Oregon Opioid Forced Taper Debate Continues

Oregon Opioid Forced Taper Debate Continues

By Ed Coghlan.

Oregon’s Health Evidence Review Commission’s (HERC) Value based benefits Subcommittee heard testimony from national pain leaders, Oregon physicians and nurses and pain patients during a day long meeting on Thursday.

At issue is the controversial proposal that HERC is considering to force taper Oregon Medicaid patients off opioids in one year. While they are essentially guidelines, HERC calls them a prioritized list policy – HERC dictating how doctors care and prescribe for their medicaid patients, essentially.

The proposal raised the ire of pain patient advocates and medical professionals across the country. HERC’s Chronic Pain Task Force, which developed the guideline, has been asked to meet again on September 20th and consider the testimony heard this week.

Oregon physician Dr. Ginevra Liptan, who opened the nation’s first practice devoted to fibromyalgia was among those who testified—tearfully–against the guideline. Dr. Liptan has had fibromyalgia since she was in medical school at Tufts.

Also testifying against the guideline was Bob Twillman, Ph.D., is the Executive Director for the Academy of Integrative Pain Management. In that capacity, Dr. Twillman is responsible for overseeing federal and state pain policy developments and advocating for those supporting an integrative approach to managing pain.

In addition, two nurses from Oregon, Carolyn Concia and Karen Yeargin added their perspective that the forced taper guideline as constructed would hurt chronic pain patients–many of whom depend on opioid medication in their battle against pain.

Oregon’s chronic pain community showed at the meeting in Wilsonville to let the HERC members know that they believe these guidelines will hurt chronic pain patients. The “protestors” were outside the meeting site early Thursday morning, only to find out the HERC members went in the back door.

Two woman who led the protest, who do not wish to have their names publicized because of fear of recrimination against them and their doctors, labeled the day a “great success”.

They also warned–“the battle continues”.

Authored by: Ed Coghlan

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Stacey Fields

Calls and letters to legislatures are doing NOTHING! We must make a new plan to fight this and it needs to be HUGE, on the lines of the civil rights movement. If we do something big enough the media WILL come. We NEED main stream media to report on this so that the average American that is only hearing “Opioid crisis” know that we are suffering NEEDLESSLY!! The put the cart before the horse and took our meds before they had an alternative for us that actually works! MMJ is NOT the holy grail that will solve this as it does NOT work for everyone. Make sure you vote against inumbents, we have to send a message that we will nto put up with them working against us or they will NOT work for us. We have to get healthy people fighting along side of us, after all everyone is only a diagnosis or accident away from NEEDING pain care too. The CDC admitted they inflated the numbers and nothing happened. This agency is corrupt and has a long history of corrupt dealings. What is going on is inhumane and they are forcing people to the streets or to suicide. There are diseases out there that are more or just as painful as cancer. I have an incurable exrtremely painful disease that I did not ask for nor cause, it does not take long to start thinking of your choices 1) Live in extreme pain 2) Go to the streets, or 3) Suicide and many have chosen number 3. We ALL deserve proper pain care. People are getting nothing after surgery, I will not have any surgery or procedure, I will not put money in the pockets of greedy uncaring jerks. If we hit them in their pockets maybe they will get that they are WRONG! I would bet that no one in D.C. is going without pain care, I have heard they get whatever they want delivered to their offices. Our government is more corrupt than most want to believe and they have shown us that they have NO morals to treat the sick and elderly as they are This is about MONEY folks, follow the money it begins with Indivior, PROP, Shatterproof and of course our elected officials! How many politicians do you think own stock in the addictions business? How much money would the government save on disability payments and medicaid & medicare if we were all gone? How many times have they stolen form the SS fund? Maybe instead of calls we should picket the offices of our legislatures and governors. I am not sure what the answer is but I do know what we have been doing is not working!

