Response to People in Pain
CDC Guidelines for Opioid Prescriptions
The CDC Guideline for Prescribing Opioids for Chronic Pain, published by the Centers for Disease Control and Prevention (CDC) in March 2016, was meant to provide recommendations for prescribing opioids. It was not meant to mandate policy. Since then, states have developed their own restrictive guidelines for prescribing opioids largely based on the CDC prescribing guideline.
Proposed federal restrictions on prescribing might increase the difficulty of finding doctors who are willing to provide pain patients with opioid prescriptions. The U.S. Drug Enforcement Administration (DEA) is working to decrease the production of opioids while pursuing legal action against an increasing number of doctors who prescribe opioids.
Doctors Face Pressure from Government Agencies
Pressure from government agencies such as the CDC and DEA have caused many doctors to make difficult choices. Many doctors no longer want to take on new pain patients, and some have chosen to discontinue treating their existing patients who report they need opioids to manage their pain.
Many patients have reached out to me and asked for my advice. Every story is unique and reflects an individual’s personal suffering. But there are similarities.
Pain Patients Reach Out for Help
Patients tell me that they are in debilitating pain, and opioids have been helping them manage to get through the day and live some semblance of a normal life. In some cases, patients have used opioids for decades and have experienced no negative side effects. They have not become addicted, and they putatively have not displayed any aberrant drug-related behaviors. Still, their doctors have informed them they can no longer prescribe the opioids they need. They have not provided a referral to another physician. When patients try to find another doctor, they encounter resistance from doctors who believe they are drug seekers. These patients fear that, without opioids, their ability to function will be jeopardized, and they don’t know where to turn for help.
Here Is My Typical Response:
It is a terrible time to be in pain. Most doctors don’t want to accept the risks associated with prescribing pain medication. People in pain are paying the price for a large number of people who have abused drugs. I am not suggesting that everyone who abuses drugs does so by choice, nor am I saying that anyone abuses drugs to intentionally cause people with pain additional suffering. But the fact is that people who suffer from the disease of addiction are making it more difficult for people with pain to get treatment.
I don’t know where you live, but I would suggest you contact your state medical society or county medical society. You can find one here: https://federationdirectory.ama-assn.org/federations. Ask if they can recommend local doctors who are willing to treat people in pain. They should be able to provide you with a few names.
When you find a physician willing to see you, be honest with the doctor. Don’t try to conceal anything. Acknowledge that you understand the doctor is under a lot of scrutiny, and ask if he/she would be willing to help you. If you request a particular drug that has helped you, it may sound as if you are drug seeking. But if you are certain you know what has worked in the past, then tell the doctor. See if being transparent will help you develop the relationship you need to receive the treatment you deserve.
I wish I could do more. I also wish that doctors felt they were able to do their job and treat people who needed opioids to manage their chronic pain without fear of personal risks. Unfortunately, I can’t. Someday, there may be an easier path to effective and affordable treatment for people in pain. That day will be welcomed by all. I wish you well.
Currently, opioids seem to be the only therapy that helps some people. They don’t help everyone. But, for many patients, they are the only treatment that can potentially ease the pain and allow them to function. The long-term solution is to find non addictive pain medication. But, for now, we should use the tools at our disposal to do the best we can for those who hurt the most.
Lets not forget about patients like my self….an RN who has benign Hypermobility (EDS) and suffering, no quality of life. Better off dead.
Elizabe, my heart goes out to you, especially as a medical professional, that you are having to be in such pain. I’m sure this has impacted your career and passion for helping others. I was on opiates/in pain management for 15 years and then taken off of them/NEVER failed a drug screen or a pill count, EVER. I too feel that life isn’t worth living/can barely function (have no friends or family either). Saw 8 doctors who refused to help. I’m done with the health care community. There comes a point where a person snaps. I’d rather be killed or die suddenly than live like this. Some people truly don’t understand/just say, “oh, stay positive.” Very few people understand what it’s like to walk in these shoes. I don’t know your situation intimately but can grasp your sense of desperation.
This is true. If knowing how much my death would deviate my children, I wouldn’t be here now. I fight through Hell every second of every day and night for them. My pm office falsified data on urine tests in order to get everyone off opioid meds! That shaddy (probably illegal) way to stop prescribing is just Wrong, but they don’t care and a Lot of drs have been doing that exact thing all over not just NY. I get why drs are scared, but they are Supposed to be much Better than us and follow Their Oath!
Had doctors rebelled against this insanity from the beginning, we’d likely not be here. Or at least there would be a chance to not be here. By cowardly giving in to the horrible moral hazard of choosing the State over their patients, they’ve committed the same crimes that got Nazi medical people hung. The Nuremberg defense didn’t cut it then and it doesn’t cut it now. If you willingly and intentionally inflict harm on your patients you have committed a crime against humanity.
I will not feel sorry for physicians. They make a lot of money and they are entrusted with the lives of their patients. And they have betrayed us. And in that betrayal they have taken the lives of our people solely for their own convenience and expedience.
I do not feel sorry for doctors for the same reason I don’t feel sorry for Nazis. We are all obligated to act morally in this world, even at risk to ourselves. No doctor can murder a patient.
I agree, the Drs. have let us all down. I am a retired RN and I was always my patient’s advocate. Pain forced my retirement and before opiates I was housebound and isolated. I got my life back when 10 years ago after we tried everything my GP prescribed hydrocodone. That Dr retired b/c I think she saw this coming. I told my present M.D. to her face that she had no compassion and is failing cpp. She did admit to me the government is running the show. Why haven’t the medical profession fought for us??
We are being treated as less than human. The future is bleak and I just feel hopeless.
Because they’re being persecuted, having their licenses taken away and being driven out of business. The sad thing is that had they banded together, like they have in their fights against alternative medicine (because THAT impacts their income, which counts more than anything, obviously), they could have changed this. They could have stood up to the government, they are an extremely powerful lobby. Instead, yes, they caved and are selfish COWARDS. I’ve even spoken to doctors who have bought into the false opioid “epidemic,” failing to review the abysmal quality of the study(ies) used to justify claims by that horrible organization PROP and casting all critical thinking skills aside. The good docs who are out there still trying to treat patients are being harassed, intimidated and threatened. The person who likened this to Nazi Germany is absolutely correct. We no longer live in a democracy — there are a plethora of signs about this, but people are too busy with The Voice, Twitter and their kids’ soccer games to recognize that our rights are disappearing to a government overrun with corruption and narcissism. You go, America!
It is sending chronically ill/pain patients to seek help from the street dealers when they are shut off by the very doctors who pledge to do no harm. Either they seek help where they can or at worst stop trying. My heart breaks when I read about yet another chronic pain patient has given up hope inan online support group I am in and their spouse or family member actually posts to let us know they are gone.
If you are a proven “good”, compliant patient, but your doctor gets scared and dumps you after over a decade of positive interactions and treatments, there is a huge problem. Unfortunately, too little too late for too many.
#waronpatients