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Today JAMA published the heavily resisted
CDC Opioid Guidelines
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“A very useful guideline for people who don’t hurt,”
says my Rheumatology colleague
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Chilling Effect on Prescribers
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Guidelines allow Tylenol or Aspirin
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Will insurers stop paying for opioids?
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“Almost all opioids on the market are just as addictive as heroin,” CDC Director Thomas Frieden said.
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The guidelines are based on three principles. First, opioids should be a last option for these patients, with aspirin-related drugs and exercise preferred. Second, when given, doses should start out low and only increase slowly. Third, patients should be monitored and a plan for getting them off the drugs should start with their prescription. The guidelines also call for getting naloxone, a drug used to counteract overdoses, into the hands of more doctors, nurses, police, and emergency personnel.”
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Have Feds told Doctors to Stop Prescribing Opioids For Chronic Pain? CDC guidelines focus on heroin, opioid related deaths, addiction. Not pain.
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The guidelines are about addiction, heroin is everywhere, opioids cause death. So are they taking away the opioids?
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I can’t bear to read it. The small print and pages of detailed words strike my amygdala numb.
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The CDC has a mandate to prevent opioid-related deaths, so all must suffer.
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Rather than address addiction as a medical condition and offer adequate treatment programs including for prisoners, the plan is to continue wasting trillions more on militarization and the failed War on Drugs that literally created the heroin market across the nation, among rich and poor.
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…no one in this country is untouched by opioid addiction. And fuck the governor of Maine. He is anti naloxone and got hundreds of people cut off of methadone by cutting federal aid in the state for addiction related services.
Tracy Helton Mitchell today on Reddit, inspiring leader.
Author of “The Big Fix – Hope After Heroin.”
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These are “guidelines, not law.” CDC
And these are 50,000,000 Americans with chronic pain, not drug addicts.
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Voluntary. Guidelines. In this country . . . .this is a tsunami.
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Will state legislators, in the current zeal to address this heroin epidemic, put up abrupt new laws overnight restricting opioids, as they have already done in Massachusetts, as I recall, and other states. One governor ordered every one with chronic pain switched to methadone. How many died from that law?
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CDC will allow post injury/surgery opioids for 3 days, only for acute pain, only acute cancer pain while under active treatment (not chronic cancer pain), and for palliative care.
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Will insurers stop paying for opioids?
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Insurers now have federal support to deny all opioids. And denials are something they have been doing little by little for years, for many types of conditions, not just pain.
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I fear for 50 million Americans with chronic pain. I cannot bear to read these detailed injunctions from CDC and their focus on heroin abuse rather than pain – not after 16 hours of recent conference on this.
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I fear 50 million people will be frantically calling every pain specialist for help because none of their doctors will prescribe opioids. I have been seeing this already for a few months. Who will help them?
Will opioid taper lead to loss of jobs, loss of medical care, loss of insurance?
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I have written on this 17 or 18 times since October. There is nothing we can do to change it.
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The political environment could not be more toxic toward the disabled including our veterans, toward chronic pain, opioids and heroin.
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I look forward to a strong discussion on these chilling “guidelines” in the pain community from Forest Tennant, MD, Editor of Practical Pain Management, and a coming article on by Michael Schatman, PhD, CPE in J Pain Res with with Jeff Fudin and Jaqueline Pratt Cleary, which HONESTLY discusses the guideline issue in light of the antiquated concept of MEDD.
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This site is not for email.
If any questions, please schedule an appointment with my office.
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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.
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For My Home Page, click here: Welcome to my Weblog on Pain Management!
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I am a primary care physician in Ireland. I have been prescribing LDN for 9 years and it has utterly changed the lives of hundreds of people. The main conditions I see are fibromyalgia, chronic pain, MS, various cancers, Crohns/UC, chronic fatigue/ME, several other auto-immune diseases and one case of Interstitial Cystitis where a 30-year woman had “a fire in her bladder 24 hours a day” and who was due to have a cystectomy (bladder replaced by a plastic bag!) a month later than when she came to me by chance and soon became well.
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TV2 in Norway made a film about LDN in 2013 which was seen by 10 % of the population. The number using it there went from 300 to 15,000 in a few months. It is now on the website of http://www.lowdosenaltrexone.org in America and I was the only doctor outside Norway who was involved. I agreed to partake if they subtitled it in English which they did.
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Yes. Opioids cause pain. Naltexone relieves, and often resolves pain.
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My comment:
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Based on the work posted on these pages, RSDS.org sent scientists and specialists to my office in 2010. Over two days I introduced them to eight of my patients with years of intractable chronic pain, all of whom responded to low dose naltrexone, four of whom required treatment only one month with sustained pain relief for years! RSDS is now funding a study on LDN for CRPS at Stanford.
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Norway has well known large cities, UNESCO heritage sites and this absolutely gorgeous small seaport village Reine on an island in the Lofoten archipelago, above the Arctic Circle. It was “selected as the most beautiful village in Norway by the largest weekly magazine in Norway (Allers) in the late 1970’s” and is visited by many thousands annually. “Lofoten is known for a distinctive scenery with dramatic mountains and peaks, open sea and sheltered bays, beaches and untouched lands. Though lying within the Arctic Circle, the archipelago experiences one of the world’s largest elevated temperature anomalies relative to its high latitude. Lowest temperature ranges from 28.4 to 35.6 degrees F. The warmest recording in Svolvær is 30.4 °C (87 °F).
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