Cynthia Knutson

I am on Medicare/SSI and am fearful that even in CA they will be going after us pain patients in CA “we are a useless drain on society” seems to be EVERYONE’S attitude towards chronic pain patients & many people wrongly think we are addicts! I wish I could write Dr. Phil but he seems to be VERY anti opiate but I’ll give it a try because this country is NOT hearing the truth about us…OHHHHHH big surprise NOT. They want to get rid of all heroin and opiate addicts well now the hospitals are beginning to run low on opiates for patients in the hospital so is this how its going to go? People in surgery suffering needlessly? What about our patient rights? Geez I am a nurse & they are being RUN OVER! And Pain WAS one of the 5 vital signs! So now we nurses don’t care about pain or if our patients have it?
This was the main reason I went into schooling and I am getting punished for being injured on the job as many nurses are! I’ve been on opiates 15 yrs & never one issue so I feel falsely accused/slandered without proof I signed something for a class action suit against the CDC but the DEA is really going after us and lowering the guidelines so quickly we all need to fight and move fast which is hard on less medication. I’ve got a urostomy and now a blockage in it & kidney problems going on besides my huge scoliosis surgery last yr! Now I have acute pain..seeing my pain management PA tomorrow but am not very hopeful they can help me. Pain meds at this time are NOT helping much at all & this is the 2nd time I’ve started getting literally bedsores because I lay in bed & cannot do much else in acute and chronic pain man I am afraid I won’t get the pain control I need because of this attitude & what am I going to do afterwards?! I handle post op pain without adequate pain meds so I may not have surgery if they aren’t going to be sure I will have pain control after surgery.
I’ve been feeling lately all the govt and rich running this country into the ground & now by means of torture, killing pain patients this is turning into a barbaric “society” where all people care about is money/power. I see more people dying of alcohol & related disease/accidents than opioids! Prohibition does NOT work they STILL think they can control addicts and alcoholics they need a reality check!

Bill

Damn these people. Legitimate pain patients forced to endure these Draconian practices. Very frightening indeed.
Thank you for reporting on this. We need this exposed for what it is.

Leslie Meadows

Sounds like Hitler’s reign all over again ! How could Oregon’s government be ok with this? And how can ya’ll allow them to do this, it is totally unconstitutional, this a free society still we need to act like it!

CORINNE P ROBERTSON

Why aren’t they force tapering or denying smokers and alcohol users? Laws are not in place that would authorize what they are doing to pain patients. Plus we are denied the basic rights to life, liberty and the pursuit of happiness. Where is the justice? This is America!

Kim

I think everyone is right to wonder where this “opioid crisis” is actually beginning. One comment stuck out asking why the pharmaceutical’s are not chiming in.

Think about all the politicians receiving their campaign contributions, or dark money as some have referred to it. These companies could be making money on other products they’re developing or using to help the newly labeled, and wrongly labeled, addicts, off of their pain medication. The MMJ industry, the private insurance companies, etc etc. It’s bigger and deeper than we can all imagine. So, now they’ve sold this cost savings plan onto them ,Medicare & Medicaid. We have a business man in office that thrives on tv ratings. We are the unfortunate cost of his war. Chronic pain patients are expendable. The odds were never in our favor. We need to be strong enough to survive his war and not fall victim. We cannot give up and only become a statistic. We are more than a number. We our lives matter more now than ever before.

Cynthia

I am really confused about why doctors and government officials are jumping on this 90MMe and taking patients off medications because if you read the CDC opioid guidelines they are for primary care doctors only. The CDC admits there is inadequate data to support the recommendations and very little data at all about long term opiate use but make recommendations non the less. These are not law. Look them up for yourself. It is important to know for yourself even though I know that won’t help you if you’ve lost your medication. If you have been taken off much needed medication at the very least contact your state medical board and complain to them, to your state officials.

Gretchen

Thank you too all advocates Drs nurses and pain paitients that were able too attend the meeting you were representing more then just Oregon much appreciated keep fighting for our rights from a disabled chronic pain paitient in Ohio

Victim left suffering...

