The CDC Opioid Guidelines Violate Standards Of Science Research

The CDC Opioid Guidelines Violate Standards Of Science Research

Editor’s Note: The following article was forwarded to National Pain Report by it’s author, Richard “Red” Lawhern, and was first published in ACSH.org. In his words: “I believe this may turn out to have at least a chance of shaking the medical policy establishment in the US Government.” – we hope he’s right!

By Richard “Red” Lawhern

If you follow healthcare news, you know that millions of US pain patients are experiencing a world of troubles.  If their pain itself wasn’t enough, the US Centers for Disease Control and Prevention added to their agony in March 2016 by issuing a restrictive “Guideline” to primary care physicians on prescription of opioid medications to adults with long-lasting non-cancer pain.

Richard “Red” Lawhern

The new CMS standard will impose legal limits on the maximum amount of opioid pain relievers that a doctor may prescribe to a patient who isn’t actually dying of cancer.  A maximum of 90 Morphine Milligram Equivalents per Day (MMED) will be imposed retroactively on patients who have done well on much higher doses for years, with no evidence of addiction or overdose risk.  This despite the fact that the methodology of MMED is itself considered a meaningless medical mythology by many experts in the field.

Consequences of these changes are predictable.  Even more physicians will leave pain management practice, throwing thousands of patients into the street without medical referral or support when they go into opioid withdrawal.  Whole areas of US States are already no longer served by any pain management center.  Potentially millions more patients will be forcibly tapered down or cut off cold-turkey, plunging them into agony and disability when they can no longer work or maintain family relationships due to under-treatment of their pain.  More patients will be turned away by emergency rooms and family doctors.  Suicide rates — already on the increase — will soar.

A deceptive bureaucratic maze adds deep insult and possibly criminal intent to this obvious injury.

Many of the core assumptions of the CDC guidelines are supported by only the weakest medical evidence – and others are clearly contradicted by the evidence.  Medical professionals have published sharp criticisms of the CDC guideline and of the anti-opioid biases of consultants who wrote the document.  A recent paper in Pain Medicine [ref: Pain Med (2016) 17 (11): 2036-2046] offers analysis that shows the writers of the Guideline deliberately distorted the evidence they gathered.

CDC consultants performed a literature review on the effectiveness and risks of three classes of treatments for severe chronic pain:  opioids, non-opioid medicines like Tylenol, and behavioral therapies like rational cognitive therapy. Based on this review, they declared that there is very little evidence that opioids work for pain over long periods of time.  But they neglected to inform readers that they had rejected any study of opioid medications that hadn’t lasted at least a year, then declaring that there was no proof that opioids are effective over the long term.  But they did NOT reject studies of non-opioid medications or behavioral therapies that were similarly short.

As the Pain Medicine paper states, “To dismiss trials as “inadequate” if their observation period is a year or less is inconsistent with current regulatory standards… Considering only duration of active treatment in efficacy or effectiveness trials, published evidence is no stronger for any major drug category or behavioral therapy than for opioids.”

This didn’t keep the writers of the CDC Guideline from recommending that non-opioid treatments be favored over opioids, despite lack of evidence that they work.  Nor did it keep the writers from exaggerating opioid risks – using the term “overdose” no less than 150 times in their biased and unscientific practice standard.

It is time for the CDC to withdraw its misdirected “opioid guideline” for a major rewrite.  This time, the effort should be led by pain management specialists, not addiction psychiatrists.  Pain patients or their advocates should be voting members of the writers group.

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An expanded version of this article was published on March 15, 2017 after collaboration with Dr. Lawhern, under the byline of Frank Carroll in the Custer County Chronicle (SD), titled “Opioid Guideline Needs a Rewrite”.

Richard A. Lawhern has volunteered for 20 years as a non-physician author, webmaster, and advocate for chronic neuropathic face pain patients. 

Feature image courtesy of shutterstock.

