Every day we hear, in the news, a story about the opioid crisis. We hear how 130 people die each day as a result of opioid overdoses as a result of prescription medication, heroin, and synthetic opiates such as fentanyl. We also hear about how this is a severe national crisis that affects public health as well as social and economic welfare, and it costs the United States $78.5 billion annually relating to healthcare, lost productivity, addiction treatment, and criminal justice involvement.
What we must take away from this is that it’s all true. These are all the statistics collected by The National Institute on Drug Abuse (NIDA), a reputable government source that identifies how opioids and other drugs are affecting our society. There is no disputing the damage that opioids have caused, but one part of the problem is the demonization of opioid medication and labeling anyone who these substances as a “drug addict.” We have been blaming those in pain for taking opioid medications, despite it being their last resort to having some quality of life. We sometimes forget that not all opioid use is abuse.
A statistic that is overlooked is the number of those struggling with chronic pain in the United States. According to the National Center for Complementary and Integrative Health, approximately 50 million, or 20 percent of U.S. adults, and eight percent, or 20 million had high-impact chronic pain, which means that pain limited at least one significant life activity.
Chronic pain is linked to restricted mobility, opioid dependency, anxiety, depression, and reduced quality of life. In addition to the problems individuals have to deal with, it costs the U.S. $560 billion annually in direct medical costs, lost productivity, and disability programs. According to Dr. James Dahlhamer, Ph.D. or the CDC’s Division of Health Interview Statistics, “Pain is a component of many chronic conditions, and chronic pain is emerging as a health concern on its own, with negative consequences to individual persons, their families, and society as a whole.”
Opiate drugs are potent analgesics that are commonly used for several types of pain. However, the problem has been the sheer volume of those who misuse the substance. These drugs produce significant side effects that include constipation, nausea, mental clouding, and respiratory depression, which sometimes can lead to death.
Long-term use of opioids can result in physical dependence, making it more difficult to stop using when the original cause of pain subsides. Healthcare providers are placed in a difficult situation when treating moderate to severe chronic pain. For some, opioids are the only way to get out of bed and live a functional life. While there are risks, they are willing to accept these as a means to be a contributing member of society.
Tens of thousands of people who have experienced chronic pain and used opioids for decades without repercussion have become silent victims in the current state of affairs. With so many states suing manufacturers of the drugs, and new guidelines from the U.S. Centers for Disease Control and Prevention (CDC), doctors have become apprehensive about prescribing these medications.
Those who have used the drugs, successfully mind you, for decades are being forced to reduce their dose and their quality of life has been stolen away. It’s hard to deny that no problem exists, but the solution requires a unique approach, such as reviewing and thoroughly assessing each patient on an individual basis. The cookie-cutter approach harms many of those who fall in the cracks.
As a direct result of the opioid crisis, the U.S. Centers for Disease Control and Prevention issued new guidelines to doctors when prescribing medication to ensure patients have access to safer, more effective chronic pain treatment while reducing the number of those misusing the drugs. The CDC developed and published the CDC Guideline for Prescribing Opioids for Chronic pain to provide recommendations for the prescribing of opioid pain medication for patients. These recommendations focus on the use of opioids in treating pain that lasts longer than three months or past the time of routine tissue healing.
The purpose of these guidelines is to determine when to initiate or continue opioids for chronic pain, choose which opioids, dosage, duration, follow-up, and discontinuation, as well as assessing the risks and addressing harms of opioids use. Unfortunately, these strict guidelines have had adverse consequences, which include doctors being arrested, interfering with a doctor to patient privilege, and chronic pain patients committing suicide as a result of their abrupt taper forced by fearful doctors.
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With the government breathing down their necks, doctors have been in fear of prescribing opioids to their patients. Some patients have seen the same doctors for decades, but the new guidelines have made physicians resort to unrealistic tapers of their medicine, which is causing an array of problems. Even if patients are given smaller doses of their medication, they still have to deal with another form of humiliation; pharmacists berate pain patients and make them feel like criminals.
A single Mom with breast cancer pulled over to the side of the road after an encounter at the pharmacy and recorded herself – “I’m just leaving my pharmacy,” she says holding back tears, “I’m frustrated, and that’s why I’m crying. I get pain pills, maybe every two, three months, and I can make a monthly prescription last two or three months because I don’t really take it unless I absolutely need it.” She goes onto say, “the pharmacist at my local Rite Aid berated me for the history of opioid prescriptions and told me to come back later.” She felt like she was being treated as a criminal, despite having cancer.
“The guidelines are unrealistic, and they have pushed people experiencing real pain onto the brink of considering suicide. The doctors who are willing to prescribe the medications do so at a much lower dose than the patients have grown accustomed to over the years. Opioid withdrawals are among the most painful among all drugs, and doctors have provided unrealistic taper schedules for their patients to abide by the guidelines, not considering what the patient is going to experience.”
More pain-related suicides are occurring with opioid reductions and discontinuations. Allison Kimberly, a 30-year-old woman from Colorado, was denied treatment for intractable pain from interstitial cystitis and several other painful conditions. The pain is extreme and causes agonizing discomfort, and it is said that failure to properly treat the condition can result in suicide.
Allison posted to her social media account about her experience, “I was rushed to the ER because my pain was so out of control and I couldn’t take it anymore, I got ZERO help. After seven hours, I was discharged, and the nurse had the nerve to say that my kind of pain shouldn’t be that bad, and basically, I was faking for medication.” The hospital sent her home without any medication. Allison later ended her life.
Allison’s story is just one of the thousands we’ve heard as a direct result from these revised CDC guidelines. We need to remember that not all opioid use is abuse and that a large portion of our society has been using the medications for decades without problems.
Opioid addiction is a problem that must be addressed, but no one should have to commit suicide because the government interferes with their doctor-patient relationship.
If you have been using opioids as a means to cope with your pain, but notice that it has grown past a point where you cannot stop on your own, we want to help. We understand that opioid use is not always abuse, but sometimes it requires help from specialists to get you back on track. Delphi Behavioral Health Group wants to be the group that helps with your pain and gets your opioid use under control. Call us today for more information.
Kline, T., & Kline, T. (2018, May 11). #OpioidCrisis Pain Related SUICIDES associated with forced taper from https://medium.com/@ThomasKlineMD/opioidcrisis-pain-related-suicides-associated-with-forced-tapers-c68c79ecf84d
Mandatory Taper Off Chronic Opioids Might Be Harmful, Experts Say. (2019, January 02). from https://www.psychcongress.com/news/mandatory-taper-chronic-opioids-might-be-harmful-experts-say
Marill, M. C. (2019, May 21). The Unseen Victims of the Opioid Crisis Are Starting to Rebel from https://www.wired.com/story/the-true-victims-of-the-opioid-crisis-are-starting-to-rebel/
U. S. Centers for Disease Control and Prevention. CDC Guideline for Prescribing Opioids for Chronic Pain – the United States, 2016 | MMWR. (n.d.) from https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1er.htm
National Institute on Drug Abuse. (2019, January 22). Opioid Overdose Crisis from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis