Long-awaited Federal Pain Management Task Force Draft Report Released

Long-awaited Federal Pain Management Task Force Draft Report Released

By Ed Coghlan.

The Pain Management Best Practices Inter-Agency Task Force (Task Force), in a draft report issued Friday, calls for individualized, patient-centered pain management to improve the lives of millions of individuals who experience acute and chronic pain.

Members of the public will have 90 days to provide comments on the draft report’s proposed recommendations.

The Task Force, a federal advisory committee, was established by the Comprehensive Addiction and Recovery Act of 2016 – PDF to propose updates to best practices and issue recommendations that address gaps or inconsistencies for managing chronic and acute pain. The Task Force is composed of 29 members, including healthcare providers and patients, as well as federal employees. It is overseen by the U.S. Department of Health and Human Services, in cooperation with the U.S. Department of Veterans Affairs and the U.S. Department of Defense.

The draft report contains proposed recommendations in a number of areas, including:

  • clinical best practices/guidelines;
  • approaches to acute and chronic pain management;
  • pain treatments, including medications, restorative therapies, interventional procedures, behavioral health approaches, and complementary and integrative approaches;
  • access to pain care, stigma (of patients and providers), education, training, risk assessment and evaluation;
  • special populations, including older adults, women, ethnic and racial minorities, military members and veterans;
  • special conditions, such as pregnancy, chronic relapsing pain and sickle cell disease; and
  • Congressionally mandated review of the Centers for Disease Control and Prevention (CDC) Guideline for Prescribing Opioids for Chronic Pain.

“Chronic pain affects an estimated 50 million U.S. adults or 20 percent of the adult population. An estimated 19.6 million U.S. adults have experienced high-impact chronic pain, which the CDC defines as pain occurring and interfering with life or work activities most days. This draft report offers a wide range of treatment modalities with a framework to allow for multidisciplinary, individualized patient-centered care,” said Vanila M. Singh, M.D., MACM, Task Force chair, and chief medical officer of the HHS Office of the Assistant Secretary for Health. “We encourage members of the public to review the draft report and share their comments with us.”

The Task Force members have significant public- and private-sector experience across the disciplines of pain management, patient advocacy, substance use disorders, mental health and minority health.

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Authored by: Ed Coghlan

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I am only leaving a reply because I feel that perhaps my voice may actually be heard. This is my shortened version, the other is on my website. I was abused by my doctor a little over half a decade ago. I can no longer get any kind of a steroid in my body ever again. HOWEVER, I rely on having pain medications in order to run my Nonprofit FIBROMYALGIA AND CHRONIC PAIN Organization. If I do not get my medications daily, this organization will not operate. It will not be able to help those that require the support groups that they go to monthly, the resources that they lean on to get them from moment to moment, and the scholarship that we are building to get one student to further their education that we normally would not see this happen for someone in chronic pain due to financial burden. Now, do you see what the ramifications of these actions do and the trickle down effect has on a community? So, I implore you, please think about how you are going to handle this situation before you act upon it. We are not all drug seekers. Most of us are pain relief seekers, need to and desire to be productive members of society. Some are on disability but desire to do work from home on good days. Still want to feel needed and productive. This is where medications come in and make us feel as though we are not a completely lost cause. The suicide rate decreases and that also makes the economy so much better. Please, again, I ask you to really consider these facts before you act.
1. People in pain are not drug seekers, they are pain relief seekers
2. Want to be productive members of society, even if work from home.
3. Want to feel as though they matter to society and to their families who may have thought otherwise in the past.
4. Allowing chronic pain patients their Rx’s will produce less missed work days, less errors & higher production.
So there are your facts as seen from a chronic pain patient & nonprofit org owner.

Mrbscm

Who are these people who comprise the task force committee and how are they chosen & by whom?

As many readers of Pain News Network are aware, I am very active as a columnist at NPR and healthcare writer for other publications and journals. Today I want to share a progress report on the work of the Alliance for the Treatment of Intractable Pain, responding to the draft HHS Task Force recommendations.

I’ve submitted 38 pages (12,000 words) of early comments to the HHS draft: ~65 comments plus 45 references and supporting rationale. The Alliance is developing further details for endorsement by our 70+ associated medical professionals, in more submissions to HHS.

The HHS draft is a 100 page document with over 400 references. It’s a monster and reading it can be a major stretch for people dealing with severe pain and medication side effects. So ATIP is pulling up research and writing “on your behalf”. Our comments are grounded on medical evidence and phrased so that the Task Force can vote “up or down” to incorporate directly into their document — without doing a lot more original writing of their own.

The HHS effort has two sides: science and the lived experience of patients. ATIP and other medical professionals can offer the Task Force more of the science they need to convince legislators to change course. You as patients and caregivers can share lived experience on consequences of badly misdirected public policy that has caused harms. However, I must personally discourage “clip and drop” responses that may get identified as “spam” by HHS mail filters. So I won’t circulate many of my own word-for-word comments. Instead, I’ll try to point out useful directions and core issues.

