2016 Cdc Guidelines For Prescribing Opioids For Chronic Pain
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Hey all fellow patients out there, did you know the CDC has published a list of their proposed 2016 guidelines for doctors who prescribe opioids for chronic pain? That includes oxycodone, lortab, percocet, hydrocodone, opana, suboxone, morphine, and any other drug that has an opiate ingredient in it that so many of us count on to lead normal lives!

This affects all of us and the comment period ends on January 13 2016! That's about a week from now! You know the doctors are going to have to follow whatever federal rules pass so if you are worried that you might not get the care you need please go to the gov web site for the office of the Federal Register and submit your comments to them before it's too late!

"The Centers for Disease Control and Prevention (CDC) in the Department of Health and Human Services (HHS) announces the opening of a docket to obtain public comment on the draft CDC Guideline for Prescribing Opioids for Chronic Pain (Guideline). The Guideline provides recommendations regarding initiation or continuation of opioids for chronic pain; opioid selection, dosage, duration, follow-up, and discontinuation; and assessment of risk and addressing harms of opioid use. The Guideline is intended to be used by primary care providers (e.g., family physicians or internists) who are treating patients with chronic pain (i.e., pain lasting longer than 3 months or past the time of normal tissue healing) in outpatient settings."

https:/­/­federalregister.gov/­a/­2015-31375

Editor's note: Please note that the above statement "You know the doctors are going to have to follow whatever federal rules pass" is technically correct but may be misleading in this case because the CDC draft says that it is "not a federal regulation" and that "adherence to the Guideline will be voluntary."

Editor's note # 2: The title for this discussion thread has been updated to reflect the topic most effectively.

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188

Re: 2017furtherrestrictionsnyc (# 180) Expand Referenced Message

Yes, I loved when a patient of mine. 93 was told he could begin using a meditation ball...I will spare you his response as it was less than cordial. He forsnt have too much longer, maybe a year, I would guess and they're worried about him getting addicted. This is just going too far.

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187

Lovw that "voluntary" version....those that dont "voluntarily" go along with this may loose their liscense or be investigated. They're keeping doctors from using their best judgement and causing them to make decisions from fear. This is not how medicine should work!

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186

Re: some1whoknows (# 118) Expand Referenced Message

Wow. I find your response totally absurd. Working in health care, I work with patients who have chronic pain and need these medications. One that I have worked with was crushed by construction equipment, another is a ear veteran who will.have pain for the rest of his life from an i.e.d. yet another that was recently denied has kidney disease, a recurrent tumor and stage 4 endometriosis. These people arent gettin, "high", they're existing. People that couldn't hold a job. Before being given these meds (the ones I work with anyway), mostly work after. Now some will have to stop. And now, I've had another nurse have a patient who killed herself because she couldn't stay out of pain. By no means am I saying this is everyone, but shame on you for saying cancer patients are the only patients who should get these. What are your qualifications to make that statement? Also, do you realize that many patients now have to keep their meds in a safe if they get any and pay out of their own pocket for naltrexone, on the off chance someone breaks into their house and safe and overdoses? And now they're telling patients to "deal with the pain", after major surgery or giving 5 days of meds. Many of the CDC members who made these guideline are statisticians, not doctors. So glad politicians are making medical decisions they have no education or background to make.

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185

Re: BL (# 156) Expand Referenced Message

I'd love to see those state and federal "laws" as up till now, being in the health care industry, I've never seen any.

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184

Audrey, it is still up to each doctor to prescribe what in their professional opinion is best for their patients. Unfortunately doctors lie. They tell patients they are being forced to prescribe a certain way when it is totally their choice.

No state is making doctor prescribe a certain amount. Nor is the federal government. Even when their is a policy, like with CMS Opioid Misuse Strategy, there are exceptions. But, the medical commuinity gas learned that high doses of opiates are not best. It takes a while to adjust to lower doses of opiates, but it will get better.

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183

Come on...You can say reccomendation but I've had doctors fully admit they're feeling forced into this! They're fearful they will be hurt or their liscenses will be-. I've been on the same regimine for over a decade-i am a productive member of society- now my doctor tells me he "has to reduce" my medications. Can't wait for the rest of my life stuck in bed because of pain! You need some kind of codicils for those of us that have been on these meds for years/decades and have never had problems. Your punishing those of us that do as we're told!

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182

I have had 2 ACDF C5-C6 AND C6-C7 and now have to have a 3rd back surgery on C4-C5. I also have Lupus and Hashimotos Thyroid! I have been to several pain clinics in the Knoxville TN searching and begging for some help. I have gone from 2/60 mg Oxycontin ER twice a day along with 4/30mg Oxycodone IR per day for breakthrough pain to the unbelievable amount of only 2/20 mg Oxycontin ER and only 3/20 mg Oxycodone IR per day. They are going by the CDC recommendations! Which is exactly that, recommendations ONLY! My question is ARE ALL STATES going by the recommendations are they doing what's right and doing a PATIENT BY PATIENT BASIS? Every one is different, we are not the same and definitely not the same problems. Is anybody else having the same problem or is it just the wonderful state of TN?

