FDA New Guidance on Opioids Drawing Response

FDA New Guidance on Opioids Drawing Response

The FDA’s safety announcement this week that says it has identified harm reported from sudden discontinuation of opioid pain medicines and is requiring label changes to guide prescribers on gradual, individualized tapering was generally praised.

Stanford Psychologist Beth Darnall—who was in Australia speaking to the 2019 Australian Pain Society speaking on the topic—indicated that the guidance was appropriate.

“It is wonderful to see national agencies issuing dedicated communications to correct the misapplication of CDC guidelines, and to assure patient protections from iatrogenic harms caused by rapid and forced tapering,” she said.

She also said that communicating this message to pharmacies is important.

“The FDA recommends labeling and guidance to clinicians. Who will guide the recommendations and policies to *pharmacies* to assure that clinicians have the *autonomy to implement best practices for their patients* and prevent rapid and forced tapering caused by opioid prescription fills being denied?

For “Richard A Lawhern, PhD, Director of Research for the Alliance for the Treatment of Intractable Pain, this is a long overdue “baby step” the FDA has taken.

“How much longer can FDA, CDC and other Federal and State agencies ignore the even larger reality? he asked. “As several past presidents of the American Academy of Pain Medicine and other prominent medical professionals have pointed out in a December 2018 letter to the Governor of Oregon, there are no published trials data that establish benefit to legacy patients from mandated tapering of opioid therapy. To the contrary, as FDA points out, there is a risk of medical collapse when such measures are imposed.”

A dentist who had to retire due to CRPS nearly two decades ago, was even less enthusiastic.

“I cannot believe that these “findings” were a surprise to anyone that deals with opioids,” wrote Dr. Mark Helfand to the National Pain Report. “I graduated dental school in 1984 and even back then it was known that you should never stop or greatly reduce the dosage of opioids quickly. It must be done slowly and gradually over time. If not, the effects on the patient are at least serious pain and illness. At most, death.”

Gary lives in Virginia and wrote to the National Pain Report that the FDA word getting out needs to happen fast.

“Virginia must not have received the memorandum from the FDA. As of yesterday, April 9 2019, I was told by 5 pain management clinics in Charlottesville, Lynchburg, and Roanoke that they will not prescribe new – or continue to prescribe from other doctors – any narcotic analgesic.”

Stay Tuned.

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Authored by: Ed Coghlan

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mark steele

My friend Mike was cut down to 90mg of morphine a day. He was hurting so bad he went to the E.R. They did nothing for him and sent him home he lives in Denver. After he got home he went into the bathroom and Hung himself. His 25 year old son found him hanging in the bathroom. My son is friends with mikes two boys and they can’t believe their Dad did this to them. They told my son to watch me because I’m in the same boat that is sinking fast. If you have 0 quality of life because your in constant pain what’s the point of being alive. The Government thinks they are saving people but the truth is they are killing off people in pain. Leaving people suffer in severe pain is Cruel and uncalled for.

Jody Hoffman

I had lost my main provider with no warning he just retired one day with no notice, I called in my refill of oxycodone same as always and one of the providers that worked with him & knew me actually treated me & refilled my medication before flat out refused to refill it & have me no reason, I will be a little uncomfortable like stopping caffeine she said! I was so sick and I told her a week later that she better give me something to stop the withdrawal & the pain before I go to the street at least I would be able to function. I did get it back but at 1/2 the quantity. The clinic told her to cut off everyone’s meds I found out & the ones that are in pain will be able to get it back but at 50 MME, I suffered for 16 months and now she is gone and I am dealing with a new Dr again. Hopefully it will be better

r. p.

Well that’s nice…just to protect themselves from any possible class-action law suits is all that’s about. Typical Gov’t. response after the fact! I hope it helps others but I was totally shut off from my pain meds 2-months prior in Feb. 2019 to this label by my new PCP after the one prior retired. This new “labelling” or whatever it is, is lame at best! The suffering this caused me was unbearable and seeking suicide was definitely on my mind thru those 2 months and is still so even tho the w/drawals have mostly but not altogether subsided. I’m still stuck having to try to survive with 24/7 severe chronic pain though so what is the big deal on this label really?

Reece

The pharmacies have no idea what is going on. I took a prescription to Wallgreens . I have spinal stenosis and manage to function with a low dose of oxycodone. I am scheduled for a nerve block next week. My doctor wrote me a prescription as my pain has increased. I was 9 days early so insurance would not approve it. Wallgreens refused to fill it. I as if I could self – pay. She refused. The Pharmacist actually said to me. “Your doctor can write anything, it is my job to control what you take.” She was unbelievably arrogant and said her license gives her the “right” to control what I take although she knows nothing about my medical history and pain. These CDC Guidelines have made some of these pharmacists feel “powerful”. I said to her that she is practicing medicine without a license. Her response to me was that her license gives her the authority to practice medicine just like my doctor. The whole experience was embarrassing. She treated me like an addict. It is inhumane.

