Pressure Grows on FDA to Change Access to Painkillers

Pressure Grows on FDA to Change Access to Painkillers

The U.S. Food and Drug Administration is under growing pressure from other federal agencies to change the prescription guidelines for opioid painkillers – a move that could make opioids difficult to obtain for patients suffering from fibromyalgia, back pain, migraine and other common chronic pain conditions.

“These are dangerous medications. They should be reserved for situations like severe cancer pain,” said Thomas Frieden, MD, director of the Centers for Disease Control and Prevention.

Frieden made that comment last week during a press briefing on a CDC report on the growing number of American women who are dying from painkiller overdoses. Although he didn’t specifically address changing the prescription guidelines for opioids, Frieden made it clear he thinks painkillers are over-prescribed, often for conditions that don’t warrant them.

Dr. Thomas Frieden

Dr. Thomas Frieden

“I don’t think there’s any evidence of a big increase in need for prescription opioids. I think we need to better understand the risks and benefits of these medications, said Frieden. “Patients given just a single course may become addicted for life. I think there’s been a trend in the medical profession and we need to reverse that trend.”

Another CDC official went even further, suggesting that opioids should not be prescribed for chronic pain disorders such as fibromyalgia.

“I think part of what we see is other conditions like fibromyalgia, migraines, other specific types of conditions that may be more common among women, opioids are often used in those settings yet guidelines and other studies looking at the (effectiveness) of opioids in those conditions really doesn’t support their widespread use,” said Dr. Chris Jones, a CDC health scientist.

It was nearly one year ago that a group of doctors and public health officials, led by Physicians for Responsible Opioid Prescribing (PROP), petitioned the FDA to change the prescription guidelines – also known as the “labeling requirements” — for opioids.

The agency currently approves most opioids for “moderate to severe pain,” but the petitioners say that is an overly broad definition that has encouraged physicians to prescribe powerful pain medications to patients who don’t really need them. They want the word “moderate” dropped from the labeling requirements, so that opioids would only be indicated for treatment of cancer pain and severe non-cancer pain.

Doctors would still be able to prescribe opioids “off label” for moderate pain, but many would be reluctant to do so if the federal guidelines are changed.

Frieden was asked if opioids should not be used to treat moderate pain.

“In the data we have reviewed, we have not seen a clear indication of these drugs for other conditions,” the CDC director said. “What we really want to emphasize is the risks and the benefits. These are risky drugs and there are often other medications and other therapies, like physical therapy, exercise, cognitive therapy, that can be very important in addressing chronic pain.”

The FDA has held hearings and sought public comment on PROP’s petition, but has yet to make a ruling on its merits. The agency is under increasing pressure from Congress and some public health officials to take stronger measures against the abuse of painkillers. In 2010, over 16,000 Americans died from overdoses associated with opioid painkillers.

“If FDA appropriately applies existing federal law, they’ll revise opioid labels to reflect evidence that benefits may not outweigh risks when opioids are prescribed long-term for these conditions,” said PROP co-founder Dr. Andrew Kolodny.

National Pain Report asked Kolodny if Frieden’s comments were aimed at pressuring the FDA to act.

“No, this has nothing to do with inter-agency rivalry,” Kolodny replied in an email.

“Dr. Frieden’s views are informed by evidence suggesting that opioids should be avoided for axial low back pain, headaches and fibromyalgia, which encompass the vast majority of chronic pain patients. Experts in the field of pain, addiction, evidence-based medicine and primary care agree with him. Only drug companies, die hard opioid extremists and opioid-dependent pain patients (who are understandably fearful of being cut off from their supply) would argue with this.”

But critics of PROP’s petition say the extent of painkiller misuse and abuse in the U.S. has been exaggerated.

“Regardless of the CDC comments,  I believe that the FDA will take a fair scientific look where such science exists.  Dr. Frieden’s views are NOT supported by evidence suggesting that opioids should be avoided for certain chronic pain syndromes, and most experts in the field of pain, addiction, evidence-based medicine and primary care would disagree with him,” said Dr. Jeffrey Fudin, founder of Professionals for Rational Opioid Monitoring & Pharmaco-Therapy (PROMPT), which is lobbying the FDA to reject the PROP petition.

“I believe the FDA has not made a decision or near making such a decision on relabeling of opioids,” Fudin said in an email to National Pain Report. “At the very least, I trust the FDA has been carefully pondering the risks and benefits of such label changes over the past year, and although all of us have serious concerns, we have no evidence to show that relabeling will make things better or worse.”

The CDC’s Frieden is not the first federal official to publicly urge the FDA to change the prescription guidelines for opioids. A top official with the Drug Enforcement Administration expressed support for PROP’s petition in a March 20 letter to the FDA.

“The DEA is concerned about the potential public health risks resulting from the abuse of opioid drug products. Additional regulatory measures are necessary for opioid formulations to adequately safeguard the American public,” wrote Joseph Rannazzisi, deputy assistant administrator of the DEA’s Office of Diversion Control.

“The DEA hopes that FDA will implement suitable measures, such as labeling revisions, to help mitigate the adverse impact on the public health resulting from abuse of these products.”

A spokesman for the FDA said the agency could not comment on the issue because it is still under review. But a possible hint on what the FDA is considering may have come in an April speech by FDA commissioner Margaret Hamburg at a drug abuse summit.

