Oxycodone tablets, narcotic

Deaths from opioid overdoses have been surging. The CDC reports that fentanyl and its chemical cousins are increasingly responsible for the dramatic increase in casualties (CDC Health Alert Network, July 11, 2018).  Much of the fentanyl is counterfeit and is manufactured abroad. Headlines and soundbites on the evening news highlight the war on opioids but ignore the after-effects for people in pain.

Demonizing Opioids Injures People in Pain

There is a downside to demonizing opioid pain medicines. Many chronic pain patients have been denied access to drugs like hydrocodone and oxycodone.

That’s because of pressure from the CDC, the DEA and insurers to discourage prescribing or dispensing of opioids. Many well-intentioned experts believe that overprescribing pain medicines is behind opioid misuse and overdose deaths.

The message is that opioids should be used only for acute pain such as after a serious accident or surgical procedure. Health professionals are being told that prescribing these drugs won’t help patients in chronic pain. But most patients are not being offered alternatives.

The FDA Listens to Patients in Pain

The Food and Drug Administration held hearings this month and patients in chronic pain voiced their frustrations (FDA Meeting on July 9, 2018).  You can watch the videos of the:

Morning Session at this link

Afternoon Session at this link

The Other Opioid Crisis for People in Pain:

Many people in pain complained at the FDA meeting that the medications that helped them function previously are now being withheld, even if they took them precisely as prescribed.

One patient who testified at the FDA hearings was a disabled registered nurse with cervical scoliosis and ruptured disks that cause unremitting pain. She has been treated for a decade, going to the pain clinic each month and seeing her primary care physician every three months. Although she never was identified as a problem patient, she is now unable to access the pain medicine that allows her to function.

The Government Makes Opioid Access Challenging:

Many doctors have been intimidated by government restrictions on opioid prescriptions. The CDC has issued guidelines that discourage the prescribing of opioids for chronic pain patients (March 18, 2016).  Patients in severe pain may feel as if they are being treated like drug abusers or criminals because of this CDC recommendation to physicians:

“When prescribing opioids for chronic pain, clinicians should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.”

Medicare and Medicaid Dosage Restrictions:

Millions of pain patients could be impacted by a new proposal. The decision by the Centers of Medicare and Medicaid Services (CMS) not to cover opioids above a given dose next year is likely to make the problem worse for people in pain.

We have heard from hundreds of people in pain who are desperate as a result of these restrictions.

One person wrote:

“I have more than I can handle just typing right now. The pain meds don’t make it so I can walk. At times, I even try not to drink anything for fear that I might have to go to the bathroom.

“If the restrictions get even tighter, I won’t be able to tolerate it. I only tolerate it now so I don’t leave my golden retriever alone. He’s the reason I haven’t killed myself already.”

Another man wrote:

“I had back fusion surgery involving multiple vertebrae. It left me worse than before. I’ve been on [opioid] pain meds for five years, with a drug test every month, and I have never caused any problems.

“Now the doctors are cutting my meds so much that my quality of life is zero. It was bad enough before. I am considering suicide and I wonder if that is what they want.”

Erin in Reno Nevada shares this story:

“I have been looking for nearly a year now for a doctor to help me with my chronic pain. Because of the limitations that the DEA and now the state has put on doctors, the majority do not want to prescribe opioids.

“I moved from California to Nevada for retirement. I am having to drive to California to my doctor there to get my prescriptions because no doctor wants to prescribe what I need to control the chronic pain I live with 24/7.

“It’s horrible how the doctors and the DEA are treating patients in pain. We are just trying to live a normal life. We get our meds the right way. We do not abuse our medications but we are treated as if we are drug addicts. It is sooo unfair.”

Jeff is considering suicide:

“I’ve had 381 total surgeries. I’ve always done the right thing, whatever the doctor has told me. I have never taken more medicine than I was supposed to. Now they look at a computer and say we have to cut your meds since the computer says so.

“I use ice, constant getting into a tub of ice. It’s great for a few minutes. The only option I can come up with is to now drink enough alcohol and see if that helps. IF that won’t help then I’ll be looking face first down the end of a gun barrel. I can’t stand it and I’m not living in an ER any longer.

“People who have abused the medicine have made it terrible for the ones that need it. My life will have to end without any help.”

What About Cancer Patients?

Even cancer patients are not immune to the increasing restrictions:

“My father attempted suicide last week because the director of his pain clinic abruptly cut all his pain meds. He suffers irreversible chronic cancer pain!”