In the weeks before submission deadline to HHS,the Alliance hopes to help professionals focus the science and patients focus their lived experience effectively in support of better government policy. We’re talking with Ed Coghlan about how best to do that here on NPR. We’ll get back to you in this thread and in further articles.

Regards all,
Red

Chris

I couldn’t leave a response on the HHS site a few days ago concerning the “pain” draft changes but I went out there just now and I can leave a response. So folks, go to the site (others have included the link in their messages below) and give your comments!! PLEASE!! This is the only way we true pain sufferers might get things changed and be able to get our lives back normal. We need to get involved to make changes and not just complain.
Read the draft first and be specific about your concerns with the draft changes and what you like about the changes and what you don’t. Don’t ramble on and on about your specific history, going back years and years. Suggest other changes you want to see instead and include the section of the draft you are referring to (the instructions are included on the site). You are allowed to leave 3 pages of comments, so now is your chance to be heard!
I have read the draft and I already see some positive changes but let’s make more changes for us chronic pain people.

Lynne Hall

Unable to engage in survey due to government shutdown.
Are they serious!
WE ARE DYING WILL THEY GET PAID.
WHAT HAPPENED TO AMERICA. WHEN DID THE GOVERNMENT BECOME MY DOCTOR AND LORD OF ALL.
DON’T WE HAVE RIGHTS.
All I know is they have taken everything from me.
SO WHY NOT JUST DO THE HUMANE THING AND LET US JUST COME IN AND BE PUT DOWN LIKE DOGS!
They will never give us a voice.
It’s winter, as I lay in bed in my unheated home, sweating and hurting. What will I do when it actually get hot this summer? Every day a call from someone saying don’t become another statistic!

Chris

Why is it that before this so called “opioid epidemic” happened, pain pills were always prescribed for chronic pain, they worked, and nobody said a word. I remember, and my doctor verified this last week also, that about 10 years ago, there was a MAJOR focus on treating pain, and doctors and nurses received special training so that patients DID NOT SUFFER. There was NEVER a problem getting what we needed AS A CHRONIC PAIN PATIENT.
And that’s where the problem is!! Those of us who do the pee tests, have our pills counted, sign and follow the pain agreements year after year, never miss appointments, don’t doctor shop, don’t pharmacy shop, ARE TREATED JUST LIKE THE JUNKIE ON THE CORNER, or the junkie the doctor sees after you leave your appt!
My prob is:
1. Drs. see the CDC “recommendations” for opiods as SET IN STONE and won’t deviate for fear of being sued over patients committing suicide etc. I have been going to same Dr for 13 years and when pharmacist questioned me if I should have Naloxone on hand (in case of a possible OD), my doctor said…No! I’ve known her long enough to know she doesn’t need that!!
2. My dr makes me physically drive to his office every mo (80 mile round trip) for scripts, then I have to go to store to fill. Don’t want to do when I’m 80 or 90! I already feel like [edit]. Why can’t he fax script to pharm???
3. Why are we req’d to visit pain dr every 3 mos? Even if I am worse the dr said he will make NO changes to meds due to govt recommend. So ins and I pay mega bucks for nothing!! Plus another 80 mile round trip for a 5 min. dr visit!!
4. I have never considered suicide. But just like many chronic pain patients, and their stories I’ve read, the only reason I would commit suicide is due to the unrelenting pain of a chronic pain flare. The CDC and other govt agencies are making it more and more difficult for those of us who truly need opioids. Pain Physicians are quitting their practices or not prescribing opioids.
Get involved!

Lisa

Here is the HHS Taskforce Fed. Reg Link for anyone having trouble finding it.

Remember they allow anonymous comments if you want to share things of an intimate nature, you can always make a second comment. Suicide thoughts or attempts might be a good thing to be placed this way to protect one’s privacy IMO.

If we don’t don’t dig deep & help ourselves by doing a mass write-in on this Fed Register – We won’t have anyone to blame but ourselves. Not PROP, Not the CDC, Not our Dr’s …. No One But CPP’s

Federal Register Link
https://www.regulations.gov/document?D=HHS-OS-2018-0027-0001607

Matthew Berkowitz

My pain dr left the practice, I am stuck with a doctor that could care less if I live or die. I am too sick and tired to do this. after being on meds 35 years, I deserve to be tyreated with decency. Why must I be force detoxed, it is tantamount to murder.

Marg

On link, I found no place to put comments. HHS needs to know how these guidelines have already done terrible damage to people in pain

Marg

Please people, put your comments on link to be sure they are seen!

