Op Ed – Oregon Should Listen to its Patients

Op Ed – Oregon Should Listen to its Patients

By BJ Cavnor.

In a move that’s left patients and doctors asking why, the Oregon Health Authority’s (OHA) Health Evidence Review Committee (HERC), are currently considering a proposal to severely limit access to opioid pain medications for Medicaid patients. Although officially this is being done to improve the health of patients by offering treatment alternatives it seems obvious that once again patients with chronic pain are being classified as addicts and blamed for the current drug crisis.

The new rules being discussed, known as Guideline Note 60, would limit new opioid prescriptions to a maximum of 90 days, and require anyone currently taking opioid medications to taper (or reduce) and discontinue the medications completely within a specified time frame.

OHA would instead offer patients “active therapy” (physical therapy, acupuncture, massage therapy, cognitive behavioral therapy) and/or non-opioid medication. We have asked the OHA to clarify next steps if these therapies are ineffective for patients, we’re still waiting for an answer.

OHA is trying to walk back some of the proposal to better control their messaging. Publicly OHA says that this policy is about helping patients by offering additional treatment options. We are told it has little to do with combating the opioid abuse crisis, but there is obviously some confusion between outcomes and what leadership is saying.

This was evidenced in the Op-ed written by OHA Director Patrick Allen, published in the Wall Street Journal last month, “Oregon Opioid-Abuse Policy is the Right One”. It seems that even the OHA leadership can’t decide if this proposal is supposed to combat opiate abuse and addiction, or if it is a policy to improve the lives of people living with chronic pain.

Allen’s words have done little to allay the fears of chronic pain patients. In fact, the proposal has emboldened them. OHA stated in a meeting last week that they had received more than 400 emails and messages opposing to the changes. So far, and thanks largely to many of you reading this, our petition to Governor Brown and Director Allen has more than 440 signatures and growing!

People living with chronic pain want relief from their suffering. They want to be treated with the same dignity and respect that all patients deserve. They want to be partners in making health care decisions with their providers.

Opioid medications are the current clinical standard for treating chronic pain. New non-opioid treatments are in development, but many are years from approval.

Just today, a study was published in the Journal of Neurology showing that the non-opioid drug Lyrica (pregabalin), is not effective as a treatment for chronic pain because of a traumatic nerve injury. Lyrica (pregabalin) and Neurontin (gabapentin) are two of the drugs OHA plans to provide patients Instead of opioids.

People taking opioid pain medication understand the benefits and risks that these drugs can have on their mind and bodies. They are not addicts and resent being treated as such. The behavior of shaming people living with chronic pain simply trying to access legally prescribed medication is egregious. This stigma can lead to depression and isolation for patients, increasing the risk of suicide.

This is hardly in keeping with goals of Oregon Health Care Transformation, and because it threatens treatment access, may violate patient rights under Federal law.

Patients appreciate the concerns expressed around the use of opioid medications and having conversations around the benefit/risk of these treatments, and looking at additional and emerging ways to treat chronic pain. Perhaps one example might be to remove restrictions for some surgical back and spine procedures that can fix the source of pain. I would ask OHA to look at the efficacy of this strategy which can resolve the issue as opposed to additional treatment modalities to manage symptoms.

We are not asking for the impossible; we request the OHA align their opioid prescribing policy with the recommendations of the U.S. Centers for Disease Control and Prevention (CDC). The CDC guideline offer instructions on prescribing opioids, monitoring for potential misuse and using existing data sources to prevent abuse.

We ask that representatives from Governor Brown’s office and the OHA meet with patients and listen to their concerns, and their fears. Oregon Medicaid patients are afraid that the treatments they currently use to successfully manage their pain may soon be unavailable. The question is what will people living with chronic pain do then?

B.J. Cavnor manages the One in Four Chronic Health Collaborative, a voice for patients.

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Authored by: BJ Cavnor

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Sj94510

I notice we ALL are either trying to explain ourselves or point out the obvious.

As another pain sufferer, Daniel Willis pointed out http://nationalpainreport.com/op-ed-oregon-should-listen-to-its-patients-8837318.html#comment-224144

This part of Mr Willis’s post touched home”

Just think about this for a minute,?

