2016 Cdc Guidelines For Prescribing Opioids For Chronic Pain (Top voted first)

Updated

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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11

Recently, i have had a very bad spell of scattica with contant excruciating.pain,.i went to my pcp whp refused to give me ANYTHING, SO I left totally upset & went to the er where i was prescribed. Percocet, flexiril & predisone pak which helped greatly. My pcp still would not put me on percocet from chronic pain although she told me that was the only thing that would help.she did give me tramadol , which was about as good as chewing m&ms, i ended up going to a pain management dr.over 70 miles from where i live. he gave me percocet to last until an appt to get an injection in my back, which thank the goddess was immediate pain relief,my question is Why are ALL the drs. so reluctant to give out narcotic pain killers when they are clearly needed? My pain management. Dr.was even reluctant to give me percocet to have on hand in case the pain came back!!!! What. CAN I DO ABOUT THIS RIDICULOUS NEW RULING THAT I CANT EVEN GET PAIN MEDS WHEN I NEED THEM!!!##!!!????

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9

Tourture n murder used to be criminal. We all know CDC being paid off by ins. Co. so they can get away with inhumane murder. No secret severe chronic pain causes High Blood pressure, strokes, n inability to live any kind of healthy life. i just get by thanking God. alll u thieves r going to have enterity of pain in Hell u hypocrite , discriminating murderes.

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65

To All,

Do not be mistaken many physicians suffer intractable pain, as do many professional nurses. However, the physicians have one another to bounce around to. There are several who post on this forum who have stated one doc writes them this drug another
writes him that drug.

For you as a patient that is called doctor shopping; however, they suffer but cover themselves in other ways.

The Hippocratic oath is 'do no harm' and when I die in a few days there will be harm, finality, and for the 10,000 plus IP patients in suicidal pain I referred, handled, and loved since my injury may God bless each one of you...Remember until this political crisis ends stay with whoever is writing for you; they will see what to do and their conscience will dictate their pen when they write your triplicate.

I have now won in Court three times on current issue; no medical care for a year left to rot and die, because my famous had me put aside I lived another year but it was a bad year the entire time in suffering am now bedbound. Now they are going to send me to him and he never got rid of me but they involved both sides separating us. Only he could take someone as bad as me and write for me.

The key now is Duragesic at very high levels since I am an ultra rapid metabolizer has kept me walking and due to what the insurer did I have demanded to be put in a hospital out there if I can make the trip I am almost out of medication and won't make it if they do not move fast so I can go from Duragesic to liquid Methadone the most DIRT CHEAP long acting known to man. In that way no one can control the cost I paid almost $2,000 for 10 patches and yes I am on a 100% medical award for life!

I hope to be here but chances are within this period I will end my life with dignity and self respect not going cold off the level of patch for me which is too low but kept me alive and would knock normals out that is it for me.

Hold tight those of you who have a PM keep your mouth shut and let these doctors come to God. Obama will pass like a fart in the night but America will persist what has happened to us is due to his little dictatorship. He needs two kidney stones pushed into each ureter and then to be told we can give you an aspirin...That is the truth.

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1

I had a tough time finding what to do on that federal page so I finally figured it out. In case any one wants to know what is going on that page basically links to a pdf file with info on it if you wonder what they are specifically looking to do. See page 1 only. I found a paragraph where it says "The Guideline is not a federal regulation; adherence to the Guideline will be voluntary." So that is a bit of good news as far as this not being laws or anything but i can't say how many doctors will choose to "voluntarily" follow any new guidelines???

But we all know how that kind of thing starts. First it gains a bunch of attention and then all of a sudden the feds and dea decide it is time to make these "voluntary" guidelines into law, am i right? So I am submitting my comments to them and I think as many of us need to do this NOW before much else happens. I think doctors are nervous now and I don't blame them, but ultimately I don't think the lawmakers know how many legitimate patients suffer when changes are made to how and when we can get our meds. Silence is the only bad action we can take at this point.

So when you get to that government page near the top it says "This document has a comment period that ends in 7 days (01/13/2016)" and so you just click on "SUBMIT A FORMAL COMMENT". Just click on that button so you can fill out and send them a message. Tell them your story and that certain medicine lets you lead a quality of life.

Editor's note: Enabled live link to the pdf file above and also pasted the related paragraph which this user is referring to down below:

" CDC developed the draft Guideline to provide recommendations about opioid prescribing for primary care providers who are treating adult patients with chronic pain in outpatient settings, outside of active cancer treatment, palliative care, and end-of-life care. The draft Guideline summarizes scientific knowledge about the effectiveness and risks of long-term opioid therapy, and provides recommendations for when to initiate or continue opioids for chronic pain; opioid selection, dosage, duration, follow-up, and discontinuation; and assessing risk and addressing harms of opioid use. The draft Guideline identifies important gaps in the literature where further research is needed.

