New CDC Opioid Guidelines: Increasing Risk of Pain Suicides?
The New CDC Opioid Guidelines
The Centers for Disease Control meant well when it issued the CDC Guideline for Prescribing Opioids for Chronic Pain in March of 2016.
On its website, the CDC asserts that it created the guideline on “the basis of a systematic review of the scientific evidence while considering benefits and harms, values and preferences, and resource allocation.” I’d argue with that statement, but I’d never suggest that the CDC meant to hurt anyone.
Instead, I’d say only that the CDC was mistaken and misguided in its approach to creating its Guideline for Prescribing Opioids for Chronic Pain. And now, unsurprisingly (but horribly), we’re dealing with the consequences.
An oft-cited statistic by the CDC is that the number of overdose deaths associated with prescription opioids exceed the number of deaths from motor vehicle accidents. This is indeed a startling statistic.
A significant number of the suicides are a result of inadequately treated pain
But, as I have previously reported, the number of suicides is nearly double the number of deaths associated with opioids. There is increasing concern that a significant number of the suicides are a result of inadequately treated pain.
Pain News Network, in a recent article, reported that dozens of patients have contacted the editors since March to report that their doctors have “fired” them on flimsy excuses, or that their doctors suddenly are weaning them off opioids or abruptly cutting them off cold turkey. I have been hearing similar reports from pain patients who have contacted me since the CDC issued its Guidelines.
I understand that doctors are responding to the Guidelines from a position of defensiveness and fear. If they continue to prescribe opioids, they will be carefully watched by law enforcement officials and subject to disciplinary action — particularly, if they lose any of their patients (and nearly all doctors, inevitably, will be faced with seriously ill patients whose lives they cannot save).
Having faced an investigation by the Drug Enforcement Administration, I understand why physicians are afraid to do the right thing. Although the DEA declined further investigation of me, they continue to investigate and sometimes prosecute physicians who are well intended but have adverse outcomes.
So I do empathize with physicians who are worried about their careers and their livelihoods. But, frankly, I am more worried about the patients they are deserting in an effort to spare themselves.
Why are we not able to hear the cries of people in pain?
In light of the Guidelines and their aftermath, everyone should pause and reflect on the patients’ perspective. Why are we not able to hear the cries of people in pain? Why do we ignore them? Where is the humanity?
Why are the lives of people in pain so unimportant that our regulators and policymakers will impose laws and regulations that, for millions of Americans, will dramatically increase suffering and even suicide rates?
Why are we willing to subject patients to harm from the illegal use of street drugs? Addiction is a deadly disease, and so is pain.
Just as people in pain are unfortunately treated as suspects, so are many of their physicians who prescribe opioids. Therefore, doctors who are trying o do the right thing are in line for increased scrutiny. This is a fact of life.
The only conscionable action forward is to address the needs of people in pain with the same urgency as the needs to reverse the opioid crisis. I wish the CDC would find a way to focus on that as we work to find answers before the number of suicides associated with pain exceeds the number of deaths from motor vehicle accidents.
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Very close to this topic.
When my pain is not at least somewhat managed, I get very depressed. The reason being, because my quality of life totally disappears.
I’m going through this now.
I quit taking pain medication several months ago. I was tired of being asked insulting questions each time I went to the Pain Clinic. I knew by the drs. Questions they were getting noticed from the SEA
Mind you, I’ve never had any problems. Passed all drug tests.
I say all that. To say, now I can’t find anything to work as well as the Pain meds.
I haven’t been able to do laundry, get groceries,do anything. I’m in pain. And miserable.
Yes I’ve tried, what I know you will recommend. Didn’t work, not legal here.
Ashamed to go back. Especially if I can’t get dosage I need. Feel like a failure.
This is totally unacceptable for the kind of country that we live in. I personally suspect that Big Pharma is influencing the politicians and DEA to pressure doctors into getting their patients off of the cheap generic pain relievers and onto the newer brand name drugs. All of a sudden cannabis is being touted as good for pain relief….cannabis isn’t covered by insurance. If pain patients can be pushed onto legal cannabis the insurance companies won’t have to pay out as much money. Something is going on here that we aren’t being told about.