“Just how is it that stopping a person’s pain meds is going to help stop their pain????
Now if I could just Wish my pain away, do you think I would not do just that, hey, I wished my pain away, and now I am cured”. Yeah

Why are all pain patients explaining themselves now? I started pain mgmt 1984. Multiple accidents, brain head injury, whiplash, family violence, bicycle accident that broke my face jaw, i literally ate to rocks, gravel under my jaw 6 hour surgery…still never got treated correctly. Not to mention no dental insurance until 2018 Med i Cal Dent i Cal which cover nothing and nothing gets done. 2 years need full restoration with no hope in sight. Try being a person who lost upper teeth because no way to pay, only choice attractions, to many unknown wisdom teeth that broke upper molars and yrs later not many upper teeth. Can you imagine the JUDGEMENT? People and Dr’s believe the worst about a person with dental needs this serious, they think your a Meth addict or a heavy smoker or any number of untruths. people even go to jail as a result of lack of care and judgement of issues like this while all along chronic pain patients. Never breaking the law. 7 yrs later I am still not helped with my upper dental needs pain mgmt dr tortures me, I am under the 90mm morphine threshold. I cry ion pain and can’t imagine a future, but I try.

My POINT there are many exacerbating reasons that we all PAIN Suffers are in chronic pain. and then the obvious question what are we guilty of ? now we can’t even live or eat our function at this point I am harassed by the clinic I go to in San Ramon.

Comments are welcome

I must disagree with the central recommendation posed by BJ Cavnor: the CDC Guidelines are an inappropriate standard of treatment on which to rely for any purpose. Although posed as voluntary and directed to general practitioners (who are generally among the poorest trained physicians who see pain patients), the guidelines were a disastrous failure for many reasons.

1. The guidelines assume without proof that our opioid crisis was started by doctors over-prescribing for their patients. We now know from data published by the CDC itself that there is no relationship between rates of doctor prescribing versus rates of overdose mortality from all sources. The contribution of medically managed opioids to opioid mortality is so small that it gets lost in the noise. And the demographics of chronic pain and opioid mortality largely do not intersect.

2. CDC also assumed without proof that opioids aren’t effective long term. They cherry picked research results to favor behavioral therapies and non-opioid analgesics over opioids. But published trials shows no more evidence for these non-opioid therapies than for opioids, among trials lasting a year or more.

3. CDC also assumed a threshold of risk at 90 Morphine Milligram Equivalent Dose per day, where they recommended a safety review to evaluate risks vs benefits. Hospitals and pharmacies quickly — and stupidly — turned that number into a mandated maximum on prescriptions. However, at least 1.6 million Seniors are now maintained on daily doses above 200 MMED. Their overdose statistics have been stable for 17 years while deaths among youth and young adults have skyrocketed.

For more on this subject, see: http://www.face-facts.org/Lawhern

Yvette Sandoval

Yvette here still, but was saying maybe withbmy legs n feet gone so will the pain. She hasnt even bothered to respond back. This is presbyterian hospital, doc in Albuquerque nm, n rio rancho, nm. No one cares, i cnt believe im having to go through this at all, i never really gave any though, to this situation would actually become reality. Never. Said to myself they cnt do that, would never happen, it would strt a war with all of us in pain. N it, its come to this!!, anyway need help in Albuquerque nm, anybody have any suggestions or referrals?, well ty for listening fellow patients, n take care all of you!!

Yvette Sandoval

I have, what i believe, been kind 9f black listed. I havnt done anything wrong, i suffer with alot of pain throughout my body, from, fibromyalgia, lupus osteoarthritis, femus bone infections, fused feet bones, no muscle or cartilage left to cushion. I also have sciatica, so not only can i walk or stand much, neither can i sit for long either. I have been cut off from my pain medication since this past February, just for coming up with a false positive for methamphetamine, just because i was suffering from yet another sinus infection, n taking anything over the counter for relief of the symtoms, n had namonia, at the same time. It wasnt even looked into, or retested, nothing, just cut off. And all my meds at same time, anxiety meds xanax, at the lowest dose, my migrain medication at its lowest dose, n my ambien, all the same day. N i havnt found qnyone willing to help since then
Pain clinics i was. So lucky to get, i guess, only offered injection burning of nerves or an epidural in my spine, thats it!!, ive already been there n done that, even a nerve stimulator placed in my spine, that felt like an electrocution, everytime i needed to use the bathroom. My conditions, are not improving with age, like a fine wine. Everything is getting worse, adding in a few new problems, n with my age now at 50, alot harder to deal with. Panic attacks, anxiety, no sleep, n pain unforgiving migraines at times, is goin to kill me with a damn heart attack or a stroke from all of this government interferance, with what should always be our own private decisions, in reguards to our own bodies!!, i couldnt even convince any of our news stations to do a story bout this unethical inhumane torture were goin through. My doc was offended when i asked for her to just take a look n maybe read a little on this site. Offended!!, atvthis point, i finally just asked her for a referral to an orthopedic surgeon, who would consider amputation of both my legs n feet, maybe if their gone maybe my pain