Hi Jill,

I suspect the reason Big Pharma is not on the bandwagon fighting for cpp’s is because they’re all being sued for millions of $ out the wazoo, including suits from states.

Just read recent article about how Big Pharmas are awarding Grants all over the place. I’m sure they would like to portray being the “do -gooders” now more than ever before.

It will be interesting to see what happens with patient assistance pharma programs.

For the second quarter in a row, 1 Big Pharma has increased retail prices by 10% on > 100 different meds. No doubt, others have followed suit. And, when 1 Big Pharma CEO receives a salary of $27M annually, they’ll figure out a way to compensate for any lost revenue from cpp’s and pass along the price increases to non controlled scripts.

Just my 2 cents…

Victim left suffering...

Yes, the cowardly HERC people who speared and appeared at this meeting did not even have the decency to walk near pain pts. who were acting maturely and only protesting human suffering.

Until the CPP community wakes up and realizes nobody gives a damn about pain patients left suffering, expect nothing to be accomplished and the steam roller of laws on all levels to be enforced. I believe the
ACLU is likely the only way to go…
ACLU should have been involved months ago. Nobody’s interested in cpp’s. It”s ALL politically driven. All Regs are part of the scenario and major players. They’re all in cahoots with politicians and big pharma. End of story.

Maureen M.

Thank you to the doctors, nurse and others involved that day for being there to support us.
Bravo! to those disabled folks who attended and struggled to get to this meeting, if even only allowed to be outside.
Was media there? I’m so very proud of you. We must keep this momentum moving…
We need to continue to try to impact the leaders and show that we will never ever ever go away! This is about our lives of illness,pain and suffering.
Please don’t give up hope. Something has to change. We can do it warriors!!
Keep strong and willful.

Patricia Costa

As a fellow chronic patient, my heart truly breaks for the continued negative stigma that plaques and complicates our lives.
The judgment, suspicions and uneducated opinions make our daily struggles even harder.
People surmount their challenges through understanding and support.
I can’t even count the number of times I have had doctors, pharmacists, nurses, friends and family question or judge my use if opioids. Like many others I have tried to manage without them, and the quality of my life spirals immediately.
I am a nurse as well and from an ethical medical perspective, patients have a RIGHT to pain control. Its written in many hospital ethics and national policies for patient rights.
We all need to support each other and educate the community.
If anyone wants to reach out my email is patcosta250@gmail.com.
I think every one if you suffering chronic pain are TRUE WARRIORS.

Jan Poole

To Allessio: I am so sorry for what they have done you in Florida. But if “we fight back by taking to the streets and making drugdealers rich” we are basically committing SUICIDE because the dealers cut their stuff with carfentanyl, and that’s what the government wants so they don’t have to pay us our Social Security and Medicare! They want us dead and they are winning.

More people Commit suicide than OD on drugs. These are evil people and evil times. Godless, lovers of money, etc. Agenda 21 is in full force . And to the other commenter—- You can’t give your life to Christ and then kill yourself, it doesn’t work like that. I have CRPS, 19 years and have had these thoughts myself as a born again Christian. I haven’t got the answers.

I am shell shocked like everyone else. We are living in a nanny police state and once the Government controls your healthcare, they have you by the cohones!

I shouldn’t have to suffer needlessly to protect junkies from their own stupidity. Please urge Roche to make abuse resistant Pantopon vaporizers with serial numbers to discourage diversion and timer chips to control puff duration and frequency with different concentrations. If these were readily available to all the opioid death toll would drop tremendously saving addicts lives while stopping chronic pain patients suffering. Since it’s almost impossible to die from smoking opium because you fall asleep before getting fatal respiratory depression this is the best ROA( route of administration). Pantopon is clarified opium with all the alkaloids in their naturally occurring ratios. No plant should be illegal. God or Gaia(the living earth) put a plant here for every illness 🌎✌🍃🎶

