central nervous system. Suicide would stop the pain and it probably will. Is that what you are seeking?

how do we go about getting our health needs out of the government. when did they become doctors to tell us we dont need pain meds. do they or their families suffer. what about their kids. if they were wheel chair bound and in pain everyday and pain meds help, now do they also keep it away from their own kids telling them to just get over it. if they would do that, do we need them in our government, I dont thinks so.. they show they are unfeeling as they can get.

Jackie

Thank you so much, Angelika….. I have chronic pain. I am so worried about what my doctor’s plan to do. This is a great article. God Bless You

Claudia Miller Negron

I do agree with the war on Drugs more needs to be Done now its not the Doctors..under FDA And Sea regulations.. Its the streets Kids 9 yrs of age Dealing I have had 7 fusions Back also 3 neck surgeries.. I went from 13 meds to 2 now 3 . Humidity… 1 opiod most 2 noir a day prescribe 1 opioid my choice.. Most ppl are on many crpls… Horrible pain and need .stronger medication s why should we pay.. For all of the thugs purchase drugs on the streets I myself don’t take illegal Drugs like pot nor drink my choice .. We I got injured at work.. Mornings are the worst… But you need to arrest the DRUG DEALER S… W THE FENTANYL AND HERION . IN WHICH CASE I TAKE NEITHER BUT SOME PPL NEED THE FENTENAL.. CHRONIC PAIN SUFFERS .. PM DOCTOR S ARE FOLLOWING GUIDELINES… BUT ITS CRAZY THAT WE ALL SHOULD SUFFER YES I GET TESTED ONCE A MONTH OR MORE .NO ILLIGAL DRUGS IN MY SYSTEM.. ITS VERY SAD MOST I KNOW ARE WHEELCHAIR BOUND AND NEED MEDICATION S .. NO ONE UNDERSTANDS ARE PAIN MYSELF 23 SCREWS RODS AND PLATES ..BUT PLEASE LOCK UP THE PPL AND FIND OUT WRE THEY ARE COMING WELL CHINA GOT BUSTED SELLING FENTENAL. 4 WRE ARRESTED SENDING IN THE U S MAIL .. MOST ARE COMING IN FROM COLUMBIA AND MEXICO …NOW CLOSE TO HOME 4 ME INDIANA. ITS SAD ITS PATHETIC..

Cherise

I also have EDS and a few autoimmune disorders, plus have had 2 brain surgeries, and had radiation poisoning. And am now having new symptoms of some new funky [edit] going on with me. Thank you for your article, it is so correct! They mention heroin and the street fentanyl, what Dr prescribes that stuff? Not a single one. Yet those are the ones they talk about all the time! The person OPIOID you may be able to deal with your pain and wait for the next thing to come out but not all of us will be able to! And you joke about some of us killing ourselves because of our pain. I would not be able to live in the pain that I have as I’m sure there are others who would feel the same way. Your so I can’t even think of a word to use that you won’t even use your real first name. I be doubt it if you even have any pain at all.

I am a patient who really need the opides for pain (chronic also osteoporosis and the fact I am 61 with other problems). It is really hurting my life and what I am able to do. I cannot function without this medication. I have tried other meds but I can’t get the relief I need. I also was in a fire 3 months ago. I had skin grafted to half( upper back) of my back and problems with my hip and spine. I an not without some pain but I function better on pills. And I have past every every urine test. You the gov. Need to stay out of people’s meds and realize that not all people abuse meds.

Melissa Callis

Thank you, Angelika, for this well-written and well-researched article!

Wanda Norris

I have chronic insommia and chronic fatigue disorder.Bad disks fibermalgia and other health issues.my medcine has been cut to only oxycondone 15 4 times a day.Those that r not in pain do not care.It is the other street hard core drugs that r killing.They need to leave us alone

The degree of insanity & refusal to even acknowledge reality (heroin/illegal fentanyl) in this “opioid epidemic” narrative has far gone past surreal and into criminal irresponsibility and deliberate torture. I’ve been a chronic pain sufferer for decades. At the moment (tho not for much longer) I am one of a decreasing few who has not had their medication ripped from them. My pain is actually worse due to the extreme stress and anxiety of knowing I will soon be forced to live with unrelieved pain.