Leticia

What about the fact that most of the patients if not all with rare incurable painful diseases have already tried all alternative treatments? These patients have waited sometimes years to get their pain at a level they can at least function yet these policy makers that are not their doctors are making them go thru all that again!These are real lives and they are not lab rats ! Why are we even staying with the same doctor to establish a relationship for when they don’t have any say anyway.

Holly

How about sending all these replies to our government!!! It makes me sick what they are doing! As Chuck from below writes “GOD HELP US ALL!”

Granny

This is just more nonsense, ann even worse version of the ‘fail first’ philosophy. A reasonable approach would ADD the alternate therapies for those who benefit from them…but lleave in place reasonable opioid coverage for those of us who have already been through or choose not to engage in these other options per our doctor’s guidance on our iindividual situation. Acupuncture was ‘forced’ on mme, and caused the end of my ability to work at all by triggering RSD to spread rapidly throughout my body, and my baseline of ppain to be permanently stuck at ‘8’. Had my opioid meds simply been supplied, I would most likely still be working. 🙁

Kelley

A little CDC.gov forced honesty from their new report released 8/31/18:

Opioid deaths:
14,487 out of a total of 325.7 million people in the US died in 2016 from LEGAL PRESCRIPTION opioids.
That’s .000004% of the population! Now why is there a hysteria over PRESCRIPTION opioids?

Kelley

A recent article about the HIPPA violation dictated from our own Gov against its citizens, forcing Veterinarians to look into Their patients owners medical record

“It doesn’t serve any purpose except for me to humiliate a client, violate their privacy and then look at them and try to decide, ‘Hmm, are you a user?’” Mason said. “It’s beyond the purview of our practice as veterinarians, and it’s unreasonable for the law to ask us to do this.”
It really, really makes me u
Vets say the law’s goal is laudable, but in their line of work, the new requirements don’t help and are a hassle at best and potentially dangerous at worst.
“If somehow someone got into it (they could note), ‘Gee, this person has OxyContin. Their house would be a good house to go rob,’” veterinarian Erich Baumann, co-owner of the Animal Emergency Clinic of Mid-Maine in Lewiston, said.
“Its uncomfortable to have to look at their history of opiates and then make a decision about their animals based on that,” Stuer, who owns the Bethel Animal Hospital, said.
“In general, definitely, veterinarians seem quite unhappy about it, mostly ethically concerned about checking a human’s information at all,” veterinarian Amanda Bisol, legislative chairwoman for the Maine Veterinary Medical Association and owner of Animal Medical Clinic in Skowhegan, said. “Part of it is because we don’t know anything about human medicine, and it’s actually quite different. The dosages and things for most pharmaceuticals are very different for humans and animals. We’re looking information up (in the database), and we don’t know how to interpret what we’re finding.”
I can’t live with (the current law),” Mason said. “I don’t want to access people’s medical records. I’m not their physician.”
“Not treating animals pain, is just plain cruel”

