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Despite CDC Change, Doctors Remain Terrified of Opioid Addiction; Pain Patients Suffer

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Pain patients are left to suffer as doctors remain terrified of opioid addiction, despite the recent changes in the CDC guidelines. The Centers for Disease Control and Prevention (CDC) issued guidelines in 2016 to reduce the number of prescriptions for opioids following years of liberal opioid dispensing. The number of prescriptions for opioids contributed to addiction and overdose deaths—which helped spread the opioid epidemic.

The CDC guidelines influenced doctors, state regulators, health insurers, and even disability administrators to justify policies that limit prescriptions on painkillers. However, the CDC recently clarified its position, saying that the response to the opioid crisis went too far.

Dr. Joshua Sharfstein, former health secretary of Maryland and health commissioner of Baltimore, said he supports the CDC’s decision to clarify the guidelines in a way that reconciles the risk of opioids with their need.

“The right thing is to follow that balance,” Sharfstein said. Now a professor and vice dean at Johns Hopkins Bloomberg School of Public Health, he believes the guidelines “shouldn’t be used as a kind of cudgel to reduce appropriate prescribing.”

But pain patients are still suffering from reduced opioid prescriptions because doctors are still worried that their patients might get addicted to opioids. The current opioid epidemic is now being considered the worst drug crisis in US history, with over 130 Americans dying every day because of an opioid-related overdose. This is mostly what causes concern among physicians prescribing opioids.

But the ones who suffer from limited prescriptions are the patients who actually need opioids to manage their chronic pain.

New York resident Mickey Saxbury, for example, suffered from throbbing back pain from an on-the-job injury that forced him to retire. He said that only his pain medication helps manage the pain consistently.

Saxbury is affected by the decision of the judge overseeing his New York State Workers Compensation Board disability case to sharply reduce his opioid prescriptions. Click the link to see Poughkeepsie's top rehab placement programs.

Saxbury took oxycodone, a powerful opioid, to manage his lower back pain. His prescription remained steady for several years: 30-milligram pills, four times each day. But the New York State Workers Compensation Board tapped a medical expert to review Saxbury's medical chart. The expert, Dr. Chris Grammar, who never physically examined Saxbury, concluded he was being prescribed unsafe levels of opioids.

“They dropped me so far down that I can’t even get off the couch anymore,” said Saxbury, 61, who lives near Buffalo. Saxbury said his doctor cut his daily pain prescription by half. He can no longer muster the energy or tolerance to do many daily activities.

In his report, Grammar cited the state’s non-acute pain medical treatment guidelines as well as data from the CDC on overdose deaths linked to opioid prescriptions. He added that Saxbury’s pain doctor’s high dose opioid prescriptions are “no longer supported”.

“This is not to be critical of his treating physician as this approach is relatively new,” Grammar wrote. “However, in the absence of functional improvement, this patient is undergoing extraordinary risk with little benefit.” This led to Saxbury’s pain medication prescriptions being reduced.

Chronic pain patients like Saxbury are becoming more vocal about their situation because they feel as if the medical community is shutting them out. The patients question whether the revised CDC guidelines will bring them relief. Saxbury said he pleaded with his doctor to reconsider the pain pill prescription, but he was unsuccessful.

“My pain-management doctor said they cannot give me the medication because they could lose their license,” he said. “I'm between a rock and a hard place.” “With few exceptions, the patients are innocent,” Grammar said. “They're not writing the prescriptions.”

As of October 2018, 33 states have passed laws that reduce or limit opioid prescriptions, as well as impose requirements on this type of prescription. This is according to the National Conference of State Legislatures. Most states limited initial pain pill fills to seven days, while others imposed even more aggressive cutbacks that limit fills to three of five days.

Because of the opioid epidemic, and the subsequent actions against it, US opioid prescriptions have declined each year since 2012. This trend accelerated since the CDC issued guidelines. Total prescribing dropped from 46 billion morphine milligram equivalents in March 2016 to 32 billion morphine milligram equivalents in September 2018. MMEs are a measure of the amount and potency of opioids.

Pain patients are now also struggling to find doctors who would treat them, with many family doctors fearing disciplinary action from medical boards and dropping chronic pain patients altogether.

Sharfstein said “there's been a big whiplash” as doctors react to the opioid epidemic which was fueled by years of permissive prescribing. “Doctors were told they should treat pain as much as possible and now might be hearing the message they could get in trouble for any opioids.”

If someone in the family is struggling with opioid or alcohol addiction, it is important to seek help. A combination of medical detox and behavioral therapy can go a long way in the fight against drug abuse. But because every individual is affected by addiction differently, a comprehensive program tailored to their specific needs is necessary. Look for a nearby addiction treatment facility today and find out how drug treatment programs work.

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