My mother was forced to endure far, far worse; during the last opioid hysteria, 21 years ago this week, she died in unspeakable agony. She was dying of leukemia but they refused to give her anything but liquid children’s tylenol –even after she was no longer able to swallow. There were people in Georgia who abused oxycontin, so she (who never even took aspirin) suffered weeks of screaming agony. There was absolutely no question that she was dying, but by God, they weren’t gonna let her get “addicted” in the coupla weeks or so she had left to live. So she died in a tortured Hell.

The level of rage & torment (and guilt, that I couldn’t help her) I felt and still feel from that government-dictated torture is indescribable. The fact that this is happening again, more times each day, is unconscionable and barbaric.

I and many other chronic pain patients have taken legal medications safely, under very close medical monitoring and scrutiny, for decades. We are not addicts, though we are treated worse than heroin addicts. We have become high target scapegoats for the endlessly failing “War on Drugs.” The US has failed for decades to control illegal drugs, and those illegal drugs are what are driving the “epidemic” (if there is such a thing: medical errors kill SEVENTEEN TIMES more people each year than prescription drugs, but I do not hear screams for all hospitals and doctor’s offices to be closed.

The list of non-opioid alternatives I have tried to relieve my pain covers pages. None worked much, if at all; several had very severe side effects. Opioids have been safe and effective for millions of people for many decades. Sentencing people to live and die in torture because of lies and the greed of “anti-addiction” activists are crimes against humanity.

Devo

Good article. I couldn’t agree more about what’s really causing the opioid OD rates to skyrocket. It absolutley is the illicit Fentynl market that’s doing the most damage. That and uninformed drug users. I’ve always thought that education about drugs while young is critical. Kids should be growing up terrified of Heroin and the consequnses of using it.
(like I was)
I have a history (love affair) with psycoactive substances, but Heroin was always something I feared having seen up close how it ruins people. Then add to that a substance that no body has any business using recreationally. It has it’s legitimate uses, but unleashing on the drug using public is manslaughter if you really think about it.

Robert

I want to know where all the freak’n attorneys are? I realize that the government has done a good job insulting itself from prosecution and those doctors who are simply following the mandate given them to legally torture patients, but how about when a doctor uses techniques that cause metal anguish deliberately?

Are doctors allowed to lie, deceive their patients? My current doctor has been treating me for the past 3 years. He is great about making promises only to go back on them. Like so many of you, three years ago when I became his patient, while suffering from every moment pain, my medication allowed me to have some enjoyment in my life. The CDC guidance pretty much put a halt to that.

Here’s the latest example of metal torture from my Physician. Besides everything else I endure, I also suffer from “White Coat Syndrome”, fear of my Doctor. Never knowing what to expect when I go to my monthly office visit. Because my pain medication under his administration has been cut by 70%, I barely function. Because my pain level is now off the charts, it tends to increase my blood pressure and my bpm is always around 100 or above. Acknowledging the fact that pain is causing the increase, he is forcing me to take Beta blockers and has told me to make sure to take them before an office visit. He doesn’t want to be responsible for my pain to develop into a heart condition or stroke. He admits it’s to CYA himself.

3 years ago I could take a walk with my wife, go to an occasional movie, go out to eat and shower on a daily basis. Today it’s very different. I rarely leave my home, am either bed ridden, or suck in my recliner. I am lucky to have a real normal shower once a month. Two months ago, he made the claim that he would keep me at my current level without further cut backs for the foreseeable future or until they change the law. Nothing has changed in two months and during my last visit (1 wk ago), he said he was reducing my pain medication again. My wife reminded him of his promise for which he responded “I don’t care”.

My Doctor is a sadist.