Not every person in chronic pain is considering suicide. But they all deserve compassionate treatment to alleviate their agony.

Read more stories at this link. Over 700 people have shared their experiences here.

What Will People in Severe Pain Do Now?

Where are the Alternatives to Opioids?

Opioids have been used for more than 5,000 years. They are powerful analgesics. Until drug companies develop more effective and safer alternatives, decision makers need to recognize that people with intractable pain deserve relief. For some, that will require opioids.

Keeping illicit fentanyl and its derivatives out of the country might be a more productive way to control the opioid epidemic that is killing people.

Share your own story below in the comment section.

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  1. Mark
    Oceanside California
    Reply

    So today they’re taking away the peoples opioid pain medication. What’s next? Most people on pain medicine have had their medications cut in half. Know if Ann’s or butts. What’s next cut heart medication in half. Cut diabetes medication in half. Why can the government play doctor. It’s wrong it’s totally wrong. But who’s going to stand up to the government. Maybe next week the doctor cut my blood pressure medicine in half. I work at a Hospital. Can you do an a lot of things to help the opioid crisis. One of them that really makes me angry. Yes well the pain pump.

    When you get out of surgery usually go to your room With a Pain pump. Now this pain pump might have morphine or Dilaudid. This pain pump let’s patient control her pain medicine as needed. The patients are usually honest from 24 to 48 hours the new taken off of it and give the other medications by mouth. Well my hospital is giving the pharmacist the power to cut the pain pump from 36 hours to 24 hours. Remember Pharmacist not a doctor. Now did the hospital say this would help the opiate crisis. No they said it’s going to save them one million dollars. So is it about the opioid crisis or is it about money. I’m so mad I don’t know what else to say but goodbye

  2. PAB
    SW Oklahoma
    Reply

    I am 54 yo. I have multiple debilitating and degenerative health condition that affect my spine, knees, hips…pretty much every from the waist down. I have neuropathy, a neurogenic bladder, and have lost most of the feeling in my saddle area. So sex is no longer a pleasurable experience. I lost my career, I’m unable to do most of the activities I love. It’s like my old life died and I had to start over.

    I have used opioid pain medication around the clock for the past 8 1/2 years. These medications have taken the edge off my pain and given me an improved quality of life. I’ve grieved my old life and have found new ways to stay active; light exercise, Sewing and crafts, working in my greenhouse, spending quality time with my husband and adult children, and I was able to join an extension agency group. I hope to be a grandmother someday.

    Well, last month my meds were cut. My dr is working on getting his patients down to 90 mme. I do not blame my dr. He is not happy about any of this either. He is trying to protect himself and his medical license. He’s contacted state and federal agencies and representatives expressing his concerns. And I’ll be honest, I feel like any dr who consistently speaks out about how opioid pain medications have helped their patients are often targeted. Look at what happened to Dr. Tennent.

    My insurance is now requiring a prior authorization every 4-6 months to fill my pain medication. I fear they will quit paying for them. They already terminated their contract with my pain management dr and I have to pay out of pocket.

    I’ve always taken meds as directed, never tested positive for any illicit or drugs that were not prescribed to me, I’ve tried all of the treatments I have access to to try to treat the pain. So far the only thing that works is opioid pain medication. I just want to have some quality of life. I have already lost so much and now I’m concerned I will lose what I have left.

  3. Eddy
    Reply

    I have a progressive demyelinating disease which causes excruciating nerve pain. My pain specialist cut my pain meds in half 3 years ago, and now he’s cutting them again. I’m 68 years old. I do not abuse my pain medicine, and it scares me that my pain medicine can be reduced again. My body tolerates the fentanyl patch, and I do not have the nausea associated with taking hydrocodone. When I go in for my urine test I’m scrutinized to see if I’m taking some kind of illicit drug on the side. It’s upsetting to go through this process but it’s the only way I can get my needed pain meds.

  4. Torture in Texas by Joe A
    Texas
    Reply

    My mother in law is 74 and was active, taking care of herself, and getting physical therapy. Six months ago her doctor cut her medication in half that she had been safely taking, at the same level, for 20 years and may cut it completely. The doctor said she was afraid of the Texas Medical Board and DEA. The doctor also said that my mother would experience similar restrictions from any other doctor in East Texas. She is now in constant pain; she no longer is able to do her therapy and never leaves the house without assistance. A visiting nurse and therapy provider both called the Doctor and told her how bad things were, to no avail. She is being tortured by the CDC, Texas Medical Board and DEA. I am shocked that the medical community has not fought back on behalf of their patients. They are the only expert advocates they have.

