Oregon Health Officials to Reconsider Its Opioid Tapering Guideline

Oregon Health Officials to Reconsider Its Opioid Tapering Guideline

Oregon chronic pain advocates appear to be making progress.

The Oregon Health Authority (OHA) announced Friday that the Health Evidence Review Commission (HERC), will reopen discussions on the coverage guidelines related to neck and back pain implemented in 2016, beginning this spring.

The Oregon proposal to force taper patients off opioids has been criticized by pain medicine leaders and patient advocate organizations.

In addition, in the wake of mounting evidence that federal guidance, notably the CDC Guideline for Prescribing Opioids for Chronic Pain, was causing a reduction in opioid prescribing that was hurting chronic pain patients, the CDC, the FDA, the American Medical Association and the Surgeon General have ALL recommended moderation in prescribing.

“The evidence on the effectiveness of opioid therapy for chronic pain and opioid tapering are limited, but rapidly growing,” said Dana Hargunani, M.D., chief medical officer at OHA. “We are grateful to the HERC for facilitating thoughtful, methodical deliberations in the face of limited evidence.”

The Oregon policy is aimed at the Medicaid population—and two Oregon women impacted by the decision have been relentlessly talking with health officials, media and others who will listen about the inequity of the HERC proposal.

Amara M. and Wendy Sinclair were pleased today at the press release in advance of next week’s HERC meeting.

In 2017 OHA convened the Chronic Pain Task Force to explore whether a similar expansion of services should be offered for OHP patients with five other chronic pain conditions: chronic pain due to trauma, post-procedural chronic pain, chronic pain syndrome, other chronic pain, and fibromyalgia. Currently, these conditions are not intended to be covered by OHP.

The proposal that was informed by the task force garnered considerable concern and attention from advocates, providers and experts across the country, prompting deeper dives into the evidence. Most recently OHA commissioned a third-party review by Washington-based Aggregate Analytics Inc. (AAI) to evaluate how closely the proposal aligned with available evidence.

“The past year has been a valuable learning experience for OHA and the HERC,” said Kevin Olson, M.D., HERC chairman. “Not only will we apply what we learned to the chronic pain proposal currently under consideration, we feel there is enough new evidence to reopen the 2016 back pain guidelines to ensure our policies align with our best understanding of clinical evidence. I want to thank the advocates and experts who have voiced concerns and directed our attention to new information.”

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Authored by: Ed Coghlan

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Thomas Wayne Kidd

It is evident that we are now living in the time spoken of by the Lord Jesus in Matthew 24:12-13; “Because iniquity (lawlessness) abounds the LOVE of the many will wax (grow) cold. He (those) who endure unto the end, the same shall be saved.” But sadly millions have turned away from the teachings of Jesus Christ and now live by the evolution lie. Judgment has come upon all because of this nation’s gross sins. More suffering is on the way. Preparation by individuals is absolutely necessary else many will perish. I am speaking of eternal spiritual death. Those blaming God our Creator must stop and consider what they are doing and repent before there’s no time left to repent. Seek Him and His Salvation provided by His Son Jesus Christ. “Behold, now is the accepted time, Behold, now is the day of Salvation.” When the day of Salvation comes to it’s end, no amount of repenting or pleading will help. WAKE UP, WAKE UP!

Heather

I will never move to Oregon. Don’t even want to visit now, thank you. What dinosaurs they are!

I find TREMENDOUS irony in them saying that Opioids don’t have much evidence for them when they are proposing therapies that have far LESS evidence to support them.

Honestly, I think they need to have a look at their own biases. Why not let the doctors make decisions? Why pick out certain conditions to discriminate against?

I remember that I could easily rule out going to a provider simply by mentioning that I had fibromyalgia to the scheduler. Right away, “Oh, our doctors don’t treat fibromyalgia!” Thank you, I didn’t want to waste time or money.

It’s truly horrid how patients are mistreated, abused and discriminated against. And how ALLOWED it is. Disgusting. How do they sleep at night?