To develop the recommendations, CDC conducted a systematic review on benefits and harms of opioids and developed the draft Guideline using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. CDC drafted recommendations and consulted with experts on the evidence to inform the recommendations. CDC hosted webinars in September 2015 and also provided opportunities for stakeholder and peer review of the draft Guideline. The Guideline is not a federal regulation; adherence to the Guideline will be voluntary. "

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4

I have antiphospholipid syndrome (APS). The pain started when i was about 8. I would get horrible headaches (ha). I figured out when i was 16 that aspirin, an antiinflammatory worked very well at controlling the pain. I would buy bottles of 500 norwich aspirin (325 mg each) at the dime store which at 6-8 a day would last 3 months. I mentioned the ha to my doctor when i was 8 and he ignored me. I even took aspirin during all 3 pregnancies unaware that ASA were banned during pregnancy. Thank god for ASA because i was unwittingly anticoagulating myself and all 3 kids born healthy. All went well until i was 39 when the pain became unbearable. The pain had morphed into trigeminal neuralgia. The only drug that helped at all was oxycodone combined with ASA. It is now known that APS, due to microvascular clotting , causes ischemia in various parts of the body. In my case it was my brain initially and as it progressed, avascular necrosis of the jaw bone which compresses the trigeminal nerve. I had the equivalent of a tooth ache for many years. Trigeminal neuralgia is known as the suicide disease. Ask Dr Jerry Bouquot in Morgantown, WV. He is one of the doctors who first identified the jaw ischemia. WV should be very proud of him, an oral pathologist trained at MayoClinic and former chief of WV Dental School. I know he saved my life. Also speak with dr ronald brownfield. He practices at HIMG on 5170 route 60 east in Huntington. He continues treating me with multiple drugs, including oxycodone. He is a saint, even now I rrquire about 3 oxycodone(5mg) and 6 ASA per day. This does not always control my pain, but helps tremendously. Dont penalize me and others with chronic pain due to those who abuse it.

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5

How dare US it is against turture to terrorist when they have taken away medication needed for end of life inhumane murdring pain. I have had 4 people die in my niegborhood not from over dosing but becuse they were cut off needed medication in their last days. Well their last days were inhumane what used to be criminal pain.I keep getting told im going to have a stroke my blood pressure is so high becuse of murdering pain at the end of my life and no the end of my life was not supposed to be tonight but it could be becuse the only way to control my BP is with my pain med that took 8 years of suffing to finally get diognosis n treatment the only thing that can be done is control pain. no more surgery

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6

Thanks Roy for the information. My doctor about a month or so ago told me about the new prescribing guidelines and told me that I would be one of the last patients he would ever reduce my level of medication on because he could easily justify my level of Medicine.
I had a really bad epidural abcess 27+ years ago after a back surgery and while I had the infection they had me on IV steroids for 10 days which made the infection a super bug. It scared the dural sac really bad at 2 levels, scared the nerve sheaths really bad at 2 levels and basically created a scar tissue pocket the size of 2 softballs from L4 to S1.
I guess by now you get the picture of how much nerve irritation I have going on. I have a multi-lead spinal cord stimulator implant (my 7th unit and counting) and have Rhizotomys at 3 levels both sides about every 14 months.
That's basically what someone who doesn't have cancer or end of life care will have to almost have to stay on their current medication regime.
Most doctors will follow the new guidelines because if they don't they could be sued for anything that might happen because of not following the guidelines. They say it's not mandatory, but watch most doctors follow the guidelines unless it's something rare, severe and has a zero surgical fix. Like my unfortunate self :-(
There's exceptions to everything and I definitely fall into the exception category, alot of people in pain management are going to have to get by with less medicine or none at all. Most people I know in pain management where I live have already been told by their doctors if their medicines are going to be reduced or even eliminated all together and have already started months ago doing this.
Chronic Pain patients are the latest victims in our governments failed War On Drugs, sad but true! Drug abusers now have a higher priority than suffering human beings!
Everyone can complain all they want to, but until the politicians are out of office who caused this it won't change. Bless all of you who are going to be victims of our governments out of control over reach playing doctors now...

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63

To All,

I just gave the CDC my comment. This is it below...

I am a professional nurse who was injured on duty in 1998 I have progressed to Central Pain Syndrome.

First, the overdoses being charted are DUE in WHOLE to those illegally abusing prescribed medications.

Second, true pain patients become opioid tolerant which a trained physician (even a GP) knows, and can adjust safely without negative outcomes. Attempting to dictate a morphine equivalent level is KILLING your legitimate pain patients.

Third, I will likely die in 4 days due to your CDC recommendations. I was injured at work and again have seen the top specialist in America after my PM of 10 years died. I am a P450 ultra rapid opioid metabolizer and labs show this. These CDC recommendations are causing such fear in physicians that those like me who are well deserving of medications are being dumped, discarded like used toilet paper. This is an injustice.

