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

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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Sounds like your doctor gIves you 3 advance scripts a visit and dated them all same day instead of post dating them.. new doctor not aa kind and didn't research it.

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The CDC released their Guidelines for 2016 on March 18, 2016 and they are at the link below.

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016-
cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

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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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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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2017furtherrestrictionsnyc , most pain management doctors are also following the CDC Guidelines..

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I have had 2 ACDF C5-C6 AND C6-C7 and now have to have a 3rd back surgery on C4-C5. I also have Lupus and Hashimotos Thyroid! I have been to several pain clinics in the Knoxville TN searching and begging for some help. I have gone from 2/60 mg Oxycontin ER twice a day along with 4/30mg Oxycodone IR per day for breakthrough pain to the unbelievable amount of only 2/20 mg Oxycontin ER and only 3/20 mg Oxycodone IR per day. They are going by the CDC recommendations! Which is exactly that, recommendations ONLY! My question is ARE ALL STATES going by the recommendations are they doing what's right and doing a PATIENT BY PATIENT BASIS? Every one is different, we are not the same and definitely not the same problems. Is anybody else having the same problem or is it just the wonderful state of TN?

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Audrey, it is still up to each doctor to prescribe what in their professional opinion is best for their patients. Unfortunately doctors lie. They tell patients they are being forced to prescribe a certain way when it is totally their choice.

No state is making doctor prescribe a certain amount. Nor is the federal government. Even when their is a policy, like with CMS Opioid Misuse Strategy, there are exceptions. But, the medical commuinity gas learned that high doses of opiates are not best. It takes a while to adjust to lower doses of opiates, but it will get better.

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Re: BL (# 156)

I'd love to see those state and federal "laws" as up till now, being in the health care industry, I've never seen any.

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Re: some1whoknows (# 118)

Wow. I find your response totally absurd. Working in health care, I work with patients who have chronic pain and need these medications. One that I have worked with was crushed by construction equipment, another is a ear veteran who will.have pain for the rest of his life from an i.e.d. yet another that was recently denied has kidney disease, a recurrent tumor and stage 4 endometriosis. These people arent gettin, "high", they're existing. People that couldn't hold a job. Before being given these meds (the ones I work with anyway), mostly work after. Now some will have to stop. And now, I've had another nurse have a patient who killed herself because she couldn't stay out of pain. By no means am I saying this is everyone, but shame on you for saying cancer patients are the only patients who should get these. What are your qualifications to make that statement? Also, do you realize that many patients now have to keep their meds in a safe if they get any and pay out of their own pocket for naltrexone, on the off chance someone breaks into their house and safe and overdoses? And now they're telling patients to "deal with the pain", after major surgery or giving 5 days of meds. Many of the CDC members who made these guideline are statisticians, not doctors. So glad politicians are making medical decisions they have no education or background to make.

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Lovw that "voluntary" version....those that dont "voluntarily" go along with this may loose their liscense or be investigated. They're keeping doctors from using their best judgement and causing them to make decisions from fear. This is not how medicine should work!

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Re: 2017furtherrestrictionsnyc (# 180)

Yes, I loved when a patient of mine. 93 was told he could begin using a meditation ball...I will spare you his response as it was less than cordial. He forsnt have too much longer, maybe a year, I would guess and they're worried about him getting addicted. This is just going too far.

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Jenny, State Medicaid Programs each have their own list of restriction and limitations in addition to the laws and guidelines. Most, if not all, Medicaid Programs are many more restrictions and limitations than any other insurance, government or private. The proposed CDC Guidelines have nothing to do with how each State Medicaid Program governs their health care.

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Thanks Dana. I said the same thing. So sick of the addicts manipulating Dr's so they can get their fix

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Robert R., it is a drs responsibility to write things in your medical records that can affect your treatment. There is no way that a dr remembers things about patients because they have too many. If she hadn't written in your medical records that you told her you used Marijuana, it could hurt her in some situtions. If a dr makes a mistake and writes the wrong info in yoru medical records, you can ask them to change it. If they don't, you can submit a letter that is to be put in your medical records.

You said that the prescription was three month old, what did you do for pain meds for those three months ? It is always best to check prescriptions before leaving the drs office in case mistakes have been made. Most, if not all states have laws on how long Schedule II prescriptions are valid, as well as other prescriptions. Insurance companies also have rules on how long prescriptions are valid.

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Jenny, there is nothing that says anything about pain meds or pain meds being taken away or those committing suicide being chronic pain patients. The article says two thirds of the suicides in Tenn involve firearms. Is there another link that I am missing?

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Keikee, if the pain clinincs were shut down and the drs lost their medical licenses it is because they weren't prescribing according to federal and state laws. If the drs weren't prescribing responsibly, the chances are much greater that the patients getting prescriptions were abusing or diverting them.

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

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