CPPs with a legal provider and RX do not generally overdose.
What do you mean by the FDA removing “the killing fentanyl”from the streets?
Did you mean the DEA?
?s for Jane Abucha

As a provider and a person, I have a deep feeling about this pain management trends and guidelines. As a provider, we need (1) Clear guidelines for overdose risk assessment to avoid grouping all patients as potential overdose risk patients. This will help to ensure that all providers are using the same tool and provide same answers regardless of clinics or hospitals. (2) clear guideline of how to address and manage acute and chronic pain vs how to avoid prescribing opioids because of overdose. (3) List of the most effective affordable non-pharmacological pain relieve modalities to the least effective one to help patient and their provider navigate the system easily to find help. We cannot avoid treating patients with pain because they are going to overdose, we need to provide adequate pain relive by non-pharmacologic means or pharmacologic means with opioids. Lastly, FDA needs to remove the killing Fentanyl off the streets and market
Just my thoughts

Why does no one talk about the MME chart itself????
Who wrote it?
How can the meds be compared to have the same effect to the morphine amount.
The chart is outdated and seems to just been a non scientific guess.
The key is the Chart.
Question the Chart and this will solve the problem.
Why do ppl going to methadone clinics get 100 to 150mgs and CPPs are limited to 3 10mmg tablets.
3 10mmg methadone tablets is 90 MME.
Why do I have to say I am a addict to get all the pain relief I need?
ITS ALL WRONG
QUESTION THE MME CHART!!!

Arianne

Anything short of ABOLISHING “GUIDELINES” misses the mark completely.
They need to take their sights off of pain patients & doctors, as we now know that prescribing had little to NOTHING to do with the OD/ADDICTION issue in America, and improve access/affordability for those who are actually facing issues with SUD.

No one is being saved.
NO ONE.

Marilyn Pittman

Is there ever going to be a resolution to people with intractable pain? I am watching my sister fade away as her pain doctor keeps cutting back-(he says the government is making him). She has connective tissue disorder from Immune disorder, Lupus, and RA. She, now just doesn’t get out of bed because People, she is in PAIN!
Who in the heck is in charge? Who can change this ridiculous plan of action? It is hard to believe there are not physicians that also have chronic pain–what do they do to get rid of it? I expect they ‘treat’ themselves.
Separate the legal people from the drug addicts that are getting it on the street! When good people go to their pain doctor, they submit to a urine test every month, have to do what the doctor says and they do comply! Now they are told to just deal with it! How stupid are the powers to be?

I think task force members should have to wear a backpack 24/7 with heavy books in it & a very tight belt that has weights on it. They should have to wear it for six months & prove that they have been wearing it by film. Says they have a lot of private & public sector experience but it doesn’t say that they have chronic pain. Or make them sit in a sweatbox , every day for 6 months be in there at least 4 hours & then let them come out, then they’ll have experience of what chronic pain feels like not what they think it feels or hear what it’s like. That will be real life experienced. Instead of documentation of their work/educational experience. Let them suffer a little bit & that will give them an additional educational experience. Conflict of interest having Kolody father-in-law also on the board. One needs to be removed. The recommendations none of it has scientific evidence proven to work. I’ve done all of it with no success. Opiates help take the edge off. They just need to create a new medication instead of spinning their wheels on old medication / alternatives & wasting our precious time /life making us suffer. If they got water boarded daily they would learn to dread the next waterboarding. They don’t get it but they think they do with their extensive disciplines. LOL ! How can they help chronic pain people if they dont live in chronic pain? We need task force members who have pain to oversee the new protocols / guide lines. It’s like us setting up guidelines for people that are not in pain to be in pain & live that way. The normal person couldn’t adapt to our lives. Normal person would get frustrated not being able to do a lot of stuff or sleep. We don’t walk in their shoes & they don’t walk in ours. But they want to set up the rules for us to live by, then they should experiment w/ living w/ chronic pain themselves.

Jill

Davis G, every time I read a post advocating long term NSAID use for chronic pain, I wonder if the poster has in anyway researched this position. These damage kidneys, liver, stomach if taken long term. Chronic pain IS long term and derives from an illness with no cure. I managed my pain with Advil for decades before I turned to Vicodin for relief. My reward for that has been failing kidneys, GERD, and a severe esophageal ulcer, which when bleeding, causes anemia. On the other hand my Norco causes NO long term damage, least of all addiction. Since I’ve been reduced I have to spend 16 hours a day in a chair or bed. Anyone who thinks I deserve this, is not too smart

Steven

My pain is so asevere I cant see to type this. I cannot last 2 months let alone 3 and then there are years of delay. The gov just wants these off the planet. We sadly will not out last the delays.

Cynthia Sieving

Sadly , while the death rate for opioid od in Patients may go down, the deaths from illicit drugs and suicide are going up 😱!
May God help us all 🙏😰😡!!

M W

I don’t think the report will have an effect on a lot of PM Drs. Mine included in them. When I approached the less than 90 mme his response was”they don’t care about less than, they want them stopped”. So I have very little hope that things will change. Drs are still running scared!

Helene DiPonzio

To everyone who is leaving a comment on here, you should be submitting these comments on the draft report! If you scroll up you will see a link. Otherwise I don’t think the task force will even see them…….and they need to be seen!

cynthia

a waste of time. we’ve been down this road several times in the last 4 years. we need lawyers, we need class action. politicians and govt agencies will NOT help chronic pain patients. ain’t gonna happen.

The comment left by Diane Anatasi is proof that there are patients that are high risk addicts and she stated in her comments that she is one of them. She is fortunate she has found less effective medication that works for her but she is part of the problem making such statements because if she was educated on the issue she would know not everyone can tolerate alternatives and THAT IS WHY people are becoming bedridden and suicidal ….HELLO! WE HAVE BEEN TAKEN OFF PAIN MEDICATION. Be grateful for your good fortune and educate yourself before you speak.