Hamburg called the abuse of prescription drugs “a public health crisis of enormous and devastating proportion” and said her agency would take a number of steps to prevent abuse, including “modifying opioid labeling.”

Authored by: Pat Anson, Editor

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I find it kinda strange that in the comment section I’m finding little to no mention of the 16,660 people who died just last year of pain med OD’s or of the over 2 million opiate addicts in the US. The plain fact of the matter is if these drugs were better and more carefully regulated then the people who really need these drugs would be better able to get them. I know I can only speak for myself but I’m tried of read about kids getting hooked because there so easy to get, then becoming life long addicts or dying of an over dose. I hope the FDA does the right thing.

Melanie Raymond

I have four compressed nerves in my hip and pelvis, my sciatic included. My sciatic was compressed and entrapped in thick fibrous bands of scar tissue for YEARS due to a fall I had suffered. Regular MRI’s would not show this problem. I had doctor after doctor telling me there was nothing wrong with me. It wasn’t until I had specialized EMG testing and MRI’s that they found it. I had surgery for it last year to remove the scar tissue but my nerve is forever damaged and I am in more pain post surgery than I was before. I also have pudendal, obturator, and LFCN nerve entrapments that further surgery isn’t an option for me. I suffer horribly in pain day after day and have been dismissed by many many doctors in a very prominent area of our country for help to fix the problem. I am on pain medications and am tired of being treated like I am a criminal at the pharmacy to get it filled every month. I have a monthly office visit with my doctor, which I pay for and force myself to go in severe pain to get my script. I have to submit to urine testing every month and my pain conditions are well documented by testing. Why is it then up to the pharmacist to decide whether or not I should get my pain medication? I barely cope with the pain with pain medication I cannot imagine the quality of my life without it. Shame on our government and these agencies for taking this out on honest pain patients. We are the ones following the rules and we get punished for it. There will be a lot of pain patients committing suicide if they cannot get control their pain. Life just won’t be worth living but I guess it will be easier on the DEA as there will be less people to monitor that way. I wish there was some way to transfer the pain that I feel in my body to just ONE of these pharmacists or doctors or DEA agents! Then maybe they would get it!
Sick and tired.


i would like to see these officials suffer with back pain,fibro,restess leg,or any oyher chronic pain condition.this will just cause people to go to the streets to get these drugs.i guess they rather these people that od ,would be better if they commit suicde.because that what chronic pain will push u too.!people can talk all they want,until u feel the pain of chronic pain day after day with no relief,u have no clue.i go to the dr every month and they have no answers for me.they cant help u,only make u worse.but these people in these jobs want u to think they doing something when they could give shit less just like workers comp,a joke!!!!

If these non elected officials really want to solve the problem, They should spend their time and efforts into finding cure’s from all these pain conditions. They should also find ways to prevent these diseases from happening in the first place… One of the biggest epidemics in the USA is Arachnoiditis.. a 95% iatrogenic disease caused by misinformed doctors and the greedy docs who get rich by operating injections mills….and yet they want us to suffer further after they gave us all this pain!

Ann Hemenway

just because someone has fibromyalgia, they are now being labeled from these new Dr’s saying they will not prescribe medications that you’ve been taking for years, when Dr’s move and u end up being moved around like a mouse, its very hard to start over …especially when you have multiple diagnosis’s and require pain management. DDD herniated discs, pinched nerves, back pain, tenosynovitis, arthritis, torn meniscus, lupus, MS, metabolic myopathy, nerve and muscle abnormalities, PTSD, etc… your list goes on and on and you get that one Dr that is focused and on and only sees that one word… “fibromyalgia” causing you more grief, these Dr’s need to be FURTHER EDUCATED that Fibro is mostly a SECONDARY syndrome to a more complicated problem, Im very lucky to have one very intelligent and informed Rheumatologist. I only wish these wanna-b Dr’s that have some kind of power over you, and their nursing license gets to their heads or ppl that don’t suffer make all these decisions that we don’t suffer in extremely chronic pain that could be worse than a cancer patient, one of which I personally know! she doesn’t even come close to comparison with me! some ppl do abuse the system but please, not everyone is a loser and its up to these Dr’s to manage what and who they prescribe to.


Nancy: my heart goes out to you & we are all feeling this way I’m sure! I want to correct something I said in my earlier post. FORGET about laws being implemented, changes are already underway from added pressure at both the state & federal levels! I’ve been informed that doctors can no longer treat you for pain (even orthopedists)…ONLY PM doctors (even they are in fear) and if you are in between PM physicians (for one reason or another)…and treated in the meantime by the ER or one of your doctors, you can be targeted for doctor shopping! I’m hearing that pharmacies are also in fear to handle PM customers! I’m getting it from ALL corners: my Ortho, PCP, & pharmacy!! These are tragic times we are living in!! Sadly, we are in a very bad predicament as CP patients! I’m so sorry but i do not know what we can do?? Passion and anger are great catalysts!!


You have all made excellent points. My doctor went to 12 extra years of schooling to get degrees in Neurology and Anesthesiology. He only sees patients that have been referred to him and meet criteria, he first tries all the P/T, steroids injections, etc. then when he puts you on Opioids he monitors your levels and also checks your liver. He will not fill your prescription early and he follows all the guidelines and so does his patents or they are dismissed from his practice! We pain patients are going to have to find the strength to fight another battle. The battle of our rights to live a life free of pain and suffering. I have already planed my plan B if this is going to mean I can no longer be treated. I won’t live in what I consider pure Hell on earth. So we better put our heads together and try to fight them or we will have no choice but to end our life. I can’t stop thinking about it day and night and as you all know stress just makes the pain worse. I hope we can work together to resolve this issue. I spent my life working in health care and I never thought in a million years it would come to this!


