Patients Impacted by CDC Guidelines
The Centers for Disease Control and Prevention (CDC) guidelines say that doctors should not prescribe daily doses of morphine that exceed 90-milligram equivalents (MME) due to the risk of overdose and addiction. CDC actually discourages medical professionals to prescribe opioids for the treatment of chronic pain.
Even though the guideline was intended for primary care physicians only, it has been extensively implemented as mandatory across the healthcare system in the country. Many physicians and health experts believe that this guideline has limited their ability to treat patients, and has adversely impacted the quality of pain care in the US.
A Survey Reveals Severe Consequences for Patients
According to a wide-ranging survey involving approximately 6,000 patients and physicians by PNN (Pain News Network), the CDC guideline regarding the opioid prescription has affected several patients, reducing their access to pain care significantly.
Many patients have been forced to turn to alcohol as well as other drugs in their search for pain relief. The guideline that discourages opioid-based prescription medication for chronic pain was passed three years ago in 2016.
As we mentioned earlier, even though it is voluntary and only meant for primary care doctors, the CDC guideline has been adopted as mandatory policy by several states, pharmacies, and insurance companies in the United States.
The PNN survey found that this guideline has posed inadvertent consequences for both patients and healthcare providers. More than 85% of patients say the rule has made their pain, and in effect, their quality of life in general far worse. Approximately 50% of the surveyed patients said they’ve considered suicide to escape their pain in the absence of proper treatment.
According to one patient, the guideline is horrifically impacting legitimate patients while the actual drug addicts are simply turning to street drugs. He also said that his quality of life has substantially gone down to such a degree that he considered suicide last year. Thankfully, he was prevented from taking his own life but his struggle with pain has not stopped.
Medical Professionals Feel the Pressure
More than 66% of healthcare providers are scared of prescribing opioids since they could end up getting sanctioned or even prosecuted. Instead of taking the risk of going to prison, many have closed their pain care practices or simply retired.
A doctor says that a large number of physicians are afraid to do their job and are forced to leave their patients in unnecessary pain. He also said that reducing chronic stable doses of opioids of legitimate patients because some people abuse the drugs, is cruel and unjustified.
PNN conducted the survey online. A total of 5,856 patients and 157 healthcare professionals in the country participated in it. The extensive survey was done this year between February 17th and March 15th.
When the respondents were asked whether the guideline is helpful or harmful, a whopping 96% replied that they believe the CDC guideline is harmful. Clearly, a vast majority believes that it has harmed patients who are suffering from pain.
A Decline in the Prescriptions of Opioid
The opioid prescriptions in America have been going down for many years and currently stand at their lowest in the last 16 years. The slump seems to have escalated since the guideline was passed in 2016.
Eight out of 10 patients said they are receiving a lower dose prescription or that their opioid prescriptions have been completely discontinued. Many said that although no effective alternative has been provided to them, they’ve still been tapered off crucial pain medication.
According to a patient, the CDC guidelines are horrendously affecting chronic pain patients. He said his pain had become manageable until his doctor informed him his pain meds were getting cut in half. Apparently, the doctor lied and cut the medication by 85%, thus almost incapacitating the patient, who’s been bed-ridden ever since.
Another patient says she’s been robbed of experiencing a decent quality of life and she constantly thinks of taking her own life.
Thousands of patients who’ve never abused their medications and depend on their pain meds to live without pain are being treated by the CDC as drug addicts.
A nurse working with the Veterans Administration (VA) says that VA doctors are too scared to prescribe any narcotics or opioids because of the “mandatory” guidelines and education imposed on them. She added that the veterans who’ve already suffered enough are not getting treated for chronic pain, which has increased suicide rates.
It is a sad state of affairs when doctors have to choose between treating their patients in a safe, effective manner, and feeling like they could lose their practice licenses.
Doctors Unwilling to Treat Patients
Opioids are not the only thing patients are having a hard time finding. Nine out of 10 patients report that they can’t find a physician willing to treat their chronic pain. Many patients have either been abandoned or discharged by their doctors and have also run into problems with their insurance companies or pharmacies. A few patients have been directed to join addiction treatment centers.
Here are some startling facts that came out from the survey:
- 73% of patients say it has become very difficult to find a healthcare provider.
- 34% of patients have been discharged or altogether abandoned by a doctor.
- 27% of pharmacies have refused to fill out opioid prescriptions.
- 27% of insurance companies have refused to pay for pain treatments.
- 15% of patients are unable to find a doctor.
- 5% of patients have been referred to addiction treatment.
A nurse reported that she has witnessed a reduction in quality of life and an increase in anxiety and pain for patients. Doctors fear their licenses for practice could be canceled, and they could lose their livelihood. She said her staff is spending hours on the phone every day, trying to authorize the script prescriptions. A primary care physician said that even the pain management doctors are refusing to prescribe opioids and narcotics.
Watch YouTube Video: Chronic Pain vs. The CDC Guidelines: The Opioid Prescribing Question. This video explains why so many doctors stopped prescribing opioids.
Desperate Times Call for Desperate Measures
The well-intentioned motto of the CDC is “to save lives and protect people from health threats.” However, this couldn’t be more ironic in the current situation because the CDC pain care guideline has forced many patients to adopt desperate measures for finding relief from their chronic pain.
One in five patients is actually hoarding the opioids because they believe they won’t be able to access the pain medication soon. This isn’t even the worst part. Several other patients have started to use marijuana, alcohol or kratom (an herbal supplement) for pain relief. A few are reportedly using illegal drugs as well.