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181

2017furtherrestrictionsnyc , most pain management doctors are also following the CDC Guidelines..

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180

Dawn,
According to a CBS news affiliate in NYC beginning January 3,2017 tri -state area PHYSCIANS will further be reducing narcotic pain meds in an effort to get what's considered "Excessive " prescribing habits for powerful opiate containing pain meds under control.Citing the Federal guidelines established in January 2016 were insufficient So a further reduction is needed and an emphasis placed on other methods for pain control.I was troubled to hear this and reached out to area physicians in Brooklyn and queens who verified a more holistic approach will be placed on many who practice Family, General, or internal medicine. HOW this effects pain specialists is unknown. Just wanted to share this so folks visiting there medical providers in the new year are prepared. God bless....

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179

How long ago was this all written down I'm from New Jersey I'm on Oxycodone 10s without Tylenol and they I wear taking 4×s a day they no longer work on me what shall I do YES I've told my doctor I was supposed to see him 2day but he had a EMERGENCY. Any feedback will help, I just need to know what do you think my Doctor will do?? Thank you TRULY DAWN In NJ suffering from Chronic pain in my power back n spine and neck....

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178

Danny, many doctors are reducing opiates to 90 Mg Morphine/90 Mg Morphine Equivalent Daily Dose. 400 mg is a lot of medication. You need to be prepared to have them greatly reduced. The Guidelines are Not Laws and are Not Required. But, almost all doctors are going by them. If you are taking other medications like medications for anxiety or sleep that may also play a part in how much your pain meds are reduced. Even if your pain doctor is not the one prescribing them. If your pain doctor is not in the private sector, you may want to see a pain doctor in the private sector. But, that does not mean your pain meds won't be greatly reduced.

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177

I so hoped so, but... brother I went to my appointment for a refill on last Wednesday. My doctor, a great Pain Management Specialist told me "Hey we have these new guidelines, and I know it's not the news that you want to hear, but we would need to slowly lower the dosage of OxyContin and Oxycodone you're taking, again it's going to be slow and it's like 10% a month. We've known each other for years..." He left my meds the way they are despite discontinuing Tramadol completely. As for the dosage, I take two 80 mg of OxyContin (one every 12 hours, and have been on that dose for the last 2 years) and I have Oxycodone 30 mg 2 tablets 4 times a day for breakthrough pain which I have had for years. I was taking Tramadol as well, it was working all together in combination with my combo topical cream. I think Tramadol helped me too, but he said he has to cut some and Tramadol probably was the easiest one to let go of. I am an injured veteran, served this country for 24 years and what do you think, is that really not a law? Every other month their clinic does U/A's due to the amount of medication and I am happy about it because it's my way to show I am clean. This doctor has been doing Pain Management since the late 80s, he is a great guy, honest and helpful. What would my 400mg of Oxycodone a day be cut to? I just don't understand why I can't stay on my 80 mg and maybe reduce the amount of the breakthrough, but God I am not a candidate for surgery, what do I do? I haven't slept ever since that appointment in 4 days now. Can you send me more proof that it is oriented on Primary Care Doctors?

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176

Sameoldbs, You're welcome. It does get confusing at times.

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175

Kim #165, give Kratom a chance. I found a sweet spot at 1 1/2 teaspoon. It's $15/oz or 3 for 36$ depending on where you get it from. Research shows that Kratom helps with pain and energy. 3 oz lasts me 10 days. Give it a try. What do you have to lose.

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174

they prescibed drugs guess what cant even just quit coffe with out withdrawl. Chronic pain is a killer so is CDC alot of people been on same med 20 years ur just setting up
a major genicide people are going to dye yes the body does get used to what ever u put in it stop the murdering pain

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173

BL,

Well said, I think that's a concise easy to understand overview of these new cdc guidelines. Many thanks....

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172

Steve, no Steve this is not true. It is recommended that a patient not be prescribed opiates and certain other drugs like nerve medication. But it is not law. Usually, if a different doctor prescribes a nerve pill than prescribes the opiates there isn't a problem.

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171

Steve, what state do you reside? I've not read about any laws requiring Dr's limit a patient's medication to one specific class or type of drug. I have read of a state who's governor signed a bill requiring Dr's limit new pain scripts to a 7 day supply only. I think is absolutely criminal. Tell me your state and I'll check it out for you.

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170

Steve it has become sad that us pain sufferers have to make a choice. I'm so sick of our government interfering with our personal health.

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169

Is it true that if you take pain meds you cannot take nerve pills anymore? After January you have to choose which one you want to give up.

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