I took care of my mother who died from lung cancer, she went quickly in less than a month. The last day of her life was the only day she used any pain medication. I also took care of my step mother who had throat cancer (both these ladies smoked). I took her to radiation and her treatments took care of cleaning her trach, she had an order for Vicodin and Morphine, she never even had them filled. She died of an cardiac arrest. I have had several back surgeries and a cervical fusion (that did not work), my spine is so diseased and I have so many herniated discs or no discs at all. Then my last surgery I developed peripheral neuropathy and small fiber neuropathy. It is by far the most painful thing I have ever experienced and I have a high tolerance to pain. I had my baby’s natural and we had a dentist that did not even use Novacaine but this nerve pain is like I am being tortured. Even the pain meds never take it away, but it lets me get enough relief so I can get some sleep for a few hours. I can barely walk because of the nerve damage in my feet and legs. So now I can’t have the medications I need to live a life without torture. Isn’t this part of my civil rights? My God you goverment people are not only doing your jobs but making a muck of everything in our Country. Our Country has gone down hill so fast in the last decade that we are now policing doctors and pharmicists. I hope that you get a disease like we do so that then you will understand how horrific this is. You better believe suicides will increase they already have started. I just read one from a 30 year old veteran who has intolerable phathom pain for his loss limbs. He also suffers from extreme PTSD and since it is getting so hard for him to get help and the medications he needs he has already taken his life. I have read letter after letter from good honest hard working people who feel their only way out is to end their life. Is that what you want you legacy to be about? Spend a day with a few of us and then decide you are going to take away our medicine. We are falling apart and I blame the people in office for the mess we are in.

As a person who suffers from fibromyalgia, along with degenerative joint disease, 2 herniated discs, spondylitis, no cartilage in either knee, this decision would be devastating. I have never abused my medication, as a matter of fact I take it less then is prescribed. I am very aware of the dangers of pain meds, yet if I could not have them I would spend the rest of my life in bed and would probably commit suicide. My pain level is probably much worse then a lot of cancer patients. I would have absolutely no quality of life without them. I’m 57 yrs. old and my body is like that of a 80 yr. old woman. I understand there is abuse of these meds, but there are people who need them desperately. Why punish everyone? This is absurd! I’d like the members of the FDA to walk in my shoes for one day!


Recently following media coverage on a raging civil rights (march) protest in Fla. and political in-put & fist slamming by our current administration in DC in response to that issue…I found myself scratching my head & wondering; “what about our rights (not knocking theirs by any means)….are WE not being descriminated against in many areas?” What we have to endure to get adequate treatment & just plain respect is mind boggling!!!! I’m tired….sick & tired of being in fear of what is ahead for my lively hood, family, and dignity[that list goes on]!!! Their are many CP patients living within me…meaning my pain conditions, prior injuries, & rare illnesses are many & if I’m having trouble-things are THAT bad in the CP arena!!!! I know we are (justifiably) not the best advocates, but my friends…we have to take a page from “their” (re:civil rights ) book!!!! We have to do more!! I don’t know all the answers but I do know this will get hard to turn around once laws are inacted & will be a far worse an uphill battle than where we presently stand!! There just has to be SOMEONE [attorney, high profile person] willing to help us!! I’m truly worried & frightened for all of us!!!!!

I too suffer from Fibromyalgia (FM) and resent being told I don’t need my pain meds, and that they don’t work for FM. I have been disabled for the past ten years and live in pain daily even with my meds. They do not stop all the pain but make it more tolerable. After 30+ years with FM, I now have severe Degenerative Disk Disease with 8 bulging/protruding disks in all three areas of the spine, this just discovered 2 years ago as with FM you are always told all your pain symptoms are FM with no further testing. I have severe spinal stenosis in my spine and believe my spine would not be in such condition had I had adequate medical treatment. The spinal epidurals only made me worse and as far as therapy, I couldn’t afford it! They would’nt take me if I didn’t attend 3 times per week. I have a $45.00 copay per visit. Sure, I can spend $135.00 a week out of roughly $250.00 to live on. I don’t know the “dopey” feeling as someone described earlier. I was told that if you take your meds for real pain that it goes to help that pain, not make you high. You might know it would be a man who wants to stop women and FM sufferers from opioid use as the majority of sufferers are women. I go for months w/o leaving my home except for my monthly visit to the pain clinic for my meds which I take only as prescribed. These men should be run over by a Mack truck and see how well they function throughout the day. They should also experience sleepless nights due to sleep disorders and depression from the isolation. They should further look at these cases to see how many were suicides since they do nothing to help us…just cause more pain and anguish by treating us like drug addicts because we need pain medication to get through the day.