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There are 33 comments for this article
  1. Joy Collins at 10:11 pm

    After the healthcare reform act and resulting shortages, not only has opiate medication become increasingly stressful to have prescribed, but other necessary medications like ADHD, and benzodiazipans. For someone like myself with co-occurring diagnoses, I have not had my authentic,generic ADHD medication for 4 years. The fraudulent medications bearing the same name, have resulted in many doctor visits as they contained heavy metals and other toxic substances. I have tried and returned over 12 ADHD meds bearing the same name; all were non-standardized,and caused serious harm. I have written state commissioners, and many other political representatives regarding these assaults from every drug manufacturer under medicare, and medicaid, only to be told there is nothing they can do regarding medications. I contacted a public law agency as well, and was told that they can’t help with medication issues, and in answer to my question as to my basic human rights as an American citizen living in the state of N.Y., I was told that my question is “a philosophical one” I have been through 7 “Oxycodones”, [I returned one which almost gave me an anuerism]. I wish someone would analyze these medications. There is nothing more frightening than to be in excruciating pain, [throbbing blood-vessel on left side of my skull about to burst], and have to convince the pharmacist to switch this brand-out, or I’m calling the media. The side-effects of several other versions is severe sleep deprivation,mild headache, and anxiety. I have to pray to God that the one part of the medication over-rides the side-effects. I have worked very hard to overcome severe past traumas, only to be degraded, shamed, terrorized and tortured by my own government after the former administrations “Healthcare Reform Act”. My health has taken a treacherous downward spiral; the relentless shock & awes, blows to my nervous system, dirty medications, and bearing witness to the horrific medical abuses being done to my only sibling, with late stage lyme disease. This nightmare never seems to end.. Recalling the movie The Green Mile, with Tom Hanks, I wish these narcissistic,ignorant, and agenda-promoting sadists,could receive a “pain transfer”, as this appears to be the only way to an awakening of empathy. We are in a state of EMERGENCY. Every second of unrelieved and Unnecessary agony is too much. It’s beyond comprehension, and a pathetic waste of precious energy-that this subject need ANY discussion.

  2. Tim Mason at 6:49 am

    Dr. Kutzner, PCP in my town do not write prescriptions for CII pain medications. All are referred to a Pain Management Professional. It has been that way here in Southeast Tennessee since 2008.
    It was then and is now common knowledge that these medications and treatments are the sole responsibility of the pain management professional.
    I am speaking of chronic pain not acute pain or aches. I am speaking of pain causing disease states verified by diagnostic imaging and other diagnostic techniques.
    Furthermore, If patients follow the rules at these Pain Management facilities they remain a patient.
    As you may be aware, exit strategies exist for those that divert their medications, overuse or otherwise try and scam the physician.
    59 year old male, DDD, OA, Lumbar spinal stenosis. Post ALIF 360 and total hip replacement.