Recommendations should be felony incarceration for anyone abusing prescription medication on the street that is where your overdoses are coming from. One disorder of 50 I have RSD is researched at 88 x worse than end stage cancer.

I can only thank you for killing me and making addicts get compensation for breaking the law. The government has no business telling physicians how to prescribe unless they too are criminals.

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2

THEY ARE HOLDING A CONFERENCE CALL OPEN TO THE PUBLIC TOMORROW MORNING!! It doesnt say the timezone but i assume east coast?

Time and Date: 9:00 a.m.-1:00 p.m., January 7, 2016 (OPEN).
Place: Teleconference Dial-In Number:
1-888-395-7561, Participant Code: 3954121.

Matters for Discussion: The Board of Scientific Counselors will discuss the background for development of the CDC Guideline for Prescribing Opioids for Chronic Pain (Guideline) and the formation of the Prescribing Opioids for Chronic Pain Workgroup (Opioid Guideline Workgroup). We will be accepting public comments only related to the formation of the Opioid Guideline Workgroup. There will be 30 minutes allotted for public comments at the end of the session. All public comments will be limited to two-minutes per speaker.

Source: https:/­/­www.gpo.gov/­fdsys/­pkg/­FR-2015-12-14/­html/­2015-31367.htm

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7

Is this a way for the federal government to legalize marijuana as a pain reliever? I really believe the devil is in this issue. Chronic pain in seniors that pain rx helps them to lead an active life should not even be a government involvement. Is this something that Fl. Atty General Pam Bondi started? Does anyone remember the days that cancer patients died in such pain agony because doctors were afraid they would get hooked on drugs while dying or the FDA was fearful that someone would buy paregoric! This is an asinine government involvement that cannot see that Americans could be killed by terrorists ...........not a pain rx!

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13

Nancy and all: Thank you for your comments and sorry to hear about your struggling too. BL you are right that they are guidelines and not really a written law but I think you can agree and none of us can ignore that doctors are less and less willing to prescribe like they once were. Why do you think that is? Were lots of them getting in trouble? Feels like having to jump through flaming hoops in the circus to get the proper care sometimes. What else can be done?

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23

CDC should be lined up in front of ISIS n put to death for all their murders. At least they wont be left in long suffuring like they have done to pts. with incurable painful end of live conditions

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42

I Rember my old friend my original DR in Rustburg Dr Stephen Thompson who passed away after a long courageous battle with ThroatCancer he was and in my mind Will ALLWAYS be what a Good DR Should be a person who could truly tell if you were in pain. He would have helped me and not abandoned me and anyother Cronic pain patient he had in practice I do not belive he would have stopes takeing new patients I say this because the last few times I saw DR Thompson I could tell my Friend Was In Great Pain hisself I Asked Why Do You Not Enjoy The Time Left My Dear Friend told me that was what kept him going was helping His Patients. They do not make DRS like him anymore I'm very sorry for that and it's very hard when you have had a First Rate DR but I say again that the DEA has NO BUISNESS IN A DOCTORS OFFICE I DO NOT WANT TO BREAK THE LAW BUT IM going to do what I have to do to have as good a life as I can I'm not judeing anyone we have been put in a Bad Situation We Have To Deal With Daily We Are All Stuck In Wore Out Body's and if I could I'd quite happily let the good ole folks who think they know what is going on with our situation trade places I'd never let Them Out Of My Body if you Could trade places And I'd Give Them There First Bottle Of Tylenol. I Wish You All Good Luck With Your Drs And Your meds GOD Bless You All.

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68

P450 I had a horrible epidural abcess 27 years ago after a back surgery. It was made even worse by the doctor having me on IV steroids for 10 days making the infection a super bug that took 96 days on IV antibiotics (timentin and claforan) to kill it and even now there's subcutaneous pockets of this infection sitting dormant waiting for oxygen to breathe new life into it.
This infection scarred the dural sac from L4 to S1, the nerve sheaths are pitted and scarred from L4 to S1 and I have a scar pocket the size of two softballs from L4 to S1. I have a multi-lead rechargeable spinal cord stimulator, but I also take well over double the guidelines that the CDC is recommending in oxycodone. My pain management doctor said that he had no intention of lowering my dosages of ER/IR oxycodone and could easily justify it. Granted my condition and it's severity are extremely rare, but it sounds as though you have a severe rare pain condition also.
I don't understand why a legitimate board certified pain management doctor wouldn't treat your pain at the level of medications required to provide a level so you could at least tolerate the pain?
For every good pain management doctor there's 6-7 bad ones and this is right out of my doctors mouth!
It sounds more like you're getting the not so good ones that more than likely have been over prescribing and now their scared.
It makes me sad to read people's tells of suffering when help is available, but once again Odumbo's socialized approach to one size fits all is going to kill alot of people and he could care less.
All of us are an exceptable loss for the failed war on drugs. Everything Odumbo has touched has been an epic failure, but you known he's patting himself on the back again and saying look all the good I've done once again! He actually believes he's the best president of all time, but anyone with an ounce of intelligence knows he's the worst ever!
Who in their right mind would play doctor and have innocent suffering people suffer because of drug abusers? One word, Odumbo!