Here is our main problem. The Gentlemen here has been given this job – Thomas Frieden, MD, director of the Centers for Disease Control and Prevention. DISEASE CONTROL & PREVENTION ! ! !. I dare say an individual of any kind cannot, whomever they may be CANNOT perform this JOB description. To act in this position you have ONE-WAY of performing your job. That is to lessen the current count of Americans who have a Serious Chronic Illness. Next would be to decrease the amount of Narcotics being prescribed. In doing this HE must override ‘The Doctor, MD, Specialist, Professional, DO, IM, Neurologist, Anesthesiologist and every other Student who has been Schooled in the CARE of the Human Body’. Can a man, committee or any other group, organization take Control of the Professional and Human Being relationship that occurs in great numbers across this Nation ?.” ABSOLUTELY NOT!. ” ” I rest my case – for every Chronic Pain Patient “In this ‘Country of the Free & the Brave’. In which we must practice & defend our ‘INDEPENDENCE’ as Free Americans we must Stand !. Share your voice ‘Out Loud’.


Everyone should read Dr Gabor Mate’s excellent book called “In the Realm of the Hungry Ghosts” about addiction and America’s shameful policies towards harm reduction as its related. it shouldn’t be, but as a chronic pain suffering from RA, i am largely treated as an addict. Also why is the drug buphrenorphine prescribed for pasin in europe but here only as part of suboxone for addicts. Social rehab DOES NOT WORK! Whereas stats on suboxone are 80%. Other MYTHS are that withdrawals arent bad for people and cause no permanent damage. 1 in 250 ppl die for a start, and many more if other drug addictions are present. I realize bringing up addiction is off topic somewhat, but it is the attitudes towards it that are spilling over and causing genocide for those not rich enough to receive adequate pain medication management. Jails routinely misreport deaths. I do not see how hurting ppl with pain helps ANYTHING! It has ZERO effect on persons w/ addiction! I propose everyone who drinks, smokes or is overweight no longer receive any health care at ER or anywhere if it is caused by their lifestyle, because that is exactly what is being done to addicts. If the substance itself “causes’ addiction then why is not everyone ever prescribed an opiate an addict? Past trauma and social conditions cause addiction, period – NOT the drug.

Sky Queue

The stats on deaths due to opiates are srsly flawed and being used to help the DEA take their failed War on Drugs to doctors who keep good records and have assets they can seize, as well as drive up costs of heroin on the street helping out Afghani/Mexican heroin producer friends (CIA has been in the drug biz for a long time) Deaths due to the underlying reason the opiates were prescribed are disregarded by cops who now write nearly 95% of death certificates and have an obvious agenda and lack of education in this area. Less than 5% of deaths are autopsied and even those often by non medical personnel. Suicides due to chronic pain and a looking at a (non) future without access to pain meds is another mis-reported as an accidental overdose to save religious and family members grief and insurance and burial policies. The fact that America’s population is aging and that more woman suffer from pain is completely disregarded. this in itself could be the variable to account for the so-called rise. There are more environmental stresses causing diseases and conditions with chronic pain. Big Pharma as a corporation i runs the corporatocracy we call the US govt and has a big interest in getting ppl to buy $$ new and largely ineffectual against many kinds of pain makes no money off generic opiates. Also that the prison industry (our country jails 25x more ppl than any other country per capita, and the War on drugs is their main pipeline) is a huge force of influence peddling and lobbyists, and would benefit from the outlawing of pain meds as pain sufferers would turn to the black market. I have many more ideas that create significant variables that are unaccounted for in the policy debate. This is shameful and shows the slide into fascism and a police state . Just twenty years ago the govt inserting themselves into the doctor patient relationship was unthinkable.

Donna Ratliff

This article seriously made me sick. I am so tired of pain suffers having to see and hear constantly all over the media that they are addicts, they don’t need pain medications. I’m sick of the DEA and other organizations speaking about these opioids as if they have no place in society. Well.. The IOM reports are NOT wrong. They concluded that over 100 million citizens have chronic pain on a daily basis and that’s not including Veterans that are suffering too and people under age 18. Veterans are being cut off their pain relievers right now, just in case you didn’t know. How wrong is that? The government officials won’t tell if they personally have chronic pain and I’m sure most don’t know what it feels like. Good for them, but if they really cared about safety and The American people. They would stop worrying about a few deaths from overdose. Yes, I said a few, because there are 315,245,986 million of people in this country, not including over 800,000 thousand foreign students and thousands more with work Visas, So the O/D numbers they came up with are still nothing compared to the population here in the USA ! Who are the government trying to fool here? We aren’t stupid people in this country. Come on now.. OD’s are No where near the number of Americans that are suffering from the many pain conditions and causes that exist. I’m also sick of the government getting in the way of patients and their doctors. By the way, I want everyone to KNOW, what’s going on here in Florida. We are experiencing the most inhumane human rights situation against legitimate pain patients that you could ever imagine. Every legit pain patient is having very serious problems in filling their medications. I know this because I get emails everyday from patients that are severely suffering and if you could hear what their pain conditions are and hear them say, that they haven’t been able to fill their medications for days, or even months? You would think I was lying! No, I am NOT lying! This state is in a very serious crisis here. For this Dr. Frieden to say that those conditions he suggested here should not be treated with opioids for pain? Is absolutely ridiculous! For Example: This month, I can’t find anywhere to get my son’s pain medication filled in this state. It’s been a week now. This is not the first time this has happened. He has used the same pharmacy for many years but then the elderly pharmacist decided to retire because he couldn’t stand the pressure he was under with all the pain medicine problems and the DEA breathing down his back. My son has chronic Lyme disease with co-infections. Because he was misdiagnosed for 3 yrs before his blood was tested and came back positive by CDC guidelines. Only people that have Lyme and the doctors who treat long term Lyme understand how severe the pain… Read more »


If your ass was in pain, you would never talk this BS!!!!!


