Surprise Turn at Oregon Health Meeting on Forced Opioid Taper Proposal

Surprise Turn at Oregon Health Meeting on Forced Opioid Taper Proposal

The highly anticipated meeting in Oregon to consider a policy to force taper some Oregon Medicaid pain patient who use opioids took a surprising turn.

The head of the Oregon Health Authority called off today’s review in light of potential conflicts of interest by staff.

Dr. Catherine Livingston is a family medicine physician who serves as a contracted medical consultant to the Health Evidence Review Commission (HERC). In addition, she is a co-investigator on two studies evaluating the impact of HERC’s previous decision to expand pain management coverage for people suffering from back pain.

“It is vital for the Oregon Health Plan to cover safe and effective therapies to help people reduce and manage chronic pain. Yet it is also vital that Oregonians have full confidence in the decisions the HERC makes to assess the effectiveness of health care procedures,” OHA Director Patrick Allen said in a statement published in this press release released on Thursday.

Apparently, Dr. Livingston’s potential conflict was uncovered by a chronic pain activist who has been fighting HERC’s attempt to force taper any pain patients.

“We are pleased that the OHA is taking time to investigate possible conflicts of staff, consultant and commission members,” said Amara M., who prefers we don’t use her last name. “We believe there are other possible conflicts.”

The HERC proposal has received withering criticism from providers who treat chronic pain from across the country and as recently as last week the commission received a letter from Stanford’s Sean Mackey and other pain leaders who wrote:

“We continue to have grave concerns with the primary goal of the current proposal, namely, its call for non-consensual forced tapering off prescription opioid analgesics of a broad class of patients.”

Sean Mackey, M.D., Ph.D., is Chief of the Division of Pain Medicine and Redlich Professor of Anesthesiology, Perioperative and Pain Medicine, Neurosciences and Neurology at Stanford University. He is a Past President of the American Academy of Pain Medicine.

For chronic pain advocates in Oregon, today’s delay allows them to continue to work to educate HERC members and the general public about what the advocates believe will cause real damage to chronic pain patients.

“Maybe they can take the time to read Dr. Mackey’s letter and other communications by people who treat chronic pain about what a horribly bad idea forced opioid tapering is,” said Amara M.

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Authored by: Ed Coghlan

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LMC

Reply to Janice:

Ability to sue government departments requires extensive filing and in most cases motions for permission is not granted. In the very rare occasion it is approved, it it expensive. Most law firms couldn’t afford the filings, the experts and the investigators it would take to attempt to get a suit on a judges calendar. Worse, it takes time. Lots if time. Years. More time than we pain patients have, hence the suicides.

Chris

This Oregon “pause” is a small beginning but we have to begin somewhere right? For all of you who stood up and fought for those in Oregon, KEEP FIGHTING!! Every little bit makes a difference.
I opened an envelope from my prescription benefits/employee insurance plan this week and was informed that for certain pain relief drugs that I have taken for the past 20 years, I will now have to have prior authorization before they are filled AND before they will be paid for!! If I do not get PRIOR AUTHORIZATION every month, and/or if my dr prescribes over a certain dose each month, then I will be responsible for the full cost!! In the same letter it says they do not discriminate against anyone, for any reason.
Excuse me, but I feel this is total discrimination! First of all, I was not told that this is how my prescription benefit plan was going to work when I signed up. And second, does the prescription benefit/insurance company also do the same thing to people who are taking medicine for example, mental illness? If someone’s mental illness isn’t being controlled with current meds and their dr increases their meds, is this patient required to get prior authorization every time? Or pay full price for drugs after a certain dosage? I don’t believe so. Or what about someone who needs insulin? Just because they need a higher dose, does the prescription benefit/insurance company require a prior authorization every month? And again, full price for the drug once the INSURANCE CO decides you are over the dosage limit?
Yes, these prior authorizations happen with very expensive drugs that are used to fight cancer, and patients know these procedures ahead of the treatment. These “pain drug” rules just seem to change with the wind.
What in the **** happened to our doctors making these decisions for us?
If you haven’t already, make sure you submit your comments concerning Opioid Guidlines on the govt website by April 1.