    Now doctors cower in the corner and allow their patients to suffer needlessly. If she complains, she’s an addict. If we complain, we are enablers. I pray somebody with influence reads this and many other stories and does something. I have called my congressman, senator and local officials. They seem to believe the salacious stories prevailing in the current news that pain medication is the root of all evil. Help, please someone help.

  5. Barbara K
    NC
    Reply

    Cannabis, Not Opioids. No one dies from Cannabis.

  6. Virginia S.
    Upland CA
    Reply

    THANKS for your recent column giving voice to many chronic pain sufferers! I understand the DEA and CDC concerns about opioid abuse and overdoses. However as you so aptly stated “demonizing these pain meds” (and the patients needing them) has been a terrible disservice. I am a 78 year old retired R.N. and Nursing instructor. After 45 years of service I am experiencing the results of all the wear and tear on my joints I.e. OA of knees, bursitis of hips, spinal OA and stenosis.

    I eat a healthy diet, do water exercise 3 times a week, maintain normal weight, and volunteer many hours. One of these very pleasurable activities is with seniors who request medical information, interpretation of lab/X-ray results, and generally someone who listens and cares. Many have experienced what your article refers to as “complaining that meds that helped them function previously but are now being withheld, even if they took them precisely as prescribed.”

    Thankfully I have a very good relationship with my internist and have not yet experienced this egregious behavior, but I wonder what will happen as the government agencies become more zealous! As active seniors, we still have much to contribute and enjoy IF we are enabled to do so without government interference between us and our physicians. Please continue to be the voice for chronic pain sufferers who just want to be comfortable in our “golden years.”
    Virginia, retired R.N.

    Sent from my iPhone

  7. Natalie
    Pennsylvania
    Reply

    A big problem lies with our predominant, mainstream medical/scientific field researchers lack of empirical knowledge or useful guidance and treatment plan options on the human body and brain’s inner workings and an individual’s biological processing of drug addiction, drug tolerance, and drug withdrawal for general doctors to utilize. Medical “Specialists” of course may be aware of those things, but with how the healthcare system and insurance is ran and setup today- it is almost impossible to be treated or even seen by a “specialist” in an acceptable timeframe, if ever at all.

    So our undereducated, overworked general doctors suddenly quit prescribing their (in-need, law-abiding) patients’ medication without any concern, nor advice or optional treatment, therefore subjecting their patients’ to the many dangers of withdrawal symptoms (some being even fatal)- which then may lead said patients’ to an early “natural” death, suicide, or to them taking to the streets or online to find their own alternative treatment. This usually ends up being an unregulated, unsafe, unhealthy or illegal alternative treatment- like heroin, fentanyl, meth, crack and/or excessive alcohol consumption- all lethal and usually fatal choices of alternative treatment. Which all could have been avoided by the right knowledge, care, and physical help/treatment from their Doctor.

    So now we will just be seeing even more people overdosing/dying on heroin/fentanyl, and the suicide rate stats rise even higher than the high rate they are already at today. But no one of any real power seems to care…

    This is absolutely heart-wrenching to hear. The US healthcare system is destroyed. Phd-less and usually daft health insurance agents get to decide our medical treatment (or rather non-treatment) today, not our doctor. Our doctors, PAs, and nurses are now technically owned by huge medical/hospital corporations (which in-turn are owned by one of those huge billionaire monopolized business conglomerates). These medical/hospital corporations’ CEOs, CFOs, and/or Board Chairmen are in decisive cohorts with and monetarily enslaved by those huge monopolizing business conglomerates, as well as that particular conglomerates’ choice health insurance corporations or “providers” existing today. And ALL of the aforementioned are indentured to the proven corruptible and politicized CDC & FDA & DEA- whom are all in bed together along side the ever negligent & corner-cutting “Big Pharma”- who is funded/invested in and “controlled” by the handful of deviant billionaire “powers that be” (a.k.a. the “ONES” with ALL THE MONEY are the ONLY ONES in position to and who truly create & control the agenda). You’ll even notice the few chain pharmacies in business today are also subjugated to or coerced by certain health insurance and pharmaceutical companies/brands.

    Healthcare today has completely turned into a cash grubbing scam propped up on seedy Wall Street now- in our big greedy DEAD-END OLIGOPOLY ECONOMY. Fits perfectly into our country’s obvious (but fortunately currently floundering) Oligarchy.