Misty Hoffman

My life is essentially over. After trying EVERY non narcotic pain relief method available and being stable for years on medications, I am being force tapered to the arbitrary 90 MME guidelines here in California by my pain management doctor (every patient in their large practice is even though they are pain SPECIALISTS. This is a year and a half after my primary care physician told me he would no longer handle my pain for fear of the DEA) Doctor’s are running scared even if everything is legit. I don’t understand how this torture of people can happen in this country. This pain has already robbed me of a career and the family I aspired to, now I won’t even be able to be a mother to my only son or a wife to my husband because I will be bedridden in agony…until I decide it’s time to see Dr. Smith and Wesson. Dogs now receive better care than pain patients.

Barbara

It’s clear to me that people who overdose are abusing drugs. Regardless if it’s from a prescription or street drugs. If you take the medication as prescribed and don’t mix it with other drugs or alcohol, you will get pain relief and nothing more.I do not get “high” in any way, shape or form. I want to be able to think clearly, drive a car and babysit my grandchildren. I can’t believe the horror stories I’ve read about legitimately sick people having their meds taken away and treated like junkies. The problem is I read these stories here and not in the media. Nothing is ever said about the chronic pain patients. I’ve notified my local media and never got a reply. But I’m not giving up. We all need to flood the media and our congressmen with letters and e mails until somebody somewhere listens to us. Other than that all we can do is pray. Reading these articles and comments have helped me to see I’m not alone. Thank you to all who write in and God Bless you.

Sherrie

This isnt right im a pain warrior i have a back injury,then developed OA,fibromyalgia,neuropathy,degenerate disc disease,mortons neromas in both feet ,and also rhuematoid arthritis ive been on pain meds for 15 years have had the same dr for 15 years i keep my pain meds locked up at all times i do drug test and am very responsible to make sure my meds dont get into anyones hands but my own ,dealing with chronic pain has changed my life i went from an very active lifestyle riding 4 wheelers and hunting with my hubby and traveling to having to slow way down pain meds have made my life so much better i can function i can play with my grandchildren and go out with hubby ive tried to not use my meds i weaned myself off 2 times im completely miserable and cant even get out of bed or off the couch cant clean my home or do even simple things its cruel to force taper a chronic pain person this will cause more deaths from suicides or overdoses from people looking in the wrong places for relief PAIN is a horrible way to live it changes a person .Chronic pain peoples quality of life will go to nothing meds help us live a more normal life please dont be cruel and inhuman

This HERC group, who are they and has anyone in there group experienced chronic pain for decades, if not send them somewhere so they may get an education on what patients are going through. I hate legislators who don’t have a clue on what they are doing. I have been in pain management for over 23 years I would love to give them some first hand information on what is really going on. i1t4u

Steven

I was at the meeting and it was clear that the members of this committee were not at all interested in pain suffering and suicide. All they were interested in is forced take away of medicine from people who least can stand that torture period shame, Shame, Shame. To Alessio I would make the comment that opioids are not allowed with marijuana medical or not. If you’re found with marijuana in your urine in a drug test then your doctor has the option of firing you and probably will. Let’s keep these comments factual because we are talking about people’s living or dying. It’s clear that our society is simply letting genocide Rule the Day! Any pain patient with a condition that’s getting worse meanwhile his pain control is being taken away is just one pill closer to suicide. That’s what this is leading to and I feel sorry for all the people that will be getting sick in the future because they will have nothing to help them. Speaking of suicide be sure and you give your life to Christ before you go! Thank you for all of the people that took the effort to get there early in the morning and attend this meeting. It did not feel like I’m meeting to me however. It felt like a Roman dictator saying to the Lion’s Den with them. This nation has just become another disgusting dictatorship caused by the Obama so-called health Plan. Hope you all are happy with your change.