Meg Taylor

Let the people who overdose on opiates (that are not prescribed for them) die. The crisis does not include pain patients who see MDs and are prescribed opiates for pain. The crisis is due to street addicts. They have no doctor monitoring their medications, do not sign contracts, and are not subject to random urinalysis performed by their doctor. They enjoy the “high” and their dose continues to escalate in order for them to achieve the same high. When they reach that “fatal dose”, they die. Oh well. Pain patients work hard to use the lowest dose possible and never miss doctor’s appointments (unless there is an act of nature). Give the punishment where it belongs. Most of the overdoses in Arizona are due to Fentenyl and heroin that come across the Southern border.

Janice

Was just reading everyone’s comments. The idea of all of us Chronic Pain Patients sueing the CDC and DEA and FDA, what about that? Can it be done? With millions of us on board, our voices would have to be heard! Are there any Attorneys out there that would be willing to take this on?? Wouldn’t it be something for the MILLIONS OF US to stand together and say ENOUGH IS ENOUGH?!

Steve A

This is the first “positive” thing I have heard since the cdc stated the opioid crisis. If some positive comes from this I hope it has a snowball effect, and the people in chronic pain can start getting better relief again. And the suicide rate will drop also!. I wake up every morning in SO much pain I feel like I would be better off dead!. Even after my first pain pill I have a hard time making it through the day. I am neglecting the work I am supposed to be doing as far as my rental agreement and facing eviction. I would just like to have my old pain meds back that I took for years and without needing a upgrade in dosage. I have suffered every single day since the SO called crisis started because of others overdosing to get high. Or took more than there instructions because they didn’t have someone to monitor how much they were taking at home. I had my doseing under control to where I would have a few pills left at the end of the month. Now I struggle to be more pain free and wonder if I will have enough to make it till the next refill, just because I now take a less active amount….

I missed my appointment on Feb. 12th. to see my pain doctor because of a two day blizzard and they could not give me another appointment until Mar. 12th. ,in the meantime on Mar. 4th. my RX ran out. I was told that he could not write me a RX until he saw me. He was there on the 5th.but said he could not see me. He went out of town on the 5th. and was not to return until the 12th. Nurses said he would not write me a RX because I was on such a low dose I would not have withdrawal so I would have to wait until he returned. I was told to either go to the ER or take over the counter products. The ER is not an option for me because they will not treat a chronic pain patient who`s pain does not show up on tests( my pain is a bundle of nerves). I took aspirin but they effected my ears, stomache etc. I could barely hear a person speak beside me. I called many times but was again told I would have to take the over the counter products. I had no choice but to stop taking them and go with nothing for my pain. When I went to my appt. on the 12th. as things unfolded the doc took my RX from me citing I had taken too many aspirin. I had taken them according to dosing on the bottle and had even taken less than that. I currently have a complaint in and it is being investigated by Upper Management Of UPMC. They are to send a team to investigate. It will take about two days. I am still without meds. It is terrible to do these things to a patient. This doc has done this before when he took my meds for seven months with no reason given except he got mis information. It seems to be a habit with this office. Do not have much faith left in docs or our system anymore. So when I read this latest news on this blog I do not have much faith that this Oregon situation will be solved to help any pain patient or I should say victim.

Theresa Negrete

Wow, this is good news for Chronic Pain Patients, especially the elderly and hospice patients who will not have to be forced tapered in Oregon, bravo. I am of the opinion, that the full truth of this ridiculous attack on All Pain Patients will not see the light. There is too much covert manipulation going on. The Opioid Crisis that was a lie for example. Meanwhile patients continue to suffer at the hands of the Goverment and the Medical Community, we’re supposed to trust. This is one sick, twisted country right now. Everything is always about the damn mighty dollar and people are treated as commodities.

Mark L

I’ve been on opoids since 2005 from near fatal head on car accident.broken knee,hip,shoulder,and arm.Ill never be the same,to many surgies to count,and tapering will not work at all.To many irresponsible people,and herion,making it difficult for the people who need them to function through the day.

Mareaeric Campagna

Thank Goodness! Hopefully this is the start of putting the breaks on this dangerously rediculous circus show that is taking place across this country!

