URGENT WARNING: Opioid Dose Sharp Limits 100 mg Morphine per Day – Comment to CDC by Tomorrow January 13


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Center for Disease Control (CDC) has announced that opioid doses should be limited to 100 mg morphine equivalent per day for persons with chronic pain. This is a very steep drop in dose for many patients. The American Pain Society voiced their complaint of the first guideline, and CDC made no changes in the substance of the draft for this 2nd guideline. It was after strong concern that CDC allowed comments before publishing the new guidelines this week.

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I have posted warnings on these strong cutbacks weeks ago and link to CDC’s site for public comments.

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Public comments to CDC are open until tomorrow, Wednesday, January 13th. Tomorrow. Insurers will no doubt refuse to reimburse for higher doses and your physician would be at risk if higher doses are written.

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100 mg morphine will overnight become the limit for severe pain. No guideline is noted for mild or moderate pain.

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100 mg morphine per day is equivalent to

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  • oxycodone 65 mg

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  • hydromorphone (Dilaudid) 25 mg

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  • oxymorphone (Opana) 33 mg

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  • fentanyl patch 41 mcg per hour approximately

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  • fentanyl IV 330 micrograms (1/3 mg) fentanyl

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  • fentanyl is 100 times stronger than morphine and the patch delivers a continuous dose every hour

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  • methadone may differ in every person – no equivalent dose is given in many charts
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  • suboxone 2 mg may be equal to morphine 100 mg. It is not approved for pain in the United States and equivalence is not published in this country.

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The President of the American Pain Society has emailed members today:

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“… in the absence of any high quality data on the risk/benefit ratio of this practice, any guideline will be unduly influenced by opinions….Although, this guideline is said to be non-binding, several federal agencies have already gone on record supporting this, yet unfinished, guideline.

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Join me in hoping that this guideline, whatever its final recommendations, will one day be supported by a database equal to the rhetoric it has already generated.”

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The material on this site is for informational purposes only.

It is not a substitute for medical advice,

diagnosis or treatment provided by a qualified health care provider.

Relevant comments are welcome.

If any questions, please call to schedule an appointment with my office.

This site is not for email.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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2 Responses to “URGENT WARNING: Opioid Dose Sharp Limits 100 mg Morphine per Day – Comment to CDC by Tomorrow January 13”

  1. Jon wheeler Says:

    My input is pointless. My late girlfriend’s sister still suffers from the injuries suffered 25 years ago in the vehicular manslaughter that took my loved one. Crushes pelvis, shattered vertebrae… one never fully recovers from the physical pain… Fentanyl patches have been a part of her life, but threatening her doctors, causing an abrupt halt to treatment can be dangerous can it not? Can you just stop taking opioids with no dangers? She has recovered psychology from the death of her sister better than I have, but I worry for her future. More pain, horrible withdrawal symptoms, a reoccurrence of her psychological trauma… I have sent my own comments to CDC. FDA. DEA. Let the trained physicians heal their patients. Perhaps the boardroom is too far removed from the ones they are deciding for ??

    Sent from Jon Wheeler

    • Nancy Sajben MD Says:

      There are many in academia, federal agencies, private practice, families and friends who have very different opinions about the use of opioids.

      Doctors who throw food from their dinner plate at pain specialists lecturing on treatment of cancer pain.

      Doctors who are show up for required education on prescribing pain medication, who spend the hours in the hall gossiping, laughing and collecting credit for attending.

      Something about pain that ruffles their minds.

      Not all doctors and all people are like that. I’ve seen families destroy the lives of young people with juvenile rheumatoid arthritis because they were on opioids for pain. They did not feel that erosion of joints, joint replacements required opioids and they forced their young child to go through complete detox, creating suicidal despair.


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