Jill

I’m wondering if anyone could explain to me why Big Pharma isn’t fighting these CDC guidelines more vigorously. Are they not losing money with all the chronic patients no longer buying opiods and patches, etc? Ohio is suing them for the drug overdose costs and I would think they would have many studies verifying the involvement of illegal drugs in those deaths. I know medical mj wants their piece of the pie, but isn’t that also potentially addictive? This whole situation just makes no sense to me. I wish I had a better answer to how depriving me of quality of life meds is supposed to make society better. Why is NO lawyer willing to take on a class action suit on the behalf of CPP? Very strange.

Alice Carroll

Remember all the talk of “rationing” and “death panels” when the Obama administration and the Clinton administration before it tried to have a health care program for this country that would cover all citizens and it was bandied about that it could be government-funded. Big Insurance, Big Pharma and Corporate Hospital Groups all fought tooth and nail using the media to attack the proposal as socialism, that care would be rationed and cut back.
Well, What do we have here but an attempt to ration care, to cutback, to refuse to pay!

Remember “Do No Harm?” This is an attack on the most vulnerable of society. Many of these folks are faced with intractable pain because of their work, because of failed surgeries and because of accidents or diseases they have no control over. Why does HERC want them to suffer more?

As Dr. Darryl George wrote in this publication on August 9th It’s all about money. Doctors feel they are not paid enough for Medicaid patients so they fudge the paper work and short-change patients because they could be making a higher return on wealthier patients. Sure sounds like rationing to me with patient care being sacrificed for the almighty dollar. I commend Dr. George for coming forward by breaking the “Doctor Code of Silence” when it comes to matters of conduct.

Medicaid patients in Oregon or anywhere in the US do not deserve this. Many of them are Disabled. Does this proposal violate the Americans with Disabilities Act which states that those with disabilities should not be discriminated against in health care matters? The following is from ada.gov on the Barrier-Free Healthcare Initiative page. “The Civil Rights Division and U.S. Attorneys’ offices enforce the ADA in these matters with the collective message that disability discrimination in health care is illegal and unacceptable.” The US Attorneys Office is charged with enforcement. It’s time to contact them at https://www.justice.gov/usao/

Pain VICTIM

The “Experts” on the panel were awful. They did not care about chronic pain patients. They wouldn’t give any answers, like a politician. They were dismissive, detached and they clearly have never suffered from chronic pain. They kept trying to shut patients up by referring them to some website.
It’s discriminatory to prevent patients from having access to pain management just because they have assistance with their healthcare costs.
Even dogs get pain management but in the “Land Of The Free” only the dollar matters, people do not.
As soon as you cannot make money for someone, you’re considered to be a burden and less than human. That’s the America of today and it’s disgusting.

Diane P Succio

I’m so sick with the Government trying to be Doctors. I’m tired of the News constantly blaming the HEROIN EPIDEMIC on Legal Perscriptions. They never show heroin or ILLICIT FENTYL on there, it’s always Perscriptions.
My Dr went through Medical school unlike the politicans trying to practice medicine.
I’ve already been taken off one of my Perscriptions because Big Brother knows my medical condition better than my own Doctor. One day one of them will feel the pain and they will not be able to treat it.
My hope is that one day soon they will sit back and realize that they are hurting Us, the chronic pain patients and leave our Doctors alone. By all means go after the HEROIN and ILLICIT FENTYL that is coming in through Mexico and China. Go after the Drug Dealers and stop slapping them on the wrist. It’s always the Law abiding citizen that suffers.
We have to stand strong and fight for our lives.
Without my perscription I would be bed ridden. At least now I can somewhat function as a Human Being.

Alessio Ventura

Let’s look at the drivers for the “opioid crisis”:

(1) The deaths and ER visits from the illegal market.
(2) The marijuana lobby, claiming medical MJ is a much safer alternative to opiates, has current and former politicians in their “investment pockets”. People like the former Speaker, John Boehner. Pain patients are being directed to medical MJ providers. These politicians drive the new opiate limit laws.
(3) “Group think”, where now it is politically correct to join the anti-opiate crusade.
(4) Mass media, also favorable to MJ, has joined the “opioid crisis” group think parade, but has much more influence on how people view treatment with opiates.