  3. PL at 2:22 am

    Dr Kutzner,
    when you find these other treatment modalities that will lessen my pain and thus the need for pain medication, please let me know. The alternative treatments that the CDC and you encourage me to seek out are unattainable and unaffordable to me and to most chronic pain patients (especially those who are disabled). I don’t know how you think doctors will be able to “incorporate resources to provide treatment modalities” to their pain patients if we will not be able to afford them. What resources are there and exactly what modalities are you referring to? I have tried them all…PT, Aquatherapy, acupuncture, behavioral therapy, chiropractic, epidural steroid injections, massage therapy, tai chi, yoga, anti inflammatory medications, et al, with varying degrees of success or failure and great monetary expense. I currently pay close to $300/month for medications (including opiods, which by the way are the least expensive ones) which places a huge financial strain on my family. I did not want to be on opiods and went against my doctor’s advice for years before finally being convinced that this was the only treatment option left that was available to me. I do still suffer from pain on a daily basis but these medications decrease my pain and allow me to gain some semblance of my former life back. There are many of us who need and use these medications as prescribed. We are not misusing or abusing them. Many are made to follow contracts stating that if we are misusing them then our doctor’s will not prescribe them. It is hard enough to live each and every day in pain. What is even harder is to be looked at like a criminal from doctor’s, nurses, pharmacists, and other member of the medical community. I am a mother, wife, daughter, sister and a HUMAN BEING. I deserve to be treated with respect and dignity just as I treat others, especially those I hold in high regard like my doctor. I suffer from a chronic disease like many other Americans and I am being treated by my physician for this illness just like many others. How many deaths are attributed to alcohol abuse in the US but you don’t see the CDC or anyone else publishing guidelines limiting how many bottles of wine someone can buy, do you? Why am I any different than the person with diabetes, or heart disease or anxiety disorders? Do you think we should limit their medications or cut them in half with no warning or threaten to stop prescribing? Do you know what it’s like to be given a cup to urinate in every time you go to the doctor’s? Do you feel the stares from other patients? Do you have to show your ID at the pharmacy and wait while they “check to see if they have this” or while they look in their “magic book” of who knows what? Have you ever been told that they couldn’t fill your prescription or that they are somehow “all out”? Do you know what it’s like to have to schedule your vacations around your prescriptions? I don’t suppose you have ever had to leave a vacation early because you have run out of meds? I think it is “stupid, unethical, and irresponsible” for doctor’s to stop prescribing opiods to their chronic pain patients based on fear and hysteria.

  4. Sandy Auriene Sullivan at 9:35 am

    When the guidelines were announced and we heard about who was at the table and who wasn’t? That’s when I knew too that the scientific method had not been applied to the CDC guidelines of one size fits all. [my own tolerance is significantly higher than that of others 3 times my size and weight; not just due to years of pain but the way my body metabolizes opiates]

    In “my story’ shared here in 2015 and CDC public comments the lack of the scientific method was one reason I wanted it rejected. Each state does not have a *mandate* to follow these guidelines; they are a directive. A suggestion. So ask your doctor why he feels the CDC guidelines are the right way to go as a *directive* not a *mandate* — most likely he or she fears the DEA doesn’t see it that way.

    It’s cruel and sick what the medical community has been cajoled into doing.

    At this point my specialist is simply researching MMJ now that our state has adopted it for use in patients. But even then, if he followed current Florida ‘law’ on MMJ rec; he would violate federal guidelines on it which *would* impact his DEA license. You see doctors can suggest it but cannot tell you how to use it or where to obtain it. Florida expects doctors to tell you to use the items at a dispensary which doesnt’ carry actual marijuana in natural form but in concentrates.

    side note: I tried a indica concentrate in vapor form that is at the medical sites. Up till then I had not felt that MMJ would help me with chronic pain management more than it does in small amounts in the evening. But after trying that Indica concentrated vaporized RSO? I woke up the next morning feeling more ‘normal’ than I have for 2 decades! Then I cried as I cannot afford it unless there was a way to make it myself or move.

  5. Connie at 7:03 pm

    A class action suit is definitely warranted the problem is finding an attorney to take the case! I have personally spent hours being turned down by one attorney after another and there are many otherss doing the same thing!

  6. connie at 3:57 pm

    Don’t go to Maine because even animals there can’t be treated with opiates without the vet checking on how many opiates the owner is prescribed! This entire issue has gone so far beyond absurd that it’s stupid! When and where will it end?

  7. Jay at 11:31 am

    Let me start by saying that I do NOT blame my doctor for this following story. I blame all of “initial” bureaucrats….DEA, CDC etc. And now the current GOP administration for making this even worse for chronic pain patients.

    I have been on opiates for years for chonic pain. I have never abused them. I have never gone up in dose. I actually had to cut my dose in half. My other option was to go to the doctor every month instead of every other. I don’t drive, my husband cannot take off a day each month just to take me to get scripts. And it would mean 12 urine tests per year instead of just 6. The urine screens used to be just a few times per year.

