Opioid guide­lines hin­der treat­ment for those suf­fer­ing from chronic pain.»

The Denver Post - - NEWS -

Katie Con­lin says she is liv­ing “an ex­is­tence of suf­fer­ing.” Not be­cause her pain is be­yond the scope of man­age­ment by mod­ern day drugs, mind you, but be­cause the pow­er­ful opi­oids that in the past brought her relief have been black­listed.

In re­sponse to the na­tion­wide epi­demic of opioid abuse, the pen­du­lum of pre­scrib­ing these de­signer drugs ap­pears to have swung too far in the other di­rec­tion.

The Den­ver Post’s John In­gold talked to Con­lin, oth­ers suf­fer­ing and med­i­cal ex­perts about an ap­par­ent un­will­ing­ness among doc­tors to pre­scribe opi­oids to treat chronic pain.

The ret­i­cence has come from new guide­lines from both the state of Colorado and the Cen­ters for Dis­ease Con­trol and Preven­tion.

We have been sup­port­ive of those guide­lines. Un­de­ni­ably there is an ur­gent need to get a han­dle on these de­struc­tive drugs that were once ped­dled as safe al­ter­na­tives to other pain man­age­ment tools or surgery.

In 1998 Purdue Pharma re­leased a video fea­tur­ing six peo­ple who suf­fered from chronic pain ti­tled “I Got My Life Back.” View­ing the clip now can be a haunt­ing ex­pe­ri­ence, given that these days, some 16,000 peo­ple a year die from opioid over­doses.

Some­thing needed to be done about the over-pre­scrip­tion of a drug that doc­tors had been treat­ing cav­a­lierly, given the risk for over­dose and ad­dic­tion.

Pa­tients pre­scribed large amounts of these pain killers, even high school ath­letes heal­ing from in­juries or adults re­cov­er­ing from Poli­cies in­tended to ad­dress opioid abuse have un­ex­pect­edly harmed pa­tients who de­pend on the drugs to treat chronic con­di­tions, pain spe­cial­ists and pa­tient ad­vo­cates say. den­tal work, have suf­fered. Teens have over­dosed from their par­ent’s pills. When the money runs out or doc­tor shop­ping fails, these in­di­vid­u­als of­ten turn to hero­ine.

The CDC says that in 2012 health­care providers wrote 259 mil­lion pre­scrip­tions for opioid pain med­i­ca­tion, enough for ev­ery adult in the U.S. to have a bot­tle of pills.

Congress re­sponded by de­mand­ing that warn­ing la­bels be put on the drugs, and states and the CDC is­sued new ad­vice to doc­tors.

So how do we bal­ance these com­pet­ing needs with pub­lic pol­icy? Colorado’s rules take spe­cial care to note “the pol­icy does not sug­gest the dis­con­tin­u­a­tion of opioid ther­apy af­ter a thresh­old is crossed. It does rec­om­mend the prac­ti­tioner closely mon­i­tor the pain.”

But In­gold has clearly doc­u­mented that for too many try­ing to man­age their pain, some­thing is not work­ing. Doc­tors are un­will­ing un­der the new guide­lines to write pre­scrip­tions for chronic pain.

While it’s still early, the Colorado death rate also hasn’t slowed much since the new rules were im­ple­mented: “in 2014, when the state’s guide­lines first came out, the death rate from opi­oids was 6.1 peo­ple for ev­ery 100,000 residents. In 2015, the rate was 5.8, ac­cord­ing to a re­port from the Colorado De­part­ment of Pub­lic Health and En­vi­ron­ment.”

Guide­lines need to be re­vis­ited by the med­i­cal ex­perts who wrote them in the first place to un­cover why the sys­tem is fail­ing Con­lin and oth­ers.

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