Thomas G. Mccrory

I have been on pain meds for over forty years for cronic pain and it does nothing but get worse over the years, I was injured in a work place accident , and herniated L-4 & L-5 discs in my lower back, with not much hope of getting rid of it , my orthopedic surgeons then and again in 2001 said I had a 85 percent chance of being worse than getting any better, but as the years go by they take away my meds that help me deal with day to day life, I am a big man , I weighed 325 pounds now at the age of 62, I weighed 290 when I graduated high School in 1974 with not much fat on my body, I have been taking 100 hundred milligrams of Norco for the last twenty years,now they want to start taking that much away by just 10 milligrams aday from me just to meet sum Damm cdc official that has most likely has never hurt for more than a few days at a time, me I have been in constant pain for forty years and will most likely will be in pain until the day I die, please let me live the last year’s of my life in some sort of comfort, also I am taking Xanax for very bad skeleatal muscle pain from sciatica in my lower back and right leg and is moving to my left side as well, they say I should be taking flexairl for the sciatica, please I have been a test patient for most of those years , because my doctors said then that antidepressant and pain meds were a good combonation for God’s sake please don’t let them do that to you, I now can’t go out into the world of sunshine but for short amounts of time because my skin is so UV sensitive so I refused to continue with that combonation of drugs, now my doctor wants to start taking my Xanax away because that is not a good combo , please let me and my doctor make my own care plan, I think that his good doctor, but his pallitave care of me seems not to be a good thing for me by the hospital director who is stopping all of doctors from treating chronic pain patients because they would prefer not to have to deal with us as patients it easier to just abandon us and send us to so called pain clinics witch are being closed as fast as they open and are few and far between,just got off phone with the patients advocate at local hospital trying to solidify my position as a patient at this hospital for the future and continued treatment their. Good luck to all that are in the same position!

Vicki Cook

I live in pain beyond what most people believe is possible due to lupus I have pain pills that keep me able to work each day. I’ve never overtaken my meds but I go to pick up my meds last month they told me I would have to have narcan a man who overheard followed me to my car to asked what I take. The people who write these laws I hope they live for a week with the pain I live with daily

I was shocked to find out that there is some sort of national shortage or control on Dilaudid for hospitals. On June 1st 2018 I had a massive heart attack that put me in intensive care for 11 days out of the 14 I spent in the hospital. Well between the chest pain and the incredible headache I got from the nitro drip I needed IV pain medication for awhile. After having over 100 kidney stones I know the only pain med that works for me is Dilaudid. Well guess what…hospitals can’t get it except for PCA machines according to the hospital pharmacies ( I found it depends on the hospital since I got transferred to a special heart only hospital). I had a pain specialist do the prescribing and he was only willing to do low dose morphine along with 10 mg oxycodone tablets and 10 mg Oxycontin tablets. While I appreciate the effort it was frustrating that doctors don’t listen when you try to explain that those medications don’t work for you for whatever reason. The charge nurse was frustrated too because it was obvious that I wasn’t getting much relief and the continual stress from pain is not good for patients with heart problems. She called the pharmacy about Dilaudid and was told nationally it was only available for PCA machines…not for regular IV use. Well either the pain specialist or one of his myriad Nurse Practitioners refused to order the PCA machine. Well obviously I don’t have anything good to say about the so called “opiod epidemic” hysteria. In my personal opinion I believe it is a product of the CDC and the DEA terrorizing legitimate doctors and even pain specialists (most are anesthesiologists) to the point that even legitimate pain patients are being way under-medicated and often are turning to black market drugs for relief…often getting fentanyl laced meds that kill them. Yes, I know there are pill mills run by unscrupulous “doctors” but that is a very small percentage of doctors in this country. It smacks of prohibition and we all know how well that worked out. My own pain specialist had me on 10/325 Percocet for a month and I requested that we back it off when I saw him this month. We backed down to Norco 10/325 and next month we are backing that down also. I need a knee replacement so I can’t stop totally right now but I want the minimum that still gives me some relief, especially at bedtime. I only get 3 or 4 hours sleep as it is.

