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mericans broadly support new Obama administration guidelines urging physicians to prescribe fewer powerful painkillers, according to the latest STAT-Harvard poll. They blame doctors for the nation’s epidemic of opioid addiction about as much as they hold individuals responsible for abusing the drugs.

But most people are also concerned that the prescribing guidelines, issued Tuesday by the Centers for Disease Control and Prevention, could create hurdles for people who legitimately need strong pain medicine, such as Percocet, OxyContin, or Vicodin.

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Seven in 10 Americans support two key elements of the guidelines: advising doctors to give patients no more than a three-day supply of opioid painkillers to treat most cases of acute pain, and trying other treatment options first before prescribing opioids for chronic pain. There was no significant difference between Democrats and Republicans.

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For all their support, 55 percent of the adults polled said they were concerned that the new guidelines would make it too hard for people who need prescription pain medications to get them.

“If things work out where there are a lot of stories of people who just cannot control their pain, they are not able to do it in this type of regimen, you could have some sort of backlash against it,” said Robert Blendon, a professor of health policy and political analysis at the Harvard T.H. Chan School of Public Health, who oversaw the poll.

There was already pushback against the CDC guidelines from some patient groups after a draft was released last year. And concerns about patient access to needed pain medication led to changes in a new Massachusetts law to combat opioid addiction; it limits initial opioid prescriptions to a seven-day supply in most cases, instead of the three days originally proposed by Governor Charlie Baker.

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Sean Cunningham, a 24-year-old from Lehigh Acres, Fla., is among the people polled who were concerned about ensuring the ability of patients to get needed pain relief. His wife, mother, and sister all regularly take pain medicine; his wife had a herniated disc, his mom has neck pain, and his sister is quadriplegic after an accident 14 years ago.

He worries about what the CDC recommendations could mean for his family. “Unfortunately, people are going to do bad things. It’s going to happen no matter what restrictions we put on it,” he told STAT in a phone interview. But for people who live with real pain, he said, “that’s also hurting them and making their lives harder.”

Read full STAT-Harvard poll results here

The poll found that the public was split about who is mainly responsible for the epidemic that is killing nearly 16,000 Americans a year: 37 percent blamed the users of strong pain pills, while 34 percent blamed doctors inappropriately prescribing the medications.

Far fewer held pharmaceutical companies (10 percent) or the US Food and Drug Administration (7 percent) responsible.

“Ultimately, I think it’s every individual’s responsibility to know what substance they’re putting in their body,” said Brandon Deanda, 24, a self-described libertarian who lives in Tucson, Ariz.

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However, for Victoria Morrison, a 36-year-old from Morris, Ill., the responsibility clearly lies with the experts who were giving out the drugs in the first place.

“It starts with the physicians,” she said.

Morrison is among the 41 percent of American adults who said they knew someone who had abused prescription drugs in the last five years. Of those, 20 percent said the abuse had led to the person’s death — meaning 1 in 12 Americans say they know someone who died from a prescription drug overdose.

At the distribution center where Morrison works, she said many workers seem to be abusing prescription drugs regularly. They started taking ibuprofen or aspirin for pain that came with the physical labor, she said, but have since advanced to Vicodin and other stronger drugs.

Morrison remembers her colleagues asking a worker who was hurt on the job for any extra prescription pain pills to give away.

“You can tell people’s attitudes are different,” she said. “They’re not who you thought they were before they started taking these pills.”

That growing familiarity with the prescription-drug abuse problem is perhaps one reason Americans overwhelmingly favor sending addicts to treatment rather than jail.

The poll found that 84 percent thought that people caught with small amounts of painkillers obtained without a prescription should be directed to treatment programs; only 8 percent said jail. The preference for treatment was also high for people possessing small amounts of heroin (80 percent) and crack cocaine (74 percent).

Blendon, the Harvard professor, described this sentiment as a “sea change” from the “Just Say No” days of the Reagan administration.

“We have completely shifted here to a treatment-prevention strategy,” he said. “This is huge.”

Isso Dayala, a 50-year-old from Worcester, Mass., said he used to favor sending people to jail for illicit drug use, but changed his mind because he now knows someone with a prescription-drug problem. That woman originally got a prescription legally but eventually became addicted. She missed car payments and directed much of her paycheck to buying painkillers. She is now in treatment, Dayala said.

“There are a lot of people involved in it,” he said. “That’s why I changed the position.”

The STAT-Harvard poll interviewed 1,011 randomly selected adults ages 18 and older by telephone from March 3-6, in both English and Spanish. The poll has a margin of error of plus or minus 3.7 percentage points.

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More than half of Americans, 51 percent, think abuse of strong prescription painkillers is an extremely or very serious problem in their state, and a similar number says heroin abuse is an extremely or very serious problem. Heroin is also an opioid, and many people who abuse this illegal drug begin by using prescription painkillers.

A segment of Democrats and Republicans (45 percent and 37 percent, respectively) agreed that the government isn’t spending enough money on treatment programs.

But politics are still in play on Capitol Hill. The addiction treatment bill passed almost unanimously by the US Senate last week authorized grants for treatment programs, but Republicans rejected a Democratic amendment for another $600 million in mandatory spending. Congress already approved $400 million to address the epidemic in the government spending bill that passed in December, which was part of the GOP’s rationale for voting down the Democratic amendment.