    I have actually gone off the opioids completely, to see if I could manage without. Well, I couldn’t. But tapering off of them was not difficult at all. It took me less than 3 weeks, after years of use. So for those who claim they are so addicting, that is just BS. ABUSERS don’t WANT to come off of them, so they complain that they cannot come off them. And like was said in another post, the reason they die is because they take way more than prescribed or mix with other drugs.

    After tapering my opiate dose to half, my doctor added a benzo into the mix. That combo has made it possible for me to have some semblance of a life. But of those drugs, the benzos are WAY more addictive and prone to abuse. I have been through benzo withdrawal before and it is a nightmare. Twenty times harder (or more) than it was to come off the opiates. But without them, I am unable to sleep from the pain.

    So tired of being treated like some sort of drug abusing addict. I finally found a pharmacy that I am comfortable with and treats me like an individual. I just fear the day my doctor tells me he is no longer allowed to prescribe the pain meds I need to live.

  8. Owl at 1:25 am

    I am so afraid you are correct! Today I went to my pain management Drs and asked them “I have been reading up on the opiophobia witch hunt and it seems like it is restricted to general practitioners and not pain management?” They, sadly, replied “not in Alabama! They are after all pain medications here.”

    I never thought I would be forced to leave my extended family, my children and grandchildren, my dream home and the farm that has been in my family now for four generations in order to be treated with better medical care than my animals get!!! Things just became, for me, extremely threatening and beyond frightening.

  9. Jean Price at 12:37 am

    Dr. Kutzner…with all due respect, do you yourself live with daily pain? Have you had a recent surgery and been denied pain medication? Or visited your GP and been told they no long treat pain? Or perhaps you’ve seen the opioid statistics that don’t separate legal medication from altered ILLEGAL STREET DRUGS in reporting overdose deaths!

    The kind of pain I’m asking about is 24/7/365, and limits your life, by the way! In can even be severe enough to be life threatening! Or do you perhaps treat it? Or have you perhaps just viewed some of the deceitful rhetoric put out by the CDC? By those in that agency who own drug rehab facilities…and are not specialized in the care of pain…or in telling the truth! From what you have written, I have to wonder…both as a former nurse and a person who lives with persistent pain! Sadly, your attack here is all too familiar, I’m afraid! And I really can’t understand why! I wish I could, but all of this opioid witch hunt defies medical logic and common sense to me! Well, maybe common sense isnt that common anymore!

    Many in health care seem to have taken a big drink of the CDC’s “KoolAide” lately…and they fail to look at what’s really damaging and unethical…which is the current practice of causing further human suffering by undertreating pain!! By denying or reducing opioids to a non therapeutic level…while freely prescribing antidepressants and antiepileptics and invasive procedures, all with many more serious side effects! And much MORE expense and LESS effectiveness! (Yet much more profit, I might add!).

    For the record, I do not consider myself or anyone here stupid, irresponsible, or unethical! In fact, we are law abiding, conscientious, responsible, compliant, and WELL INFORMED PATIENTS…who are unable to function to even do the activities of daily care…without some level of pain relief opioids can and do offer! Our goal is to function, to have enough pain relief to allow this, and to have some quality to life despite our pain. Yet we are being treated miserably….discriminated against, denied medication for no medical or scientific reason, and forced to live in unneccesary pain…by those who once swore an oath to do NO harm. That’s really what’s irresponsible! And unethical…and down right stupid, in my opinion! Sir. We are NOT the so called “epidemic”…that is a separate issue, one of illegal drug use by those addicted to what is sold on the street! Not people with long term, proven, persistent pain…who see their doctors and have careful, thorough follow up!

    Please reconsider your stated view of this! Few GPs now even prescribe pain medication…and haven’t for years! Most people here go to pain clinic and have tried every modality of pain care available…and actually continue to use what may help a little and what they can afford!! Yet pain medication IS one of those modalities, too… and must be considered when all else fails to give adequate relief! To treat patients in pain without considering opioids is just not appropriate! There is nothing else at this time as effective, with as few side effects!