Holly

Open the link and scroll down….You will find the reasons for all this [edit]!

https://www.ciaag.net/uploads/1/1/6/5/116509489/theviolationofanationciaagproposal.pdf

Kate

After all the guidelines, recommendations, task forces, … on and on it goes, I really think the only thing that might (who knows?) change things is a huge class action suit. Finding an attorney/law firm who were willing to fight for us because they believed in the cause and not just dollar signs might be impossible. Just a thought.

trish hochheim

Enough allready!!!
I need my meds back!!!
Stop this FDA, CDC ,GOVERNMENT [edit]!!!!
If the meds work, let us use them!!!!!!!!! Dont condemn all us chronic pain patients, for people who are looking for a buzz!!!!!
I’m sick of this garbage ,sick of suffering , sick of laying in bed
and I’m sick of this pain!!!!!!
I had a life for 13 years on my meds!!!
Karma a [edit]…I hope these people making these guidelines and problems for us dont ever have pain…uh oh!!! Then what??? You might have a problem finding help. Or just take tylenol…lol
This is a joke!!!!
And wrong!!!!!

What really is beyond amazing to me is my dog has no problem getting pain medicine. His hasn’t been tapered, adjusted or even mentioned by his Vet.
But as humans, good luck trying to get help for your chronic pain. How pathetic we have become when our pets are treated better then humans.

Lisa

Yes this is correct…. I live in Virginia and am currently being forced to taper on what is considered a low dose already. I’ve had 4 spinal surgeries, suffer from fibromyalgia and have osteoporosis with ableist of many other related medical issues that cause pain. I just saw my doctor today and he was gracious enough to forewarn me about the kind of withdrawal symptoms I may experience after taking pain medication daily for 12 years and now reduced by 75% at once. I was floored with what I was hearing and this is the same pain management doctor I’ve seen for 12 years. He admitted finally that there was some fear involved with the potential for loss of license so ALL his patients are being forced to taper regardless of the amount of pain they are in. He has pushed me hard for the past 6 months to consider a spinal cord stimulator or the pain pump as he stated he wants to get away from prescribing pills.

This should also be applied to LAW ENFORCEMENT AGENCIES!!! When you get put in jail for any reason, if you’re taking a barbiturate or any type of pain relief medication, you just DO NOT GET IT FROM THE DOCTOR OR NURSE IN JAIL OR PRISON!!! They detox you themselves!!! HOW CRUEL!!!

Connie jackson

Wow this is a big change from a year ago when everyone was talking about it would not hurt a person at all I’m going through withdrawals from opiates I assume you’re talkin about pain medication not heroin which is the main reason for the epidemic and chronic pain patients are suffering. I suggest you do your research a little bit farther in advance before you pop off on your findings. Do you realize how many people have been kicked off a pain clinic cold turkey? But now you claim it’s not good for them. I don’t think you people know much of anything

Scott

First get the dea out of drs offices, then make sure all insurance companies and pharmacies comply with the regulation now most important have the surgeon general write a letter to every dr in america explaining how the past general wrote a letter that was not evidence based, Please disregard and treat -offer your chronic pain patients with the same dose as they were on PRE CDC GUIDELINES.
THEY MUST DIRECT ALL DRS TO TREAT ALL LEGACY PATIENTS AS THEY WERE AND NEW CPPS ISE ALL CAUTIONS AND TRY RO KEEP THIER DOSES AT OR BELOW 180 MGMME.
SOUNDS LIKE A DREAM, BUT THIS SHOULD IMMEDIATELY TAKE PLACE

Fran

Hey
I am a 58 y/o male who has Ankylosis spondilitis. And I am in constant pain. Especially at my job where I sit at a computer. Let me tell you this. Pain meds help me have a so call normal life. I can get out of bed
I can move around easier with pain meds. Also I have severe hearing loss and anxiety and depression. Pain meds help me with anxiety, allergies,and chronic pain.
Not every body who takes pain meds are addicted, and abuse the pills. I’ve been taken pain meds now for 3 years and it makes a big difference from 3 years prior. I was miserable difficulty moving about like a normal human being. What is the purpose of living if one cannot go outside or just try to be human. Please don’t stop opioid production. I know there are people out the who take it for recreational reasons. But there are decent people who need this drug just to function like a normal human being.
If I couldn’t get this drug I would probably be extremely obeese and very depressed. Not now,
I can move around a little more freely. Its a damn shame society have to pay for people who don’t care bout themselves or anyone else
Terry we should all get together and ride our wheel chairs to the hill. And protest
Not all people who take pain meds are criminals. Also I think we should all get together and sue the [edit] DEA

Mary La Fleur

After reading more of the discussion I have to say this. I have been dealing with chronic pain since 1990. Herniated disc throughout my spine. Throughout those years I had pain pills, Steroids. Epidurals, injections , physical therapy. I decided to stop it all and started walking and rest my body 20 minutes a day for years I felt better. Then Bam Cancer got involved and then Chemotherapy and my whole entire body went to hell. That was 5 years ago and I am still dealing with the chronic pain of the side effects of Chemotherapy. Chemo it blew out the Thoracic Herniated Disc that surgery thoracotomy was no picnic but again walking made me feel better. Swore off Dr for awhile and then ended up with the Cervical blow out of my disc’s. Another surgery endured. So my point is this. Had I had surgery prior to these herniation getting into my spinal cord I would have been relieved of my pain and all the medicine dr visits. Physical therapy, shots all would of never had to happen. Most days I feel my pain in my neck and thoracic is a 2. 2 decades of pain level 8.
Now I have just arthritis.
So I feel for everyone who has chronic pain and is dealing with the current situation. It’s a shame and a disgrace what is going on.

Mary La Fleur

Really? No one ever knew this before? When is the FDA going to wake up? And where are the Dr’s prescribing these drugs. Literally anything you start taking even water when withdrawn quickly causes an effect on the body.
This whole article has demonstrated to me the FDA must be filled with a lot of people who got jobs there because they know someone. I am not even in the medical field and I know this as fact. I wonder a lot what is going on with these government agencies. I am not a big fan of President Trump but every now and then I think he might be right about something’s.

Doc Anonymous

This is indeed a step in the right direction. But why did it take such a huge federal effort to uncover the horrible reality of life with chronic pain and the added torture from the CDC guidelines? Perhaps it is good to look at past history. The CDC Guidelines simply codified and effort to suppress pain management with opioids that began long ago. I remember seeing, in the early 2000s, an announcement that the DEA would start to target doctors who treated chronic pain patients with high dose opioids. The persecution of doctors and their patients started in earnest with a crescendo that seems to have peaked now that pain patients are routinely excluded from care. Doctors who dared to treat pain were sanctioned under the guise by the DOJ, DEA and State Medical Board regulators that the doctors’ practices were “outside the scope of normal practice.” The persecution of doctors was always based on the opinion of a so-called “expert,” who in reality had no real first hand providing chronic care to patients in chronic pain. This practice continues, in spite of the fact that the majority of drug deaths are caused by fentalogues (fentanyl derivatives) that are available ONLY through illicit black market supply lines.

Ultimately the new statements by the FDA will have a beneficial effect if the result in one thing: an irrevocable cessation of the used by the courts and regulators of the claim that prescribing opioids is “outside the scope of normal practice” or the equivalent. Indeed the FDA statement seems to refute the claim that opioids for chronic pain are “outside the scope of normal practice.” But until the approach of the regulators is altered, doctors will continue, and rightfully so, to fear the wrath of people who really do not care one whit about people who suffer from chronic disabling torturous pain.

Researcher

Again people. Identify the problem 1st. The CDC didn’t jail Drs & pharmacists. Think about it.
The AMA didn’t do this. The CDC has no real power. Not to jail Drs for “overprescribing” without saying how many patients they CAN & CAN’T have.
What will happen to the Drs who are facing charges or retired?
Nothing. So what will change Drs prescribing in the future?
Nothing.
The DEA did this. They got their orders from higher up. They knew this would result in suicides.
And don’t think addicts are to blame. They’re dying of mysterious “fentanyl” (amphetamines) that’s added to heroin.
And who got blamed for that? China? What a coincidence. The US hates China….and heroin comes from Afghanistan. Where US troops are….doing what? Involved in the drug trade.
Wake up.
Peace&love❤✌❤✌

Becky

Good for FDA to try to help CP folks. The suicide rates have increased since 2015 for Chronic Pain patients.
The CDC guidelines are not law nor should they be considered as such for CPP community.
Tapering will bring the country to its knees with a huge increase of people who cannot work with their meds removed.
The DOL Department of Labor is trying to get disabled people back to work. Common sense is people working brings in more taxes and keeps economy going.

Visa Oakley

Now, the CDC who has business being in the business they have crept into are now blaming 91 deaths on an herbal pain coffee tree plant that I have had to take due to being pulled off my medications. This is [edit]. If someone has an allergy to something and does not know it, that is not the plants fault. It is helping more of us than hurting. Stealing our medicine is killing more and more that only the dumb asses who don’t follow directions right on the medicine bottle or junkies on the street. That is their fault. And then the FED wants to lie and fudge the numbers on opiate deaths. Bull [edit]! If you were in a car wreck and die and just happen to have a bad back and took a medicine then they counted that as an opiate death, not injury from a car wreck. This is what is killing me. If any one has an ounce of “give-a-danm” left in them PLEASE STOP KILLING THE REST OF US. We are all going to die eventually anyway. We do not need your help, CDC. We have got to be able to have something for the pain. Now you are even trying to mess with a coffee plant. Come on, this is insane.

Joseph busa

The damage to all pain patients is done!!! Everyone was supposed to go to pain management and all they want to do is injections, all these new FAKE tests to bill the insurance companies and make so much money and you usually have to pay cash, 400.00 to walk in the door. To write a prescription isn’t making them money so we are all walking around in pain, physically addicted, just from being on pain medication for so long and where does that leave us? Going to illegal drugs, suicide, its just disgusting what has happened to the reason people need medicine just to go to work and be productive without being in pain.

Rebecca Hollingsworth

Here here Terry. Wholeheartedly agree. We are all screwed. I’m sick and tired of trying to fight this garbage. Yep same symptoms as well. Can anyone tell me what state has not adopted the CDC stupid useless guidelines as gospel? Cuz if you can I’m moving there. Not much left in the tank. I’m 54 years old and dont want to be disabled. Appreciate any help I can get.

CSA

What is incredible is that the allegedly highly educated doctors now refer to opioids almost across the board as narcotics. The word narcotic is typically used to indicate an illegal use of a substance, or a substance that itself is illegal. When doctors used this term to describe the medical use of opioids, they are being extremely condescending/cynical at best, and usually self-righteously indicating that they now believe the use of this medicine to be illegal. They do this without having any proof whatsoever that chronic pain patients in mass ever misused these medications, that they will be helped by any other medication, or that they have any hope of retaining their functionality without opioids. . And then in the next breath they offer up costly surgeries to help the patients do without the medications. In any other field or instance, this would be deemed coercive, thus making them the true criminals in this abusive relationship. How many people have to suffer, lose their livelihood, and in many instances die before the individuals who we have entrusted with our medical care wake up and realize you cannot treat another human being this way without you yourself being anything other than a monster?

Lorene Gonzalez

The BIG opioid problem is at the border!!! The focus should be on the illegals coming over with tons of illicit drugs, like fentanyl, heroin, and fake, deadly oxycodone. I’m sure there are many , many more drugs being crossed. I live in a border city in Texas. We the chronic pain suffering should not have to be punished in any way, because of this political game being played.
That is where the focus should be. The media reports on so many ” opioid deaths” but what they conveniently fail to mention, is that , it was caused by people buying illegal heroin or something classified as an opiate! Not the kind us pain patients have anything to do with. We take our meds appropriately, we get randomly tested we go through hell waiting for hours to be seen. And we better not show up late, or we’ll have to wait for another month before we can be seen. Then we have to pray after sitting for hours at our doctor’s office, that the pharmacy has them in stock and won’t give us a hard time about filling them. We suffer enough as it is. We don’t need this added aggregation. Please stop punishing us for chronic conditions we didn’t ask for. Go after the real problem! I’m not a criminal! Never have been, I just want relief so I can attend church, play with my grandchildren and make dinner from time to time.
May God help us all suffering needlessly.

Dar

How much longer will it take to allow patients to get the medications they have been taking for years, and end this injustice? Are the politicians, etc., finally realizing pain patients have legal rights to be treated effectively, and doctors have taken an oath to ease pain and suffering? With all the hype in the media making pain patients look like criminals, and the death and suffering caused by this, will the guilty (the moneymakers and fraudulant scare tactics) finally pay the price for their inhumane treatment of people in pain? Will doctors, whom by the way spend a great deal of time and money, to earn the status of medical professionals, and take that oath to treat patients, be able to continue practicing medicine without fear? Pain patients have been unfairly targeted as criminals, and doctors have also been targeted. The public should be aware, and take this very seriously. What, and who will be targeted next? This is America, but keep in mind there will always be people trying to take our rights away. Power and money can be very dangerous in the wrong hands. We have a right not to suffer in pain. Since it is clear empathy does not matter to these people who are so quick to overlook our basic rights, perhaps the tables should be turned. Pain patients should not only be immediately be able to receive their medications, but lawsuits should be filed against the guilty policy makers who have caused these miscarriages of justice. Be careful American citizens, it is not always clear what can happen in the blink of an eye, and you don’t really know how bad it can be until it happens to you, or someone you care about. These injustices against people in pain must end immediately.