Susan

I would like to see o list of names on the advisory panel including some background on each name.
One of my concerns is the jump to judgement for MD’S asking patients to seek a mental health evaluation. In these times, mental health evaluations are risky to the patient. Too much can be construed from a “visit”. Maybe patients should seek a psychological review of the MD before making an appointment.

Nicole Pucciarelli

I have suffered with CRPS(Chronic Regional Pain Syndrome) or RSD(Reflex Sympathetic Dystrophy) for over 11 years. Also known as the “Suicide Disease.” I am 46 years old and was stuck with this disorder that typically develops after an injury, a surgery, heart attack, or stroke. It typically affects an arm or a leg but is also known to affect some patients throughout their body. Essentially it feels as if someone has removed all of your skin and is constantly pouring boiling oil on your exposed nerves. It NEVER stops, 24 hours a day, 7 days a week, 365 days a year. Imagine life where air blowing against your skin can reduce you to tears, or the water hitting you in the shower feels like you’re being stabbed with a million needles on top of the burning pain that you are already experiencing. I was a biologist that ran a marine facility for the state of Florida for several years and had a career in environmental education for over 20 years. As a result of getting CRPS, the pain was so intense I could no longer function in my position and had to give up my career. I spent nearly eight years almost completely bedridden as the slightest movement caused me to go into hysterics. It took over 11 doctors, many of which called me crazy and told me I was imagining it. Imagine being told by a medical professional that you were crazy, Maybe if you were just trying to score pain medication, but when your entire leg is purple and blue and 20 degrees colder than the other one and swollen up to five times the normal size, how is it possible to imagine that? And for so many of us suffering from this horrific disease, even going to a hospital where you think they would know everything and anything, 80% of the time I have doctors and nurses ask me what is CRPS? And for most of us the only thing that gives us a little bit of relief is opioids. And unlike people that use them to get high, we use them just to get by.

Ruth

All these reports upset me even more. Nothing is the same. Every doctor reads into them what they want, pharmacies override some doctors and some refuse to fill your meds.
I have had P.T., O.T., injections, burning nerves, surgeries, tens units, patches, hot tubs, swimming, braces, hot packs, MRIs, xrays, ultra sounds, accupuncture, IV therapy and more.
I am on pain medication, same one and amount for years. I am allergic to many others. I am not going to hit the street for any other drug. I take what I need from my pain management doctor. I do not like being considered someone in that same category as someone who does buy on the street or those who sell some of their medications and those who just want to get a high feeling.
I just want not to hurt, I just want to survive. I don’t want to sit in a chair or lay in bed and not be able to function.
Those of us that are chronic pain patients, should not be penalized by those that are your drug seekers or drug addicts. We seem to know more than the doctors because when this all began to effect us we were the ones who had to get educated. But who am I to fight the doctor or the CDC or the drug makers or even Congress. Things were fine for us before you all got into the mix. And lets not forget each state then began to make their own laws. That made it even worse.

Douglas B Christine jr

I’ve been paying $230.00 a month for my methadone because I can’t get enough from pain management. I roofedr for thirty years and have been on disability for six years. If I could get MediCal without a $650.00 share of cost instead of Medicare I wouldn’t have to pay. Thing is a month of methadone would only cost me$2.02. I heard that in January 2020 the clinics will accept methadone in CA. Until then pay I guess.. Peace out 🌈

C meeks

I’m 56 I have Rheumatoid Artharitis, Psoriatic Artharitis, osteoarthritis and severe osteoporosis. I’ve had 10 spinal fusions and two nerve surgeries and need my deformed hips replaced. My ankles and wrists are eroded from the arthritis and I have chronic migraines due to the bone spurs in my neck and the remaining disc that bulging that’s too dangerous to fix. I have Sjogrens that is causing my teeth to crack and due to the RA my eye sight is diminished. I also have a sticky mitral valve. I was a registered nurse for 30 years. I used to help people like myself but now the very system I devoted my career and soul to has turned its back on me. I’m a chronic pain patient. I won’t get well. Tylenol won’t help me, ibuprofen won’t help me, I was cut off by my surgeon due to scare tactics by the Oklahoma Attorney Generals lawsuit against the pharmaceutical industry and the made up opioid crisis by the CDC guidelines. This has got to stop. I’ve been waiting weeks (7) to get into pain management. It’s unethical and barbaric to treat American citizens so inhumain. Stop the madness. God stop the maddness.