Here’s the current situation:
- 26% of patients are using medical marijuana for pain relief.
- 22% are hoarding opioid meds.
- 20% are using alcohol for pain relief.
- 20% are using kratom for pain relief.
- 11% are using their friends, family, or black market to obtain opioid medication.
- 4% are using illegal drugs such as fentanyl and heroin for pain relief.
- 2% of patients have found other treatments that work just as well.
One patient revealed the terrifying picture as she reported knowing seven people personally who went to the streets to get pain relief, only to find a worse fate awaited them. Four of them died because the street drugs were mixed with illicit fentanyl (which is coming across the porous southern border of America) while two committed suicide.
The Incidence of Overdose and Addiction on the Rise
Even though the CDC guidelines appear to have brought down the dose and quantity of opioid prescriptions significantly, the majority of doctors and patients believe it has failed to minimize the drug overdoses and addiction.
In 2017, approximately 49,000 Americans lost their lives to opioid overdoses, but more than half of the deaths involved the use of heroin or fentanyl. One patient notes that the CDC is attacking the wrong problem. He said that since the pain patients are strictly monitored by their physicians, their addiction rate is far lower than the general populace. Another patient added that the real addicts always find a way to assess the illicit drugs and these guidelines are not stopping them at all. It’s only hurting the genuinely suffering patients.
The Discrepancy in Prescribing the Medications
The PNN survey also found a wide inconsistency in how healthcare providers have adjusted to the CDC recommendations. According to the survey:
- Nearly 50% of doctors are still prescribing opioids above 90 morphine milligram equivalents (MME)if they feel it’s the right thing to do.
- Nearly 20% are prescribing below or near the 90 MME limit.
- 14% have stopped offering opioid prescriptions altogether.
A pain management doctor reports that the primary care providers are no longer accepting patients on opioids. Another provider who works in urgent care says that acute pain is not getting treated properly anymore and many patients have been denied opiates to control their pain. He said that the patients are paying the price for something that’s not even their fault.
Doctors under Scrutiny
The Drug Enforcement Administration (DEA) along with other law enforcement agencies keeps an eye on the prescription drug databases (PDMPs) to track prescriptions of opioids. PDMPs were originally promoted as a way to safeguard doctors from patients who’d visit multiple physicians to obtain multiple prescriptions for otherwise illicit drugs.
But now the DEA is using these databases to single out, intimidate, and raid the offices of healthcare providers who prescribe higher doses. This is despite the fact that there is no evidence whatsoever that patients are being harmed by the opioids.
A pain management expert says that the DEA and other agencies have weaponized something that was being appropriately used for treating acute and chronic pain. According to an addiction treatment doctor, these agencies are shaming the patients who have been prescribed high doses of opioid medications, and the prescribers are being treated as criminals.
It seems the CDC is ignoring the fact that the majority of drug-related deaths have always been street addicts – not legitimate pain patients. One expert says that their guidelines have allowed the medical regulators to conduct a “witch-hunt” of doctors who prescribe opioid pain meds, resulting in a frightening impact on prescribers.
This crackdown has equally affected the insurance companies and pharmacies. Almost 73% of patients say a pharmacy has refused to fill their prescription while 70% say an insurance company has refused to pay for their pain management.
One provider asks what many are thinking, “why does CVS – which openly sells NSAIDs (Non-steroidal anti-inflammatory drugs) – control how pain treatment doctors treat their patients?”
A physician informed the insurers are going one step ahead of the guidelines and sending threatening letters to healthcare providers, to ensure they don’t prescribe higher doses of opioid medications. It’s clear that insurance companies and pharmacies are dictating how to treat the pain patients even though they lack the medical qualifications and authority to diagnose or treat the patients.
CDC Guidelines Need to be Revised Immediately
Nearly 97% of the patients and doctors expressed their opinion that the CDC should modify their guidelines regarding opioid prescriptions. It should be noted that when they released the guideline in 2016, the CDC said it would evaluate it and make future updates if necessary.
A spokesperson for the CDC recently got in touch with PNN to inform that there are multiple research projects in progress and the agency is assessing the impact of the guideline. However, he didn’t comment when asked whether any changes are in the cards.
Healthcare providers, as well as patients, are saying the guideline is taken the wrong way and needs to be amended. A patient wrote PNN that it’s a fabricated document created to gratify political pressure which pushed for such a report. He further wrote that there is no scientific or medical evidence to back up the claims made in the document.
Another patient insists that the CDC needs to rectify their blatant error; they need to ensure that doctors in the country must be reassured that they won’t go to jail for treating patients who are suffering from pain disorders.
The majority of patients think that the CDC needs to admit they messed up and they need to right their wrongs before more patients lose their lives. The fact remains that even though the guidelines are useful, they shouldn’t have been turned into mandatory regulations. It’s obvious that patients with acute and chronic pain disorders are suffering. Clearly, it is time the CDC reviewed its guidelines with an aim to bring relief to millions of pain patients in the country.
Watch YouTube Video: Some Doctors Say It’s Time to Reconsider the CDC’s Guidelines on Opioid Prescribing. The video below explains why some doctors are calling on the CDC to re-examine their guidelines on opioid prescriptions.
Sacramento Personal Injury Attorneys
I’m Ed Smith, a personal injury lawyer in Sacramento. If you are a victim of a personal injury due to another person’s fault, please call me for free, friendly advice at (916) 921-6400 or (800) 404-5400.
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