Article Politics of Pain in Kingman Daily Miner

The Kingman Daily Miner interviewed me for an article on pain medications....

The Politics of Pain 

There Are NO New DEA Rules Requiring Physicians to Reduce Patient's Opioid Doses

When I saw my pain management physician he told me a new DEA rule said it was mandatory that he had to cut my pain medications in half. I contacted the DEA diversion unit and was told there are no new DEA rules on prescribing opioid medications, and DEA does not tell physicians what or how to prescribe medications.

I don’t know where he gets his legal advice, but I found what he was referring to. It’s not a new DEA rule, but a 2016 CDC Guideline for Prescribing Opioids for Chronic Pain that was not meant for pain management physicians.

On the CDC’s web page the CDC Guideline for Prescribing Opioids for Chronic Pain summary says “This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care”.

The guidelines are not meant for pain specialists, in fact in it tells primary care physicians to seek “recommendations based on consultation with pain specialists” when doses are over 90mg’s.

The guidelines are for new patients, not patients who have taken opioids for years, are not problem patients, and don’t agree with reduction in medications due to tolerance and withdrawal issues.

The CDC Guidelines say this about established patients, "Established patients already taking high dosages of opioids, as well as patients transferring from other providers, might consider the possibility of opioid dosage reduction to be anxiety-provoking, and tapering opioids can be especially challenging after years on high dosages because of physical and psychological dependence… For patients who agree to taper opioids to lower dosages, providers should collaborate with the patient on a tapering plan. Experts noted that patients tapering opioids after taking them for years might require very slow opioid tapers as well as pauses in the taper to allow gradual accommodation to lower opioid dosages."

Forcing patients who have used opioid medications for years and have both a tolerance and dependence on those medications is cruel and can cause serious medical problems.

The attached letter from the CDC Director says “Specifically, the Guidelines Includes a recommendation to taper or reduce dosage only when patient harm outweighs patient benefit of opioid therapy”.

If you have been a good patient for many years, and have never abused your medications. Then reducing your dose will cause for more harm than continuing the opioid therapy.

Ask your  pain management physician to restore your medications to a workable dose, or explain to the medical board how the harm outweighs the benefits of continuing my  opioid therapy.