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In an age of hyper-polarization, Blendon found the consensus for government action on opioid addiction remarkable.

“Republicans and Democrats can talk about this together. They can move on legislation,” he said. “People will fight about pieces of it, but the bipartisan nature of this is really quite incredible.”

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  • This issue is not some elementary school question in which you give a simple answer and then find out who is at fault. Some pharmaceutical companies do hold some blame. Are you willing to pull them from your 401k investments? Some physicians hold some culpability too. Before you cast the first stone and eliminate the rogue providers who make up less than 1% of docs who sold scripts like drug kingpins are you ready then to take responsibility for the patients’ end in the opioid addiction phenomenon? That’s right. A huge number of people in this country literally curse at and threaten lawsuits against emergency department providers when they deem their pain is uncontrolled. Has anyone even asked this ballooning number of teenagers and college students who now are addicted why when so many have so much in this country why it’s not their fault they are “bored” and trying various drugs? There is a problem when I take care of patients in their teens and twenties who their view their occasional use of drugs as recreational. Then they get in over their heads and somehow it’s not their parents’ or their fault? Their experimentation leads to the addiction. This is not something you are born to die from without the active participant of the user.

    I am all for appropriate regulations, state databases, MD education and cracking down on miscommunication and deceit from culpable drug manufacturers. But the time has come a long time ago for Americans to come out of the fear of self reproach. Thousands of people became addicted because they did not heed warnings by parents or society and brought the nightmare on themselves. I have older patients who tell me their drug use is simply for occasional “fun” and these well to do employed individuals look at me with scorn as I explain the minefield they are running. Those individuals are guilty of the consequences they experience. And no, no one wants their patient to see the end of this behavior but for many this is a ride they chose to get on of their own free will. And please do not spout off about those who inadvertently became addicted. This is not about them and we all know it. There are thousands who played Russian roulette and are losing but it’s their own fault. We should help them but you cannot fix this without understanding the problem and we need to stop the idea that “trying experiences” and excessive alcohol use or drugs and needing to find excitement in our lives is a right and not without consequences.

    It is not fair to those with real chronic pain who require regular opioids to be rolled into the regulatory nightmare and stigmatization that now evidently is attached to anyone using opioids.

    Here’s the bottom line. Why don’t we stop looking for the only transiently fulfilling answer to this mess? Why don’t we pause and say we don’t just want to find the easy target of our anger while ignoring the complexity of this problem? Americans’ issue with opioids is due to numerous factors and one of these, the potential real culpability of the user themselves, needs to be addressed in a dispassionate way so real solutions can be found. The world can be awash in narcan and if the other reasons people develop any addiction are not dealt with we will still be buying coffins especially since so many people are doing heroin and other classes or drugs. If we do not work on this in a more intelligent fashion, you can sue and blame and cry and hold town hall meetings and pay for more detox but you will not stem the tide of this tsunami.

  • The cdc and the government needs to stay out of our doctors office. They are tying the drs hands who try to help us with this disease. . Yes chronic pain is a DISEASE. . It is am epidemic and we are not getting the care and medications we need to live a half way normal life. Where are our rights as patients to get the care, medication and humanity we need to live?
    They have to place a blame and they’re starting in our drs office, because we are an easy target. Let them go after the doctors, because they can..
    We are alive but we definitely are not living any type of life due to pain.

  • You ever had pain, ever had a shoe wearing a blister on your heal, it’s painful, it’s distracting, makes you limp when you walk. Sure you can put a band-aide on it and it eventually goes away, and you go on with your life. Now what if that shoe/blister effect was inside your body, same pain, same distractions, and it hurt when you move. Sure you go see your doctor. They may give you medications, and tells you we can try this or that treatment. Sure the pain medications, take the pain down, so you can function to some degree, but the treatments, are not fixing the shoe/blister problem, so you move on to the next treatment, and this is now a part of your life now, constant pain, pain medications, and treatments. So after a few years, there are no more treatment, no more options, and the only thing left to help with the pain, is the pain medications. You know the pain medications, are not the best thing for you, because of the possible side effects, you know your are not addicted, just dependant. And you know the pain will come back if you stop taking them. But you still want to be able to have some ability to function, tend to daily things, cleaning house, family, friends, a job. So really what would you choose?

  • To you the minority. Just wait till you have an accident or have arthritis. You are self righteous hypocrites. Doctors were just doing what they are supposed to do, treat pain so people in pain can live a liveable life. I bet you fascists are happy with these new cdc laws. You’d rather have pain patients commit suicide for the ultimate pain relief. You have no sympathy for your fellow human beings.

    • I totally agree with the writer before me; thoughtless commentators need remember the last time they felt excruciating pain, [tooth-ache, migraine, earache]. And consider what that relentless pain would be like 24/7, w/o any relief or compassion. The CDC, [center for “disease control”] shouldn’t be in charge of healthcare. The CDC can’t even tell the truth about the pandemic of lyme and associated diseases that are now world spread, no-less the failed and deadly vaccines that have damaged adults and killed children. Many officials at the CDC are resigning due to suppression of evidence and political interests. When it comes to human pain and suffering, and the lack of knowledge and access to intelligent screening insurance measures, torture is never an option. It’s cruel and ignorant to judge the pain of another.

    • Wow sorry you feel this way but you have either a prescription of these drugs and are scared they are coming to take it or you as you have accused us who desire some regulation here, do not care for your fellow man.

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