You make a VERY valid point about medical marijuana. It is being touted as a miracle pain reliever and insurance companies are loving it!
I remember a conversation I had with my pharmacist back around 2002’ish. He told me that Medicaid was paying roughly 2 million bucks a week for opioid prescriptions alone!
He told me, way back then, that Medicaid was growing quite tired of dishing out all that cash!
So, it’s absolutely no surprise to me that we have landed where we now are and that NOTHING has been done to abate the so-called “unintended consequences” of substantial rates of suicide and self-medicating!!
It’s absolutely a violation of every human being’s unalienable right to not be tortured and chronic unabated pain IS undoubtedly torture!
Everyone, please find me on FB. Together we CAN work for chronic pain reform … and actual, real reform that WORKS for everyone involved but moreover and most importantly chronic pain patients!
That is the truth!! I am a retired RN( 30+yrs) and also have been on disability and pain management for 13 yrs. I have a lot of painful diseases and have had my meds cut to barely nothing and was given a bunorphine patch. I knew immediately what was going on. The pain clinic changed hands in July, the Empathetic Dr. Retired immediately. Now a research Dr running it and calling it by a strange name? All the nurse practitioners immed quit also. Didn’ want to see their pts. Suffer, I presume.It is bad and wrong. I will join to help get this stopped, if contacted!!
I have been a ‘chronic pain patient’ since my first auto accident, in 1974.
Again, almost fatal accident, in 1991 caused me to stay in a coma for 14 days, broken from head to toe. I lived with titanium rods that helped my ‘broken spine in 3-fused together for a whole year. I was paralyzed from the neck down. Luckily for me, the experimental ‘rods’ worked, and I regain 80 percent mobility, but a lifetime of chronic pain. I have ‘tried’ all the medications, pills, patches. lollipops and all the combinations of opiates, depression pills and break-thru pain all at once. I have never, stayed in higher doses, or 3-4 types of medication at once. Some help you, but give you awful side effects, My last ‘strong’ pain medication was Fentanyl 100cc patches, which work for a while, but then turned me in to ‘sleeping zombie’ I only try ‘new’ pain meds for 2-3 weeks, if my ‘body’ doesn’t like them, I change, lucky for me, I had a very understanding physician, that ‘respected’ me that I also was in the ‘healthcare’ field, and was very ‘knowledgeable of what I was putting into my body. Finally after so many ‘synthetic’ opiates, I finally found my ‘miracle’ pain medication. Sulfa-Morphine IR 30mg. the lowest dose, and the least that will ‘damage’ your internal organs. I have been on this regimen for 8 years, now. I took 2 pills every 6-8 hrs. I never in my 42yrs of taking opiates, have never ‘accidently’ over-dosed, or got ‘addicted’ or got ‘high’ on my pain medications. Now, at the present, with this modern ‘witch hunt’ on “pain patients”, my ‘scared’ physician, has reduced my ‘pain medication’ to 3 pills a day. Now I am in severe and relentless pain for 10 hours a day. My blood pressure is an all time high, and I keep having panic attacks, sweating, and its just pure ‘hell’ for me. How long do they think I will last like this? They don’t care if I am a ‘legitimate’ pain patient, I have about 400 pages of medical diagnostics, consults, and MRI’s that tell any physician, that I have Fibromyalgia, Grade4 Spinal Stenosis, 2 Benign Tumors on my spine, pressing all of my ‘nerves’ , O have ‘cervical discs that are slipping out, others are severely ‘full of arthritis, and 3-4 Hemangiomas, benign tumors that live on your blood supply, very painful, on my spine. Yes, I am now bed-ridden, numb in some parts of my body, some are on “fire’ all day, some are in “pins and needles” and the ‘places where they ‘drilled’ holes in my head, due to a Halo’ press my head so much that I feel like a hammer is beating me down on my head. Add, chronic fatigue, and Insomnia, and depression. and guess what, due to my ‘age’ I am 64now, and all the ‘complications’ of my spine and neck, they, physicians and Surgeons, cannot ‘do’ anything else for me, other than to ‘keep’ me comfortable, until I completely are unable to walk. Now, how does this makes me want to live anymore? If every time I go to get my prescription for ‘pain’ medicine, they reduce it, every month, until I get “nothing”….then what?…what am I suppose to do?…Exercise the pain away? or do Yoga? or stare at a light bulb and meditate?.. The healthcare system has been broken, and all the agencies tied to them have gone completely ‘mad’. If they think they have a problem with ‘drugs’ you just wait, and see, the statistics for the next 6 months. Drug addicts will always ‘find’ a way to get ‘their’ drugs. But “legitimate” chronic pain patients, where do we go?…
http://www.painnewsnetwork.org/stories/2016/7/19/cdc-opioid-guidelines-not-rule-regulation-or-law
I am an opioid advocate for non-cancer chronic pain patients.