James Robert De caro

They the pain mnbmt doctors have just cut my wife’s pain meds again though she hasn’t had her surgery yet for a very bad rotator cuff that requires five procedures and she’s been waiting two years to have done she suffers from a variety of other ailments she is distraught now what is she supposed to do he says he’s following CDC guidelines on cutting out pain meds if they don’t read the reports what’s the sense of any of this, what kind of world are we living in she suffers in bearable pain and they have consistently cut her meds now she talks of suicide curse these [edit] who do this to us there has to be a special place in hell for you you uncaring unsympathetic bastards shame on you

How in the world are they trying to say they have newly identified harm with rapid discontinuation? Are you kidding FDA? This makes me so angry. The push to penalize prescribing doctors (appropriately prescribing doctors) and their chronic pain suffering patients has been an epidemic in and of itself for several years now. Doctors are terrified of having their licenses yanked for trying to treat pain and as such have responded with a knee-jerk, wash -my-hands-or-you reactions that have led to exactly what the FDA “just discovered,” when patients aren’t appropriately cared for, incidences of drug-seeking, illegal substance abuse and suicide sky-rocket. The government agencies such as the FDA have a large part to do with the epidemic, and pretending that they are just realizing all the patient harm that is occurring because of their villianization of opiates, prescribing doctors and chronic pain patients is disgraceful. So great Captain Obvious, now what do you plan to do address the “newly discovered” harm? Are you going to recommend common sense prescribing and not create an atmosphere where chronic pain sufferers are treated like junkies and prescribing doctors are treated like smack dealer? Doubtful. It’s much easier to neatly sum up the socioeconomic and healthcare crises by declaring opiates are bad and taking them away will solve our countries addiction problems.

Gail Honadle

We got [edit] out of both the 2 CDC PDF’s and FDA warning, except to go more slowly with the FORCED TAPERS. WE DIDN’T GET OUR MEDS BACK, FUTURE PATIENTS WON’T GET MEDS. THE 2,3 5 DAY SCRIPTS FOR SURGERY ARE STILL IN EFFECT. Cancer Patients won’t get the higher dosages they need. FARCE DELUXE wrapped in legal gorgon.

Robert Redfield a Virologist is CDC Director his 37 son OD’d on Heroin/Fen laced. He then declared War on Pain Patients, because we are Soft Targets. Plus ins companies are looking at the bottom line, and Big Pharma has no answers to our diseases, and are being sued by everyone in government. It’s a money game to them to reap funds at state, city, and Fed level. A bogyman we all hate. Ins is to H with patients if chronically ill die they have 1 less patient with high coverage. A Patient Cured, is a Patient Lost.

DR KLINE. https://www.dropbox.com/s/wmkw6yl4ishu213/Twitter%20data%20final%20to%20hhs.docx?dl=0&fbclid=IwAR1wFYGtS1gPFkag-4D8fewITbIlSDENzV624DXVKsgr5H9AQAmgxawONIY

Terri James

Stay tuned….that’s about all we can do other than pray. I still like the idea of trying to bug the living day lights out of our government as well, for what it’s worth.

Jeanette French

yep, as we all know this is a little to late, they are responsible for many murders and deaths over the last few months and they need to be help liable for all of this, patients taking their lives over untreated pain and being tapers and some being totally cut off facing incredible pain and death. This is a huge issue and no one wants to do anything about it, as we have no voice, we need people with status , money and c=voices to help us fight this.Each and every pain patients live in mortal fear of this, and doctors are terrorised into fear of losing their licence, it is terror and torture, seems like we are on House of Cards, only it id in real life. Someone has got to stop this madness, why are we taking people off medications that allow them to work and function, this is [edit]. Adn they know it.

Tammy Meyers

Already

Tammy Meyers

We are now living in a World Where We Are Being Told What Meds We Can and Can’t Have! How Much or How Little!! Our privacy is Invaded! Our Medical Records Are Looked At!! Told How Much Pain We Are In !! They have Created A Worse Problem! Addiction has been Around For Year’s!!!! And All You Guys Have Done Is Helped To Add to The Problem By Sending Innocent People, In Pain— to the Streets– Because Their Own Doctors Can’t give them their Medicine!! Addicts will continue to Get Their Drug’s!! The Elderly- And People Who Use their Medicine Properly Won’t!! Thanks for Creating a Disaster!