    And THAT is the whole truth and the obvious MAJOR problem at the root of the matter.

  8. kathy c
    Mesquite, TX
    Reply

    I am in the same boat that you all are in. How do we fight this? What organization can we work with to be heard? How would be lawmakers feel is ALL pain relievers were banned? I will not be able to work if they take my medication away. I do not have social security so I am not eligible for even disability.

    How will I support myself? I made a promise not commit suicide until my mother passes away, but if we are both in pain it might be a murder/suicide. I am tried of people passing judgement on me because I take morphine. Lots of animals that I could have helped will suffer from my absence.

  9. David
    Reply

    I’ve written before about all the restrictions,and removals of our opioids that the government agencies feel will stop the opioid abuse and deaths. I’ve had to fill out new forms for my doctor,my state, counting of pills, urine tests, threats of my prescription being stopped or cut to levels that will leave me in constant pain.

    I have degenerative hip disease,back,and can no longer walk since I no longer have a hip socket or ball. The pain can be excruciating
    as like a hip fracture,and my back is also in constant pain because of no pelvic stability. No one wants to do surgery, plus I am prone to infections that also scares surgeons away.

    I have told them to do it whether I die or not, I don’t want to live like this not to mention working for 40 years and now my Medicare wants to tell me that I don’t need my meds, it costs to much but I paid for then and I pay for it now.

    And the government thinks they are capable of making decisions for my health care when they don’t know a thing about me. I don’t tell people what to do and I would never want the responsibility of the potential problems I would cause someone because of my ignorance and stupidity . Just leave me and my brothers and sisters medical problems between us and our doctors, and find something else to waste our tax dollars on.

    I am so mad , hurt , and frustrated that we are treated this way . I never asked to become disabled and in one night my life changed just by getting out of bed.

  10. Carolyn E.
    Vermont
    Reply

    So, according to the statistics I read, 60,000 people died in the US in 2016 from overdosing on medications. That same year 220,000 people died due to mistakes made by hospitals and doctors. The latter statistic rate will no doubt go up due to suicide by the people that no longer can stand to live in their broken bodies without any relief from their pain.

    For the doctors that are so narrow minded that all pain medications are either good or bad, black or white, etc., I hope that you or one of your loved ones never have to suffer like we do. Although, if you experienced first hand how pain can affect family, work (if you’re still able to) and all other aspects of your life, perhaps you would be more able to see the whole accurate picture and not what you see from sitting behind your computer and listening to only half of what is told to you.

  11. Barbara K
    NC
    Reply

    Cannabis is the answer. Pain goes away, and no one dies from it. North Carolina Needs This.

  12. Lois J
    North Carolina
    Reply

    I receive my pain medication, Tramadol, for chronic pain I have been living with since 1980, at a pain management clinic. I sign a contract stating I will not obtain pain meds anywhere else, I am given urine tests twice a year, and can fill a prescription for only one month’s supply at a time.

    This is why we have specialized clinics for the MANAGEMENT of pain, which I live with ebery day. I would be unable to live independently, drive or help others if I could not manage the pain. I do not get “high” as my body needs the medication for the pain. The people getting”high” and abusing the drugs are either taking too much, or probably don’t need it at all. CHRONIC pain does not go away. In fact when you have a progressive disease as I do, it only gets worse over tbe years.

    Legitimate pain management clinics are not the problem. It’s doctors who continue to give meds for acute pain. If the pain continues reger your patients to pain specialists! I’m horrified to think my insurer could be trying to stop pain management clinics to take patients with known chronic conditions off necessary meds. God help me if that happens to me!

  13. Oliver
    New Zealand
    Reply

    I am so glad I live in New Zealand where doctors are realists although the same thing did happen in the 1970’s when opioids were very hard to obtain. Today this is not the case and long may it continue that way as it is totally unnecessary for anyone to suffer acute pain. With right wing politics prevailing in America I feel intense sympathy for those in this position but am not surprised at the knee-jerk reaction

  14. Linda
    Alabama
    Reply

    I have some of the same issues as already stated. I’m 70 years old with fibromyalgia back problems resulting in two surgeries bad arthritis and so on. I can no longer tolerate NSAIDS due to stomach issues. I’m using long-acting acetaminophen and Tramadol but now the drug store and my insurance are doing everything they can to make me quit the Tramadol. WHY???

    Like the others who have written I never took more than was prescribed always followed the doctors’ recommendations and now I am being treated like an addict. I just want to be able to function some of the time. Is that asking too much?

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