Anonymous

I thought when the truth began to emerge that pain patients and their prescriptions were not the true problem the government would stand up, take charge of this mess and straighten out the problem.Instead,I am seeing the country that I was taught was a kind, caring, understanding, compassionate country turn it’s back and abandon a group of people who are suffering so bad many of us have already committed suicide.For God’s sake why is it that our country has the ability to produce these life saving drugs, and yes, although they may cure nothing,for me they are life saving. I would think that the people who have committed suicide after losing access to this medication would agree that these medications were life saving for them also.My wife is very sick with lupus,liver, kidney disease, numerous autoimmune issues and she suffers from dementia. I am her sole caregiver. I am slowly losing access to the only medication that allows me to care for her.So in our case I guess the evil opiates are life saving to both of us. I use the term life saving because as I said before these drugs cure no disease but without them I am in so much pain that it doesn’t matter if I can’t get out of bed or not I can not live with this amount of pain. I am only 50 some odd years old and can remember thinking what it was going to be like becoming a senior citizen.I had no idea that when they said to keep taking the medicine and you might have to take it the rest of your life that the government would rise up and I would be abandoned by my Dr., Government, and even my in laws who still say it’s a shame that Drs. and patients have caused this. I have truly given up hope that chronic pain sufferers are going to be helped and I am mad as hell that our Drs., politicians,news outlets and government have not only allowed this to happen they have perpetuated it in many ways or just stood by and allowed suffering on the scale of torture.I mean if you can’t see that pain,not the lack of medicine, but the actual pain that is placed on someone from lack of pain relief has already caused unknown numbers of suicides you are not willing to look at the true information.It is there.Look at Montana.Jesus Christ people,we are not in the wild west where you kill your family member instead of letting them suffer.Even that is more humane than torturing us to the point of taking our own lives. I do not care how long I live I need to have some quality of life.Life with no quality is not worth living.

Lori Barton

I just moved on medicare can’t find a pain mgt have cp a disk fracture and days where I cánt move I now live in s.c

johnny C Pilkington

My wife’s doctor refused to write opiates after her PCP internal medicine doctor retired she crippling psoriatic arthritis. Before her doctor retired she had taken 7.5 my loratab for 14 years. She tried to go along with the new doctor all the negative about miss use, and all the deaths from opiates. Well you just as well say she was party of the death toll during the CDC guidelines hype. Her death certificate reads “combined amitriptyline, duloxetine, hydroxyzine, and tramadol intoxication”. 14 years without a problem on loratab, then the irresponsible dumb asses at the CDC murdered my wife and took her away from. When they away her pain medication she could not get out of bed, zero quality of life, then gave her the above medications, and I found her in bed with her eyes bulging and her body stiff. Thank you so much CDC, I hope you who came up with the guidelines feel real good about yourselves as well the doctor that did not have the since to monitor her on these dangerous medications, not knowing that they potentate each other and kill my sweet wife at the age of 59.

Mark

I to am a chronic pain patient. I have never gotten high from taking my pain medication. I currently take 6-15mg Oxycodone per day. My doctor said I have arthritis from my neck down to my feet. He tried to give something stronger but I told him that was to much for me. If I was using it “get high”, I would have not told him about it being not right for me. He tells me I need surgery on both knees, hips, and 1 ankle. The government needs to stay out of it!