Maggie Dent

I am 60. I’ve had 5 spinal surgeries including a titanium H cage with screws and donor bone. My hips were too arthritic to remove bone from them.
My spine started degenerating below my fusion about a year after my fusion. Well they offered a spinal cord stimulator. I got one. It helped the about 8 months with about 12 adjustments made by Medtronic. It stopped working. Medtronic told me the leads were placed too high for the pain control I needed. Hmmmm. Three years later they offer me a Intrathecal morphine pain pump Medtronic of course. I got one because now I’ve been diagnosed with failed back syndrome. I didnt fail, the doctors failed me. The pain pump helps but I kept having to have my dose increased about every 2 months to get the same pain control. Every 2-3 months for 5 years. That’s a lot of morphine. Then we moved to a different state. Ha ha try to find a different doctor to “service” your pain pump. Within 120 miles around me out of 8 qualified doctors. Only one would accept me. I’ve never had a dirty pee/blood test since 2001. I am a good patient. I ask questions but I do what my doctor says.
Recently my PM doctor wanted to switch my from morphine to Dilaudid. I had to wean off the morphine 10% each week for many months. When they took out the last bit of morphine i had hellish withdrawal. Two weeks until I felt “normal “. My doctor wanted me to take a drug holiday so my opioid receptors would reset. I made it three weeks. My pain was horrific. I’m getting the Dulaudid in my pump now. It’s being microdosed. I have a lot of breakthrough pain. No oral pain meds to cover that. My doctor doesnt believe in any breakthrough meds. I’m still in a lot of pain. Medical marijuana needs to be federally legalized. I could use the THC rich oil with by pump and never OD. When is our government going to get wisdom? Until then all of us suffer.

Researcher

Stand Against
Yes, the government absolutely has the right to punish & kill (by suicide) pain patients….or they wouldn’t be doing it.
The WHO & International Board
for Narcotics states “Pain Control is a HUMAN RIGHT.”
What went wrong? The media, FDA, Drs who updated the DSM-5,
DEA, Big Pharma, & now the CDC has been sued for lying.
The government has told you what they are doing. REALLY doing. Follow the cookie crumbs (or Agenda) & you might figure it out.
Hint: It’s not the addicts, they are dying too, from government actions.
Hitler killed the disabled 1st.
Like Nazi Germany, the US has made no secret of what they are doing….they just didn’t say HOW. You can find it on Wikipedia & look up sources from there. Try agenda & depopulation, 1993.

Researcher

TERRY
“FENTANYL” is not fentanyl at all, it’s amphetamines when tested. Narcan doesn’t work. It’s not a OD on opioids. Mia from Pulp Fiction?!?
2) ANN the reason the DEA targets the “good doctors”, and they do, is because they get paid extra PER BUST.
3) The DSM-5 was updated to say DEPENDENCE is addiction. So under Dr, Insurance, & government guidelines, anyone in pain management is a ADDICT, no distinction for Vets, cancer patients, etc they are the same as recreational users.
4) CPP’s love to blame the addicts……but are they writing these Draconian laws? No. AND why would ANY drug dealer want to wipe out it’s customer’s? Oh, it’s CHINA, right? There aren’t illicit labs all over China, Afghanistan produces 99% of the world’s illicit heroin….that’s controlled in part by the US, you can watch it on YT.
Put these facts together, plus the suicide rate, or OD as reported, is now mostly people over 65 yrs old!!!!!
That’s never happened in the history of the US. But neither has this.

Anthony Harding

My wife was cut down to half her pain medicine, she was in so much pain that she commited sucicide because she could not take the pain and be bed bound for the rest of her life. A lawsuit should be taken to sue the CDC and other agencies trying to hurt people and trying to make them commit suicide. That’s what the CDC wants a mass suicide of people that are in pain. I really hope that the people that make these laws and guidelines has a child or family member that gets so hurt and disabled from an accident and are in debilitating pain so they see it first hand and see how wrong it is what they are doing

I had some more thoughts: as of now the only treatment U get physical therapy, injections, given not enough opiates to even really work. So why go to pain management? Why pay those fees for urine test, physical therapy, injections when the insurance only cover so much. Why go in debt? It’s been hard on me not being in pain management only for the fact that when they were adequately treating me w/ opiates, I could do more & sleep better. which made me feel better. But I do not miss what it has become a ball & chain, bunch of BS. It is much cheaper to go to your PCP or a rheumatologist an get a steroid injection in the rear. It’s systemic. works much safer than getting it in the spine. I have gone to physical therapy so many X’s that I don’t need a trainer. I do my physical therapy everyday @ home. Don’t need to pay P.C . If ur inexperience there’s many excercises on the web detailed for ur issues. Just Don’t Force Or overdo it. We have got to rely /help ourselves as much as possible bc that’s what it is come down to. It’s all I have. My heart goes out to the people who’ve had surgeries & multi surgeries. I’ve had 1 in my neck & hope I don’t have to ever in my back. I have difficulty walking around. I do best i can. If u need to cry, cry but u r ur only hope. For some never get to c a doc but they just do best they can. Horse liniment, different braces on the web, the lake in the summer x free to exercise, sitting in a chair lift your legs. Get creative!

Rose

Why don’t they address the use of medical marijuana for pain? I have a prescription for Tramadol and Flexeril for the pain assocwith my fibromyalgia and arthritis- however since being approved for medical marijuana last March I’ve been able to reduce my use of these pharmaceutical drugs to only when I’m in a very bad flare! The ability of the products I use (vape pens, tincture drops, and ointments have changed my life and improved it immensely!