Please read the link about my letters to the CDC and especially the
response from Dr. Houry at the CDC who oversaw the development of the
Guidelines for opioid prescribing.
I believe hundreds of thousands of chronic pain patients are being thrown
under the bus because of the CDC’s guidelines. Yes, we should do all we
can to save the tens of thousands overdosing BUT not at the expense
of all the suffering the non-cancer chronic pain patients are now enduring,
I being one of them.
Please feel free to use anything in the article and please contact me if
I can be of any help.
We are suffering needlessly. Please help us.
Sincerely,
RIchard L. Martin, BSPharm, retired due to pain.
Thank you, Richard, for the letter from the CDC. I will bring it to my next appointment with my rheumatologist. I am so relieved that I am not the only person suffering because my doctor lowered my dosage and the rheumatoid arthritis has now become severe. I am currently having to wait a month and a half to see a pain management specialist. Do you think it would do any good to start a petition on Change.Org?
My Dr just cut my prescriptions one by 50% one 25% for the first round. I’ve been his patient for 5 years since my accident 3 of which I constantly turned down his offer for opioids to try everything under the sun FIRST scared to death of trying opioids. I thought about ending my life and decided that wasn’t better than being on opioids and gave them a try. I got a little sliver of my life back, not much but a little now I have to give that sliver back. I don’t know if I’ll survive it this time.
SOS Help!!!
Will some brave doctor please help me?!?!?
I can’t live like this much longer …. through 10 years of chronic illness opioids gave me life.
This year Obama’s new war on drugs with the CDC and the quivering doctors have taken it away.
I am becoming a shell now. Withered empty and dried up in pain.
Law abiding, follow the rules, pain contracts…. no avail. Hopeless desperation says you’re a drug addict.
I just want my life back. Please, somebody help me.
It will take more than courage for a doctor to give you the correct dose for you to have some quality of life for several reasons.
It is also true that this opiate crackdown that used a very wide brush to paint opioids was started under Obama’s administration, I just don’t want this issue forcing us to pick sides politically because we will be used as pawns and our doctors will not be able to help us or those worse off than us.
The Insurance companies closed door meeting with the CDC is bad news because the DEA was in that meeting which amounts to bureaucrats (not doctors) and insurance company CEOs using the DEA to enforce new “guidelines” on how many MGs of opiate medication you can have.
This MG amount is 90 per day in a dozen or so states where it is law but still a “guideline” in the rest of states. The doctors in “guideline” states are being threatened with prison or I should say they have received the message when DEA agents pay their office a visit.
My life is now stuck on a couch too after my medication was cut 66%, I hope someone can ask President Trump to consider pain patients that were stable for years with opiates as important too because we have been scooped up like dolphins in a tuna net.
Contact your state and federal law makers because this looks like a first step to the CDC telling us that Yoga is the answer to severe chronic pain but insurance won’t cover Yoga which shows a lack of understanding about the folks with severe injuries and diseases.