My pain management doctor began cutting me back as soon as the recommendations were made public to them. I am suffering severely now. I have arthritis in knees, hips, hands, shoulders and spine. I also have severe fibromyalgia, spondolitis, sppndolithiasis, and cervicogenic migraines. I have been in a wheelchair for about 5 years and spent a great deal of time in bed. I was forced to give up a career that I dearly loved, stop hobbies like quilting and change my whole life style. Thanks to opioids and Valium as the only muscle relaxer that worked I was able to go to church, visit friends and family, go to movies and go out to eat. In the last four months my doctor has decreased my medications down from fentynil patch 100 mch every 48 hours to 2cg every 72 hours, oxycodone 15mg every 6 hours to Norco every 6 hours, no Valium. Her plans to take away the fentynil completely this month. I now do nothing except go to doctor appointments. I am in bed 24/7 practically only getting up to use the bedside commode or to take a bath. I have a walk in tub and an adjustable bed to help. I am blessed that I have a husband and daughter who take care of without complaining. I am 68 years old and don’t feel take addiction should even come into play here as how many more years will I be around. Even if I were younger the problem of addiction should no be considered in chronic pan patients. I do not take the medicine to get ‘high:” and have never taken more than prescribed and I have never bought drugs illegally. The people dying from drug overdose are the ones getting it illegally not the bonified chronic pain patient. That is never going to stop. Just like taking them from honest citizens will not keep the criminals from getting them. The CDC has in my opinion signed my death certificate. I am now at much higher today of DVT and pulmonary embolism and hearty disease. My quality life is nothing. The government needs to rethink the limitations they have put on doctors and the unfair suffering they have caused honest patients. O was a registered nurse and one of the patient rights mandated by the government was the right to effective pain relief. Now that is impossible. I know people who have had surgical procedure and were sent home with no pain medication. This is rediculous. Doctors are running scared of losing their licenses and rightfully so. Something has to be done to stop drug abuse but this not the answer. The government is attacking the wrong ones.

Ali

For me, simply reading/hearing about the “Opioid Crisis” and the thought of my medications being reduced or worse, taken away altogether, makes my pain even worse! I’m not addicted to the pills, if I were I would go through them a lot faster. As it stands I usually have a few left at the end of the month. I don’t get “high” from them and they don’t take all of my pain away. In fact I’m still in a great deal of pain!! But I have an excellent Pain Management specialist and between him & his team they keep a close eye on his patients. I don’t feel like the government needs to make laws out of some guidelines. Pain is far too personal and highly subjective.

Furthermore, much like Prohibition, just because something is illegal doesn’t mean that those who want it bad enough won’t be able to get it. It will only serve to cause those of us that live EVERY DAY OF OUR LIVES in excruciating pain to find alternatives that aren’t monitored or governed.

If you don’t live in this kind of pain you really don’t know how lucky you are!! I often wish that I could share my pain with others, for just an hour or a day, so they could get a sense of what it’s like. I have several forms of arthritis, scoliosis, both knees & hips are blown out and need to be replaced, and I could go on and on but there isn’t enough space.

There is my 2¢ worth, in case anyone is interested.

Matty

Thank you Angelika for having the courage to write about the truth. You show bravery, something that I have lived in fear of doing. It’s a sad thing to live in fear in the great U.S.A, “the land of the free”. I fear that if I speak up, that I will get booted from what’s left of the pain management that I am getting. I fear about knowing that this pain is here to stay for the rest of my life. That was the surgeons words when I had this surgery, a neural schwannoma tumor invading my spinal cord, attaching itself to my lungs and ribs. All while my 98 lb. body was working for a company hoisting 50 lb. boxes on to my shoulder to carry to a conveyor that was as high as my head and flipping them upside down. One after another 8-12 hours a day, mandatory overtime, 6 days a week. Think about lifting half your body weight over your head. Yes there was bigger men that could have done this job. But some of the people upstairs in upper management thought it would be a great idea to send over people that needed discipline for when they were being bad. So on top of doing this back breaking job, I was suppose to train a whining crying “ I don’t want to do this job, my job is to drive the fork trucks”. Yes, I was certified to drive the fork trucks, but some workers were pros at causing down time. So no, that was not an option. I saw a 275 lb. man having a temper tantrum like a child one day while covering for me. Throwing things, basically shutting production down. They put me right back on that job after I returned to work. Then my discs started blowing out. Basically, the job that I was so very thankful to have because there wasn’t any decent paying jobs left in my area was tearing my body apart. My Dr. couldn’t in her right conscious let me return to a job that was going to continue to make me worse. She had me call them and ask if they could take me off that job, they said no !! What it boils down to is I have spinal nerve damage. To describe the pain, it feels like I am constantly getting zapped with bolts of lightning. I cant remember what it is like to get more than two or three hours of sleep. I have always followed the PC rules, have been on the same dosage for 10+ years and have survived the dose without dying in my sleep. Hello, I am still here ! The CDC needs to stop sticking their noses in where it doesn’t belong. Stop threatening the Drs. with taking their licenses away. Let Drs. do what they are trained for, like PAIN MANAGEMENT. We can’t live like this !

Judy K Jones

I agree with Angelika’s article and view that prescribed opiods rarely cause death by overdose, unless the pills are tainted with Fentanyl, combined with benzodiazapines such as Xanax, Clonopin, Valium, etc, or it is an intentional overdose.
What the extreme control over physicians not being able to accurately prescribe opiods for legitimate pain, people are turning to the streets to purchase illegal opiods. But because of the high price of illegal opiods on the streets, people are often turning to Heroin which is a cheaper alternative to control of their pain.
We are now seeing a Heroin epidemic!!
And people, wake up!! It’s Heroin, not prescription opiods, that is causing deaths from overdose.
But yet there is another problem concerning the so called opiods crisis:. the difficulty in getting help for opiod addiction. Subutex and Suboxone is a wonderful prescribed medication used to treat opiod addiction, and with great success. However, doctors from every category jumped on the bandwagon to prescribe these medicines for cash. In order to prescribe these medicines a doctor only need to take a six-week course to become an addictionologist. And more than not, these doctors treat addicts on a cash basis only. But not charging their normal office visit price such as $100-$150 for a sick visit for someone who doesn’t have insurance, instead the prices they charge patients for addiction range from$350-$600 a month. Why is this legal? And why is this being overlooked?

Kel b

A.N. – not sure where you were going with your comment? Everyone’s pain is different , treated different, caused by different means, etc. If you are good w no meds that’s fantastic! But I am not!
I work every day whether I want to or feel like I can or not, as I provide for myself with no helpvfeom anyone or anywhere. I have a fast paced highly responsible managerial position- and I love it! But it’s as a lot easier to manage when my med regime was on spot. I’m on call 24/7, I’m salary so if it takes me longer- I get no extra pay.
My pain condition is non surgical n non reversible. Im stuck like this.

For the comment who said the gov wants us to just expire- I agree….but what the gov is forgetting is that many of us do work many jobs and pay a lot of taxes!!
Join the rally this september!! In the meantime call your local media she’s here your stories!

Donald Amos

I LIKE THIS BLOG

mike Martinez

If it wasn’t from pain medication my wife and I couldn’t get around we both have serious back injuries due to an accident we both are on 30 my roxicodone and it barely eases the pain makes life somewhat normal it’s the junkies/abuser’s that make it hard for people like us to get our medication’s.

Cheri Furr

I would also like to thank Dr. Lawhern for his work and for what we know: the CDC did not get the number of deaths caused by opioids correct and included deaths that should not have been included in their numbers. That would certainly include deaths from illegal heroin and the very illegal and ultra-potent fentanyl powder being smuggled into this country. I’d also like to point out that physical dependence for pain relief is not the same as addiction. I have never gotten “high” from oxycodone and have not gone from doctor to doctor or ER to ER to obtain higher and higher amounts of any opiate. I have also gone to the same neurologist and the same pharmacy for the entire 18 years since being diagnosed with CRPS.

F.S.T.

Omg, this is a woman after my own heart. She put into words exactly what the rest of us — hundreds of thousands, maybe millions? of us were trying so hard to say.

I can add nothing. Thank her, will you? I can’t type anything else because my chronic pain has become intractable chronic pain since the forced decreases in my opioid medication that WAS working well before Dr. kolodny got his hands in it and made things very messy.

Cheri Furr

You are SO EXACTLY right on all accounts! It IS an illegal fentanyl and heroin crisis. Opioid doses are titrated just like insulin doses, which also vary from person to person widely. When these drugs have been used safely for thousands of years and are the ONLY thing that works for chronic pain illnesses that are incurable, it is a crime to scare doctors to death, make states enact laws, pharmacy chains set their own limits on the amount of pills that can be prescribed, and insurance companies to pay for even less! The worst part is that it wasn’t even the CDC’s job to DO THIS! Legally, the FDA is the only agency who can set prescribing limits! They approve all drugs on the market and write the package insert, including their usage and dosing. Sadder still is stigmatizing CPPs and making them even more stigmatized than they already just for HAVING a chronic pain illness!!! AND, at the Assistant HHS Secretary’s two-day Committee (charged with making “opioid crisis resolutions” to Congress) meeting that was shown online, the representative from the CDC said that they were only meant as “guidelines,” not mandates, and even the guidelines were just for GPs, not specialists! The FDA just had a meeting in which they heard from scores of CPPs. I would encourage everyone to make concise comments to them stating their disease or condition, how their pain was managed when their doctor prescribed the opiates they needed for pain management versus what it’s like now, and whether they have been tapered down, lost their doctor completely or can no longer get any opiate prescription. Google “FDA 2018-N-1621” and make patient comments.

Bob

As a chronic pain sufferer and former heroin addict I can wholeheartedly attest to the absolute nonsense that is punitive prescribing.

After my third surgery out of a total of 11 my surgeon made a joke about me selling my pain pills and told me what I could score per tablet he was prescribing me.. at first I thought it was just that a joke.

Then came surgery number four and at my follow up the surgeon hinted that only addicts need the dose that he was prescribing (he doubled my script because this surgery was far more invasive and they had me on a morphine drip the entirety of my stay there.)

Ok. I know what your thinking, this drug addict is sour that he couldn’t get as much pills as he wants. Well you would be completely wrong. Having had spent a total of 8 months in and out of the E.R./O.R. – getting a prescription for 5-7 days at a time was ridiculous – especially when I would call for a refill the doctor would either dodge me or straight up ignore my requests.

This led me to the dark net where I could pay street prices but atleast I got pain relief. Unfortunately I suspect some pills were laced with fentanyl and then bamn I got addicted. Before I knew it my pain relief transformed into a miserable addiction where all I did was have compulsive thoughts about the next time I could smoke whatever I had my hands on.

Since I have been seeing a psychiatrist for 6 years I opened up about my addiction and started on suboxone treatment. I know I will have to take this for a long time but there are days I go without it completely fine and if I ever feel like I am craving it I simply place a sub under my tongue and then everything is a-ok.

I would bet my left nut that if the doctor originally prescribed enough to help my pain I would never have gotten addicted less get addicted to heroin.

Something else I noticed is that the prohibitive cost of street pills is increasing adding to the counterfeit fent pressed pills like I experienced or will force people to switch to heroin like myself. I would rather be over prescribed opioids and given a script for naltrexone in case something bad happens than be forced into being a heroin addict ever again. Once we stop viewing these meds as good or bad and realize it’s simply a tool to combat pain that is completely amoral than the pain suffers of these United states will finally have some true relief.

Larry

Hi Angelika it Mike’s guitar teacher and friend Larry. Your articles really hit the nail right on the head and are my sentiments exactly. Thanx for supporting people with chronic pain.

Lisa Mellick

Barbara is right. The governing force in this country knows
EXACTLY what it is doing. Limiting opioids for people who genuinely need them is part of the government ‘agenda’ to beat down, and emotionally/ physically cripple, the population; and if death is a result, so what.
Look at what’s going on:
– government won’t fix healthcare in this country
– government is now refusing to reimburse obamacare insurers
-government granted states work requirements in the hopes that people will drop out of Medicaid
-government has talked about tampering with Medicare and social security. The one thing these all have in common is: Our Health. Keeping us all sick and in pain means we’re right where the sickos operating ‘behind the scenes’ wants us to be. Noone should have to suffer needlessly, and those that makes the laws will never give a darn.

Cindy Deim

Well said!