Teresa

Long-awaited Federal Pain Management Task Force Draft Report Released

Teresa

I don’t understand why, those of us that are “doing the right thing” and following the rules, are being made to suffer , because of those that are abusing pain meds… Anymore you can’t even have a major surgery and have the pain meds you need!! And God forbid, a current medicine your taking is causing you to fail a test.. then you get kicked out, no questions asked… And the best part is, if you have medicaid, and your pain management doctor excepts the card, but then the pharmacy says you have to have a prior approval before medicaid will cover the cost of the medicine. Well guess what, my local pain management WILL NOT UNDER ANY CIRCUMSTANCE, give a prior approval, and will tell you that up front. So you call medicaid , they say to call pain manegment, pain management says it’s not their problem, pharmacy says not my problem… So who’s damn problem is it… I will tell you who’s.. the person suffering because they can’t afford the medicine. Our government needs to fix these problems..

same medications they have used for years Cymbalta, Gabapentin, antidepressants I have tried all that junk & it doesn’t work but it does make U want to go to sleep or make u feel like molasses. NSAIDs If U have gi disorders / asthma/ blood disorders they’re not thinking about the people that can’t take that & then it will cause internal bleeding. Is that a life always sleeping but you’re still in pain. notice throughout the report it talks about additional funding from insurance companies to spend more time w/ patient & do these extra procedures. That will just raise insurance cost & those that don’t have insurance doctors won’t take anyway.😦. the people who get pain management as you know if they’re not injecting u in ur back or doing Chiropractic treatments, if U come in for ur so-called refill & tell them that U have a flare-up or something like that the PA will quickly remind you ,you’re here for a refill. No discussion. new protocols will not get patients more time with a doctor / PA. It’s a way for the doctor running the clinic to get more money. the treatments that u do get u will be rushed thru them. It’s all smoke & mirrors. I think all of treatment should be filmed w/ audio & the doctor should have access to it / patients / government/ insurance If no one has anything to hide then why not film it. Proof in the pudding. I think it’s awesome that they have to send e-scripts. need to drop this on call urine test bc if ur out of town or u have an emergency & have be out of town & can’t reach ur pain doc & ur dropped that’s crazy. Might as well be wearing ankle bracelet.The pill count each mo is enough! U dont kn if or when urine tested comes up in 28 days. Thats enough!

Shannon M Riggle

Please
LOOK INTO HEROIN AND FENTANYL
USERS
That is the REAL PROBLEM With
opiod ABUSE
Not people that are in Real pain and have been cut due to THE REAL PROBLEM!!!!!!!

Myra

1. With the states allowing medical marijuana when is Medicare going to start covering it? Because if a patient test hot for illegal substances which marijuana is by federal guidelines tjose people can loose their meficare and any other benefits being received through the government. As for myself I can’t use it because it causes extreme paranoia.
2. If your going to reclassify hydrocodone so people have to go to the Doctor every month, who’s going to give them the extra money for the additional co-pay, transportation etc. I get $359 a month for SSDI how am I to afford the extra cost, as most doctors will only seebyoubfor one thing at a time. Example: to address my tailbone I have to make an appointment for that pain then I have to make another appointment to address my sciatic pain, then another appointment for the injections etc. Etc. Etc.
3. No matter your pain you can only have so much narcotics on board. Even though any doctor will tell you every patient is different and what works for one doesn’t work for all. The doctors know their patients not the dea, politicians, or the President and the First Lady.
4. I have dealt with chronic pain continuously for 27 years. Now thanks to our lawmakers I have to suffer even more. I have a 15 day old granddaughter and I can’t even enjoy because of the pain. I can’t play simple games with my 10 year old grandson or spend quality time with my husband. Because as the pain gets worse each hour of everyday my body puts me to sleep to cope with the pain.
5. The doctors are so paranoid of the laws they say your not allowed more than 50mcg of narcotics period. And I was told by one I had to be off all narcotics by the end of 2018. And that I would have to have a pain pump implanted that has been recalled, not for use with a artificial heart valve, which I have. And my other physicians and my husband amd I were mot allowed to question anything. It the pain pump or no further medications. Found me another doctor.

Myra

My condition (conditions: rheumatic heart disease, mitral valve replacement, aoric valve regurgitating, breast plate pain from open heart surgery, 3 back surgeries with removal of 2 disc, fusion, bone grafting taken from both hips, instrumention, fibromyalgia, degenerative disc disease in Cervical, thoracic and lumbar areas to include arthritis, scoliosis, levoscoliosis, arthritis in both knees, broken tailbone and restless genital syndrome) was stable for over 3 years. And because of my heart I am not a candidate for surgical procedures. Now with the guidelines you have set forth the doctors are taking it at law to the point of taking me off all pain medications then inserting a pain pump (not happeningas my other physicians are not okay with this). I was on Fentanyl Transdermal Patches 100mcg/72hrs with hydrocodone 3 tid or as needed for pain. Over the past 27 years with pain management doctors we have tried various forms of treatment (anti-inflammatory medications, muscle relaxants, anti-depresants, PT, aquatic therapy, tens unit, masage therapy, injections and most recently radio frequency) which each worked for a limited time. Quality of life about 80% I was able to go visit occasionally, have meals out, go shopping, now with the new guidelines and doctors changing dosing to 50mcg/hr and 1 lower dosed hydrocodone per day, I have less than 30% quality of life. I’ve never overdosed or taken more than what I was prescribed.
Your new guidelines put me in the same bracket as your heroin, cocaine, barbiturates addicts and those that commit suicide. You allow the states to legalize recreational marijuana for the high which for decades there is research to prove that leads to more dangerous drugs. Why don’t you do something about the habitual users. They need mental help in a hospital not behind bars in a jail or prison it’s a disease.
You all need to speak with real doctors when making up these guidelines, not for political votes.
Fix this…NOW

