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March 28, 2016

The CDC tells doctors how to prescribe. How Quaint.

By | Healthcare Policy | 6 Comments

In a startling show of brilliance, The CDC has decided that Physicians are to blame for the prescription painkiller addiction epidemic. They have published ‘guidelines’ for opioid prescription that will serve no end but helping people win lawsuits because their family members died of opioid overdoses.  Usually because they didn’t take their meds as prescribed by their physician.  

When are we going to put all of the pieces together and realize that the changing climate in healthcare rainbowis responsible for these deaths, not individual physicians? We had to keep the patients ‘satisfied’ and started over prescribing to the squeakiest wheels. There are ‘pill mills’ in every state.  We just shut one down in a neighboring county in my home state of Missouri.  The doctor was prosecuted.  I am quite sure that the physician began by trying to help people control their pain, and then just kept prescribing.  It was an error in judgement, and a serious one.  However, most physicians do not prescribe opioids like skittles.  And most physicians are just trying to keep their patients comfortable.  And this will cause more people to be in pain.

I personally have a chronic pain condition.  I was hit by a car at 14 years old.  The growth plate in my left mandible was damaged, but unfortunately, it was not detected.  It left me with a cross bite, bad teeth, and a misalignment that causes spasms constantly for weeks and causes me absolutely debilitating pain. Like, fetal position pain.  Pain that has had my husband calling my Physician’s exchange to get a prescription for low-dose valium and vicodin to relieve the spasms, as well as the steroids for the inflammation that caused the problem.  I was on Vioxx for years, and I had an amazing relief of my symptoms.  And then we took it off the market, and people like me were back to opioids and muscle relaxers. And now my doctor cannot even call in a prescription for opiate pain relief, because the laws in my state prohibit anything but a paper prescription.  Thankfully, my pain has been managed by tolerance.  The low-dose vicodin I was on stopped working.  I muscled through, and it was horrible. It’s still horrible sometimes, but I cannot live on these medications while I am practicing as a nurse. However, that does not mean I am not in pain.  I am. Every single moment.  It is exhausting. 

Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing, called the recommendations a “game changer” that doctors are likely to follow.

“For the first time, the federal government is communicating clearly that the widespread practice of treating common pain conditions with long-term opioids is inappropriate,” Kolodny said. “The CDC is making it perfectly clear that medical practice needs to change because we’re harming pain patients and fueling a public health crisis.”

So, insurance companies require 6 sessions of physical therapy while you are in excruciating back pain before you are allowed an MRI to determine if you need surgery, but we need to tell physicians to do what? Stop prescribing opiates to people with debilitating pain? Three weeks of agony while you do the PT, no diagnostic films, and no effective medication? You will also have to continue working while you are doing this, because we live in the US and adequate sick time or short-term disability is not always available. In their guidelines they actually state that insurance companies do not cover many of the non-opioid therapies they suggest.  Yet, they wrote these guidelines as if these people would be able to pay for them out of pocket.

This is barbaric.

Maybe we should stop prescribing heroin too..... oh....wait...

Maybe we should stop prescribing heroin too….. oh….wait…

This is what is going to happen.  Physicians will soon stop prescribing opioids – period, because they will not want to get sued for every person who decides they like the way vicodin makes them feel.  The CDC now has published ‘guidelines’ like you can shove every patient into the same-sized box, and give them three to seven days of opioids and all will be well. So Physicians who prescribe these drugs outside of the guidelines will be at risk for lawsuit, because they tried to help their patients.

Oh…and as for teenagers getting high off of their leftover prescriptions and overdosing themselves….I have kids.  We throw the medication out when they no longer need it.  Parents must parent.

Do I think doctors should prescribe opioids to only those who need them? Yes.  Do I think we need to ask about pain control on satisfaction surveys?


CDC….go back to Ebola and the Zika Virus, please.  Let doctors be doctors.  They’ve got this.




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