By Ed Coghlan.
Chronic Pain Leaders and pain physicians are ripping the forced taper opioid guidelines it may approve on August 9th. The new policy would impact Oregon Medicaid recipients. The changes include a forced taper for all chronic pain patients on opioids (within a year), no exceptions. Opioids will be replaced with alternative treatments (cognitive behavior therapy (CBT), acupuncture, mindfulness, pain acceptance, aqua therapy, chiropractic adjustments, and treatment with non-opioid medications, such as NSAIDS, Acetaminophen).
“Persecution of patients with pain is an abomination. Persecution of financially-disadvantaged patients with pain is an abomination and an atrocity. What can these ignorant policy-makers be thinking?!” said Michael E. Schataman, Ph.D. who is Editor-in-Chief of the Journal of Pain Research and the Director of Research and Network Development at Boston Pain Care.
“This is NOT the right approach-fibromyalgia patients need more pain management tools NOT less” she tweeted. “As a fibromyalgia specialist in Oregon, this change would be devastating to my patients. I strongly urge any and all of you to comment on this policy. You don’t have to live in Oregon to do so, and it would be catastrophic for this to pass and set a precedent for future legislation.”
For Bob Twillman, Ph.D., who is Executive Director of the Academy of Integrative Pain Management urges HERC to slow down.
“We are still trying to get all the details we need to understand exactly who would be affected, and who wouldn’t. But we can say that the idea of tapering people already being treated with long-term opioid therapy is fraught. It is unsupported by evidence, logically inconsistent with other aspects of their opioid policy, and increases the risk that patients will experience decreased pain control and function, with no option to stop the taper or reverse course if that happens. It’s clearly not a well-thought-out idea,” Dr. Twillman told the National Pain Report.
A Roseburg, Oregon physician says in Douglas County, the Comprehensive Care Organization that manages care already has been denying chronic pain patients opiate medications since 2013. He claims despite the fact that the Oregon Health Plan says certain medications should be and are covered expenses, Umpqua Health Alliance clinics and doctors deny patients these medications so they can save their program money that gets distributed to those providers at the end of the year as bonuses.
“Denying patients governmentally approved treatments and more all for the sake of bigger year-end bonuses is unethical but common practice here in Oregon,” said Dr. Darryl George D.O. “They also deny many other medications in their efforts to control costs.”
Dr. George also pointed out at the recent Oregon Pain Guidance statewide conference in Eugene, it was clearly stated to the audience that too many providers are tapering their chronic pain patients too fast.
“Those providers don’t care if you go into withdrawal,” he said. “The faster they get you off opiates, the better THEY feel. They have been doing a poor job with pain management because they don’t pay attention to what they are doing; misread drug tests, no PDMP checks, cut-and-paste chart notes, no physicals, etc.”
Two Oregon women—both chronic pain patients—have been working to bring attention to the policy changes that they believe will hurt chronic pain patients in the state. And neither want us to publish their last names for concerns about retribution to the doctors who treat them.
As Dr. Liptan indicated, people—in Oregon and beyond– can comment about the process. HERC has suggested that comments should be received by August 1st, in order to guarantee that they are read by HERC committee members. Oregon law demands that committee members receive a packet 7 day in advance of the meeting, including public comments.
To send your comments about the policy change, send an email to firstname.lastname@example.org. HERC suggests you submit the comment no later than August 1st. The comments are limited to 1000 words and it is recommended you put “VbBS” in the subject line to assure your comment is part of the record.
Editor’s Note—if you send comments to HERC, please share them in the comments section of the National Pain Report.
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