John Hoover

I recently was asked by my pain doctor to pick one of the two opiate medications to get off of. His protocol was to have take one Morphine tablet for a week, then quit. After three days I was in mild withdrawal. Then on a medication refill visit the sent over the new script for hydrocodone which I have been taking also. Well the insurance company said it was to soon. So now I have no pain medications and in such a state of withdrawal and pain I want to go to the ER, but they would just label me “drug seeker” and throw me out. My pain mgmt Dr and staff have also been unresponsive to my needs. FYI my neck and lower lumber MRIs would make you weep and I have degenerative nerve damage. So yeah, I need some heavy meds to control my pain. So CDC, want to know what you have done, I have nausea, vomiting, diarrhea, sweats, chills, skin crawls, sleep problems. As if you care. You guys need to look into the Pain Mgmt scam. They get dependent on the drugs, then you get the shots, now they want to run two wires up my spine with a battery pack in my butt with a blue toothy type device to control it. What could go wrong. Refuse any one of these treatments and your meds will be cut back or your out the door, because you are no longer a profit center.

John Hoover, Criminal Inv. Retired
Healthcare and Financial Fraud

Amy

Im glad someone spoke out im so tired of hearing that these prescriptions are the reason for heroine thats there damn choice to shoot up know one forces them to stick a needle but maybe if they could just get there pills they would of just kept taking those but since people are stupid we all get treated like addicts and my god you basically have to.give your first born child these prescri have been around for years and you didnt have all the bullshit there eventually will be something that surpaces heroine then what are they gonna blame it on other countries you can just get them and they made it so there legal.and guess what they have no overdoses and the one country they give the addicts there heroine its monitored and given by a professional but its worked were just stupid over hear and its away to.control us and they get there money the only reason people need to smarten up

Finally,someone states the real issue. I agree 100%. ,Living through the nightmare of a grandchild with drug addiction, plus personally knowing Several deaths from same, the overdoses are heroin and fentanyl. Not prescribed Vicodin or Percocet. I am sure that they happen, but not like the real culprits. I understand that prescribed opiates can be addicting, there are systems in place and can be controlled.Dont withhold pain management from those who need it. Let the doctors manage their patients.

This is the best article I have read and we completely agree with everything written! I take pain meds because of chronic pain and it has allowed me to continue to work and support my family. My husband is 43 and has been disabled for 12 years due to severe chronic pain as a result from multiple injuries. He’s had surgery and has tried absolutely everything available to try to fix his “issues” and in hope to ultimately alleviate his pain. I also have tried these same things…. all it has led to is us having to rent our home because we couldn’t afford to stay in our home anymore because of all our medical bills. Pain meds make life manageable and bearable. Now that those have been reduced to nearly nothing we are left in constant pain. I can’t even begin to count how many times we’ve broken down and just cry with no hope in site. My mom is in the same situation. I’ve never heard her cry from so much pain. The issue is with all these people who get scripts and sell their medications, street drugs, and street manufactured pain meds. I find it hard to believe these people making the decisions have absolutely no clue of what they are doing to all the chronic pain people in the world. They categorize everyone and anyone on pain medication the same and we are not all the same! If they’d put their brains to use and figure out how to find these people that get scripts only to sell them they would cut the so called epidemic in half and then the rest of us left that are truly in pain every single day of our lives can get back to having enough medication to properly manage our pain!!! Its ridiculous what idiots are allowed to makes these “rules”!

Linda

[edit] As I stated on my header at the top of this article I just shared on Facebook, “This author just hit the proverbial nail on the head!!!”.

Stacy Cooper

I’m on a 50mg Fentanyl pain patch which actually saved my life. I don’t get that high feeling I used to get when taking too many oral opiods and I don’t run out early and go through withdrawals. I’m afraid the bad name Fentanyl is getting will cause doctors to avoid it for pain patients. I’m so grateful my doctor tried it and that when I had to change doctors my new doctor wasn’t and isn’t afraid to prescribe it.

By the way, I got a letter from the Dept. of Consumer Affairs investigations unit making me sign a release for them to obtain my medical records from my last doctor that started me on the pain patches. They are “investigating” the quality of care he provided me. Bull crap, they are investigating me because I’m on this Fentanyl patch! I wonder how many of us are getting such letters.