  10. Steven C Glass at 10:54 am

    40 year pain warrior..Had some quality of life 18 months ago, now bedridden. There have been LESSER things done to folks that have received punishment for attempted MURDER..CDC,DEA and all MISINFORMED?,COLD HEARTED, “IMMA YES MAN” BULLIES….YOU ARE ENDANGERING MY/OTHERS EXISTENCE. THINK ABOUT IT.

  11. connie at 8:47 am

    I just got off the phone with yet another attorney with the usual response. They start with “your not in our state”and when you tell them that there are people in EVERY state with the same issue trying to find legal representation they go to ‘it’s not in our scope of practice”. Without legal representation we haven’t got a chance and the legal community won’t touch this with a ten foot pole! His reccomendation was to call our state bar association. Yeah right, they aren’t interested either! If someone was treating an animal the way we as chronic pain patients are treated there would be hundreds of people ready to jump on it! It makes no sense but it’s the way it is, the old “you can’t fight city hall” only on a massive federal level! We keep asking what we can do and I fear the answer is a resounding nothing!

  12. Gregory Krabbe at 8:41 am

    It’s like any other venue in American society. If you can afford to treat your pain, it’s no problem. However the snooty medical profession looks down on the poor, as if they are far less worthy of compassion and care.

    This doesn’t effect me personally, as I don’t suffer from pain at present, nor am I destitute. But the truth is well known.

    Hate to say it but it’s a fact, objectively speaking. If you’ve got money, you are just more valuable as a person to many in the medical profession.

  13. Owl at 9:29 pm

    So how do we fight back for what we all know is unethical, biased and requires real doctors to do the opposite of what they have sworn an oath to do? This is NOT about OPIOIDS, it IS about MONEY. I don’t think anyone doubts what and who are behind this has nothing to do with helping lower the suicide or overdose deaths but it’s just stuck at everyone repeating their story and no one listening. We need to file some sort of ‘legalese’ that requires THEIR motives and methods be examined by outside sources and be published so that the whole world can see the criminals who are driving this.

  14. David Gray at 6:31 pm

    I have been dealing with severe degenerative disc disease for 20 years, I have had several surgeries and no benefit from any. I continue with a quality of life with the help of oxycodone.
    I get tested every 90 days or so to make sure I am taking what has been prescribed and not taking street drugs. I have had two of my pain management Dr,s walked out in hand cuffs.
    One was forced into retirement, while the second one was treating over 10,000 patients and they had him under investigation for years before they found a reason for his arrest. All of his patients were left out in the cold to fend for themselves. The system is very broken…

