After weeks of uncertainty, a federal advisory committee has endorsed controversial opioid prescribing guidelines that the Centers for Disease Control and Prevention proposed for physicians.
During a meeting late last week, the National Center for Injury Prevention and Control’s Board of Scientific Counselors unanimously supported the recommendation of a CDC expert working group, although the committee did suggest modifying some of the language.
“At this point, everything has been turned back over to CDC with the request for us to consider taking a closer look at the guideline recommendations where there were mixed opinions,” a CDC spokeswoman wrote us. Although she added the agency feels a sense of “urgency” about issuing its guidelines, there is no timetable for finalizing the proposal.
The meeting was held in response to criticism that the CDC draft guidelines were based on weak evidence and would unfairly restrict some patients from obtaining needed pain relief. The agency was also chastised for using a “secretive” process to formulate the guidelines, which some critics argued had violated federal law. As a result, the CDC delayed issuing the guidelines.
As we previously noted, the guidelines were assembled last year in response to a long-running epidemic of opioid abuse and misuse. Every day, 52 Americans die from overdoses of opioid painkillers. In response, the CDC convened a group of outside experts to draft guidelines for primary care physicians, since family doctors and internists write the vast majority of prescriptions for these drugs
The CDC guidelines suggest doctors prescribe opioids only after other treatments fail. The proposal also suggests doctors start patients on short-acting opioids — instead of extended-release, long-acting opioids — and initially prescribe the lowest possible effective dosage. The overall theme is to bolster physician awareness of abuse problems and encourage greater monitoring.
But some critics charged the guidelines will be far too restrictive and, consequently, make it difficult for some patients to be treated with the most effective options. Last month, the National Institutes of Health’s Interagency Pain Research Coordinating Committee held a meeting and then filed an objection to the CDC, prompting the National Center for Injury Prevention and Control’s Board of Scientific Counselors to review the guidelines.
It is worth noting that some critics who participated in the NIH committee meeting last month included patient groups that receive industry funding. Among them were the US Pain Foundation, the American Chronic Pain Association, and the Center for Practical Bioethics, all of which receive some funding from drug makers, including Purdue Pharma, which sells OxyContin.
In any event, one CDC expert working group member said the suggested changes appear to be minor.
“The tweaks to the wording resulting from these debates do not materially or contextually change the intent of the initial guideline recommendation. Most of the wordsmithing suggested here is neither surprising nor inappropriate,” said Dr. Lewis Nelson, an emergency medicine specialist at the New York University Langone Medical Center.
Meanwhile, one critic of the CDC proposal remains skeptical of the proceedings.
“They seem almost unchanged, which makes me think the ‘review of the review’ was strictly cosmetic and that the fix was in and it still is,” said Peter Pitts, a former Food and Drug Administration official who now heads the Center for Medicine in the Public Interest. He noted that the FDA also voiced objections to the guidelines. “It will be interesting to see if the guidelines are further modified.”
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I have been a Chronic Pain Patient for 9yrs. I can’t remember how many times I have been HUMILIATED by people, because I use OPIATES! I have been treated as a DRUG-SEEKER, a DRUG-DEALER, a WEAK, & USELESS human being. It’s becoming worse, due to “THE WAR ON OPIATES”. Anyone who has anything to do with Medicine feels they have a right to question me, & pass judgment on me. It doesn’t matter if it’s against the H.E.P.A Laws. These LAWS don’t apply to OPIATE users. No, WE are all perceived the same. Losers who are taking the easy way out. I am 56 yrs old woman. I was hit Head-On, by a Drunk-Driver when I was 19 yrs old. The DRUNK died instantly. I spent 3 hours trapped in my car W/ my right leg Crushed, & 2 Compound-Fractures. It took me 1 yr to recover, & I recovered well due to the shape I was in(I was an Exercise Instructor)& my age. I didn’t start taking ANY Medications, until I was 45 yrs old! I lived in Boulder, CO. So, I had many Alternative methods for pain available, & I did them ALL. BODY-WORK, Chiropractors, Exercise, Acupuncture, & etc. I NEVER asked for PAIN-MEDICATIONS, I was told, by DOCTORS, it was time for them. Now my pain is completely consuming. I am always in PAIN. W/ the opiates. I have several SURGERIES coming up. Hopefully they will help, because my Pain Medication has been CUT-DOWN, continuously since 2015. I don’t DRINK, or Smoke Pot.(wish POT helped me, but it makes MY pain worse, for unknown reasons)Opiates have been around for thousands of years. They aren’t EVIL, & help many people to have better lives. People who need help controlling their PAIN, are NOT weak, or bad. I don’t buy illegal medicine, but I am afraid I am going to have to do this. That’s what will happen when all opiates, are taken away from people in PAIN. The’1 size fits all’ Medicine doesn’t work, & is CRUEL.(1 time a Doctor from India, told me that in India, there were no chronic pain patients, that Americans had made this up, I hope that he gets to experience CHRONIC-PAIN, in his life time)But, what does that matter? ‘The Opiate epidemic’ will have be solved! RIGHT? Very doubtful, because just like Nancy Regans, “WAR-On-Drugs” was a failure for the country. Getting rid of ALL Opiates won’t stop people from using illegal drugs.(it isn’t getting to the root cause of WHY people want to get high)The drug of choice will change. The REAL chronic pain patients will have suffered unnecessarily. People are all different, & PAIN TOLERANCE is different for EVERYONE! We are doing what we ALWAYS do, going from 1 bad situation to another. Doctors over prescribed Pain-Medicine,for decades & now they are under Prescribing them. Hopefully after a few decades, SANITY will return, & the people who NEED OPIATES will be able to get them again. W/out all the unqualified people SHAMING us into completel, & constant despair. Remember when Alcohol was considered EVIL? Prohibition! Another American failure. When will we learn? That most things are not Black, & White.