Why on earth would the FDA consider the opinion of a psychiatrist when making decisions about meds for chronic pai n??? I am 55,a homeowner tax paying, voting citizen of Florida. I have debilitating RA, without opioid meds, I cannot work to support my family! I can barely walk to the bathroom!!! There’s no cure for RA, at best, I can only look forward to it getting worse, so why would you take away the only medication that helps my quality of life? The DEA has their noses stuck so far us the pharmacy ‘s behind that it is nearly impossible to get my oxycodone filled as it is. Last month alone in Pinellas County I had to go to 26 pharmacies to fill my prescription! That is just plain insane! What do you suggest as an alternative? Should I quit my job, blow through ‘my retirement, and then apply for welfare for the rest of my life? Or maybe I should just kill myself. The only bright spot in this article is that Dr FUDIN weighed in..I am not a drug dealer! I am not a criminal! I take my meds exactly as prescribed! So why punished the thousands of us who live with chronic pain?


I am a pain patient with numerous conditions brought on following a car accident in which I was rear-ended by a Budweiser truck (the huge kind). He wasn’t paying attention. I was at a traffic light. Trauma such as this causes a cascade of pain problems that don’t go away. I will have to live with pain for the rest of my life. Thank God, my doctor understands. She fears the DEA but knows I can’t go on without treatment. Without pain treatment, patients will be faced with 2 options. Try to live with debilitating pain — bed-bound — most likely. Or suicide. Problem with suicide (besides the religious implications of “playing” God) is that the government’s statistics will include suicides as drug-addicted overdoses and the situation will become even worse. Pain patients need to organize. We need a big-name advocate with national name recognition. We need to “come out” and stop fearing the degrading labels they give us. We need to fight back. It’s not easy to fight when one is disabled and in pain, but it will get worse if we don’t act now.

John Quintner

What modality of treatment would Dr Frieden suggest for those unable to cope with their pain (irrespective of the particular diagnostic label) who have failed to respond to regimes of exercise, phyical therapy, and psychotherapy, and have found that medications such as simple analgesics, anti-seizure agents and anti-depressants have been unhelpful or poorly tolerated? Furthermore, has he considered the issue of opioid tolerance that may necessitate an increase in daily dose beyond an arbitrarily decided upper limit of daily dose?

Rose Ragan~McWain

If everyone who is considering telling us we cannot have our medicine had our illnesses for ONE DAY…this would be a non~issue. Because of FAITH and medicine, today I was able to teach Bible School. If you WANT more Americans in BED…You are on the right track. Find ANOTHER WAY…Trust the Doctors and Diagnosticians to SPOT ACTUAL illness. Chronic Pain KILLS! Please help us cope with this HELL we live with. My illness. ..ARACHNOIDITIS. LOOK IT UP! I thank you.***

I no longer need opioid medication for my pain, but when I did I was so grateful to have access to it. Who decides when something subjective, like pain, can be labeled severe? The determination can only be part of the communication between the physician and patient.

I was very careful to maintain my physician’s trust while taking these drugs, and he was careful to monitor my opioid use. We were a team and respected each other and the power of the drug. That should be the norm and we should educate patients and physicians to that norm.

To change and redefine the entire treatment regime because some overprescribe, abuse, or sadly, become addicted, is just crazy and extreme.

JOY, IC, MCTD autoimmune, FM and trigeminal neuralgia patient.


I don’t believe it is the intention of medical professional to deprive patients of the treatment that gives them relief. My question is are our phycians educated correctly on the risk/benefit of opioid pain relievers. I have a child who is a recovering addict and recently lost my mother who suffered from chronic pain. From my perspective this is a phycian and pharm monitoring issue. If the FDA changes the labeling that may prompt better education for the medical community.
One example of events that have shaped my opinion is when my daughter closed hand in car door, no broken bones or abrasions, ER doctor wrote script for an opioid pain reliever ……….why? I gave her tylenol and ripped up the prescription. Was she in pain? Yes. Did she need prescription relief? No! Based on the medical facts; xray and visual inspection of the hand there was no need to prescribe.
This is but one of many experiences I have had over the past 5 years. There is no correlation between this accident and a person living with daily pain. These patients are trying to live with chronic pain and opioids may well be what they need. What we all need is to be more educated on what it is our phycians are giving us. Also we need our phycian to really understand what they are prescribing. These medications are “habit forming” which are nicer words than addictive. I mean no disrespect to those suffering every day but I would ask where does the physical pain end and the addiction begin? Having spent 48 hours in an emergency with someone detoxing from opioid abuse I can tell you there is a lot of physical pain when the medication stops as well.


The thought of the FDA or any other govt agency regulating our ability to have our medications in this manner is frightening and one of my deepest fears. It makes no logical sense to me at all but appears to me to be a reaction out of fear and actually overreacting to those idiots that are abusing their rights to have these medicines by selling their scripts or giving them to others who in turn wind up overdosing and then dying causing all the panic we are now seeing amongst the DEA and legislators who have to stop it “yesterday” to save us all from the evils of opioids and ourselves who can’t control our actions without big governments regulatory assist… Its just one big ridiculous circle of more and more government control taking over our lives because we can’t manage them on our own. Well I’m tired of the government having its nose in every aspect of my life, especially when it comes to managing my medications and my healthcare. I don’t want to be told that I can no longer take my opioid medicines because my pain isn’t on this list or that list. Its not the governments right to determine if a medication is right for me or not, it should be between me and my physician, not between a legislator and my insurance company and my pharmacy too.