  15. Linda Coffman at 5:24 pm

    Wonderful article! I completely agree. The authors were very non-opioid biased, and a paper on guidelines for writing pain medications especially for chronic pain patients should be done by pain management specialists. I understand addiction and overdose is something that must be addressed, but by decreasing pain medications to chronic pain sufferers all that is done is increased their misery and taken away their ability to function as a member of society. After battling advanced cancer, I became a chronic pain sufferer from the damage to my nerves that the chemo drug Taxol caused. Prior to trying opioid medications, I tried every other treatment modality available. I still use non-opioid methods today. My pain doctor finally convinced me that the only way I would have any quality of life was to take opioid medications. I have been on them three years now, and these three years were much better than the prior seven years. I am able to work as a middle school math teacher and missed half as many days as years before. We are already punished by uncaring pharmacists who see our RX and decide we ate drug addicts. I have had more pain since my cancer remission than during the time I was actively battling cancer. I take my medications as ordered, do my drug screens to ensure I am compliant, never take pain prescriptions from other doctors even when offered. I can tell you the long term use of these medications has been effective. Yes my body is now dependent on these meds but no differently than the daily cymbalta I take for my chemo induced peripheral neuropathy. I do not experience any euphoric feelings taking these meds, only the feeling that I can handle the dulled pain and continue with my day. Imagine knowing that your pain would NEVER go away. This is what we live with. Normal conditions such as surgery, there is acute pain, but the knowledge is there that this too will pass. A chronic pain patient has no pain-free time to strive for, instead with the correct dosage of our medication we know the pain can be dropped from an 8 or 9 down to a 3. Just this month, my pain doctor had to decrease the total amount of breakthrough pain medication I was taking due to these guidelines and the insurance companies. I go to a board certified pain management doctor to treat my condition. I do not think it is right for addiction doctors to be writing these guidelines. Their minds are already made up that opioid treatment will cause addiction which is NOT true with chronic pain patients. Do some become addicts, yes sadly, but that is due to the addiction gene. To punish all chronic pain patients should be illegal. The job of a doctor is to do no harm, yet they are harming millions who already suffer daily. Please let my doctor do her job. Do some studies on the efficiency of opioid treatment for chronic pain before telling the CDC and doctors it doesn’t work and we are better off with Advil and Tylenol. Trust me if those treatments worked I would gladly use them. I find the guidelines to he extremely biased and not evidence based. Instead they are opinion based which us not the way guidelines should be written. Anyone who stands up for pain patients is automatically labeled and found to be lacking. Instead I found the qualifications of the authors of the guidelines to be lacking in the experience working with long term pain patients.

  16. Michael G Langley, MD at 3:19 pm

    Thank you. Now that I suffer from a post traumatic neuropathy and inadequate care for it, I really am aware of the practice that ended my medical career. I was just about twenty years ahead of time. I guess I should have learned by experience that following the urging-s of people like Dr Portenoy and other scientist/MD-s only got me into trouble. So much for keeping up!

  17. Caryn Abrams at 2:22 pm

    I am a chronic pain patient caught in this utter CDC-CMS Standard Firestorm of ignorance and misinformation.
    What is being done to bear down pressure ON THE CDC to restore normalcy to this horrendous mess they have made by these terrible slanted ill educated laws? Who is fighting the CDC to change this? Do Veterans, Chronic Disease
    Patients, Accident Victems have anyone in the fight to push the CDC to change these guidelines asap?
    Who is fighting now for truth and revision and retraction of this terrible mistake in our medical management?

  18. connie at 1:03 pm

    Great article. Did it in anyway affect what the CDC did and continues to do to millions of people who suffer daily with pain that only responds to opiate pain meds above the ridiculously low amount that they arbitrarily chose? I tend to be an eternal pessimist and very much doubt that anything we say or do is going to help. I can just hope that karma bites them in the [edit] with a vengeance!

  19. Dr. Kutzner at 12:36 pm

    Absolutely unethical, irresponsible, and frankly stupid.

    OPIOID MISUSE IS KILLING PEOPLE AT EPIDEMIC RATES.

    PRIMARY CARE PHYSICIANS (PCP’s) ARE THE GREATEST SOURCE OF THESE OPIATES.

    Every article written over decade’s state that WE MUST FIND OTHER TREATMENT MODALITIES to add to a patient’s treatment regime that lessens suffering and the need for opiates.

    Behavioral therapies, physical therapies, non-opiate medications may be found to lessen the pathology causing the patients pain and thus lessen the need for relying solely on opiates which do nothing for the underlying pathology.

    To address chronic pain we must provide these treatment modalities to effectually lower opiate overdose. PCP’s are asked to incorporate the resources to provide these treatment modalities. Where they are not able to then they should refer the patient to a clinic where they can be provided.

    It’s just that simple so stop being so stupid, irresponsible, and unethical.

