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

Posted by 19lin @19lin, Nov 3, 2016

There are many pain groups that are taking issue with the decision of the government agencies to reduce the availablity of opiods. I suggest that any one who suffers from pain, whether they use pain medicine or not, needs to let their elected offical know how they feel about cutting pain medicine to chronic pain suffers. There are many groups out their although Mayo's is one of the few with a discussion board. Some of the others are Peoplewithpainmatter.org; USpainfoundation.org; Pain News Network and others. Some of them are sponsoring a campaign to write to your represenative about pain issues. Even if you can manage your pain without medication there are others who need the extra help of medication. This constant attempt of politicians to interfere between a doctor and their patient is a dangerous trend in my opinion. Medical doctors have a lot to do and think about without worring about if they perscribe some pain medicine will they end up in court defending their license to practise. One thing we all need to do is be aware of the events that effect our lives, beyond the immediate need for treatment. Too often the law makers over react to events without considering the long term effects of their actions. There is a group who is pushing for ways to prevent abuse of pain medication and that is fine, but if they do things their way they will stop all pain medicine except for terminal cases and emergy needs. This is why we need to contact our law makers and let them know that any law they pass can have an adverse effect on long term sufffers. Many people use strong pain medicine so that they can continue to work and carry on with their life in as normal a matter as possible. If the medicine is stopped then they can't work or take care of their families or even lead a near normal life. (Sorry the spell checker is not working) 19lin

Interested in more discussions like this? Go to the Chronic Pain Support Group.

@david56

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.

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@david56, I have updated information. New members can post links once they have been a member for 10 days or have made 3 or more posts on Connect. This is a safety precaution to prevent "spammers" on Connect. I look forward to seeing more posts from you on Mayo Clinic Connect.

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@IndianaScott

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.

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Yes, the over-prescribing and overdosing are a public health emergency, as stated by the National Institutes of Health. I have seen that emergency first-hand, up close and personal (I am active in the healthcare field). And no, my concern is neither sound regulation nor privacy. In its attempt to address the public health emergency, the CDC's guidelines are so strict that people with chronic pain and a legitimate need for pain relief are left hurting.

I am determined to reverse the "one size fits all" policy of CDC (as to opioid prescribing) and the blanket policy against use of opioids for chronic pain. The CDC guidelines are ostensibly "voluntary" but have had a "chilling effect" on physicians who fear consequences for crossing those lines. Patients with chronic pain often do rely on opioids -- they are "dependent" not "addicted". The CDC guidelines are too restrictive for that vast majority of patients with chronic pain who are responsible and compliant patients ... patients who do not ask for increasing doses, do not abuse their prescriptions and are compliant with monitoring programs.

When a non-addictive and highly effective pain medication is available, we will all be better off.

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@david56

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.

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Yes, Fentanyl is "legally" available only by prescription ... very true. The problem comes from "illegal" Fentanyl from China and Mexico ... street drugs.

As reported by NPR (Aug 25, 2016):

A report from the Centers for Disease Control and Prevention says that there was a 426 percent increase in seized drug products that tested positive for fentanyl from 2013 to 2014. And separate data show the number of deaths involving synthetic opioids, a class that includes fentanyl and tramadol but not hydrocodone, rose 79 percent during that same period. That suggests, the authors say, that illegally manufactured fentanyl is driving the spike in overdoses. (Deaths attributed specifically to fentanyl aren't reported in national data.)

Note from david56: the above also points up a flaw in the gathering of statistics.

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@IndianaScott

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.

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As my wife's use was based on hospice care, I will gladly bow out of this discussion.

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@predictable

@barbara94, my understanding of the DEA's authority is that it focuses on drug manufacturers -- setting ceilings on the amount of a medication that a manufacturer may produce AND sell. Its influence on pharmacists is indirect -- through the pharmaceutical manufacturers, as I understand it. Does this make a difference?

I'm not sure, but it looks like we patients have the power to make demands of our medical treatment teams as well as our pharmacists, without encountering DEA authority or enforcement. I'd be inclined to argue with my pharmacist, just as I argue with the first medical specialist who gives me a quick and convenient (for him or her) diagnosis and treatment plan. This is another chance to stand up against misguided medical advice.

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@predictable, I meant to reply to this post when you posted it. Our daughter and son-in-law, both pharmacists at the local VA hospital, and he, specializing in pain management, assure me that the problem isn't with "lack of supply." Rather it's government authorities believing they need to do something to look like they are responding to the illicit epidemic. Problem with that attack is, it penalizes legitimate, suffering patients, (as you well understand), and does absolutely nothing to curb the epidemic of substance abuse. This is what I wonder-- how adamant would these beauracrats be if a member of their immediate family suffered unbearable pain? I have to believe they would be more careful!

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@predictable

@barbara94, my understanding of the DEA's authority is that it focuses on drug manufacturers -- setting ceilings on the amount of a medication that a manufacturer may produce AND sell. Its influence on pharmacists is indirect -- through the pharmaceutical manufacturers, as I understand it. Does this make a difference?

I'm not sure, but it looks like we patients have the power to make demands of our medical treatment teams as well as our pharmacists, without encountering DEA authority or enforcement. I'd be inclined to argue with my pharmacist, just as I argue with the first medical specialist who gives me a quick and convenient (for him or her) diagnosis and treatment plan. This is another chance to stand up against misguided medical advice.

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@barbara94, I have no concern about a "lack of supply" and don't remember using the term. In fact, if I understand you correctly, we probably are on the same page of the opioid-control bible.

To lay out additional thoughts, some medical professionals are carelessly writing prescriptions for people who are simply addicts or in the business of supplying opioids to addicts. Pharmaceutical companies like these professionals because they are expanding the market for synthetic drugs; the DEA's control of drug output of each company is their legal way of attacking the supply problem.

Other medical professionals, wary of being branded by enforcement-committed government agents, have cut opioid prescriptions down -- sometimes to near nothing -- caring more for themselves and less for their patients. In those cases, the supply has shriveled, leaving dependent patients in pain and addicted patients in search of new sources, incentivizing suppliers. This behavior is attributed repeatedly to suspicions that CDC and the FDA are collecting data on individual medical professionals, pharmacies, and patients and, in doing so, setting them up for prosecution or, at least, public embarrassment.

A broad and inclusive strategy is essential. Instead we have "regulators," providers, physicians, and patients working in isolation from each other to solve their peculiar problems. They all need to sit down together, listen to each other, set aside their beliefs in favor of facts, and agree on an enduring strategy.

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@predictable

@barbara94, my understanding of the DEA's authority is that it focuses on drug manufacturers -- setting ceilings on the amount of a medication that a manufacturer may produce AND sell. Its influence on pharmacists is indirect -- through the pharmaceutical manufacturers, as I understand it. Does this make a difference?

I'm not sure, but it looks like we patients have the power to make demands of our medical treatment teams as well as our pharmacists, without encountering DEA authority or enforcement. I'd be inclined to argue with my pharmacist, just as I argue with the first medical specialist who gives me a quick and convenient (for him or her) diagnosis and treatment plan. This is another chance to stand up against misguided medical advice.

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@predictable, I'm sorry if I seemed to infer that you mentioned the supply end. Certainly didn't intend that. Just wanted to add to the discussion.<br>And you're correct that we are on the same page. You're just much more articulate than I.<br>Always appreciate your input.<br><br>

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