Brenda Eiland

I have a rare type of myoclonus along with foot and ankle problems that surgeries helped but resulted in imbalance of weight distribution. I manage my time “up” and am able to lead about half a somewhat normal life. I’m grateful for that. Pain is constant, but much worse when on my feet or after sitting without being able to recline. I am able to take only half the smallest dose daily of opiate pain medication because of side effects, but it reduces the muscle movements and takes the edge of pain. Now, I have to make long trips for pee checks in addition to appointments. When I travel, it makes the myoclonus worse. So I lose an entire day by meeting the additional requirements when there has been no reason at all to believe abuse is involved, or selling the meds. I also have to go pick up a paper prescription once a month.

When the government gets involved in patient and doctor judgement, there’s more trouble, expense, and just plain craziness to deal with. We get put into the same category as addicts on the street who need treatment desperately, but not the same type people like me need.

I’m considering going “alternative,” completely, without a physician’s guidance. I live way out in the country, so there’s plenty of soil to grow things. If/when I do that, I hope I won’t go too far, but medical care for what I’ve got is almost guaranteed to be gloomy thanks to our over-reaching government that says one pigeonhole fits all, and no room to use good sense..

Greta Harsell

The thing is that because people can’t get their prescription’s that they are turning to street drugs to relieve their pain and that is where they are dieing. Not from what they are prescribed (if they are lucky enough to get their pain medications) but from the drugs that they are having to get from the streets and they don’t know what someone has put in the street drugs all because they can’t get the prescribed medications from their Dr all because of the regularations set forth by the DEA who has NO idea of what pain is unless they have been through it. DEA you are killing people all because you have nothing to do but justify your work position by coming up with stuff to hurt people and cause them to commit suicide because they can’t take the pain any longer. What about put a LAW INTO PlACE that someone who COMMITS SUICIDE because they COULDN’T get their prescription’s and they were in so much pain
that they couldn’t think straight and the DEA are LIABLE for the DEATH, they PAY for EVERYTHING and COMPENSATE the family for the rest of the life of individual based on their age. The bottom line is that people are seeking out street drugs because the DEA has made it so hard to get the medications that people need. DEA let the Drs do their job and help people, if you didn’t think they could do the job why did you give them a diploma? Tell American that.

I agree with a lot of the things commented. I have severe chronic pain and suffering with it for 4 months. Because they dropped me because of new regulations and laws. But the heroin addict has no problem getting anything they want. It really angers me, that someone being truthful get jacked around and dropped. The addicts have no problem getting what I need badly and then can’t even get disability. You are by far not got a handle on anything.

Angel

Take Kratom if your doctor won’t help you. It has saved me from hard, chronic pain. Research it, it’s true.

Rich Reifsnyder

Hi, Happy New Year, Why two different treatment lies?At addiction centers suboxon and bupropion,methadone is used for treatment for addicts,and benzodiazepines,Valium,Alprazalam,are given out also for anxiety.Now CPP,S who like me have anxiety going through the roof from this mental torture not knowing if you will be given your pain medication upon your next visit,don’t like you taking a Xanax for stress while you take pain meds.Now what is the difference,probably the addiction meds are real strong meds containing Opiods.Always against us!!When I do the next Urine Test I’ll have to ask which Hand Should I Hold The Cup in,because Iam Right Handed,and don’t want to violate the contract.Iam not a chemist but Iam sure there are opioids in addiction meds so why are they getting benzo,s and CPP,S are frowned upon if we do.Iam Disabled since 1998 and take pain meds and a prescribed Xanax when needed for diagnosed anxiety and I ain’t *******Dead Yet.Another thing I was involuntary decreased oxycodone from 160mg/day to 60mg/dsy.At my pain clinic there is no such thing as 90mme,Everyone and I said Everyone get 60mme dosage per day.There are so many lies,fictitious data on Prescription Opiod Medication OD Deaths it’s disgusting.Where is the CDC supposed to look at the guidelines almost 3 years ago for “unintended consequences”of the guidelines.The guidelines were intensional and weaponized against our Pain Specialists to seize their assets.It is a war against 50-100 million of us Intractable Chronic Pain Patients,Veterans and Pain Specialists.The DEA goes after weak Disabled Veterans and Intractable Chronic Pain Patients,we don’t have guns like the drug cartels have So were the easy target.This is the Worst Human Rights Violation in our history and all involved be prosecuted for homicide.Happy New Year,God Bless

Emerseven

Why punish people taking this medication as they should. I had a life but now because of the illegal use of opioids all suffer. After 35 yrs of being on pain pills my doctors decided to now set me free to go and live a life without them. Exactly what am I suppose to do.