Guess what is NOT on the list. Legitimate prescribers of opiates medicine for real pain. There are a few bad apples, but contrary to the misleading data that you have seen, “over prescribing”, for example after surgery, is NOT a major factor.

Like gun control, the innocent person takes the brute force punishment of opioid limit implementation. Recentlt, after 3 failed left shoulder replacements and 4 failed right shoulder replacements, including sepsis after the first replacement, and 2 failed spine surgeries, Florida physicians cut my IR OC from 30mg to 15mg, 4x per day, then to 10mg Vicodin, all within 2 months to meet the new July 1 daily limits. They also cut my Fentanyl patch from 75mcg to 50mcg to 25mcg within those same 2 months. Not only has my pain gone up dramatically, but I am also in full blown witndrawal because of the drastic cutting. The physician I was seeing then started to doubt me when I told her that Fentanyl,patches were not the best choice for me because I live in Florida, I sweat alot, and these patches fall,off all the time. The directions innthe Fentanyl box are clear: fold and discard any patches that fall off. All my urine tests were as expected.

So here I am, living in hell, because some politicians have conflated data and have fallen to the MJ libby. I am living in hell while they are enriching themselves.

When I told my physician that I just cannot take the pain and that I am having bad thoughts about my life, they called the police, who held me for a day and forced me to speak to a psychiatrist because I expressed that I cannot live with the pain that I have. They just don’t get it..I have tried all of the “coping” strategies, like meditation, yoga, physical therapy, accupuncture, etc. None of it works for me. I have no choice left but the streets.

Susan Brucks

I read today that the recent F.D.A. meeting which was , to my knowledge,designed to hear and review pain patients testimonials regarding CDC guidelines and FDA’s proposed measures regarding opioid prescribing. Many patients wrote testimonials as well as participating in surveys and the actual meeting. Apparently, the FDA was unfazed by the plight of the chronic pain patients. At this time they will only be dealing with acute pain (post surgical) and cancer related. They issued a statement that said they WOULD NOT BE REVIEWING OR MAKING CHANGES REGARDING CHRONIC PAIN AT THIS TIME.
I have tried to make sense of this, but I cannot. Who would ask the chronically ill patients with intractable pain to tell their stories only to disregard them? I find it cruel and irresponsible. Many patients spoke of suicide, others talked of a complete loss of quality of life and hanging on by their fingernails. I can only conclude that they do not want to be associated with denying chronic pain patients the medication they need because of possible retribution (lawsuits). Could they possibly be feeling guilty? I doubt it. When it comes down to it, it really doesn’t matter what their motivation could be. Because at the end of the day the pain patients are being told that it’s just too bad. They couldn’t be bothered with something that could have a potentially negative political fallout.
I hope this is not the case in Oregon. I hope this delay to hear feedback from chronic pain representatives will actually result in chronic pain patients actually being HELPED.

Alessio Ventura

I’ve had it with this “opioid crisis”, that punishes real pain patients because of the illegal opioid trade.

I live in another state that has forced a reduction in total daily opioid limits, causing widespread withdrawal and misery, not to mention increased pain.

I’m convinced that the marijuana lobby is in the pockets of politicians who are pushing these new regulations. For example, former speaker of the house John Boehner has a big stake in the pot industry, recently announcing his investments in that regard. More and more states are pushing MJ.

Bottom line is that those who suffer from pain have no voice. When they complain to the doctor who put them on opiates that the cuts are too sudden, too soon, they are dismissed from tne practice with the inference that they are drug addicts. Pain practices are now so afraid of government liability that they dismiss pain patients over the slightest annoyances.

Well, what to do?

I say, it’s time to fight back. Take to the streets, make the drug dealers richer, get your pain relief from the medicine you need. Yes, in some sense it is hypocritical, but, if nobody is listening and speaking for pain patients, what other options are there?

FIGHT BACK!