Oregon’s Proposed Tapering Policy Is Still Undecided

Forced Tapering Proposal

On March 14, 2019, the Oregon Health Authority Health Evidence Review Commission (HERC) had planned to vote on a proposal that could affect thousands of Medicaid patients in Oregon.

The proposal would limit Medicaid coverage of opioids to 90 days for chronic pain patients. Those who have been using opioids for more than 90 days, regardless of their individual needs, would be forced to taper off the medication and switch to alternative pain treatments.

Letter to HERC

I, along with more than 100 other experts in pain and addiction medicine, public health, and bioethics, signed a letter to HERC that raised concern the proposal by HERC would cause harm to many people in pain.

In the letter, we raised our objections to the policy and explained that it “violates the very principles of patient-centered pain care that HERC itself declared foundational to pain treatment in Oregon.” Dr. Sean Mackey, chief of pain medicine at Stanford University, wrote that “evidence supports that this proposal represents an alarming step backward in the delivery of patient-centered pain care for the state of Oregon.”

This past week, the U.S. Food & Drug Administration (FDA) publicly issued a medical alert stating that sudden opioid discontinuation, like what is being proposed in Oregon, could be harmful to patients.  In addition, this past week,  the Director of the Centers for Disease Control and Prevention (CDC),  Dr. Robert Redfield, issued a statement that the CDC’s 2016 Guideline “offered no support for mandatory opioid dose reductions in patients with long-term pain.”

Tapering Policy Is in Limbo

As of the publication of this post, the policy appears to be in limbo. Oregon could be the first state to take steps to unilaterally taper opioids. That may have serious unintended negative consequences for people with the most disabling pain. Hopefully, HERC will reconsider their proposal before people are harmed from an ill-conceived policy.

Unfortunately, the problem isn’t limited to Oregon, either. As KARE 11 News in Minneapolis reported, doctors all across the country are increasingly refusing to prescribe opioids for their patients and forcing them to taper their medicine. They have few, if any, effective pain treatments to offer in exchange.

Reducing opioid prescriptions without addressing the need for adequate pain treatment won’t solve the opioid crisis. Oregon’s proposal is just one example of how many people could be hurt by hyperfocusing on the prescription opioid crisis while ignoring the pain crisis.


  1. Wilma L Ingram on April 14, 2019 at 2:05 am

    When valid pain patiens are allowed to suffer, after proving they do not over medicate, then those that suffer, should file lawsuits against those government official’s, and states that allow humans to suffer and or commit suicide.
    Funny how the alleged opide crisis should be about the rampet uses of meth, not opides !

  2. Terri McFarland on April 14, 2019 at 8:03 am

    We can only hope that at some point the powers that be in Oregon wake up. I’m a CPP and resident of Oregon and am being forcibly tapered presently. I believe they are trying to get all CPP on Oregon Medicaid off before any ruling so they can almost guarantee that a doctor won’t put patients back on medications. I’m about at the end of my rope. Thank you for advocating for the chronic pain community.

  3. Josh on April 15, 2019 at 2:09 am

    I only imagine that Ron Wyden is somewhere behind this proposal. He has been terrible when it comes to chronic pain patients. What is that man’s problem?!

  4. Pamela Check on April 15, 2019 at 4:55 am

    I am outraged. Oregon is making people in chronic pain suffer because they are poor. What does that say about Oregon? I hope nothing but pain and suffering for Oregon Health Authority Health Evidence Review Commission and everyone they care about or love.

  5. Lynn on April 17, 2019 at 2:13 am

    I have chronic pain and I’m on the low end of the dosage but 4 years ago a pain doctor said there was good reason why I’m in so much pain and now because of the opioid scare quack of a doctor said oh she’ll be fine on tylenol arthritis. I dont have that in my back I have more serious damage in my back. Hes just to chicken to prescribe me what I really need. He should retire cause hes to chicken to be a doctor. These people who are taking away the pain meds are the ones who don’t need meds but wait until they need meds they’ll get them and they wont think twice about it when they do.

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