CathyM

I created a diary over on Daily KOS about the news – and mentioned it on Twitter. It’s important to get the word out, and I suggested that patients take the full statement to their doctors.
https://www.dailykos.com/stories/2019/4/10/1849351/-FDA-Warns-Sudden-Opioid-Tapering-is-Harmful

Thomas Wayne Kidd

In my opinion, this was and is a population reduction test run. I sincerely hope that I am wrong. I resigned myself that it is probably the end of what little life I have and that I will not survive being taken completely off the Methadone which I have been taking for more than 30 years. I am so tired of being lied to, ignored and mistreated by the medical community. What I just read has been before, like back in the late 90’s and early 2000’s when my wife and I were suddenly without warning kicked out of the pain clinic we were going to. At that time I was the only one who had Medicare and after getting into the clinic I go to now I was forced to share the medicine with my wife. If I should mention this to my doctor now we both would be in dire straits. At our age this should never have been pushed upon us. But here we are 14 years later in the same shape, only worse off. My prescription has been reduced 5 -10 mg per day to 2- 10 mg per day and I still share with my disabled wife. We don’t have enough meds to function and take care of ourselves. Cooking a meal is a big struggle for either one of us and our eating habits have gone to the dogs. Free country, my A– we would be just as well off to move to Russia. We are Christian and have lived our lives according to the principles of the Bible for most of our adult lives. For most of my 30+ years of being treated for chronic pain I have been treated as a dope head and criminal. It hasn’t been easy and now we are being mistreated horribly wrong again and it seems that no hope of being returned to the way it should be. This insanity was tried in the Prohibition and caused the greatest crime wave seen up to that point in our history. But idiots continue to attempt to legislate morality. Our nation is falling and I fear it will not rise again. I will not even contemplate killing myself, but I realize that I would be much better off dead.

Don

Really, it’s kinda little to late for many Pain Management Patients. I am positive some have ended their lifes or switch to drugs off the street and lost their lives due to overdose. My last appointment the PA again try to cut my medication down when I am already on the edge, less then the 90mme. I am scared they will take it away from me. I work full time and probably the only thing that keeps me able to work is the medications without it I would be forced on Disability. I have had two surgeries and countless rf and injections into my lower back. I am sick of dealing with this nonsense so now I am using Marijuana it does help with the pain. I am subject to drug testing and will lose my job if tested positive. So the only thing I can do is fudge the drug test. I refuse to live my life in pain when I know there are drugs that can helps me.

Holly

Day late dollar short [edit]! As I sit/lay in my recliner short on my meds because I cant take the pain! Reduced to over half of what I was getting….I feel like [edit]! Everyday! So many have already died…..unbelievable! Nothing will change until the DEA is GONE!

What irritates me about this article is chronic pain suffers should NEVER be tapered off needed relief. It’s like having your hand squeezed in a vice, letting the pressure off slowly doesn’t remove the pain.
I don’t wish anyone any ills, but put someone in my pain for one hour and then let’s hear them talk about tapering off needed pain relief. We were placed on opiates because nothing else works, nothing else’s stops the pain. While you all are patting yourself on the back we are still without help or pain relief. Congratulations for nothing.

tapering does not mean stopping. many patients in severe chronic pain may want to just drop the level… and cannot stop. impossible. try having biochemical catastrope with Levaquin adverse reaction that ruptured both achilles tendons that cannot heal, and then painful small fiber neuropathy that is intermittently terrible pain 24/7. FDA made big mistake approving this drug.

Heather

We need the CDC Guidelines fully retracted. They have done harm (which I will very gracefully try to assume was unintended). Truly, if they don’t backpedal quickly and fully, they will impose further harm and will have to be held accountable for patient suicides and patients who have turned to street drugs. The FDA statement also cites these risks:

https://www.fda.gov/Drugs/DrugSafety/ucm635038.htm?utm_campaign=FDA%20MedWatch-Opioid%20Pain%20Medicines%3A%20Drug%20Safety%20Communication&utm_medium=email&utm_source=Eloqua

The CDC’s continued failure to take action is nothing short of gross negligence!

And yes, I saw their statement, which was entirely inadequate and not strong enough. The pocket guide still refers to the CDC Guidelines. IF THEY WERE MEANT FOR PRIMARY CARE DOCTORS, they did not reach their intended audience. That, in itself, indicates there is something flawed with the guidelines. They were supposedly meant for only opioid-naive patients… THAT also was not adequately communicated. Therefore, the guidelines must be retracted.

The CDC has a responsibility to rectify the situation they caused before further harm occurs.

Maggie King

Poor, rural areas are seeing a huge number of PM Clinics just lock their doors. And not all were pill mills. ALL narcotic RXs in MS have been monitored by the state for 5+ years, contracts used since at least 9 years.
Jobs here are dangerous: logging, shipbuilding, commercial fishing and oil rig workers. When “experts” see stats of every Mississippian would get four million pain pills per yr” BS, they see addicts everywhere. I see my friend whose legs were crushed by a crane or the firefighter who fell when the 3rd floor collapsed.I see unscrupulous docs churning revenue from Medicare & Caid with injections, back braces, lab fees etc.
I see very little evidence-based, informed compassionate Care. And that was true pre-PROP/CDC “guidelines”, and now is run amok. Thousands of us here are effectively doomed to an isolated low quality, non-functional life, Imbued with pain, loss of family, friends, careers, JOY!
In the “greatest nation on Earth”.
Pathetic and I totally get the rise in suicides.
It’s been 3 years, and NOW the premier agencies tasked to protect us has tossed millions into the wilderness. Not addicts before are turning to “self-medicating” since MDs seem to lack the cojones to advocate for their patients.

