2016 Cdc Guidelines For Prescribing Opioids For Chronic Pain (Page 9)

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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Cynthia besides my rheumatoid/fibro/osteo conditions which warrant the use of opiates, my heakth otherwise was fine. I weaned off the fentanyl patch due to the opiate induced adrenal insufficiacy and hypothyroidism it caused. Of course to avoid withdrawal I overtook my breakthrough pills since basically I was only doin one patch every two weeks. Of course I got my discharge letter two days after my last orfice visit. Since then my blood pressure has doubled! My ekg's are abnormal and I need elec...something...like a heart sonogram. I keep telling everyone that it's withdrawal but since im not cramping; noticeably, or vomiting or have any of the regular withdrawal symptoms, they just roll their eyes and ignore me....im having chest pains, trouble walking (bones feel as if they are spliting as I walk), and cant catch my breath during any movement....funny thing is...all these people getting were discharged (myself included) for showing addictive behaviors right? addiction: craving or use of a substance in spite of negative effects or to the detriment of the user. Most pain patients used more and their lives IMPROVED, not got worse!

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Electrocardiogram perhaps, Spyz? I don't see how you AREN'T still experiencing withdrawals. Your chest pain, high blood pressure & shortness of breath while doing the most basic movements is very concerning to say the least. Please don't spend time alone. Women(can)have a very different set of symptoms when experiencing heart attack & you don't want to find yourself alone with those symptoms. My mother was 63 when she her heart attack. I can remember a few of the symptoms; back pain, SHORTNESS OF BREATH, nausea & belly pain. She did not complain of pain &/or numbness in the left arm & chest pain. Please be careful!

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Echocardiogram I meant. Ekg is electrocardiogram. Duh.

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I keep getting sent to hospitals now that my PPO ins was taken away. Hospitals wont even bother to take blood test they said what do u expect me to do your heart is strong now but it wont stay that way. 17 months no pain med.I think we all know its nto withdrawl anymore its the damage done when i was left for 31/2 years with apedicitis then still left in hospital bed after apedix turned to gangreens n was left there to die. Well i flat lined 5 times they finally came in my room, half ass surgery sent me home with gangreene, mrsa, and refused to follow up until my father took me back to hospital. When i was too stiff to move from infection they left in me and he said "What do u mean u don't do follow up? I have a whole pack of matches b****. See all those oxygen tanks? You are killing my daughter again. U can call the police but I bet all you murderers will be blown up before police get here."

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Is anyone else out there suffering over the new CDC guidelines? My doc is arbitrarily reducing my pain medication too low to help the pain. Anyone??

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Kim (#165) --

I went thru same thing after failed spinal fusion a year ago since surgery. They decided to taper me completely off of oral meds to fentanyl. People die from fentanyl so I refused after a month on it. However I was extremely skeptical of Kratom till I tried it. It truly works. I use green Malay for pain when it's a 5. The green Malay works for hours at least six and I only use 1 tsp=5 grams. You get moderate euphoric effects with great pain relief. I use red indo when my pain is an 8 but that one is sedating. The white maeng da is great for stimulation properties but not good on pain. Plus it's inexpensive, I get an oz of each for 12$ each so I pay $36 for almost 2 weeks of relief.

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Keizer...heart turned to be placement of electrodes...back on an impossibly low dose of Oxy so blood pressure is down but not where it should be. Lack of sleep is biggest problem now and of course minor withdrawal everyday via PAWS. The way folks are trying to get cannabis legal is the way I feel about Opioids! Thanks for the concern Keikee

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BL yes patients should study the laws that affect them. We also should be knowledgeable regarding our medication, side effects, proper dosages etc, etc.. Unfortunately I have found that No, most pain docs don't know the laws and when we inform them, they get pissed, we get dismissed and it's back to the Yelliw Pages for us. Pain Doctors know the signs and symptoms of addiction more than knowing how opiates are metabolized, what they metabolize into, side effects, what groups of people should not be given long acting/abuse proof opiates or that they are even detrimental to certain groups of patients and once you inform them; they get that 'deer in the headlights glaze' and reply "it's our standard procedure". They aren't familiar with individualized titration and lump everyone the same. Sorry but that's what I've learned by listening to them repeatedly lying to me regarding laws, guidelines and possible consequences. When I called the TBI (TN bureau of investigation) and DEA and Medical Board they all said the same thing. Pain Doctors can prescribe how much they see fit! What attracts attention are stupid errors like 'forgetting to sign prescriptions, incorrect diagnostic codes, or leaving them out, all of their patients on high doses, and so forth.

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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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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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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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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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BL,

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

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

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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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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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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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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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