WHAT about humans?,

Bangotdailynews

Calla

I am a chronic pain patient with bipolar disorder, ehlers danlos syndrome, fibro. I have gone to physical therapy, tried non opioid pain meds that did not work or that I couldn’t afford even with insurance. The worst was savella. It caused irregular heartbeat, increased sweating which was embarrassing. My hands shook so bad I looked like I had Parkinson’s disease and also had random bruising. My first pain management doctor was wonderful. He did not make me feel like I was an addict looking to get high. Unfortunately he retired so I have a new pm dr.He never asked for my old medical records and started me on p/t, non opioid pain meds, supplements and cognitive therapy. Again. So I go to this dr every month hoping he will prescribe pain meds which I know works. He did prescribe suboxone which my ins doesn’t pay for so I would have had to pay 177.00$ out of pocket. I went to six different pharmacies and no-one could fill it. One pharmacist told me they didn’t sell that drug and the others seemed very judgemental. It made me feel like shit in plan English. I’m going to see what happens at my appointment nxt month and find a new dr if I have to. We all have read about the number of od deaths but I haven’t seen much about chronic pain patients that have committed suicide or overdosed from street drugs. I did read about one who had been a police officer before she got hurt. She was still being prescribed her meds but was so afraid of not being able to get them that she killed herself. If an addict od’s every day they are given narcan every time and offered rehab. What are pain patients offered? Pain. My thoughts are with the pain patients in Oregon.

Jill

Debra, so sorry for your situation. Sounds like you have to endure until Oct.5th. So wrong and you feel alone. You are not. Find your inner strength and hang on. I worked in diagnostics before I retired and feel certain the gastro doctor will give you something for the pain. And he’ll take another look at your CT. Take it day by day.

Debra Kurtz

One of my chronic pain conditions is that I get obstructed bowels or they just get severe pain from not working right. This condition exacerbates without warning. Since Sept. 20th. I have been in one of these attacks with pain in the 6 to 8.5 range. You can actually see my abdomen and bowels pulling and pushing under my skin. Today I went to the ER and they did blood work, a urine test and a CT scan. No pain meds while I waited for the CT results. I never saw a doctor but a CRNP. She came in and said all my tests were normal and that they could not give me any pain meds. They gave me a tordall shot which is worthless. This nurse had seen that my lower belly was rigid. I was told to take tylenol, use warm compresses ,see my gastroenterologist (who is 3 and a half hours away and booked up to Oct. 5th.), find a position of comfort ( there is none), see my primary care doctor within 72 hours ( he is not there on the weekends and does not prescribe any pain medicine that is effective) and to return to the ER if i get worse or am in distress. i have been in distress since Sept. 20th. I know my CT is not normal, it never is. I am scared right now. No relief in sight right now. Going to see who I can tomorrow. For the first time in my life I wish I could get some illegal drugs right now. I have never done that before but wish I could right now. There is nowhere to turn right now. Wish I could put my pain in some of those people who tell us to try mindfullness.

Laura

Bath gabapentin and Lyrica are abused and some states have scheduled gabapentin. I’m sure more will do so soon once states realise how much these drugs are abused. Both can have terrible side effects and are beyond hell to get off of. Lyrica is known to cause suicide in some patients.

I’ve taken opioids, gabapentin, and Lyrica at different points in the last six years. Of the three, weaning off opioids was easy while gabapentin and especially Lyrica were months of withdrawal hell even with tapering. I’m pretty sure that I became psychotic towards the end of my Lyrica taper and had lost my grip on reality. I wanted to end that unbelievable hell I was in and attempted suicide. While taking Lyrica, I was a brain dead zombie. The stuff had literally turned off my personality. Doctors didn’t believe anything I told them about both side effects and withdrawal. Everything I said was dismissed even when I was desperate for help and full blown suicidal. Pain patients are treated as hysterical liars and nothing we say matters to anyone. We’re not worth even basic courtesy, let alone compassion. It’s an unbelievably screwed up system. I know I’ll never trust a doctor again.

Just think about this for a minute,
Just how is it that stopping a person’s pain meds is going to help stop their pain????
Now if I could just Wish my pain away, do you think I would not do just that, hey, I wished my pain away, and now I am cured, it’s a medical wonder drug, just Wish your pain away. Wish I was told this year’s ago.
Government wake up, people are hopefully not that stupid.
Even a vet will write a dog out pain meds??. Are humans not more important?? I have never seen a dog go to work to support there family’s and pay taxes, but they do not have to hurt. Now is that not strange??
I would bet all I have on the fact that the same people taking away out given right to pain meds, have pain meds in their home, all they want. Does that mean only rich government official’s have pain, but not the common people, well just how is that, I want to hear that one. Oh, I forget they just Wish their pain away and zap it’s all gone. Tell me another one with hair on it.
And just how is it the government can tell us if we are hurting or not and just how me can handle our pain, it’s none of their bussiness anyway, we are not children that must be told what to do with our own bodies. We don’t tell them how to live their lives, the government would not let us tell them that. so just why it’s it the government’s business to tell the common people how to live. Or how much pain we are in, like the government cares anyway. Just another way to rule over us, keep us in our place. The government wants to keep their common people beat down.
If the government really cared about us, they would stop all this silly stuff and do their jobs and just run the country, what they were elected for, not to stick their noses in all our business. There’s much bigger fish to fry.