Kristen

I left a comment yesterday and had mentioned I was dreading going today for my monthly appointment with my PCP because twice I had been decreased and not knowing what today’s visit would turn out like.I will start by saying that I asked my Dr if she read the FDA safety announcement yet and she said no.I than showed it to her and she laughed! She said we have known this forever.I said well it’s a start anyway and she proceeded to tell me that it really doesn’t make any difference because Drs are still going to be gradually getting all CPP in the guide lines or cut them completely.I was left with a few options.First one was she said they had a big meeting and it has been proving that long term opiod use does not help those in Chronic Pain.At this point im feeling on edge and real angry because I know thats a big lie.She said I could go on Buprenorphine which is safe and more drs will be offering it.I refused.Other option is a decrease again from percocet and keep Morphine the same as last month which by the way these two and my Soma have been decreased twice already I choose this option however she did say by next month I will no longer be giving percocet at all but will get Morphine 30 mg twice daily.By now im really pisssed because I told her im back to resorting to my bed more,no friends really anymore,im not longer able to function with this severe pain and I’m lucky if I get two hrs of sleep a night! Also reminded her 12 years ago I was put on Morphine for a chronic cough while spending over 30 days in hospital for interstitial lung disease and it has helped and helps with my other chronic pain issues that are documented and proven with many MRI’s.Now my cough is back full force and im on a 30 day event heart monitor and developed high BP since the cut.I than said i have hope that soon but not sure when something will give and us CPP will be back on the meds that gave us some quality of life.Her response was it will never happen.I am so angry now that im crying.

Liam Allan-Dalgleish

We should get rid of the notion that someone else is needed to control our lives. Drs., with whom I generally have had aTWILIGHT-ZONE experience, should serve their patients—the patients should, within reason, prescribe for themselves. The system (if you can call it that) is a joke. There is no “safe” or “controllable” amount prescribable. The amount should be determined by the patient after he can prove he consulted with a knowledgeable individual of the danger of death from taking this medication. But there are FEW deaths from opioids prescribed for REAL pain. It’s a sort of scale. Those who take opioids for pain are trying to get back to life and when they get there, that act as a kind of regulator. Those taking it for fun are using it to get away from life and no amount of opioid is enough. The monthly examination is another joke. I have been a pain patient for ten years and only once have I had a real physical exam. They’re usually [edit] sessions or else sales of more expensive procedure. The regulations should be nationwide. You should be able, without a lot of made-up reasons, get supplies for more than one month. Otherwise, the patient becomes a prisoner in his own country, and in reality, of his own state, and in real reality, of his own doctor. There should be ID cards. It should be a federal requirement that every state provide a government prescriber to help people who are caught in a different state out of emergency or other reasonable reasons. Like homosexuality, there should be a law to protect a pain patient from abusive language like addict. Finally, there should be a giant hypodermic needle in the sky filled with plasma Common Sense that’s injected into the whole system at regular intervals.

Deanne Daniell

This is JUST A BABY STEP in correcting the WRONG-HEADED BIASES against the continuing prescription of OPIODS for CHRONIC PAIN PATIENTS!!!!!

Thomas j shutt

wow now the FDA knows what every chronic/severe pain sufferer has known for as long as they were fortunate enough to being prescribed pain reducing medications. Before force taper to agony daily too quickly. Or would it be better to torment these patients severely with a fast withdraw they would appreciate all that the government is doing for us ? No? in this draconian move to reduce medicating those of us whom suffer deeply with afflictions that none of us asked for and some if not all of us can live with. The almighty FDA has chimed in with a guiding statement that for some of us and it is quite a substantial amount , it is far too late. But wait it will get worse, when Patients forced to taper quality of some sort of life,giving medicines hit their wall of depression and despair from the daily grind of suffering from agonizing pain and lack of any human quality’s of a life.And we are many , and we are not strong , unfortunately, we have been battered from under medication into a subdivision of life that prior only those in the throws of severe illness, not ambulatory and too sick to get out of bed. the non stricken might think that agonizing pain should not be categorized as a severe illness , as those with Cancer or other end of life horrible diseases.I can tell you that unforgiving pain such as arthritis, fibermyalgia,lupus, crones ,and degenerative disc and many other crippling conditions play heavy on your psychic daily as it burns and aches and and stabs minute after minute ,hour after hour , when every movement hurts so lay still as to not aggravate any thing further, but you cant sleep through the pile driving agony that relentlessly reminds you of your affliction continuously with out letting up. Some of us will recall a pain reducing medication that was working before the “crisis” to provide you with just enough relief to get you through the day, no it doesn’t work all the time , but usually with adequate dosage it was enough to provide you a life. ,

Rosalind Rivera

These miraculous findings( a joke) are fine yet as the dentist pointed out should come as no surprise to any doctor worth his salt. My problem centers on the very critical and life threatening tapering or simply taking away OPIODS from patients that need and I repeat need their pain medications to literally function and in many, many cases survive. I for one, and there are myriads in my position cannot even get out of bed until at least an hour has passed after taking my pain medications. As I vehemently stated in a prior comment am suffering tremendously since my pain management doctor began tapering my medications. I now also rely on many demeaning contraptions such as a raised toilet seat and walker just to be able to get to the bathroom and relieve myself. What is being done in even tapering of pain medications to those who have proven evidence of their need is criminal. I don’t want to admit this but in order to salvage my and many others sanity and very existence, I can now clearly understand the need to turn to outside sources for relief. Shame on those in control of these murderous laws. While people were losing their lives in droves because of their illicit use of prescribe medications,are a small representation, versus those purchasing drugs such as heroin or Fentanyl patches, in back alleys and often right in public on street corners, those in true proven need are and will resort to the exact same actions
In short, tapering in general is being addressed to all, to all, and that is a very sad state of affairs as not all are in as they say, the same boat. There are many including myself with medical and expert proof that are suffering and whose quality of life is disintegrating with each passing day, not counting of course those that are establishing a close relationship with their drug dealers which they meet with on a regular basis. I am not going to address how these drugs are being paid for but I will say that when desperate enough, people will die

Vincent

Great question raised, there is a bigger problem here. This is long over do and it gives me some hope but there is a much bigger problem. Think about all the progress people have made and the progress people have made is getting thrown away even still, suffering patience need our rx regimen rights restored and a revision of the guidelines, if not people are still going to be tapered down to non effective doses, it’s like a diabetic patient being tapered down to where the tapered dose leaves the patient in a state of borderline hyperglycemia. How do you go to work feeling like that.

Terry

I think there’s a lot of hoopla over nothing. The damage is already done. By this time I would venture to guess that nearly ALL chronic pain patients have had their meds drastically reduced or discontinued all together. So talking about being aware of tapering correctly is a joke. The only thing the chronic pain community wants to hear is that the CDC guidelines have been changed and everyone’s pain meds should be reinstated to previous levels that were sufficient to combat our chronic, intractable pain, and that is NEVER going to happen! So why are we even still talking about this? Maybe I should sue my pain doctor for getting me dependant on 195 mgs of oxycodone daily over the last ten years and then cutting it very quickly down to 60 mgs daily. I’ve been feeling horrible and going through withdrawals for 6 months straight! The thought of suicide makes its way to my brain from time to time as well. Somebody needs to be sued but who? I’m really tired of even talking about it, it’s just exhausting. It’s never going change and we’re all just screwed.

Sheila Leys-Garcia

It took these idiots how long to clarify this?! How many CPP committed suicide because of forced tapering? Not to mention all the extreme suffering since this ridiculous mandate. They’re afraid of lawsuits. That’s the ONLY reason they dialed this back.

I have been on pain relief opioids for a long time and was SUDDENLY taken off. I had seizures, headaches, loss of bladder control, and more! But NOBODY would listen to me and said that I didn’t know what I was talking about. I still suffer from chronic pain but now I have the added problems with “Cold Turkey Withdrawal Syndrome”!!! The effects are a lifetime achievement for any medical or law enforcement organization that forces this process.

Gary Raymond

Who is in charge? The CDC, FDA, or the States? Guidelines, guidelines, guidelines! It appears to me this inhumane witch hunt started when someone realized the CDC had super-fund money. A disease was invented, an emergency was declared, and 3 billion dollars was distributed. Information media, doctors, hospitals, pharmacies, and substance abuse courts are being paid to sing the same song. New rehabilitation facilities have been opened. Many people have found employment opportunities. Compassionate treatment is now readily available for addiction and mental illness. However, nobody has considered beefing up pain management clinics. These services have been overwhelmed trying to provide mechanical alternatives for effective opioid analgesics. I can have my automobile serviced faster and more reliably than scheduling appointments for ineffective, and repetitive, injections for pain relief.

Debbie Nickels Heck, MD

It always takes longer for implementation after recommendations of anything. A bigger question is what’s going to happen to the Drs who were prescribing appropriating but got caught up in the sting operations and are now facing unfair prosecution? With these changes in guidelines, I’d hope those charges against such Drs will be dropped immediately.