Is Beth Darnall, PhD right about the CDC Guidelines?

[drusso]

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The National Imperative to Align Practice and Policy with the Actual CDC Opioid Guideline

In response to data evidencing sharp increases in opioid overdose rates and the need to advise prescribing clinicians, the Centers for Disease Control (CDC

academic.oup.com

"As a pain psychologist, scientist, and author, I have spent 15 years helping people use strategies to minimize their need for pain medications. However, the assumption that ‘less opioid medication is always better for everyone’ is just as flawed as assuming that an opioid is right for everyone; absolutes in either direction confer risk. What could be one person’s poison could be life-saving medicine for others, such as patients with complex medical conditions who rely on medication to maintain function and quality of life. The CDC statement makes clear that opioid reduction is not right for everyone and, in so doing, reflects the individual differences in the experience and treatment of pain."

 

[Ferrismonk]

Simple survey to a complicated question, so obviously results will be skewed. There are good points being made, however the realization that opiate pain medications are more dangerous that we thought is the real legacy of the CDC guidelines. If >90 MMED puts a patient statistically 10x more likely to overdose, then it doesn't really matter what they were on for the last 20 years. It's too dangerous and needs to come down. First, do no harm.

 

[willabeast]

//
There is an important idea in psychology: The 'just world theory,' which says that it is very important for us to convince ourselves that the world is just and things happen for a reason. That there is some elemental fairness in everything, which creates the illusion of justice.//
Malcolm Gladwell

 

[Ducttape]

no middle ground to your poll...

have to remember that the time that this came out, many physicians were still of the belief that there was no upper limit, that there was no ceiling effect, and opioid use does not increase risk of addiction. because that is what they were taught.

 

[Aether2000]

1. She is not a physician, and does not prescribe opioids
2. Because she cannot prescribe opioids, she does not understand the responsibility that comes with prescribing opioids
3. She is not subjected to hostile threatening behavior from patients that do not receive opioids from her
4. She is not subject to state board of medicine actions against her license for overprescribing or opioid related deaths
5. She is not subject to criminal prosecution by state attorneys general for opioid related deaths
6. She is not subject to confiscation of her personal property due to opioid prescribing
7. She is not subject to medical malpractice suits by families of patients that have died from opioid overdoses
8. She is not subject to DEA registration revocation
9. She is not subject to bankruptcy and career destruction due to opioid prescribing
10. She takes the position that the appropriate opioid dosage for patients is whatever the patients believe it is, regardless of data demonstrating the futility of high dose opioids in treating chronic non-malignant pain

 

[hyperalgesia]

1. She is not a physician, and does not prescribe opioids
2. Because she cannot prescribe opioids, she does not understand the responsibility that comes with prescribing opioids
3. She is not subjected to hostile threatening behavior from patients that do not receive opioids from her
4. She is not subject to state board of medicine actions against her license for overprescribing or opioid related deaths
5. She is not subject to criminal prosecution by state attorneys general for opioid related deaths
6. She is not subject to confiscation of her personal property due to opioid prescribing
7. She is not subject to medical malpractice suits by families of patients that have died from opioid overdoses
8. She is not subject to DEA registration revocation
9. She is not subject to bankruptcy and career destruction due to opioid prescribing
10. She takes the position that the appropriate opioid dosage for patients is whatever the patients believe it is, regardless of data demonstrating the futility of high dose opioids in treating chronic non-malignant pain

Well said!

 

[hyperalgesia]

The primary professional objective of a psychologist is to validate the patient's perspective.

The physician's is to do no harm.

 

[SommeRiver]

She's changed since I worked with her.