I recently did have my pharmacy tell me that they couldn’t fill one of my scripts because the quantity was too high and they had just instituted a policy that they were only going to fill a limit of 180 of this medication and my script was for 240 so in addition to just plain being told we can’t have scripts by our doctors, now when we do get them we also get to deal with pharmacists deciding how many pills they are going to allow us to have in a month no matter how many our doctor has prescribed or our insurance will pay for so its getting very ridiculous out there in our new world of Big Government Big Retail and Big Insurance where everyone wants to control whats “best ” for the patient but no one really cares about what the patient truly needs in order to have a real quality of life and maybe live without or with reduced pain. Yes, I’ve been a bit sarcastic in this post intentionally but I hope you got my points. I am a chronic migraine sufferer as well as a fibromyalgia, osteoarthritis and sleep apnea patient and I live with constant pain and I definitely don’t want to see this proposed change take effect.

PROP co-founder Dr. Andrew Kolodny and his petition with the FDA is so far off base that the FDA has put his petition on the back burner. Dr. Andrew Kolodny has no compassion for pain sufferers and does not care if they suffer. To say that 100 mgs of Morphine a day and the equivalent is enough for any one suffering individual is cruel and unusual punishment for the person that suffers. To strike moderate pain from being treated is a mistake because if moderate pain is not treated soon it will become severe chronic pain. Any and all that Dr. Andrew Kolodny asked for in his petition is out of the realm of his understanding. Reason is Andrew Kolodny does not understand chronic pain because he is a Psychiatrist not a Pain Specialist.

So by the FDA not giving Dr. Andrew Kolodny what he is asking for is like saying you crossed the line here and we cant give you what you want. Too many people suffer from chronic pain and we cant let these people just suffer.
Even though the FDA might make a few changes, this petition has done nothing but cause trouble for pain sufferers and the doctors that treat them.

Mark S Barletta


Dr. Frieden need’s a hit along side the head with a 2×4 so he can correctly label migraines as severe pain!!! How DARE he attempt to judge how much pain a person is in. Last month a migraine patient took her own life because of the amount of pain she was in. This is up to a person’s own doctor to decide, not the FDA or DEA!!


The only difference between my chronic pain and cancer pain is my pain is not going to cease in the near future through remission or death.



This is so horrible I have suffered since before I started my first menstruation with ENDOMETRIOSIS! I am now 36 and still suffering and for me and my fellow endo sufferers this would be devastating. It is bad enough that this disease is affecting millions of women everywhere and it is still called the invisible disease, why you ask well I don’t think I need to tell you that it is because it affects women! Now you are telling us that our only source of relief from the pain is going to be taken away because we need to protect the addicts give me a break and implore you to walk one day in my of my endo sister shoes and let me deny you a pain killer. As for risks I hate to break it to you but any medicine has risks so are you gonna tell people with diabetes not to take insulin or someone with angina no you can not have that nitro. Also the reason more chronic pain conditions happen in women is because most of these diseases come together hand in hand. How about instead of claiming this is to help us you do something to really help and find a cure!!!


The only way this is going to change is if the government steps up.. I’m a recovering opiate addict and Suboxone is what took me Heroin.. Which ironically was made to help people get OFF heroin. Doctors are basically dope dealers with a degree.. Opiates are killing people everyday and the sad thing is alot of deaths can be prevented even just by regulation changes.

Barbara O'Connor

I am so tired of being told which medicines I can take by insurance companies and the FDA. So some people kill themselves taking too much pain medication. If you don’t allow people to use the medicines that work for their pain, you may find you have an increase in suicides. Each person has a different response to medications – that’s why some medicines say the side effects are diarrhea and constipation. Some people have one and some the other – you can’t have both at the same time! I have a daughter who takes Lithium, but the only one that keeps her level is the timed release one, which is of course the most expensive. She takes hydromorphon for joint and muscle pain and she needs it. I take hydrocodone for the same pain. We both started on otc pain killers, but soon found they didn’t do enough. If you don’t have chronic pain, you have no idea what it is like. Stop trying to limit what I need to take to get through the day!


I ask you what makes you think a cancer patient has more pain than what a migraine patient has or any other patient with pain? Pain is pain. A migraine and a “headache” are NOT the same thing. A migraine causes very intense, severe pain along with many other symptoms.
If an opioid is the only thing that takes away the pain – then you have found at least part of your treatment plan. It is an insulting joke to suggest that exercise or physical/cognitive therapy would be an alterternative. If my doctor verifies that I am suffering from severe migraines, then I should have access to pain control strong enough to alleviate the pain and gain control over the attack. Anything less is not acceptable.


IF they could solve the problem that is causing the horrible pain then my husband would gladly give up the medication. He hates taking it. He continues to hurt even on the medication the thought of being off of it is horrifying! 6 spinal surgeries 1 failed that painfully paralized his leg and he is in so much pain still. I think they are hoping to ease the world population by not medicating the ill..Or maybe they will only choose the the party in control at the time…


As both an RN & a patient with Rheumatoid Arthritis &fibromyalgia, I see both sides of this issue. I must say that I find the CDC & FDA positions short-sighted & unnecessarily political. Opioid use has grown as medicine has prolonged the lives of those with diseases that used to kill at an early age. In order to maintain function & quality of life in these patients, physicians have used the medications available to them to control their patients pain. Many of these people only have the ability to work or take care of themselves because of these meds. The small number of those who misuse these drugs can be alleviated with good patient teaching, good mental health support, & a centralized controlled substance data base. Punishing these patients for their illnesses is both cruel & inhumane.


