The CDC and FDA are trying to cut back opioids by 25% nation wide

I agree that "the government is not trying to hurt anyone in this". The opioid epidemic is devastating indeed .... but does CDC have the right culprit?

The Pain News Network published this:

Fentanyl & Heroin Changing U.S. Opioid Epidemic
November 19, 2016
By Pat Anson, Editor

A prominent Alabama physician says the U.S. opioid epidemic has changed so profoundly in the last 3 years that a serious reconsideration of government policy is needed. STEFAN KERTESZ, MD states that "“Heroin and fentanyl have come to dominate an escalating epidemic of lethal opioid overdose, while opioids commonly obtained by prescription play a minor role,” Kertesz wrote in a commentary published in the journal Substance Abuse.

Kertesz says the Centers for Disease Control and Prevention relied on faulty data and failed to address the changing nature of opioid abuse when it released its opioid prescribing guidelines in March. Since then, many pain patients have reported their opioid doses have been lowered or discontinued, while some have been discharged by their physicians and forced to seek treatment elsewhere.

He likened the situation to Pontius Pilate washing his hands.

Thanks @david56, especially for your question, "Does CDC have the right culprit?" Did Dr. Kertesz answer your question? He said "opioids commonly obtained by prescription play a minor role." Isn't Fentanyl a common prescription drug? Is culpability linked to prescriptions? Are medical professionals responsible for reducing or discontinuing dosages? For me, the question remains unanswered.

Yes, the reference was to "heroin and illicit fentanyl" ... the fentanyl at issue is not from prescriptions but from cartels in China and Mexico. I am new to this site and not yet allowed to post links, sorry for the lack of sources. My point is that "prescribed" opioids--especially the carefully considered doses from the primary care physician--are not the "main" culprit.

That's helpful @david56. In this discussion, it seems to me we have been talking about culprits for two different human problems: First, growing widespread use of opioids obtained from medical professionals as well as illicit drug channels and, second, the shrinking supply of even licit opioids needed by chronic pain victims whose doctors are reducing to eliminating their needed dosages.

Medical professionals (including PCPs) are involved in both of these problems to some extent. I wonder why they are allowing federal law enforcement and health officials to override their decisions about the care needed by their patients-in-pain.

Yes, I recently was a guest columnist for "Pain News Network" (again, no link posting allowed yet) speaking to "government overreach".

In a valiant attempt to stop an "opioid epidemic", the CDC statistically linked pain pills with HEROIN. Lumping those statistics together produced some frightening statistics, but left the New England Journal of Medicine ("Reducing the Risks of Relief") and others questioning CDC's underlying research. There is simply not enough evidence for a "one size fits all" solution. The CDC guidelines are officially "voluntary", but have had that "chilling effect" on physicians who would not want to risk the time and trouble necessary to defend their decisions. Per the CDC, chronic pain does not qualify for opioid pain relief. The patient's chronic pain is at once acknowledged and also not addressed as to a solution.

So, when you wonder "why they are allowing federal law enforcement and health officials to override their decisions", it is a the "asymmetry of power" ... the physicians have less, and no time to fight it individually.

Thanks for the additional insights, @david56. Seems to me we're zeroing in on at least one primary culprit -- the Center for Disease Control (CDC). Hopefully, the CDC is not participating in any law enforcement procedure for recording detailed data on physicians' prescriptions issued or on patients' prescriptions satisfied. That would make the CDC a government agent for physicians to fear even more than the CDC "voluntary" guidelines for prescribing opioids. Reduced consumption of opioids is good news only to the extent that patients who need them are not denied them in an atmosphere of fear of government consequences.

Just as a point of reference, here is the data on opioids and Rx information. http://www.cdc.gov/drugoverdose/data/overdose.html

In our Indiana community opioids are out of control -- and yes, fentanyl is available by Rx only!

I am sure any number of statistics can be used to justify anyone's point of view and I am not trying to start any kind of argument, but the PRESCRIBING of opioids is cause for alarm and big pharma and individual doctors cannot be the source of attempts to control it. If we do not collect data we won't know squat!

See this link just for the increase in prescriptions for opioids. http://nationalpainreport.com/remarkable-increase-opioid-prescribing-u-s-8821689.html

Breaking the addiction to opioids is an immense undertaking, which is neither easy nor pain free. In my opinion the nation has to do something. It is wrecking havoc across America in rural areas, small towns, and large cities alike. It is a non-prejudicial attacker. Young, old, middle aged, white, black, native American, male, female.

Yes, regulation makes for a challenge, but then again we put up with regulation in our lives all over the place. We have to drive the speed limit, travel with a passport, show our drivers license every time we fly, we have to buy liquor only in certain places and at certain times, we must show our ID to buy a drink (if we are lucky enough to look young enough), and so we must adjust with opioids.

If your concern is privacy, I would suggest we are all at a far greater risk of privacy invasion by whatever Google, Facebook, Microsoft, etc. are doing with, selling, reporting, etc. the data every time anyone types in 'opioid' in a web browser!

If you want a real-world view just go into your local police station or sheriff's office and talk with a Sargent or two. They will tell you what opioids are doing right in your own area. I did both and it really was eye opening and helped me adjust my thinking about the degree of this problem.

Just my two cents plain.

Hello @david56, welcome to Connect. Not being able to post links is only a temporary thing for newer members on Connect. We are looking in to how long this will last and will inform you as soon as I find out. Thank you for your patience.

I thank you, sir. This Mayo site is new to me and has stimulating posts.