Misti

#7 suicide in my area in WI of a chronic Pain Patient a Vet shot gun after non treatment forced taper to zero after a motorcycle accident last Summer

I no longer have a pain doctor either or opioids or nerve blocks I have looked since Mar. 2019 and cannot find another pain doctor. The pain doc I had played games with my pain and did not care if I was in pain. He took my medication on Mar. 12th. 2019. I had another really horrible attack on Wednesday night that is still hurting me They will not treat my pain in the ER because it is chronic. I am in fact told if I go to the ER they will not treat my chronic pain. My pain never goes away. Like I asked on one of the other forums, what are we supposed to do if we have already lost our doctors and medication? How is this mess going to be rectified. Maybe there should be a special pain clinic at a reasonable distance set up so people who have lost access can receive their pain meds. Even if these regulations can be reversed and I doubt it, there needs to be a way for pain patients who have lost access to a doctor to be able to get their medications.

Terry Ott

I still am dumbfounded that people who formulate these kinds of regulations, guidelines, advisories (whatever we call them, they are pronouncements from somewhere “on high”) are able to filter out (i.e., ignore, discount, dismiss) the experiences of SO many pain sufferers who’d gladly stop taking opiods (and celebrate even!) if they were able to find any other option that would provide some predictable relief and not have (as in my spouse’s case) horrible physical and emotional side effects that the opioids do not, for them at least.

What sound-proof cocoon do they live in? How can they be so ill-informed when the evidence of partial relief from opioids is plentiful and, in fact, resides in the sufferers and the medical professionals who strive to provide assistance to their patients despite all the flak.

Literally MILLIONS of our fellow human beings are living partial lives in a holding pattern that’s made marginally bearable by the moderated and prescribed use of opioids, while they hope against hope that medical science finds better ways to help them before they die. And then we have voices shouting at them, “stop with the opioids, they’re bad because ….. (insert the reason, if there is one) … and just suffer in silence as long as you can.”

It’s truly mind boggling, is it not? And it’s a huge and vicious tragedy.

Lori P

What about those of us that have already been forced off opioids? Too late for us. Going from pain specialist to pain specialist only to be told we are too stupid to know what works for our pain and to try all the things we have already tried to no avail? Add to that, being treated like drug addicts. I have exhausted my resources. I have been blacklisted by every pain management clinic in my state. I was ejected from my last hope for advocating for myself and daring to say I knew they were trying to feed me BS. Now, to get the pain meds I need, I can either do without or obtain them illegally. What happened to “first, do no harm”? What about those who could no longer tolerate this living hell and had no real choice but to exit from it? I wish every single person involved in this scam has to some day live with the same pain we do and be denied the only treatment that helps. I also hope I live long enough for the inevitable class action lawsuit to be filed against these a$$holes and see them held accountable for ruining the lives of so many (including the caretakers of chronic pain patients). If I sound angry, it is because I am.

Billie McCurdy

So what does that mean for the rest of America? There are thousands of us that can’t get up and fight who’s going to help us win this battle?

Marilyn Pittman

I am so pleased by this report. It seems like finally the DEA and FDA “gets it.” Millions are in recurrent chronic pain with no other option than pain medicines that they obtain legally and are monitored.

Jeanette French

I hope they come to their senses and review all the harm that has been done to pain patients across the nation by the cdc guidelines, the suicides and the loss of jobs, houses, etc. that has ravished the pain community, the denial of medications, the denial of treatment, the loss of hundreds of pain clinics and the blacklisting of doctors prescriptions by pharmacies. It is all so very wrong, prescription drugs have been found to NOT be at the root of the overdoses yet we continue to be targeted. If you really want to end the war on drugs this country will follow Portugal and Canada’s drug policies. Many folks are now dead who were good productive citizens, and those deaths are on the heads of the cdc guidelines makers. If it was meant to be voluntary, then why were doctors sent warning letters for prescribing above the guidelines, pharmacies were sent letter threatening to close them down, doctors were terrorized into the fear losing their licenses, many of whom walked away from pain care,and pain patients are being tortured. Terrorism and torture. And why oh why do American soldiers still guard Afghanistan Poppy fields? These guidelines were made to be law, and were treated like laws by all leaders in this country. Pain patients have been demoralized, threatened, taken their lives and treated like drug addicts, shunned by their doctors and refused treatment of any kind of doctor based on the fact that they take a pain medication. Most other doctors outside of pain care are refusing to treat pain patients for anything.Leaving them to die or live with illness’s that are easily treated. THIS HAS TO STOP, and it has to stop NOW !!