Juli Snyder

One day, and I mean either today, or tomorrow, these government ( I’m not going to say what I want to call them) that either they become in SUCH PAIN, THEY CANT GET OUT OF BED, HAVE NO TO TRY AND EAT, CUZ THE PAIN IS SO INTENSE IT LEAVES THEM VERY VERY SICK TO THIER GITS, ANYTHING THEY TRY TO EAT, COMES RIGHT BACK UP. OR BEING LEFT ALONE IN NED FOR DAYS, BECAUSE NO ONE AROUND THEM BELIEVES THEY ATE IN THAT MUCH PAIN. OR GO TO A DOCTOR’S OFFICE THAT LOOKS AT YOU AND SAYS, TO ME YOU LOOK FINE, AND SEND THEM OFF WITH TORDOL. OR BETTER YET GO TO ANOT ER, THEN BEING LOOKED AT AS YOUR ADDICTED, TO ONLY GO BACK TO THE PLACE YOU ONCE CALLED HOME, BUT IS NOW YOUR PRISON!!

Verona Johnson

The problem not addressed is the number of pain patients that live in rural areas. It’s a 120 mile round trip to see my Primary…there are no “alternative remedies” available at all. Most Medicaid patients can not afford medical cannabis or (for me) the 30.00 co pay for anything but the Primary. If this passes we need a class action suit against the State. I have Medicare and Health Net but since I’m low income I’m considered Medicaid. I’ve been on pain meds for the past 20 years. I have reduced the amount I was prescribed. I have never abused my pain meds. If this bill passes I’ll be unable to most of the activities I do now.

Denise Morris

BJ, thank you so much for this well-written, well-researched and timely piece. Successful pain management saves lives, and sometimes opioids are the only effective remedy. Not everyone can do yoga or manage many of the alternative methods due to the disability caused by pain in the first place. Beyond Oregon, many cannot access THC and the plethora of other alternatives. Ice packs on, off, on, all day and night do not constitute survivability for a person suffering severe unremitting pain. On another note the patient-doctor relationship and physician prescribing rights should not comprise a legislative issue.

ruththella white

I am a 68 y.o. black female.The arthritis started in my early 20s. I have already been through every treatment modality. None allowed me to live a meaningful life. Wheelchair, PT, pool therapy, massage, acpuncture, tens, steroid spine injections, lyrica, antidepressants, neurontin, topamax, botox, tramadol, non-opiod medication which aggravated an undiagnosed congenital heart defect. Nothing stopped the pain of arthritis that has calcified the tendons and ligaments in my spine, hands,feet, arms, legs, knees and shoulders. osteophytes are so large they are compressing nerves in my spine and one is almost touching my heart. Although I lived and worked with chronic pain since my late 20s without any opioid medication and given birth natualIy three times I was sent to counseling to change my attitude about pain. I was given opioids only after an orthopedic surgeon stated my condition was inoperable and prescribed a wheelchair replacing my walker. I discovered that white patients were already receiving opioids. Previously, I had been accused of being an addict by medical professionals even when I didn’t take opioids. A member of the board making decisions about
treatment denied me a muscle relaxer and sent me home with pain so severe I wanted to take my life. Two weeks ago I was diagnosed with MS. I have never abused my meds, filled early or visited different doctors. Currently, the MS spasms have not been treated and I was told it was anxiety and acid reflux. Due to HOCM, withdrawals and pain block blood flow in my heart. A hospitalist stopped one of my pain meds without tapering sending me into withdrawal then sent me home without treatment. Only my persistance in finding an answer led to the test for MS. There are no cures for me only palliative care, but I am more often than not denied care for my medical disorders because I take opioids. “Pain is inevitable, Suffering is optional”. Treatment of pain stops suffering and prevents suicide and assisted suicide.