Michele Howe

At least for a period of time, these poor people will be left alone and have reduced pain while trying to live some resemblance of a “normal” life. As a Chronic Intractable pain sufferers, I am angry, I am sad and very frustrated to hear about the proposed forced Opiod use. Anyone who has severe, non-stop pain is already dealing with it, the damage is has caused to our lives and the emotional scars it induces. I was injured in a botched surgery that almost killed me. It was not my fault. I did not choose to lose my career to become a house bound person who is constantly in pain. The smaller percentage of people who abuse pain medicine are the problem that is affecting the greater percent of responsible persons who are taking their meds as their Doctor has ordered.
What gives anyone the right to decide who is going to be able to live with minimized pain and who isn’t? Why does someone sitting behind a desk get to overrule a Physician who specializes in pain management and make these crazy decisions? The outcome will be tragic, I’m sure of that. If they get this legislation passed for Medicaid, yes, there will be a reduction in use… because of the amount of suicides that have taken place. I know what hell it is to live with non-stop pain. I would not be here today if I had not found my chronic pain Doctor. I had an implanted pain pump put in my Abdomen 2 years ago and it was the best decision I’ve ever made. A very small amount of medication that is constant, 24/7. Nobody can steal it from me, not can it be “lost”. The Doctor is in full control of the dosage. I believe that this is the better solution to the drug abuse situation. They can’t sell out of their pump! I am being sarcastic, I know.. but I am so tired of the drug seekers being the topic of conversation instead of the larger percentage of the responsible people who don’t abuse their meds. A true pain sufferer is so glad to have relief that there is no way they will sell their medication. Relief, for now.

dave

Advocates can and will restore sanity and humanity to pain care. I have witnessed the remarkable mobilization of many people in pain in the past 3 years who dedicate remarkable amount of time to helping others in pain despite the increasing burdens of being in pain and the crazy chaos in our pain care system. They have inspired me and I am in awe of their integrity and ability to discern the problems in pain care.They are the real source of hope to reverse the current theater of cruelty in pain care today.
The need to make people in pain a protected class with a bill of rights is needed as our institutions cant get pain care right as they seek to dominate people in pain with their self serving designs. This is not my idea- it is an idea from the 1960’s- probably from some hippies in a volkswagon minibus smoking weed… Anyway let us not lose this opportunity to make a better foundation for our pain care system so that people in pain will be empowered to be in control of pain care in government, health care and in academia.

Angie

Great news!!!…for us cpp s…..
Thank you to all that have worked so hard on getting this turned around….GOD BLESS!!💗

Gail

When do these DOCTORS? stop and think about all the damage they are inflicting on pain patients!!! Do any of them have common sense??? How about putting yourself or your family in the spot you have put so many of us!!! This is a witch-hunt and you doctors need to think about the damage you have caused!!! I can see pulling fentenal but not the rest!!! I thought you were supposed to care for patients!!!
I’m angry that the majority of pain sufferers DO NOT abuse the meds and yet we are being punished! FIX THIS NOW!!!

Stacy Thoman

THANK YOU TO ALL OF THE INTRACTABLE, CHRONIC PAIN PATIENTS & ALL OF THE TIRELESS ADVOCATES, FIGHTING TO KEEP WHAT LITTLE “QUALITY OF LIFE” ALL OF US HAVE, FROM BEING ARBITRARILY DENIED TO ALL OF US “PATIENTS”!! FOR THOSE OF US WHO ARE SUFFERING, EVERY MINUTE OF EVERY DAY AND HAVE BEEN GOING THROUGH THIS INHUMANE & CRUEL TREATMENT FOR 3 YEARS, NOW! THANK YOU FOR ALL THE CONTINUING HELP, TO BRING THE “OTHER SIDE” OF THE OPIOID PROBLEM….ADDICTS WILL ALWAYS FIND “SOMETHING” TO ABUSE!!
ADDICTS NEED NO JUDGEMENT, JUST HELP!
INTRACTABLE, CHRONIC, PROGRESSIVELY WORSENING, DISABLED PAIN PATIENTS NEED SOME RELIEF….IN ORDER TO COOK A MEAL, SPEND TIME WITH LOVED ONES…OH, EVEN TO BE ABLE TO TAKE A SHOWER!! WHAT GOOD IS PICKING ON THE VERY ILL & IN PAIN PEOPLE GOING TO HELP ADDICTION??
IT IS “ILLICIT DRUGS” THAT ARE THE PROBLEM, PRIMARILY ANYWAY! LIKE I SAID, “ADDICTS” WILL ALWAYS FIND SOMETHING TO ABUSE…I.E. GLUE, HAIRSPRAY, PAINT THINNER…ETC.!!! DON’T PUNISH “PATIENTS” THAT SIMPLY NEED SOME RELIEF, FROM UNRELENTING PAIN!!

