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Author: Shernide Delva
The opioid epidemic continues to worsen year after year. In 2015, painkillers and heroin killed more than 33,000 people, according to the CDC. About half of those overdoses involved prescription pain medication.
New policies and laws introduced in recent years aim to prevent the number of opioid prescriptions distributed. However, these stricter policies come riddled with negative consequences. For example, chronic pain sufferers are finding it more and more difficult to manage their pain with opioids now that some of these laws have been implemented.
An article in The Tennessean references a woman named Bridget Rewick. Rewick has experienced pain for all of her adult life. At 56 years old, she is on disability. She does not work and worries about the strain on her body from being out. Pain swells through her body causing her to need a cane to walk.
She has avascular necrosis, which means her bone tissues are dying faster than her body can repair it. Rewick uses opioid painkillers to manage her pain. However, these days, when she goes to the pharmacist, she says she gets looks. She admits she feels judged by the increasingly conscious medical community.
“I am almost afraid to go to the doctor sometimes to say I have pain,” Rewick says. “Because I don’t want be seen as a pill seeker.”
Unfortunately for Rewick, she has more than judgment to worry about. The recent federal crackdowns on drug abuse have resulted in stricter guidelines on the use of opioids to address chronic pain.
Opioid Limits State by State
In Tennessee, there is now a limit set by the Department of Health on how many daily doses of opioids doctors may prescribe. New guidelines spell out protocols for giving drugs to women of child-bearing age and establish certification requirements for pain medicine specialist.
Tennessee is not the only state seeing these types of policies. Across the country, new legislatures limit the amount of opioids and range of opioids that can be prescribed. Therefore, chronic pain patients are finding it increasingly difficult to manage their pain, without having to overcome assumptions and red tape.
In fact, some doctors have opted to stop prescribing opioids completely.
This leaves those with legitimate chronic pain with fewer places to turn to. While most chronic pain patients agree that it is absolutely necessary to tackle opioid addiction issues, they still believe there are legitimate pain sufferers who struggle to find relief.
“This epidemic has destroyed people’s lives, and I think the motivation (to regulate) is appropriate,” Rewick says. “But they don’t understand the ramifications of how pain affects people every day. … I am not expecting to be completely without pain, but I have the right to have quality of life.”
In the United States, at least 100 million adults suffer from common chronic pain conditions. Chronic pain is defined as pain lasting longer than 90 days. Chronic pain can range from disease to injury. Sometimes the cause of chronic pain is unknown.
Sadly, chronic pain reduces quality of life and productivity. It disturbs sleep and can lead to anxiety and depression. Chronic pain is the leading cause of long-term disability.
Building Relationships and Trust
Furthermore, it is difficult for doctors to know if a patient is authentic. No one can look a patient and know for sure if their claim of pain is insecure.
Dr. John Guenst, an internal medicine doctor with Saint Thomas Medical Group, sees chronic pain patients all the time. He believes the relationship is the most important factor.
“You have to listen to their story; you have to examine them, you have to start from scratch without your bias and turn over every stone that is reasonable,” he said. “You are giving patients the benefit of the doubt.”
Guenst said his opioid prescription rate “is very low compared to my peers, but I am not afraid to use them.”
Clinics Say No to Opioid Prescriptions?
Still, some medical professionals have decided not to prescribe all-together. Last year, Tennova, one of the largest health systems in Tennessee, decided to no longer prescribe long-term opioid pain medications to patients at two pain management clinics.
This was a response to recent CDC guidelines. Although the guidelines set by the CDC are voluntary, many doctors around the country are adopting them and are weaning patients off opioids or choosing not to prescribe them at all.
These sudden changes come with good intentions; however, it remains a tricky manner. Untreated chronic pain is connected to depression, mental illness, financial problems, and even further substance abuse.
What is the solution to this? Time will tell. However, it is clear this is a serious problem with an even more complicated solution. If you are currently struggling with substance abuse, please call now. We want to help.
CALL NOW 1-800-951-6135
Author: Shernide Delva
In an effort to curb what many consider to be the worst public health drug crisis in decades, the CDC has issued a series of guidelines and restrictions intended to reduce the abuse of prescription painkillers. On Tuesday, the federal government released these CDC standards, ending months and months of disagreements with pain doctors, and drug industry groups. However, many are still asking the same vital question: will these guidelines even work?
The CDC guidelines will be the first national standard for prescription painkillers. The guidelines are intended to provide a more sensible approach to prescribing highly addictive medicines. In the past, drugs like OxyContin and Vicodin were easily prescribed to patients. Although efforts have been made to reduce the amount of prescriptions prescribed in the medical community, these guidelines will further limit how opioid medications are distributed.
“This is the first time the federal government is communicating clearly to the medical community that the risks outweigh the potential benefits of these drugs,” said Dr. Andrew Kolodny, head of Physicians for Responsible Opioid Prescribing, which supports the guidelines. “It’s one of the most significant interventions by the federal government.”
These guidelines recommend what many addiction experts have long called for which is pushing doctors to recommend other pain management options. The CDC guidelines also limit the amount of prescriptions a doctor can prescribed at one time.While these new guidelines are non-binding, they are likely to have a huge influence in the medical community.
New CDC Painkiller Prescription Guidelines
Just to give a brief overview, here are some of the main specific guidelines that will be implemented in the next coming months.
- Doctors should first try ibuprofen and aspirin to treat pain prior to prescribing more high-risk drugs such as opioid medications.
- Opioid treatment for short-term pain should last only three days, at the longest seven days. This will be a significant change. Currently, doctors prescribe for anywhere from two weeks to a month of opioid medications for short-term pain management.
- Doctors should have patients undergo urine tests prior to getting prescriptions.
- Doctors are to participate in a drug tracking system to ensure patients are not getting medicine from somewhere else. Currently, 49 states have these systems yet only 16 are required to use them.
- These guidelines will not apply to patients receiving cancer treatment or end-of life treatment.
The new guidelines are a dramatic shift from the ideology of the 1990s. Back then, an initiative to fight for pain management resulted in opioid prescription painkillers soaring in popularity in the medical field. Pharmaceutical companies and medical experts pushed to have these drugs readily available because at the time, they were thought to be effective solutions to treat back pain and arthritis without the fear of addiction. Boy, were they wrong back then.
Now, as overdoses continue to mount, and addiction claims more and more lives each year, the country is desperate for an answer. While these guidelines may have good intentions, other professionals argue that more rules can cause more harm than good. Recent tighter restrictions on painkillers have resulted in the drugs soaring in cost on the black market. As a result, a significant number of addicts turn to heroin to satisfy cravings.
For nearly two years, these standards have been bitterly opposed by Big Pharma and pain doctors who feel that these guidelines will only post unfair hurdles for patients who really do suffer from chronic pain. They argue that drug addicts will simply find another way to get their fix, like heroin. Opponents of the new guidelines also believe that these rules are an incursion into the role of doctors.
Dr. Thomas R. Frieden, director of the disease centers, responded,
“It’s become increasingly clear that opioids carry substantial risk but only uncertain benefits — especially compared with other treatments for chronic pain.”
He continues to support the guidelines, stating they are meant to be “a tool for doctors and for patients to chart a safer course,” describing them as a benchmark for medical practice, not an unbending dictate. The idea, he said, is to balance the risks of addiction with the needs of patients.
“For the vast majority of patients with chronic pain,” Frieden said, “the known, serious and far too often fatal risks far outweigh the transient benefits. We lose sight of the fact that the prescription opioids are just as addictive as heroin. Prescribing opioids really is a momentous decision, and I think that has been lost.”
Essentially, Frieden is saying these new guidelines are meant to help with the addiction crisis and certainly are not meant to prevent those with chronic pain from receiving medications they need. Furthermore, it is uncertain the effects opioid medications have on chronic pain in the long run, so we can not assume that restricting these drugs cause any harm to those patients.
Considering how urgent the addiction epidemic is, something has to be done, and at least these new guidelines encourage conversation. Education and prevention is the key. Each year, the data is increasingly more frightening. There clearly is not a one-stop solution to all of this. Do you think these guidelines will be effective? If your or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
Dealing with Chronic Pain in Florida
By Jenny Hunt, Palm Partners Recovery Center
February 23, 2012
Florida is home to over 1,000 pain management clinics. Chronic pain sufferers seeking relief often pursue treatment at these clinics, only to have their problems compounded. This is due to the fact that many of these chronic pain management clinics are actually “pill mills.” Pill mills are clinics which prescribe excessive amounts of prescription painkillers to their patients without clear medical need. Florida doctors bought 89 percent of all the Oxycodone sold in the country last year. The prescription painkiller epidemic has caused deaths related to prescription drug use to outpace deaths from automobile accidents.
For people suffering from chronic pain in Florida, this can be very dangerous. Often, these doctors do not offer any therapy to treat chronic pain apart from prescription painkillers. Sufferers often find that the longer they are taking these painkillers, the more pills they need to relieve chronic pain. This is the beginning of a viscous cycle that often ends with dependence, addiction, and even death. Moreover, these medications do nothing but treat the symptoms of a chronic pain problem; they do not address the cause of the pain.
Chronic pain may be generally described as any persisting pain that occurs beyond the usual course of a disease or beyond the reasonable time for an injury to heal. There is a place for prescription painkillers in chronic pain management, but it should not be the only treatment, and treatment with prescription painkillers should not extend indefinitely. Over time, when the body is receiving a constant supply of pain medications, a tolerance is built up. The body stops producing as many of its natural painkillers, making an individual more sensitive to chronic pain.
Chronic pain can be treated using a variety of methods besides prescription painkillers. Physical therapy is an often-employed method when treating chronic pain. Physical therapy uses a variety of methods to strengthen muscles and improve overall health to reduce chronic pain. Physical therapy focuses on the treatment, healing, and prevention of other diseases. Often physical therapy can address the source of chronic pain, prevent worsening of the chronic pain condition, and sometimes improve the condition causing chronic pain.
Massage therapy is also effective in treating chronic pain. Studies have shown that massage therapy can offer as much relief from chronic pain as narcotic pain medication. Massage therapy not only reduces pain in stiff and sore muscles, it also reduces cortisol, which is the stress hormone released by the body in response to chronic pain. Massage therapy has also been shown to improve circulation and reduce blood pressure, two things that tend to be affected by a chronic pain condition.
Some people, when seeking treatment for chronic pain, inadvertently become addicted to narcotic painkillers. It is important that these people receive treatment for both the addiction and the chronic pain. Addicts who receive treatment for the addiction and not the underlying chronic pain condition have a very high rate of relapse.
If you or someone you know is suffering from a chronic pain condition and needs drug or alcohol treatment, call us at (877) 711-HOPE (4673) or visit us online at www.palmpartners.com.