Ellen

I have dystonia active makes me worse I went to state of unable move left side during physical therapy I did massage therapy after car wreck prior knowing I had dystonia and made cervical muscles hurt so bad never went back
And to go after poorest makes me disgusted When Medicaid patients had use methadone most dangerous to prescribe due long half life people got called in their H and P’s by residents doing them assumption undergoing heroin methadone treatment
It is worse then mass shooting or terrorist bomb because it is done by American government to its own people and how can they do that when the meetings at federal level is still in session
I don’t get this it is medical care at it worst and I had horrible experience on consult in Oregan
A great one for endometriosis and excellent standard Patient analgesia for one night in hospital since took uterus this time and cut all other out Dr Redwine in Bend but neuro was prior meet me assumed my dystonia was from psych even though UCLA said absolutely not so for several years I went out of state for neurologist and then found Seattle neurologist trained UCLA he is a gem believes dystonia is very painful so far Pain Clinic is doing me right along with Neuro infusions of receipe he knew to use
God bless or whoever you go to for strength and hope I would move out Oregan

Susan Simpson

This government is the most corrupt I’ve ever seen in my life! Jeff Sessions – which I hate! How are you going to put a man over a opiate epidemic who can’t get past hatred over a natural plant? You think he will have understanding toward a opiate pill? It’s like having the head of the DEA who compared heroin and marijuana as equal?? Jeff says take a aspirin for pain? The man knows nothing about addiction nor pain? Did you all know the DEA bragged about a doctor they RAIDED, PUT IN PRISON – key words over “not sufficient medical reason” ! I of course looked into it because I don’t trust them at all!!! I am here to tell you they said he was not a pill mill doctor but equally worse he abused his prescription pad writing ONE patient oxycodone – I will not use the words here that I tweeted to them! It was NOT nice at all..I did tell them “what according to your all new guidelines as police and your not doctors because you all seem to want people on heroin instead” !!! They are low down scum! Now does anyone question why doctors are scared to write? I am telling you it’s a scam for profit they turned safer pure opiates like morphine, dilaudid – perfection, oxycodone, Norco to go synthetic making everyone out like addict abusing what should be a short term detox drug, a beautiful one (9 days avg) giving it long term) giving for pain not FDA approved for pain!!! Because Suboxone are expensive – the $$$ maker, doctors saying they ARE NOT addictive – A LIE! So I get to looking what all the FDA has recent approved for opiate treatment here we go: Zubsolv – same active ingredients as Suboxone just stronger with different brand name! Sublocade – Injectable Suboxone! list goes on! They are killing pain patients & addicts! Destroying the American people and our families! Get ready Lucemyra is going to be the new fix! Watch & see! The DEA not 1 Suboxone raid? Amazing!!!! Feel free to share!

kelly

Oregon knows what people in chronic pain can do then…there’s always that handy (& much cheaper) option to “die with dignity.” This proposal has nothing whatsoever to do with improved patient care & everything to do with the task farce’s predetermined position –abundantly clear from attending or listening to their meetings or reading the minutes (which are online) that EVERYONE who is on opioids is an addict with an abuse disorder. They’re not even subtle about loading the task farce and they’ve ignored, subverted, or suppressed their own evidence that contradicts their extremist position.

The task farce is also, amazingly, full of people who stand to benefit directly from the very “therapies” they insist on replacing opioids with. Astounding coincidence.

Terry

Unfortunately the OHA agrees with the public at large and it’s all because they are too lazy to investigate and act appropriately rather than ruining the lives of millions of chronic pain patients. It’s very typical I’ve been finding out, just start a conversation with someone about the opiate crisis and you’ll see what I mean. The blatant ignorance abounds among the average person on the street. Publicly, genuine, real statistics ARE available and frankly I can not imagine taking steps to stop opiate use for chronic pain patients based on assumptions rather than hard facts. For instance, 98% of ALL opiate related overdoses are caused by people using illegal and illicit drugs, most are from using fentanyl and heroin and moreover a combination of the two. Chronic pain patients who use opiates gotten through legitimate prescriptions account for LESS than (two) 2% percent of ALL opiate overdoses. For the OHA and also our federal government to punish chronic pain patients based on NOTHING is an absolute sin!!! Shame on them!!! Do your job(s)! The information is ALL available. We are suffering needlessly and I don’t know the reason why except it is a knee jerk reaction, which is typical of our government, and they are famous for not “walking things back” once they’ve made a decision. God bless all of my chronic pain brothers and sisters.

chuck darrah

God help us all !! Some very powerful people want to take away all opiods from those of us who suffer horrific constant chronic pain ! It has to be all about the money folks .This whole guideline ; one size fits all is insane and inhumane.There are millions of us; we have to use our voice and our vote now before it is too late !!!