  20. Barbara W at 10:59 am

    I hope this will have all Pain ma nagement specialists in every state step up to the table & be counted! These pshyciatrists r clearly greed oriented by rehab etc started back in 2002 with the main DEA DR was allowed on the panel of the FDA stating this exact lie about opiods. A psychiarist ist who treats addicts not patients & runs a rehab clinic. These are all self appointed opionated schams driven by power & greed & kick backs! “Physcians for responsible opiod prescribing” the Exact opposite of the head of “Physcians for Common Sense prescribing” who is a true Pain Specialist treating chronic pain patients. He states the under treated chronic pain becomes its own cancer attacking the nervous sytem causing negative outcomes to the heart & other major organs! He also states people whom cannot come down off if opiates with out severe withdrawel are addicts. Normal people taking opiods correctly do not experince that.

  21. Mary L Marshman at 9:46 am

    This article is discussing the guidelines that were put in place last year, not future guidelines, correct? I am up against the 90 mg dose per day with non cancer pain.

  22. Tim Mason at 8:54 am

    I am still working on an article showing the malstatics, fake news and malfeasance by CDC and others. I have 10 articles and references and I am writing my blog in my spare time. I still work full time. references will be provided as hyperlinks.
    It is interesting to note that only 1/5 of 1% of chronic pain patients become addicted to their medications.
    Great work Dr. Red!

  23. scott michaels at 8:25 am

    Will this article go anywhere that would repeal these tortuous guideline. Can I now take kaiser to court for doing harm by reducing my medication by 75% after years of unquestionable prescriptions that took most of my pain away.

  24. Patti at 8:11 am

    Sick to DEATH of healthy, painfree, idiots making ignorant realities for those of US that rely on those meds for even a small semblance and quality of LIFE.
    Do ANY of these people even begin to understand what chronic pain DOES to a person? It affects you mentally, emotionally, physically AND spiritually!!! Ever single aspect of life is a challenge! Taking a shower, washing dishes, even walking to the end of the DRIVEWAY to retrieve the mail or the paper is a huge challenge for us! I really AM sick of others making my life anymore unbearable as it is!