This is an enormous mistake. It’s one thing to encourage people to get up and move around – if they can. I was shocked that darvocet was taken off the market. It was a low-dose pain med and had been around for years. So then our doctors had to go up to another level. That’s insane! I believe there must be a certain quality of life to continue to try to live a “normal” life. I am able to exercise because I DO have meds. There will be so many suicides if they take the only thing that helps those in chronic pain away. What are they worried about? Yes, there is such a thing as dependence and it doesn’t matter to those of us who hurt terribly. There are no alternatives. Self-medicating is far worse than any pain meds. If they really care about our quality of life they wouldn’t do this. I hate to say this, but I hope these people experience some awful pain so they won’t be so judgmental.

Sandra Weidner

This Dr needs to get his head our of his ARSZ. There are too many pain patients that get no help in dealing with their pain issues. There are too many people still working only because they have pain relieve, either totally or to bearable levels. I believe Drs need to do as mine does. He has patient sign a contract that they will not go to another Dr to request pain medication. He will do urine testing monthly for a few months and then spontaneously. If a person fails the urine test, they get no pain medication. But I do believe that opoid pain meds should be used conservatively, while other measures are used to relieve pain. Then if the conservative treatments fail then the patient be given the appropiate pain medication that is needed.


Please don’t do this, I am a warrior of Syringomyelia, fibromyalgia ,small fiber non diabetic neuropathy and RED/CRPS and without these meds I can’t walk let alone take care of my daughter. I am not a surgical canadite because the risk is to high. 50% chance I’d lose all feeling from the neck down. These meds are my only hope of living a somewhat normal life and being a good mother. I dont take any drugs I’m not prescribed and I don’t sell them or abuse them. RSD alone is has worse pain levels that some cancers and Syringomyelia is incurable and disabling. I can’t even believe this would be up for dissucussion. Why not take away alcohol, that kills hundreds of thousands of people a year and its legal!! I just don’t see the reasoning behind taking these meds away from good honest people who need them. People that misuse these meds are making mine and thousands of other people’s life’s harder to live. We take these meds they way they we ment to taken, we can’t control the mis-users and we shouldn’t be punished for someone else’s stupid actions!!!!!!!!!

i suffer from chronic migraines due to a heart murmur i can not take whats actually classed as a :migraines medicine” it makes my heart feel like it is going to leap out of my chest i have been on SEVERAL preventatives an had countless nerve blocks rdf ablation on greater an lessor occipital nerves (they are pinches) the only thing that knocks out my migraine or neck pain is a medicine that is classed an as opoid i only take it 2xs a wk (the way it is i could prob do 3-4dys but i dont if this was removed from my meds bc of changes i would be in the er all the time or become one who does go the illegal route i have a family n child to take care of people out there need these medicines to go on with their lives to feel as norm as poss maybe u all should suffer the way ea person does who is prescribed this then maybe u would understand

Howard Hoffberg, MD

Although opioids have significant liabilities, so do opioid sparing pharmacologic agents including tylenol, anti-inflammatories, antidepressants, anticonvulsants etc. Someone I know was prescribed tramadol only for her pain, despite continued seizures of “unknown etiology”, and has been unable to drive.
Insurance companies are reluctant to cover non-pharmacologic therapies including acupuncture, chiropractic, TENS (with a recent determination that it will no longer covered by Medicare for low back pain) or the co-pays or these services including physical therapy, and psychotherapy are high with pre-authorizations, caps and limitations that can be stifling. There needs to be better access to comprehensive pain management with insurance approvals for the “outliers”, and with incentives for wellness (ie weight loss, tobacco cessation, compliance with home exercises) to insure success in such a program.There are many desperate patients who undergo costly spinal or orthopedic interventional procedures or surgery with possibly short term benefits, due to the reluctance of providers to prescribe opioids, and end up with more complications that require chronic opioids or additional procedures. Patient, and provider education along with health insurance access to other options, with close monitoring of their condition without exorbitant copays or limitations, and safer formulations of opioids (with a lower cost of these branded products to the patient) is the best solution.

My daughter suffers from Chronic Migraines and has a pain level of 8 and above for sometimes 10 days straight without a break. The few pain meds that I do give her is the only break or rest she gets. She has been to different specialist and we have spent hundreds on medicine and doctors with little help. If this passes you will see the suicide rate go dramatically as a mother it breaks your heart to hear your child cry in pain and say I wish god would just take me if I have to lay and suffer this way. Why would some ignorant person that has taken an oath to “do no harm” suggest something that most definitely will cause harm with those suffering can not take the pain anymore!!! I wish you could suffer one day like the others do and dare you to ask for anything for relief.