Katrina Bergman

How inhumane is it to be bed ridden because the pain is to much to take they took out a fractured& infected hip buti would rather die than go threw that pain again!

Rafael Rodriguez

I have had many back surgeries, I am in pain 24 hors a day and now I can not find a dr that would prescribe the pain killers I need to have a semi normal life.

Holly Davidson

GOOD JOB Amara!! it’s all crooked! A Family medicine physician instead of a pain Dr. studying this? Unbelievable!

Linda Kay Thomas

AWESOME TURN OF EVENTS !!! Even though I live “down here in S.E. TEXAS” I have been paying attention because Oregon is KILLING All of Our Brothers and Sisters caught in the Middle of THE CDC UNABLE TO DISTINGUISH BETWEEN PRESCRIPTION AND FAKE FENTANYL DEATHS.. Heartbreaking !!!! Oregon; You’re in Our PRAYERS……

James McCay

It’s about time some COMMON-SENSE entered this issue! Dr. Livingston is a FAMILY MEDICINE doctor! How does that make her a Pain Management expert all of a sudden??? Because HERC says she is, or the CDC says she is? GIVE ME A BREAK!

Finally someone calls these QUACKS for what they truly are. My (recently made paranoid) Pain Management doctor of 7-years just lowered ALL his opioid patients meds down by 10-20% in lieu of this idiot Dr. Livingston and other General Medical doctors used a pain “experts” by the CDC. He jumped the gun in order to AVOID a possible future THAT DID NOT OCCUR! Yet all his (60 or so) Chronic Intractable Pain patients (like myself for 16-years) were all made TO SUFFER NEEDLESSLY to make our doctor feel more comfortable and less paranoid???

And I’m sure this happened to millions of people across the country who have Chronic Intractable Pain thanks to the threatening letters the DEA (by order from the CDC) have been sending all doctors weekly for over a year: ALSO BASED ON “FINDINGS” BY FAMILY MEDICINE doctors!
Hey doctors >>> STICK TO WHAT YOU KNOW! Stay out of OUR Pain Management Specialty where we have more than enough TRUE EXPERTS of our own that the CDC should ONLY be consulting (and Chronic Intractable Pain patients as well: I’ll be the first to volunteer!).

The CDC thought it would pull the wool over everyone’s eyes by using Family Practice doctors as Pain Management Experts to get their way. SHAME ON YOU CDC- HOW MANY DEATHS BY SUICIDE ARE NOW ON YOUR BACKS!?!?! Maybe the CDC should stick to what they know as well (CDC=Center For Disease Control- CUTTING OUR LIFE-SAVING MEDS HAS NOTHING TO DO WITH YOUR PURPOSE!!!) as Chronic Intractable Pain patients (like myself) ARE NOT PART OF THE “Opioid Crisis” or overdose deaths in any noticeable quantity!!!

Chronic Intractable Pain patients should file a CLASS ACTION lawsuit against the CDC! I’m way too sick to start anything, but others should.

Jeanette French

Thank God, They are wise to see the other side of the pain story for chronic pain sufferers, and to look at the damage already done to them, Also that their laws reducing opioids to patients is not changing the overdose rate at all, it is in fact making it worse as they are pushing more people to use illegal drugs for self treatment and they are not safe. Thanks so much to Dr. Mackey !!

Pamela Lee

Thank God. But we need to keep up the pressure. NOW is the time to provide additional testimony and research articles. Ofcourse it would be great if Medicaid recognized and paid for alternative medicine, but NOT as a trade for chronic pain population obtaining pain meds and FORCED tapering to zero.
Get involved Oregonians! !! YOU are part of the solution.