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131

Everyone be nice. We are all in the same boat.. Let's not be mad at each other. Be mad at the system. No need to physically hurt anyone

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132

I Don't know of anyone wanting to Hurt anyone And I Pray it Is That way WE CAN DISAGREE BUT STILL RESPECT THE OTHER PERSONS VIEW BUT WHEN ANYONE CALLS ANOTHER A BAD NAME. IT ENVITES A ILL WILL IN ALL I HOPE FOLKS WILL THINK OF THE DAMAGE A UNKIND WORD OR TWO CAN DO AND WE DO NEED TO BACK THE THROTTLE BACK AND COOL OFF WE ARE SUPPOSED TO BE ADULTS WE ALL ARE IN PAIN AND WE ALL DESERVE MEDICAL MEDICANES FROM OUR DOCTORS AND BE KIND AND HAVE A TENDER HEART ILL NOT DO AS I DID I KNOW ANYONE WHO WANTS CAN TURN AROUND. EVEN ME I APPOLIGUSE IF I OFENDED ANYONE LETS ALL CARE MORE FOR OTHERS NOT JUST OUR SELF ATLEAST THATS WHAT I WANT JUST BE KIND. ITS EASIER THAN BEING MEAN. ROBERT R LESS PAIN PEACE

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17

The research/studies were paid for by the taxpayers and the government agency involved will always get the exact results they want to promote. In other words backup their BS with their fingers on the scale and we're paying for it... I've never seen a government study yet that wasn't severely biased toward the outcome the government wants to promote, this won't be the first one that's not biased either.
No Severe Chronic Pain patient needs a study to tell them what they need to control their pain and how much is needed. You can't lump all injures and diseases into a single category and treat them all the same! That's just complete insanity! But the best part is yet to come! A severe increase in street drug abuse which will have a severe increase in crime of all types. The terrorists are licking their lips in anticipation of all the opium they'll be putting on the streets of America after this huge American Government blunder... Funny how our government rarely if ever looks at the big picture of their actions. Welcome to our next nightmare courtesy of Odumbo! The government will now tell you how you feel and exactly what you need because your doctor and you are to dumb to think for yourselves! Don't you just love Odumbo socialism?

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45

Amen to that.I've has 25 back surgeries and severe chronic pain.There are days I don't know how much more I can take it.It's been going on for 36 years now.On the correct pain medication I have a functional life.I take pain meds because I have too , not because I want too.

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67

Fellow sufferers,

I need your prayers now for the true healer that is GOD.

He allowed me to live almost 20 years in intractable pain and identified to physicians who are gifted the P450 DNA that allowed them to treat my pain in 2012 to stabilize.

He allowed me to fight the Attorney General in the state where my WC injury occurred and I WON hands down for ultimately Judicial Law should protect the innocent.

For a year I lived on substandard amount of medication put aside as told by my famous doctor. WC broke us apart and now with 4 days of long acting left I in Texas he in California I have redone my genetic testing, filled out my paperwork and asked the one person for WC who has handled thousands of cases over the years to 'get real and help me get me back to Dr. T before it is too late no one but him could stabilize me' and am willing to go to DIRT CHEAP liquid Methadone for my DNA does not metabolize opioid pills properly they jet out of my body in 10 minutes including long acting.

I have done my best for we are human. The errors made by government must change for ADDICTS who abuse our opioids for pain are addicts they increase the heroin business for to me heroin would not work; Duragesic is 100 x stronger and my brain knows the difference between Duragesic and liquid Oxy solution; I have more then enough of the latter if my brain would accept it as replacement.

It took a genius physician and researcher to see my rare disorders and now that I am Central Pain and my brain is damaged from intractable pain my life will exist if it gets me out to the west coast pronto with pain forevermore. Opioids do not get me high, or kill those like me; they make the pain more tolerable.

I ask for prayers for God will listen to strong voices. My voice is now faint, weak, indiscernible for the PAIN is screaming, howling and demanding I die with dignity not cruelty and take my own life.

Today I ask for your strength, hope, and your prayers. Send them to Dr. T. so he makes this happen.

Thanks...

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74

I just cannot think a DR would do thease things to people who live in pain SHAME ON BARRACK HUSSIAN OBAMA HE COOKED THIS UP AND HAS DESTROYED THIS COUNTRY BUT IF YOU ARE NOT IN PAIN WHO CARES FOR US?

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