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Physicians may be inadvertently harming patients by going out of their way to not prescribe opioids.

Jerome001Jerome001 Cocoa Beach, FloridaPosts: 377

I saw an article from a US government organization today that states "While opioids -- even for medical use -- are controversial for many consumers, a new report found that many physicians may be inadvertently harming patients by going out of their way to not prescribe opioids." “The intent of the CDC guidelines was to individualize treatment, but the overly restrictive prescribing policies created by legislatures and payers have led to unintended harm for some patients,” the article said. “In addition, burdens, fears, and stigma related to opioid prescribing have been instilled in many clinicians, and that will be even more difficult to reverse.” If you want to read the article send me a PM for the link.

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Comments

  • dilaurodilauro ConnecticutPosts: 13,434

    Jerome,

    That has been an ongoing problem since the initial CDC guidelines came out.  No question about many patients not getting the proper amount of opioids because of those guidelines. 

    But the bigger problem lies within the physicians who do not do the proper job.   Those guidelines are just that guidelines.   Any doctor has the ability to review, analyze and justify/rationalize the amount of opioids that they need to prescribe to a given patient.   When they do that work, they are in no danger of being reprimanded and the patient gets what they need.

    Unfortunately, many doctors do not do that work to justify the prescriptions.  Its much easier to lower the dosage or to not prescribe at all.  That way, they would not be in danger of any government reviews.

    I know of so many chronic pain patients that are getting the proper level of opioids even after the CDC guidelines.   I also know patients that have not.   Coming from the same geographic area some doctors do their jobs as they should and some do not.

    Thats sad and I have no idea how that can be corrected.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • My biggest fear that despite CDC admitting this. Most chronic pain suffers or I should add most people that suffer severe chronic pain that requires stronger doses will never again get what they need to live a more quality life. I was told in January I need more surgery but on the other hand my wc insurance company would love if I just stayed right were I am in a non working pain management . Alot of these type companies are utilizing the crisis to the fullest. I feel for the doctors like mine that want to help me but are being told no and I know it's the truth because despite me having a lawyer this company has called me multiple time just to scream at me and let me know I will NEVER EVER get any increases in my opioid medications. So it had to have come from him requesting it be cause I didnt ask..I mean his hands are tied..I even told my lawyer since when are insurance adjusters doctors ? Most of them dont even have any medical schooling so why have they now been given such authority to dictate my care. So even despite CDC stating this it's going to be a long time if ever before things turn around cause theres so many players involved now.

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  • dilaurodilauro ConnecticutPosts: 13,434

    I wonder how much workmens compensation has to do with this.  I know two individuals just recently that had their opioid dosage increased because of the increased pain they were in.   Doctor had no trouble what so ever in doing this.

    It just seems the more and more comments I read, so many of these lack of opioids somehow are connected with workmen comp cases.   I dont know if there is any truth to this, but the people dealing with workman comp cases have been the ones who have been more vocal.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences 
  • @dilauro

       It has alot to do with it..like I said they the insurance companies that deal in workers comp are utilizing this to the fullest but see it's a win win for them..it spell less out of pocket cost bottom line.

      I read a article a few months back from a lawyer that's handles workers comp but not on the injured employee side but for the insurance company. 

      The artical was about how this law office took a injured worker in front of the commission and got his pain management cut off. This man had multiple spine surgeries including one less then 6 month pryor . Of course this law practice spoke like he was just delaying and trying to stay on opioids ect..not the fact as most of us know after multiple surgeries some do like myself end up with chronic pain. I showed Keith EMT guy the article it was horrible I cant do it any justice speaking like this....what really got me is how they spoke of palliative pain management which he was slated for...but what is palliative pain management if this poor man isnt allow things he needs? I know my palliative would only include medication when it comes to my neck.. I am no longer allowed any epidurals rfa ect..so what good would it really do the poor man.

      It really just sicken me reading it. The lack of empathy its was all about cutting cost.


  • Ron
    Excellent summary you know me big time negative about the results of those guidelines that were not created to do what has happened. 
    Sherri

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  • Jerome001Jerome001 Cocoa Beach, FloridaPosts: 377

    Maybe just maybe one of the non-opioid pain meds will actually work and get approval. It's amazing how this has occurred!

  • Ron Dilauro

    Read your post As a chronic pain sufferer for decades, I have been impacted by the opioid crisis.  My regular doctor (not a pain doctor) did not go through the process to prescribe opioids after 2016.  I had a pain physician for 2 years who maintained my doses (<90 mme) for 2 years then decided as many are not to prescribe anymore because of the administrative burden and the fear of retaliation from the state.

    I also am from CT and have been looking for a replacement physician since last November.  I am familiar with the CDC guidelines and boards of health, etc all of which exempt chronic pain sufferers from the limits and rely on the physician.  My current cut my scripts in half, limiting my functionality by 60%.  You indicate you are aware of doctors who are doing the right thing.  Where do you find them?  I have been to several, all of whom want to cut the meds and "use injections instead".  I have had every injection known to modern man as well as several surgeries to the spine over the last 20 years.  I have spoken with the associations for pain management all of which are sympathetic and are aware the rules do not require the experience I am enjoying but say the situation won't change until the legislature indicates they are safe from unnecessary review and loss of privileges.  I am at wits end.  I am starting to look to other states or Canada to find a reasonably compassionate Prescriber.

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