Missy Weisinger

Diane, you sound like you’ve been listening to the uninformed “Andrew Kolodnys”of the world!
I got the same speech from a former pain management dr. who while poking her finger on her head said very loudly “IT’S YOUR BRAIN, IT’S YOUR BRAIN!” and at the same time I’m screaming in my mind, “NO IT’S THE PAIN, IT’S THE PAIN!!
In the beginning my body was in so much pain I began seeking drs in different fields. I thought a diagnosis might explain why my pain was sooo bad. Note… at this time I had not ever taken a pain pill! I was hurting and it had nothing to do with an opioid or my brain!
After seeking a pain management dr I was put on an opioid and was sooo much better! I was living again! After a year I was presenting outward symptoms and my PM dr sent me to a rheumatologist, diagnosis, rheumatoid arthritis. Once I was put on appropriate medications I was able to do without my pain meds for some time. I just stopped taking them, and whyyy, because I didn’t feel the severe pain like I had been. You see Diane it’s very simple, chronic pain patients don’t take opioids for fun, we take them when our bodies hurt so bad and nothing else relieves our pain.
How people like you think being tapered off opioids IS THE CAUSE OF OUR PAIN is just wrong! Our pain is from the underlying condition or disease we have. When a dr starts taking the opiate away from the patient it’s not the rewired brain causing our pain, it’s the disease we have!!
My diseases are painful! Do you think once the opiate is out of my bloodstream and the so called tapering to zero has occurred that I’m going to feel better? Just like you?
No Diane, the pain that’s been under control for over 20 years is going to rule my life again, thanks to people like you who think you know better than the thousands of us who say just the opposite!
The current guidelines are inhumane and causing suffering!

Donna S

Does anyone recall the days (about in the early 2000’s) when sitting in the waiting room of almost Any Doctor and in comes the ‘med reps’ carrying their bags of ‘samples’, talking our doctors into hawking More prescriptions to their patients?!! My doctors were all too happy to have me taking Multitudes of Pharmaceuticals an in essence ‘trying’ to help my chronic pain. Fast forward to today, I am older, endured Many surgeries and other procedures without much success. I am now 58, legally disabled and have untouchable daily 24/7 total body pain. And Now, some of those very same doctors are no longer getting their complimentary free lunches or kickbacks for prescribing to their patients! On the flip side are those Few physicians who still believe in trying to genuinely Help their patients in obtaining some sort of quality of life in their daily activities But a bunch of paper pushers who have quite probably Never hadthe horrible experiences that me and so many others live with every Single moment of Every Single day come to some conclusion that these meds are not acceptable and that there is some new darn terminology to group Everone into…The Opioid Epidemic!!! Wtf.
Give me a break. I take my prescribed medications Only as and when prescribed. I live in daily fear too that soon we will be shut off of the only things that help us through our days. Do these proverbial pencil pushers ever take into consideration as to how many people Will make much more dangerous decisions in trying to contend with their pain? How many ‘regular’ joes will consider ending their own lives with new intention? Do they really care at all? I think Not!

Christine T Branham

Bottom line, those of us suffering from severe debilitating pain can’t get help while the abusers still get the drugs! Once again bad guy ruins it for good guy!

Terry

Well I read thru a lot of the report. I have a few observations. First, they used the term “opioid epidemic” when referring to chronic pain patients, that’s very prejudice. In this report they even admit that only about .022% of opioid overdoses are from legitimate prescriptions. This was copied from the report: For example, the CDC guideline identified a dose limit of 90 morphine milligram equivalents (MMEs) per day. More recent data evaluated the risk of death related to opioid dose in 2.2 million North Carolinians and found that the overall death rate was only 0.022% per year. The researchers noted that: Dose-dependent opioid overdose risk among patients increased gradually and DID NOT show evidence of a distinct risk threshold. MUCH of the RISK at HIGHER DOSES APPEARS to be ASSOCIATED WITH CO-PRESCRIBED BENZODIAZEPINES. It is critical to account for overlapping prescriptions, and justifies taking a person-time approach to MME calculation with intent-to-treat principles.” Pain management docs are taking the CDC guidelines for prescribing as law, they are afraid to prescribe above the guidelines amount, for fear of losing their licenses, it’s happening! So getting a script that goes above the guidelines is impossible! Also in the report was the following: Synthetic opioids (a category that includes prescribed fentanyl as well as illicit fentanyl) are now the leading opioid involved in overdose deaths in the United States. So it agrees with the studies that say 98% of ALL opioid overdoses are from illicit fentanyl either by itself or mixed with heroin. Nobody wants to talk about the REAL opioid epidemic, which is heroin cut with fentanyl or just plain heroin. What they need to do is SEPARATE out the chronic pain patient statistics for overdosing and those using illicit drugs like fentanyl and heroin. Since the chronic pain patients are the ones that are affected by the CDC guidelines, not the heroin/fentanyl users. They are now undertreating pain.