If this becomes a political issue then chronic pain patients are doomed, the suicide rate of good people in brutal pain will go up and there will be some that do worse. There are many Combat Veterans like my dad fought 2 wars and 2 bronze stars 34 years never missed a day of work now 70 years old and he was cut back in this opioid panic.
I watched him go from walking and mowing his yard to 30lbs heavier stuck in his chair and I know my pop is tough as nails but he is being culled off and I am upset because there are so many more like him being punished for the actions of others.
This needs addressed soon and if for no other reason because it’s just wrong, severe chronic pain isn’t imagined, it doesn’t know race, religion, sex, it ‘s on a MRI or CAT scan plain to see so what level of pain is ok? this should be left to doctors not bureaucrats, I hope you hang in there or as the CDC says just walk it off.
You are right!!! It makes me sick. I am a retired RN, 66yrs old, also have been on pain management for 13 yrs. See above comment I made. I want to help stop this!!
If opioids are prescribed, they should be at the lowest possible effective dosage to reduce the risks of opioid use disorder and overdose.
There are going to be more deaths!! Not from opioid OD’s but from people like me who are having their pain meds cut back! I just attempted suicide but could not go through with it. I now have a shattered patella! because the gun went off when I slammed it down on my lap because I didn’t have the balls to go thru with the suicide. I have been in chronic pain for over 45+ years. We need our meds or we’ll meet upstairs!!!
The vast majority baby boomers who have been on OxyContin, Oxycodone, etc for over 5 years I believe are not candidates for suicide, unless their mediation has been severely reduced. I have been taking 10 mg of Oxycodone six times per day and wearing a 50 mg Fentinal patch for 7-8 years, never thinking of suicide. It just worked for me!
I’m a 60-year-old retired carpenter and carpentry contractor with degenerative disc’s and 12 major surgeries. I’ve had three back surgeries two shoulder surgeries both hips replaced one knee replaced and a few others. My orthopedic surgeons have told me that I now need my other knee replaced and a neck surgery due to degenerative compression.
My first pain doctor whom I had been with for about six years told me last November she no longer wanted me as a patient because I was not having my surgeries done by the surgeons in her specific group. At the time I was taking 10 mg of Oxycodone six times per day and wearing a 50 mg Fentinal patch.
My second pain management doctor was from the group of surgeons that are performed all but one of my previous surgeries, I had visited him many years ago for one visit and did not care for him but felt I had to return to him. I had asked both doctors before I left them if they thought I could be free of all pain medication someday, and they both told me yes absolutely. I recently realized that the real reason for them releasing me was due to the new government regulations. After the second doctor took me off of the oxycodone and I voluntarily took myself off of the Fentinal patch, I now have been diagnosed with severe diabetic neuropathy in my hands and feet. I have been in the hospital emergency room three times ( in 6 weeks) with uncontrollable pain. I have contemplated suicide many times over the past few months but my faith in God, prayer, and a second daughter engaged to be married in five months are the only things that have held me back. Now on my third pain specialist I have found a sympathetic doctor but one who is still not willing to prescribe the medications that I really need or had previously been on. He has admitted he is in fear of losing his license to prescribe and I keep thinking how much better the Social Security system will be if they get rid of a few million baby boomers! I am having more thoughts that there is a wedding I will never attend.
The psychological effects of all this pain for months and months can make a normal human being question their own sanity.
I understand, see my comments above. Please don’t hurt yourself, for your daughter’s sake.
A little background on me, I was very athletic and joined the military for 6 years, I was a MPI and even completed police academy with my MPI section. I then signed up for college completing 48 credit hours when I saw UPS was hiring on the school bulletin board and spent 14 great years with UPS until I was injured so bad the company doctor said I was finished. I loved everything about being part of UPS it kept me in shape and was paid very well, I can’t think of anything better than being the UPS guy and have only good things to say about the company, bad things happen, folks get hurt.