I’m still very interested to see if this “rethink” is merely yet another example of OHA PR BS –something to get people to stop pestering them so they can go ahead & quietly do what they were planning anyway…I’ve dealt with these people for a long time, & that is largely their MO.

Since I’m stuck in Oregon, I’ve got more than an intellectual interest in it. This hysteria about opioids & the non-existent “epidemic” has already destroyed what life I had.

OHP services have always been about cost control; limit spending in any way possible. Each of the CCO’s that operate in Oregon do whatever they like with the money given to them by the state; there are no set rules that they must follow for everything. Even when certain conditions and medications are considered “covered” benefits at the state level, each of the CCO’s can decide on their own if they want to cover them or not. Douglas County’s CCO, the Umpqua Health Alliance (run by DCIPA) has been denying certain mental health medications for years. They also started taking chronic pain patients off their opiate medications back in 2013. What I find most disturbing is the fact that these same medical providers will treat back pain in the good commercially insured patients with opiates, but DENY the same medications for the same conditions for OHP patients and Medicare patients. That shows you that it is all about the money, not about any concern for the patient’s medical condition or quality of life. By denying treatments and medications to OHP patients, UHA saves money that gets distributed to their members in the form of bonuses every year. Therefore if they write more prescriptions and perform more tests, they get a smaller bonus. So which do you think they prefer? Of course it’s to get bigger bonuses by denying those prescriptions and tests. They have given themselves millions of dollars in bonuses over the last few years. That’s all from taxpayer funds that were set aside for healthcare expenses, not bonuses. But CCO’s like UHA are private for-profit organizations that don’t have to have open public meetings to let the citizens of Douglas County be aware of their spending habits. They have even used their funds to buy off legislator votes to prevent laws forcing them to have those public meetings. Until laws are rewritten to prevent the huge profits being made by CCO’s and insurance companies and these hidden bonuses, patient care will suffer.

Rosalind Rivera

I am a chronic pain victim! My former life has been reduced to that of a bed bound further disabled individual affected by the tapering in dosage amounts of my pain medication by my pain management doctor.
It doesn’t take a rocket scientist to come to the only conclusion that cutting of dosages or cutting off pain medications adversely affects pain, severe pain, to all pain patients and particularly chronic pain sufferers and victims such as myself.
I was under the naive impression that those in CONTROLL of this critical issue were aware of this!

Rosalind Rivera
Lucerne Valley, Ca.

Maggie King

For Oregon officials to even imagine forced tapers of just Medicaid patients is nothing short of classism and vicious profiling of the poor and minorities.
I was shocked it went this far.

I remain without a clinic, a pain management doctor and still without opioids OR the Clonazepam 1 mg I took for 12 years for a “severe PLMD” , a neuro disorder. Now I get to enjoy about 20hrs a day of muscular and bone and joint pain and my painful twitching, spasms and aches.

I would like to extend a heartfelt thank you as well to those who have hopefully and finally gotten through to people that should have known better in the first place!

Gary Raymond

For three years, each authoritarian who has never experienced chronic pain has suddenly developed intimate knowledge of chronic pain and how to treat it. Government committees cite their need for “evidence” although there is no device to measure pain. Our wounded warriors have been subjected to inhumane experimentation and now these committees intend to persecute those receiving public assistance. The CDC edict is not a law! And it is certainly not something that should be construed 50 different ways. I propose a national coalition of Mothers who testify before each of their State’s legislative bodies about their experiences during natural childbirth.