ElizabethR

This is good news–many thanks to the activist who uncovered the potential conflict of interest. Although it may not make a difference in the end (SO hope I’m wrong!), at least HERC is questioning the objectivity of one of its members. Apparently, she holds a specific view on the subject of pain–as long as it’s someone else’s.

Policy is so often made for us by young, healthy, able-bodied people who have never experienced ongoing, life-limiting, joy-sapping pain. I often wonder how soon they would change their tune if they had to spend a week or more in our situation.

kelly

This delay, which annoyed the Task Farce enormously, could have been prevented if the “transparency” that Patrick Allen claims to consider so important had been present in any amount from the very beginning. They’d have voted their proposal through with zero contrasting voices long ago if their attempts at secrecy had not been thwarted by the extraordinary actions of very, very dedicated & intelligent people, to whom I’ll be forever grateful.

I was at the meeting (& have been to others), & while they claimed to consider input, I honestly don’t believe that these people can be deflected or swayed. They carefully set up their little group so that it is completely insular & self-reinforcing, no dissenting voices are given more than lip-service, and their position on evidence is the farthest from scientific that can be imagined.

I’ve never in my life more desperately prayed to be proven wrong.

As good as this is it was not a vote but a delay to procedure. What else can be done to actually reverse the direcrion of a non opiod mindset

GREAT! Thank you God for some reasoning. Bottomline is can we find a doctor willing to prescribe? 90 mme is the most I have found currently. Not enough for most CCP. What about pot in conjunction with something else . I am just pulling all the stops. Anyone gone off 90 mme in favor of pot? Also, Capcha is bad.

Rebecca Payne

Thank goodness for having the truth come out and considered. We need to listen to the experts on pain management; pain management doctors, and most importantly the chronic pain patients. Also those who have extensive knowledgeable on pain management such as Dr. Red Lawhern. Who we DONT need to give any attention to are those who are NOT experts and have questionable motivations such as Kolodny. Follow the money. There are those who have potential financial gain to be had by labeling chronic pain patients as addicts and not seeing us as human beings with debilitating illness and injuries. They try to force upon us medications such as Suboxine (forgive me if my spelling is not correct). This medication does little for chronic pain patients and we suffer greatly as our effective opioid meds are slashed and denied. My meds have been cut to very little and I have considered suicide, as many of us have. Too many are successful. I have been confined to my bed for the last year. My body is in too much terrible distress and I have no relief in sight. The only thing that will help me are opioid pain meds. I thank the knowledgeable people who listen to us and have the compassion to stand up for us!! Please listen to us before more chronic pain patients end their lives.

Terry

I hate to be a wet blanket but what are you expecting to happen? Are the doctors going to reinstate the amount of pain meds we use to take? I think the answer is a resounding NO. The pain docs won’t want anything to do with raising meds, they’re super paranoid about losing their licenses. The DEA has these doctors scared to death and they’re not going to risk everything so we can feel better. I think even if they changed the so called guidelines in our favor, we’ll never get relief through pain meds again. I hate to burst everyone’s bubble I’m just being real. God bless all my chronic pain brothers and sisters.

Janice

So happy for those in Oregon that have suffered terribly at the misinformed law makers who are not quilified to make these decisions. I hope and Pray that it keeps going until Oregon “Officials” realize the harm their doing to some of the most vulnerable in our Country.
I am in Oklahoma, have been forced to taper and the one Med. that helps me has been denied by my Insurance Co. Now I am forced to take a med. that only works some days and when it does it only last 6-7 hrs. out of the 12hrs it is supposed to last. Now our new Govenor is sueing Purdue Pharm., the company who makes the med. that works for me. I dk the details and I dk what will happen next. I have a good Dr. thank the Lord but like millions of other Drs., his hands are tied. What else can we do, other than write and call our State and Fed. Offices? With incurable genetic autoimmune diseses, I have no other alternatives but to take pain meds. This is not living, it’s just surviving day to day, as I know so many millions feel the same. What else can be done?

Rebecca Hollingsworth

Hurray a small victory. Good work pain activists! Let’s hope it’s not just a delay and people understand the awful suffering of chronic pain. Provides a glimpse of hope for the rest of us. Congrats!

This is an awfully flimsy excuse to delay a meeting. A paid principal investigator is paid to publish investigative findings, whatever they are.