I got a problem, why should us people with chronic pain suffer because the HCP (heath care providers) with their inadequate abilities to keep the medications out of the abusers hands? HCP would rather have us chronic pain sufferers be in total life changing pain, not being able to have even a close to a normal life. So the HCP are saying that the abusers are more important than us people who are suffering??? Is it just me or is there something wrong with that thinking. Lets cut off the left hand because we can’t find out whats wrong with the with the right hand?????????
The more I read and research this CDC Guidelines panel and the reports and papers involved the more I think this whole issue has to be started over with an upfront panel that does not have any special interests in the out come. What is going to happen when the general public becomes aware of the deception and the price gouging to come. When Mother Alice goes to the E.R. with a severe injury and is discharged with 3 aspirin and call your regular Dr. in the A.M. then this whole scheme of withholding opioids with faulty info. and no transparency will eventually come to the fore. There may be suicides from opioids (there are always 10 to 25% problems with any program) but to say these suicides are because of legitimate use of these drugs is just and excuse for some of these panel individuals to have their own agenda realized.
The true people,once again, who suffer are the individuals who needs these drugs for their well being.
It is a disgrace what they have done for money greed political votes. Chronic pain patients that had decent lives living in stable controlled pain had the rugs pulled out from them. Pain that was being relieved are now loosing their medications are left living in misery. Because the efforts of the CDC, PROP Dr. Kolondy & others to supposedly protect or help people was all garbage it wasn’t to help anyone but themselves. There are way too many chronic pain patients dying, going to the street that never even would of thought that possible, but find themselves returned too so much pain they can’t stand it. So they go to the street in an attempt to self medicate after being abandoned by their doctors the medical feild. Worse the ones that can’t find relief or won’t go to streets are killing themselves they use what meds they have left to relieve their pain and O.D. die. Then the CDC use their deaths to add it to their over blown numbers to prove their point it is a disgusting mess. Pain patients are suffering they are dying and no one NO ONE seems to care we are suffering so severely we would rather die then exist bedridden crippled in pain. Would you want to live that way? Would anyone want to live that way? This needs to stop and soon before anymore dies.
Mine was changed today after 8 years of always coming to appointments, always passing drug tests and obeying every law and rule. I will be at a lower dosage than my first year year with no break through pain treatment. This is due to a new doctor coming in and bringing up guidelines which I have yet to find proof of. The biggest problemis that no one cares. They don’t care if patients kill themselves or get thrown in jail out of desperation. The director of the pain clinic in Charlotte almost seemed giddy delivering this news to me because the doctor I normally see was out of the country. I had never me this man before and he acted like telling my life was over was fun. To know how little I will now be able to do with my only grandchild devastates me. My life wasn’t great anyway but at least I could get out occasionally. Since my feet are the most painful, that eliminates walking. I won’t be able to even sleep to get relief from the pain. I can’t understand why these people think they know what’s best for anyone. If it happens to them, they have enough money to get their meditation. Is the insurance companies paying them off? Who else gains from this but insurance companies. I guess Medicare and Medicaid do. My only hope is that every person that made the decision to leave people preferring like over death, be gripped with the most pain possible and go broke buying medication, they can’t be prescribed. Doctors and years of mis-diagnosis led me to this place. Now they want to end my desire for life as well.
Please excuse my typos. Swype keyboard changes comments after they are typed correctly. I meant life instead of like. The missed space was my error.
Mine was changed today after 8 years of always coming to appointments, always passing drug tests and obeying every law and rule. I will be at a lower dosage than my first year year with no break through pain treatment. This is due to a new doctor coming in and bringing up guidelines which I have yet to find proof of. The biggest problem is that no one cares. They don’t care if patients kill themselves or get thrown in jail out of desperation. The director of the pain clinic in Charlotte almost seemed giddy delivering this news to me because the doctor I normally see was out of the country. I had never me this man before and he acted like telling my life was over was fun. To know how little I will now be able to do with my only grandchild devastates me. My life wasn’t great anyway but at least I could get out occasionally. Since my feet are the most painful, that eliminates walking. I won’t be able to even sleep to get relief from the pain. I can’t understand why these people think they know what’s best for anyone. If it happens to them, they have enough money to get their meditation. Is the insurance companies paying them off? Who else gains from this but insurance companies. I guess Medicare and Medicaid do. My only hope is that every person that made the decision to leave people preferring life over death, be gripped with the most pain possible and go broke buying medication, they can’t be prescribed. Doctors and years of mis-diagnosis led me to this place. Now they want to end my desire for life as well.
Kuddo