What kind of people are running these test! definitely no one with chronic pain, I watch the clock so I can take another, I’m not addicted just in so much pain from Fibromyalgia! You should do test on people with pain and then make your decisions! Our insurance’s are already paying less and now you say they need to do exercise and watch their diets! What kind of people come up with these ideas!

it a shame that they don’t have to deal with the pain that l do everyday of my life then they would understand that yes people with fibromyalgia is a chronic pain syndrome ….NEED SOME KINd of RELIEF …l can’t really get much relief from they pain killers when its really doing its thing …..what will we do then ????? Have to suffer because some idiot doesn’t understand what chronic pain is ….l guess only if you are affected by this debilitating pain can you really understand …

jessica M

Quite frankly as I chronic pain patient with Degenrative Disc Disease, Firbo, Migraine and Peripheral Neuropathy i can’t understand why anyone would want to limit our access to adequate pain management. Telling people that we have to have Cancer in orer to get pain meds is crazy. I normally wouldn’t wish my pain on anyone, but I sure do wish this guy would feel the pain I do for just one day and have someone tell him “sorry it’s not cancer so you’ll just have to deal with it”. I have to sign a pain mgmt agreement and drug teast monthly just to get my dilaudid, what more do they expect from us?


I have a chronic pain disorder called Interstitial Cystitis. Some days I am in so much pain I can’t even sit up. It feels like there is acid in my bladder burning me from the inside out, like I am peeing needles and pins, like someone is taking a knife and stabbing me over and over while twisting it at the same time! That’s just the tip of my condition! I have never had cancer and I pray to God I never do, but this pain is more painful than giving birth and they numb you for that (I know, I have 3 children)! For people with IC this is about the only way we can make it thru the day…if you take the one thing that helps us away what the heck are we gonna do?! This would only hurt a lot of the people who actually need the medications.

Gerard Hill

I have degenerative disc disease and three herniations in the neck and one missing in the lower back.I had four epidurals in the spine and kicked the oral usage of pain meds.I now am on a low dose Buprenorphine patch which has kept control of my pain so I can function.It does not enter your system the same way.I wear one per week.Is this the future?.It has helped me greatly and doesn’t get me dopey.Only a certain amount is delivered every hour.I am able to get a script from the hospital and my anethesiologist says I,m a success story.

Only a person w/o chronic long term pain would think these drugs aren’t necessary.I have been battling Postherpetic neuralgia,severe spinal stenosis,DDD. and R.A. for years and only use what I absolutely need to see me through the night. I am still working and cannot take controlled drugs during the day,my pain has built up so much by the time I get home,it takes hours for it to level off. Sleep is fictional,at best it’s hit and miss. I have had epidurals,steroid injections and numeral facet blocks,most recently,medial branch blocks.I am scheduled for my 2nd surgery on my left foot due to osteoarthritis. I keep going,as do most people with chronic long term pain,soon I will not be able to “Get up and go” everyday,this by itself is depressing enough w/o the Federal government deciding that maybe I really don’t need pain killers.I am seriously beginning to think that part of this ‘Affordable Health Care’ rackett is to kill off all of us that require long term help.Leave my pain relief alone and spent your time and money going after the illegal drug users.


I know that if they take away pain meds from people who need them just to get out of bed & function they will see more crime (people going to blackmarket to get meds or suicide. I for one would commit suicide if I had to feel the immense pain every min of every day.www my skin crawls from thinking about it is now, I wont go to hospital because they pulled back on how many pain meds they will give you. I have degenerative disc disease, severe spinal stenosis, herniated discs throughout my spine that cannot be operated on due to scar tissue, migrains, non -diabetic neuropathy, sjogrens syndrome, osteoarthritis on both knees


There will be even more deaths if you take the medicine away from the people who need it just to survive. Suicide and assisted suicide will be your new problem!!

Treatment of pain is as important as treatment of any other medical condition. With the advancement of time-released opioids, patients are now able to live near-normal lives, whereas before patients with severe chronic pain became disabled. Patients do not abuse pain meds, it is a treatment as important as any other medication for survival. The patients being prescribed opiods for chronic pain NEVER experience a pain free day. It is the difference between severe pain and manageable pain. As a patient advocate and a patient, we need to educate the public, policy makers, etc on the improvements made to prevent the abuse of time released opiods and ensure that patients who suffer with chronic pain have access to these therapies in order to live productive lives.


I am recovering from my fourth spinal fusion in the past 7 years. I was in a roll over four wheeler accident. I have a degenerative disc disease to compound the condition of my spine. I have Fibroymalgia and non-diabetic neuropathy in my feet and legs. I have planter faciatious in both heels. My pain level has never been below a 4. I cannot get out of bed without taking my oxicontin. My feet hurt so bad it is hard to even get to the bathroom. It is only after an hour that I can get out of bed. I have to get to my physical therapy to try to recover from my recent surgery. At night, my Fibroymalgia and neuropathy pain in my feet which feels like they are on fire. When I was young, I had third degree burns on the bottoms of my feet from a fire. I need my pain medication in order to walk. Please don’t take away the only medication that relieves my pain so I can function from day to day. I also suffer from depression. Please, please, don’t take away the only medication that keeps me to be able to function. The thought of the increase amount of pain is unfathomable!


They think overdose is bad. Wait and see what happens when people with pain such ad RSD/CRPS have no meds to help them even a little. Suicide is very high in the RSD community becouse of high pain. People in pain do not get the “high” from pain meds.
I agree if one of these people came down with chronic pain they would change their thinking. So many people are being cut off of so many of their pain meds already they are not even able to get out of bed now.
They are trying to help? Ha, they will be responsible for all the suicides caused by their “ideas”