While addressing OHA policy is a good step, it only deals with payments of what they consider “covered” or “accepted” treatments. Whether or not opiates are a covered benefit will be a moot question when the providers who WRITE the prescriptions refuse to do so as so many of them are doing now. The CDC Guidelines and actions by state licensing boards and the DEA are scaring providers away. It’s just simpler and easier to say, “We don’t take care of pain.” It used to be when you called looking for a new medical provider, the first question the office staff would ask was “What’s your insurance?” Nowadays the first question is “Do you have pain? We don’t treat pain.” And often they will add “We don’t care if you get your pain medications from someone else too. We still don’t see patients with chronic pain issues.” This type of discrimination is occurring across Oregon and other states. When regulators prosecute doctors just based on dosages or quantities, when insurance companies deny prescriptions or require lengthy prior authorization processes (and still deny them), when pharmacists question the prescriptions and deny them too, and when the media portrays most doctors who write opiate prescriptions as “licensed drug dealers,” why should the doctors deal with all this drama when it becomes easier for them to just say “NO.” More pain clinics are closing, more pain physicians are retiring, and the few that are left feel like they are just targets waiting to be hit despite all their best efforts in following good medical practices. They get investigated and prosecuted by laymen with no medical training whatsoever. Until society and governmental regulations change, you can just expect more of this to get worse.

William Dorn

The CDC guidelines also need to be changed to allow each person in chronic pain the proper dosage to treat their condition. One size does not fit all. GOD BLESS those suffering in Oregon and I pray that their GOVERNOR does the right thing.

Anon MD

And today the news that 80,000 died from flu and complications last year—far more than died of overdose. Spread the news wide! If that isn’t a crisis, if we aren’t in an all out panic to vaccinate every citizen, we shouldn’t be in a rush to take the pain relief away from every innocent victim of a terrible disease. No one is going to knock on your door with a flu shot, and I bet you won’t hear a peep about that on the news.

Connie Woods

Thank you for writing this. Living in Fear is taking its toll on us, causing all kinds of problems we didn’t have. Not sleeping and not eating, depression, scared, being home bound, bed bound, unable to do ADL, even the smallest thing, unable to care for our families and unable to work. We don’t deserve that. We didn’t start addiction. We just want our life back, being able to trust our Drs, our health care.

Jay

I’ll answer that question……we all know the answer especially the government.
Suffer with horrible pain for the rest of there lives.
Go to the streets for illegal drugs.
Sucide.
Unfortunately the government is hoping for the latter.
The chronic pain community feels this way about our government. Our leaders say alot about the so called crisis. BUT NEVER do I read about how taking all opioid medications away are killing the pain patients literally no one cares. NEVER hear about the Gov/media talking about people that do illegal drugs. To me the norm is pain patients are worse than junkies and those that do illegal drugs. Alternative treatments are wonderful but if you cant get to the treatment because your in too much pain then what?? My question is to the pain patient and to myself…
Which of three choices will we decide to do?

Carloe

I think this is DESPICABLE!!! You are labeling and judging a specific segment of the population!!
Long-term this will end up costing EVERYONE more money!!
Additionally, where is specific long-term studies to indicate people in chronic pain, getting relief through opioids, are exhibiting “substance abuse behavioral?!!”
Eliminating one’s only way to deal with chronic pain WILL lead to illegal substance abuse, as people look for anyway possible to end their suffering!!
Is there studies completed on suicide rates among chronic pain sufferers that have been denied medication AND….
Studies on chronic pain sufferers using opioids for relief that are able to lead successful lives/careers with pain relieved!
Punishing those with chronic pain conditions by denying opioids is a pitiful, ineffective solution to America’s substance abuse problem!
.