  25. Heather at 7:53 am

    Thank YOU!! This is spot on and absolutely correct. The CDC makes up BS and “new guidelines” to make it sound like pain patients are constantly overdosing and ADDICTS. Well this is the farthest from the truth. You see the truth is that there is an epidemic in overdoses involving herion and cocaine with fentanyl along with those who use recreationally and illegally on the street that has caused this whole blow up, NOT the REAL PAIN PATIENTS and the CDC said themselves their evidence was not scientifically based in regards to long term use of opiods. As a patient and an advocate for pain patients I will continue to fight for our rights. We are treated inhumanly, like addicts that we aren’t, neglectfully, barbaric, and down right disrespectful. Mainly from hospitals and ERs. They don’t know how to deal with chronic illnesses and patients who may have flare ups or may really truly have something wrong with them. They immediately say “oh you take pain meds, we are not here to give you drugs”, and they discharge you without even doing bloodwork or any testing, but better bet you get billed. Here in Florida multiple people have died in parking lots of hospitals due to this kind of treatment. Patients refusing to leave the hospital as we know our bodies and they refuse to listen because we take pain meds and the police come and one died of a stroke, one of a PE, all the while police yelling get off the ground and no one would help. We don’t go to the hospital for pain meds, we hate hositals quite frankly because of how we are treated, but when we do go something is truly wrong and we need treatment. Not to be kicked out the door like a herion addict who came in high or overdoses. We are alert and oriented. I’m also a nurse, what happened to the rule of what the patient states there pain is, is what it is? Now they say it is what the Dr says. Bull!! Those of us who have chronic disorders learn to cope and may be able to smile when we are at 9 on pain scale whereas someone who doesn’t deal with pain comes in with a 9 and they think they are dying. We have no choice these days but to learn to cope. I’m sick and tired of this nonsense and Drs not being able to practice medicine that they spent many many years to get a degree and a speciality field and the CDC dictating and threatening them as well as now allowing pharmacies to report them. Seriously? The insurance companies have jumped on the lovely bandwagon as well and now We unfairly pay double copays each month for 3 of my meds, which are not narcotics or controlled, because they are over the quantitiy of 100. This should be fraud and also switching meds without any notification or justification and can’t even tell you when they changed their policies. One month you get your meds full amount and the next you don’t. I reported them as well because by law of ins they have to notify members of any changes within a ongoing year. Never happens. Also had one med that was $6 go to $75. “Oh it’s not on the formulary anymore, is a Tier 3.” Once again, ins fraud and someone getting rich. We have patients in a group I run who have had pain meds stopped totally and not weaned which is dangerous when they have been in them for 15 years and worked and some who have been decreased and a large majority who suffer greatly with nothing. How is this America and legal or even humane. Aniamls get better treatment than we do, seriously. And you are correct and I’ve been ranting and writing all local and federal legislative offices in regards to suicide rates. It is unfair and should never happen. We lost 6 people under the age of 50 within 2 months. It was horrible. Why??? Becuase of lack of care and treatment and they just could not carry on anymore. It saddens me deeply we are being treated this way. They need to rewrite the guidelines and take the opioid overdose with heroin and cocaine fentanyl or any other recreational illegal use and place it in a separate category. We don’t belong there. Once again we are not addicts. We have done therapy 10 x, seen psychologist, done alternative therapies like massage, acupuncture, water therapy (by the way is the best), tried many different medications before opiods and most of us have reactions and so on……So if our meds are working why mess with them?? Most of us have been on the same doses for many years without changes. We don’t ask for increases because they are working. So why try to fix something that is not broken. If it weren’t for the medications We would have no quality of life and no even be able to get out of bed. At least We can do that some of the time. We are real, we have legit diagnosis, with legit testing to back it up, autoimmune, cancers, athritis, severe back issues with bulging disk, MS, AS, Lupus, and the list is endless. There is no cure for our disorders only to get worse over time. We have to take chemo meds at times to help slow the progression and it makes us very sick, our pain is real! It’s time to take a stand, speak up, let our voices be heard, write to your local and federal representatives and agencies over and over until they get sick of it. And most importantly STAY STRONG AND BE YOUR OWN ADVOCATES!!! Just because we take opiods doesn’t make us addicts. We are under contracts, have to do every 3 to 6 month drug testing, pill counts, etc… I will continue to fight for us all every single day…..It is my life’s mission. Make it yours!

  26. Drew at 6:30 am

    I retired from the federal government and I know, first hand, that “studies” such as this one are written to support a predetermined hypothesis. Budgets and government jobs are affected by these “studies”. The issue is, there is little scrutiny and oversight, so anything can be claimed … and often is. Opioids are the new demon that will save countless criminal justice jobs in the U.S. since marijuana’s days of illegality are about to end. Did you ever wonder what happened to all of those alcohol prohibition agents after the end of prohibition in the US? They became drug enforcement officers. A new Demon was found … quickly.

  27. Edna at 4:38 am

    I’ve had cronic pain for years was injured at work in 95 my spine is now degenerated from my neck which I tore a muscle in rt shoulder my pain is unbeatable without meds neck shoulder arm whole back but especially mid low back hips rt leg I’ve had all the injections that’s a joke injections made me so much worse without meds I’d be better off dead I’m worthless in this much pain our meds don’t kill it would kill without the meds people from here an other countries bring an sale street drugs do something about that why should old people like myself have no relief from our pain because of that killing us won’t stop ur heroin deaths an such those people chose to use street drugs please help us thst are unable to survive without some relief

  28. John P Crotty at 4:27 am

    What ever happened to the good old class action law suit , nothing at all ???

  29. Jud at 3:43 am

    I simply don’t understand why they are doing this. Why do they hate people who are suffering with incurable painful medical conditions?

  30. Cynthia o. at 1:34 am

    Is there anything we pain patients can do to help this great letter get some attention? The CDC has to stop this nonsense. Surely it’s driven by money. There is a new non-addictive pain med (probably several) coming on market. I think pharma is out to make big bucks. This has to be stopped. It’s immoral and unjust. I still think a class action suit is well warranted.

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