I was a stable pain patient for 8 years, never had any issues with my medications, I am under close supervision of an excellent doctor. The new CDC/DEA guidelines for opioids is more than a guideline, in some states there are laws that use a wide brush to paint everyone not terminally ill with A 90MG limit of oxycodone per day.
To someone with a sore shoulder or back ache this may seem sufficient but for the folks suffering from severe spinal damage, nerve damage, failed surgeries, inoperable injuries, it is far from enough. Why should bureaucrats without any medical knowledge of my condition/ injuries be making decisions on how much pain I should have to live with?
I have gone from some quality of life to almost none, I went from able to help my parents to stuck in bed most days with my eyes watering just to get up. My doctor was pressured by the CDC/DEA to cut patients to 90MG of oxycodone per day or less as the “guideline” recommends. I wasn’t living the good life but it was living and 22 years of W2’s and being productive put my income $600 a year above the SSD amount to get Medicaid.
I can’t imagine what it’s like for folks worse off than me but I know they exist and nobody should have to live in that much pain. I see that numbers are being manipulated to scare folks about the opiate monster but do some research, then know that you could end up in the position many pain patients are in.
I see heroin ODs being included in pain patient data along with suicide deaths counted as opioid deaths but I don’t think these numbers are fair to pain patients that have been stable for years. My generation sees opiates as medicine not drugs and treat it as medicine. I keep my medication locked up in my safe & use it as directed but some use it to get high or sell it but should pain patients be punished for other folk’s bad behavior?.
I never took so much as a Tylenol until I was injured and was once a skeptic of how anyone could be in that much pain since nothing ever hurt me before so those people were just weak. I do know that the insurance companies met in a closed door meeting with the CDC/FDA/DEA before these “guidelines” were put in place so it makes me wonder if some of this is financially motivated.
I keep hearing about the number of opioid related deaths each year but how many were pain patients? how many were heroin? how many were suicides? if someone wants to die they will find a way just like the folks that blame guns for suicides, that is an emotional reaction to the problem not a rational one.
Please don’t let this become a political or financial issue, anyone can find themselves in our position and in need of more than 90MG a day of opiates just to have some quality of life. This opioid crackdown will do far more harm than good which is one of the reasons for me writing about it now, but people will dig in on this due to one reason or another instead of considering the millions of Americans with a legitimate need for these medications.
Anyone that believes these medications are the problem, you haven’t been hurt bad enough, they do take the pain level down to a 6 for me, it isn’t right for insurance companies to coordinate with the CDC/FDA to save billions and give the illusion that they have a fix for drug abuse and then force the DEA to do their dirty work.
I know that the DEA agents don’t enjoy enforcing these new laws, I was in law enforcement with my brother a cop and several friends that are or were cops so trust me LEOs are not the bad guys but have to enforce laws we don’t like or even agree with but that’s the job.
If a member of congress, insurance company CEO, head of the FDA, needed 180MG of oxycodone for their injuries do you think the 90MG limit would apply? I guess that was rhetorical because they would be treated as individuals with their doctor deciding what level of pain is acceptable with the proper amount of opiate medication.
It will take folks looking out for their neighbor to correct this one and we will suffer until someone with power helps us or enough people speak up, I went from mobile and very low medical costs to needing CAT scans and MRI now off o a neurologist as pain shoots to my head.
A year from now ODs will be higher and pain patient suicides will rise a lot, the druggies will still be high, drug cartels will celebrate, crime will rise, and good folks will suffer because this wide brush shouldn’t be used to paint all pain patients and doctors.
Thanks for reading if you made it this far and I will pray that someone in power takes another look at this issue because I went to church, I worked hard, I’m a Veteran, was a LEO, I don’t take drugs or drink, I voted, now none of it matters and to the folks with worse conditions I wrote this for you too and I hope you let folks know what you are going through, write or call state/federal lawmakers before this gets out of hand.
I have an idea– why don’t they become harder on repeat drug offenders and also spend money to make more GOOD rehabs that drug addicts may enter immediately instead of telling them they have to wait months. They will not go if they have to wait! I know this as a RN and from people I know and have tried to help.