New CDC guides- scary

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New CDC guides- scary

Post  sconesail on Tue 15 Mar 2016, 2:58 pm

Hi All,

I came across this article and thought I would share it. It is really kind of scary.
CDC guidelines

Pain free days,
sconesail

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Re: New CDC guides- scary

Post  7777Trinity on Wed 16 Mar 2016, 10:53 am

Scone
I hate to think of a day when I am in excruciating pain that there will be no medication for me. It is frightening. Self Euthanasia would look really good at that point.

Trin
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Re: New CDC guides- scary

Post  Migrainegirl on Wed 16 Mar 2016, 6:08 pm

This is going to have serious ramifications for all the people who live with very real pain every day. Although supposedly "voluntary", compliance will very quickly get pushed into insurance requirements and many physicians are already afraid to write pain prescriptions for their patients. It's going to get very very difficult for people with chronic pain to get treated and there goes what little quality of life they have. I predict suicides will go up along with countless needed pain and suffering.

Just more red tape and more costs. I will very happily submit to a drug test as often as they like. But who pays for that? The patient at about $300 a pop. What about people who can barely afford their meds as it is?

I generally don't wish ill health on anyone, but it really makes me wish these people would live for just a few months with chronic pain, and then they can decide what these rules should be.

( I am a bit peeved about this)
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Re: New CDC guides- scary

Post  tortoisegirl on Wed 16 Mar 2016, 9:07 pm

I'm hopeful this won't have any significant impact for managing chronic pain with opioids. It appears that this is geared towards primary care physicians treating chronic pain, and a lot of this should be common sense.

Although I am all for treatment of pain with whatever it takes, including opioids: I have heard of people being prescribed 30 days of a strong opioid for injuries that would typically only require 3 days worth. Or, being prescribed high dose Oxycontin (a long acting med for chronic pain) to take for a week after a surgery. Or, opioids being used as a first line therapy instead of NSAIDs, pt, ice, etc, and before a diagnosis is made. Or, combining opioids, benzos, and sleeping pills.

I think these guidelines are meant to discourage prescribing more like that than saying don't use opioids for chronic pain. I agree with the articles associated with the guidelines that there is a real problem out there. However, some guidelines previous to this were much more restrictive (such as the one in my state of WA which quotes an actual upper recommended daily dose limit for chronic pain!), These new guidelines (and they are only guidelines) don't actually scare me.

I'd be curious on the stats for addiction and overdoses and the like which stemmed from starting to take opioids for legitimate pain based on whether the patient was prescribed in a way which met common sense guidelines or not...it seems like many issues stem from prescribing opioids too long for acute pain, prescribing a medication which is inappropriate, med combinations, starting with too high of a dose, not evaluating whether the patient is a high risk (ex. addiction tendencies), etc.

Or, in the case of overdose, whether some are suicides, especially in chronic pain patients. I'd think its more likely the majority of issues aren't from prescribing for severe chronic pain. Pharmacists can also flag some of these issues, but I've also heard of them going much too far.

For patients with documented chronic pain who have trialed other treatment methods which receive their pain meds from a pain management specialist (like me), I'd hope this doesn't have an impact. I think most patients are much better off seeing a pain management specialist by the time they are thinking about a long acting opioid for their chronic pain (or ideally, well before then); they have the training and experience that primary physicians don't.

Although I'm very glad my primary doctor started me on Methadone years ago as its been the only thing to significantly and consistently treat my pain, and I agree it was time to try a long acting pain med as we were out of reasonable options, he didn't have the experience he should have to prescribe it, and made some mistakes that could have been dangerous.

Plus he rather quickly escalated the dose when it wasn't helping enough, which has caused me some problems long term as it gets to a point that no one will prescribe for your tolerance level, even if you are getting less pain relief than someone on a fraction of the dose because they have a low tolerance. My dose was reduced down to lower than I first tapered up to. Best wishes.

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Re: New CDC guides- scary

Post  Porsche Fan on Thu 17 Mar 2016, 1:43 am

Everyone needs to contact their legislators and file a letter of complaint.  You do not need to disclose your medical/personal health issues, however in a letter of complaint you can say that medication helps your daily life.  Describe diseases / problems in minor detail.  Or call your Congressman and ask for a meeting, or it's possible to meet with a staff member.   Looking at the FDA guidelines, Ibuprofen and Acetaminophen have serious interactions with patients on other medications and others with health issues.  Amazing how the FDA ignored other health issues.  They'd rather have you develop a blood clot or have liver damage than take an opioid medication.  The primary treatment for pain, outside of an operation or procedure, and within the short term of 4-7 days includes opioids.  Outside of that, they want patients to take ibuprofen or acetominophen.  Hmm....that's open counter.  And those meds are not covered under insurance.  
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