The government has physicians who treat the nations 100,000,000 pain patents so afraid of loosing their license they are failing to treat pain patients responsibly.
Many physicians out of fear an not medical necessity are lowering long time patient doses even though DEA the CDC Pain Guidelines and the new Arizona pain treatment law advise not to reduce long time patient doses without the patient agreeing.
DEA has told me patient doses should only be changed because of medical necessity and not because of policy. This email from the Arizona Governors Office stresses the fact dose for current patients does not need to be reduced.
Pain patients with a documented painful conditions who have been on opioids for many years without problems are being cut to 90 MME that's 90 milligrams of morphine or the equivalent, while there is apparently no limit for the people who abuse opioids.
I understand the reasoning for this as most people who abuse opioids have a high tolerance, much like long time pain patients. So if you try and give someone half the dose they get on the street, they just go back to the street because what you gave them was worthless to them.
Don't get me wrong, we need to do everything we can to help people with an addiction problem. This is a medical problem, not a law enforcement problem, we can't arrest way out of this.
But I find helping those who abuse opioids stay comfortable and out of withdrawals while physicians punish those who require opioids for pain relief.
Pain patients are being left to live in pain, live with withdrawals, or to end their pain by ending their life, while people who abuse opioids are given high doses....
I predicted several years that suicide rates would go up with the reduction of patients medications. Just like in Mohave County in 2009 when a pain doctor was arrested leaving many patients with no where to turn, the suicide rate had a significant spike in suicides with no other apparent cause.
With the current increase in suicides I predict many will be pain patients who give up the fight. So who is going to be held responsible in the current suicide crisis, the physicians who chose to listen to social media rather than follow government guidelines
Am I reading the documents below correctly? That Pain Patients get 90 MME and addicts get 360 to 540 MME? So addicts many times get 80-120 mg's a day of Methadone. The dose of Methadone equal to 90 mg's of Morphine is 20 mg's of Methadone.
Various government agencies including the CDC have issued Pain
Guidelines that have confused most pain doctors. My pain doctor was so confused he told
patients DEA was requiring they only get 15 days of medications at a time. That
meant hundreds of patients coming into his office every two weeks for refills.
That lasted all of 30
days, and then it was back to seeing them every 90 days and pickup refills at the office other months. A couple months later his office called saying
they had to cut my dose again even though the CDC guidelines
and new Arizona prescribing law doesn’t require current patients to reduce their doses.
Many current pain patients are having their dose cut in an unreasonable fashion, against the CDC and Arizona guidelines causing pain patients to go through painful and dangerous withdrawals.
Physicians opiophobia or unreasonable fear of opioid regulations is causing this problem by NOT following the CDC and Arizona opioid prescribing guidelines.
Even DEA investigations in Washington D.C. has told me that patient doses should only be reduced for medical reasons and not for policy.
About Drug Rehabilitation Doses....
Many current pain patients are having their dose cut in an unreasonable fashion, against the CDC and Arizona guidelines causing pain patients to go through painful and dangerous withdrawals.
Physicians opiophobia or unreasonable fear of opioid regulations is causing this problem by NOT following the CDC and Arizona opioid prescribing guidelines.
Even DEA investigations in Washington D.C. has told me that patient doses should only be reduced for medical reasons and not for policy.
About Drug Rehabilitation Doses....
FROM Public Policy Statement on Morphine Equivalent Units/Morphine https://www.asam.org/docs/default-source/public-policy-statements/2016-statement-on-morphine-equivalent-units-morphine-milligram-equivalents.pdf?sfvrsn=3bc177c2_6
Equally as important,
recommended dosages of methadone and buprenorphine when used to treat addiction
involving opioids differ from recommended dosages for pain treatment. The ASAM
National Practice Guideline for the Use of Medications in the Treatment of
Addiction Involving Opioid Use notes that, while a relatively low dose of
methadone (e.g., <30 mg per day) can lessen acute withdrawal, it is often
not effective in suppressing craving and blocking the effects of other opioids.
viii
Most patients fare better if their initial 30–40 mg per day dose is
gradually raised to a maintenance level of 60–120 mg per day. Indeed, multiple
randomized trials have found that patients have better outcomes, including
retention in treatment, with higher doses (80–100 mg per day) than lower doses.
FROM Calculating Total Daily Dose of Opioids For
Safer Dosage - CDC
HOW
MUCH IS 50 OR 90 MME/DAY FOR COMMONLY PRESCRIBED OPIOIDS?
~20 mg of methadone (4 tablets of methadone 5
mg)
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