NYT: Group calls on CDC for Re-eval of Opioids Guidelines

[drusso]

Good News: Opioid Prescribing Fell. The Bad? Pain Patients Suffer, Doctors Say.

Letter to the CDC HP3 March 6, 2019

"They say the guidelines are being used as cover by insurers to deny reimbursement and by doctors to turn patients away. As a result, they say, patients who could benefit from the medications are being thrown into withdrawal and suffering renewed pain and a diminished quality of life, even to the point of suicide."

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[Aether2000]

Of course their tacit assumption is that given adequate amounts of opioids, people would not commit suicide. This is simply wrong. Some people use the opioids to commit suicide.

 

[Ducttape]

1. there are only about 16 ppl that I can see out of the 300 that are pain physicians.
2. there are 3 times more "patient advocates" and pain patients than pain physicians on that list.
3. well known names on that list include Kertesz, who has been the most vocal on this, Fudin, Webster, Darnall, Mackey...

Legacy patients are a different category that they are advocating for. the problem is, how to treat them and how to avoid opioid naïve people from becoming Legacy patients.

maybe they should be treated by palliative care or addiction medicine (with or without MAT) instead of PCPs or even pain docs, eh???

 

[drusso]

1. there are only about 16 ppl that I can see out of the 300 that are pain physicians.
2. there are 3 times more "patient advocates" and pain patients than pain physicians on that list.
3. well known names on that list include Kertesz, who has been the most vocal on this, Fudin, Webster, Darnall, Mackey...

Legacy patients are a different category that they are advocating for. the problem is, how to treat them and how to avoid opioid naïve people from becoming Legacy patients.

maybe they should be treated by palliative care or addiction medicine (with or without MAT) instead of PCPs or even pain docs, eh???

It will be interesting to see how a new group of experts revises the guidelines. Most physicians will just follow whatever guidelines they're given. Sheeple. Too much COI with last group.

 

[emd123]

Maybe the new guideline will ban opiates and make them schedule I accept for in hospital use. My job would be 1000 times easier.

 

[emd123]

I wonder if the new guidelines will acknowledge the fact that the majority of opiate deaths come from fentanyl and heroin made overseas, which never come from a US drug maker, never are dispensed from a US pharmacy, never are prescribed by a US doctor and never are prescribed to an actual pain patient seen by an MD and that all the CDC guidelines in the world will not touch this part of the problem in the slightest?

For the uninitiated, fentanyl = synthetic, blue line

?

 

[drusso]

I wonder if the new guidelines will acknowledge the fact that the majority of opiate deaths come from fentanyl and heroin made overseas, which never come from a US drug maker, never are dispensed from a US pharmacy, never are prescribed by a US doctor and never are prescribed to an actual pain patient seen by an MD and that all the CDC guidelines in the world will not touch this part of the problem in the slightest?

For the uninitiated, fentanyl = synthetic, blue line

View attachment 253113 ?

I think that in 2020 we will view the 2016 CDC Opioid Guidelines the same way we view this AP article about climate change from 1989...the experts missed the mark.

"The most conservative scientific estimate that the Earth’s temperature will rise 1 to 7 degrees in the next 30 years, said Brown."

U.N. Predicts Disaster if Global Warming Not Checked

 

[hyperalgesia]

Of course their tacit assumption is that given adequate amounts of opioids, people would not commit suicide. This is simply wrong. Some people use the opioids to commit suicide.

That's what the pts are telling them

 

[Ducttape]

it has risen just about 2 degrees since 1980s.
One in six of world's species faces extinction due to climate change – study

Analysis: Global warming killing some species

 

[lobelsteve]

it has risen just about 2 degrees since 1980s.
One in six of world's species faces extinction due to climate change – study

Analysis: Global warming killing some species

But that sounds like way too much. If that pace continues the world ends in under 300 years. Or sooner. Really need more context of temps x10000 years. We are several billion years old on this rock.

 

[callmeanesthesia]

But that sounds like way too much. If that pace continues the world ends in under 300 years. Or sooner. Really need more context of temps x10000 years. We are several billion years old on this rock.

Here you go
xkcd: Earth Temperature Timeline

 

[Disciple]

Legacy patients are a different category that they are advocating for. the problem is, how to treat them and how to avoid opioid naïve people from becoming Legacy patients.

maybe they should be treated by palliative care or addiction medicine (with or without MAT) instead of PCPs or even pain docs, eh???

Yup.

Though the specialty might disappear, or would need to be re-branded.

Need "Pain Mgmt. BOLD", like the AAPMR did with Physiatry.. haha

 

[Disciple]

Maybe the new guideline will ban opiates and make them schedule I accept for in hospital use. My job would be 1000 times easier.

And you might no longer have a job.

 

[TheLoneWolf]

Dont these advertising groups get funding from drug makers?

 

[emd123]

And you might no longer have a job.

Ooh, early retirement?
You're making me downright giddy.

 

[kstarm]

I wonder if the new guidelines will acknowledge the fact that the majority of opiate deaths come from fentanyl and heroin made overseas, which never come from a US drug maker, never are dispensed from a US pharmacy, never are prescribed by a US doctor and never are prescribed to an actual pain patient seen by an MD and that all the CDC guidelines in the world will not touch this part of the problem in the slightest?

For the uninitiated, fentanyl = synthetic, blue line

View attachment 253113 ?

The deaths are important and get all the headlines. I think the bigger tragedy though is the millions and millions of people that are on chronic opioids and use them (knowingly or unknowingly) to check out of life. They end up muted, apathetic, and still have the same issues with pain.