There’s more to this story than meets the eye. The only way there can be a conflict, is if the study itself was designed to produce faulty data, that pretended to show the new Oregon policy that’s going to kill Sickle Cell patients and other pain patients by a forced taper to zero, will seem to have helped a few patients somehow.

Will Dr Livingston take the fall to protect higher-ups in the Oregon power structure?

Rick Klingenstein

I have to day thank you on behalf of all who suffer chronic pain.. I live in the Tampa Bay area and work as a collision tech in a major dealership. I am seen by a spine specialist and prescribed two pain killers. A long acting and short acting, if I could no longer have access to those medicines then I wouldn’t, no couldn’t work and support my family. I have to say that I work six days a week and most days double shifts.. That’s right, I’m prescribed opiods to manage my chronic pain and I repair wrecked automobiles and work 10-13 hour days. So I’m living proof that opiods give me mobility and the ability to work full time to support my family and pay taxes!!! Keep up the good fight!
Rick K.

Judy Klingenhofer

Good news, kudos for the work done in showing the conflicts of interest in this group. Glad to see Dr. Livingston outed, she’s just another MD who chose $ instead of patient care/

M Gate

From what I have read in other areas, there are a group of “lobbyists” (if that’s what you might call them) where they have an agenda to prevent chronic pain patients from receiving these medications “because they know better”. (at least that seems to be the case). They seem to think that they need to protect the innocent from potential overdoses, forgetting the good that these medications do to make life better and productive for so many who would otherwise never get out of bed or home. If it is true that this Dr. is conflicted as it appears, I can only say “Thank You!!!” because there are already too many people with this power. I am so tired of these people who “try to help” and instead, “hurt” because they think they know all they need to know, and I doubt they have experienced a full day of severe pain (or had a family member in this position). It would change their minds completely if they did.

Thanks Ed, that is good news.

Barbara Snow

That’s wonderful news. Thank you, whoever is responsible for shutting this down. I’ve been watching thing all the was through. Now I’m not mad I couldn’t get the video.

LMC

Wow. Kudos to Amari for bringing this information forward, (a less scrupulous person would have waited for the meeting to be held and then released this information to a greater fallout if the meeting results were less than favorable to chronic pain sufferers).

I am curious as to why ANY general practitioner is a co investigator in a subject matter that has actual specialists in its field? Its like a court clerk investigating a supreme court judicial matter. Furthermore, why was Dr Livingston even weighing in on ANY chronic pain studies, policy OR investigations? Her daily working position would require her to REFER potential chronic pain patients to actual SPECIALISTS or be under threat of arrest by the DEA.

None of this entire assault on the chronic pain community has made any sense.

Gary Raymond

Forced tapering and rehabilitation. Neither will alleviate pain. It doesn’t take a PhD in Nuclear Physics to figure that out. I must have insulin. People who suffer from chronic pain must have opioids. This exposure of conflict of interest shows a mentally ill doctor. Even though Dr. Livingston was challenged, she will not recuse herself. What does a family medicine physician know about pain management? Pain management specialists do not understand their craft. The sadomasochist personality disorder of many in the medical fields, including pharmacists, is appearing en masse. What has been occurring nationwide is text book example of a witch hunt. Why does not this unity occur in American politics? Because those withholding effective pain medication can see and hear their prey suffering and sense nothing themselves.

Susan Domokos

The same can be said of forcing long term opiod patients being straight cutoff of their pain meds…i have been on a 7 year hell journey after being forced off fentanyl 75mcg patch…the mental anguish and severe verbal and mental abuse by members of my medical team has made me question myself and question the laws that would make my team ABANDON me…#notajunkie #ohio

Heather

Thank God. They cannot continue to harm patients who were stable on their treatments… I am saying that it is utterly unethical for them to pursue that path! The hippocratic oath says “Do No Harm.”

Period.

If that oath is meaningless to them, then we have the wrong people on the panel.

I am angry and frustrated that they have gone as far as they did in that direction and it is time that they work in favor of saving lives rather than destroying lives, ending lives and decimating people’s quality of life.

PS, these captcha codes are adding so much effort to posting. I have decided not to post at times. I had thr code correct, I was sure!