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CDC Ending Comments on Opioid Use for Chronic Pain

chronic painMesh News Desk, January 12, 2016 ~ Several months ago the Centers for Disease Control and Prevention (CDC) proposed guidelines for opioid prescribing for those suffering  from chronic pain and mesh pain.  Since then there have been 1,800 comments registered.

Wednesday, January 13th, the CDC closes the comment period.

With 259 million prescriptions written in 2012 alone, prescribing has become a problem, reports the CDC.

Many women who have complications from a mesh implant also experience chronic infection and chronic pain as an adverse events.  They too are prescribed opioids. In fact, some of the worst pain cases, now have complications from their prescriptions, not to mention addiction.

The CDC reports about 140,000 patients have died from opioid use since 1999.  In 2013 alone, there were 16,000 deaths associated with opioid use, four times the number of overdose deaths in 1999.  With physical dependence, tolerance and addiction long-term problems of opioid use, these guidelines were developed with the help of a core group of experts, Core Expert Group (CEG).

Again, public comment closes January 13th.  Public Comment here in the Federal Register – it says Comment Now!

http://www.regulations.gov/#!documentDetail;D=CDC-2015-0112-0001

An Institute of Medicine (IOM) committee in 2011 published Relieving Pain in America. It reported there were 100 million Americas living with chronic pain, about one-third which is called high-impact chronic pain or disabling pain.  While doctors have an ethical obligation to treat pain, they do not have to prescribe opioids to all pain patients, says the government.

Actress Jennifer Aniston in 2014 movie about chronic pain, "Cake."

Actress Jennifer Aniston in 2014 movie about chronic pain, “Cake.”

 

THE ARGUMENT

The Center for Practical Bioethics (here) is advocating for letting opioid management be between the doctor and patient without government involvement.  One of the new guidelines states that those with acute pain can only have three days of narcotics. Period!  The proposed guidelines are a requirement that physicians do urine drug tests before they prescribe opioids for pain.

Ridiculous,” says one MND reader.  “Think about someone who has extensive dental problems such a TMJ that does need medical management…can you imagine dentists having to do this? The invasiveness of it it chilling..almost stating that everyone who needs opioids is a drug seeker. And who is going to pay that cost? Really such a bad direction for those in pain.”

One mesh survivor, involved with this issue professionally, tells Mesh News Desk (anonymously, she is represented by counsel),

“If they do not hear from thousands of people with chronic pain, this new opioid policy will slide through, which will have devastating consequences for mesh-injured women and others with chronic pain. We need to push many comments out so please encourage your readers to be part of the conversation AND please encourage them to send out the link to anyone on their contact lists. It’s that important.”

“If these guidelines are not rewritten there will be a feeling of desperation across the country, our expert says. Forgive me for pushing this, but this is where the rubber meets the road in pain management We need voices that are loud and clear! If these guidelines are not rewritten there will be a feeling of desperation across the country.”

 

BACKGROUND

The CDC Guidelines for Prescribing Opioids for Chronic Pain- United States, 2016, is a guideline proposed by the Centers for Disease Control and Prevention (CDC) for doctors and any care providers. The guidelines consider – when to begin or end opioid use for chronic pain; which opioid to select and for how long; and assessing the risk of a specific opioid.

Opioids are commonly prescribed for pain not just for cancer but for acute and chronic pain.   In 2012 there were 259 million prescriptions written for opioids.  Opioid prescriptions increased 7.3% from 2007 to 2012.

Chronic pain is defined as pain lasting more than 3 months after the normal healing time and can result from an underlying me3dical condition, injury treatment inflammation or unknown cause.  In 2005, its estimated 9.6 to 112.5 million adults about 3-4 percent of the U.S. population were prescribed long term opioids.

Options to opioids include physical therapy, weight loss (for hip and knee implants), complementary and alternative therapies (acupuncture, massage manipulation), and psychological therapy.

 

LEARN MORE:

Center for Practical Bioethics

http://practicalbioethics.blogspot.com/

Here is the Draft CDC Guidelines for Prescribing Opioids for Chronic Pain

http://www.cdc.gov/drugoverdose/prescribing/guideline.html

Public Comment here in the Federal Register – it says Comment Now!

http://www.regulations.gov/#!documentDetail;D=CDC-2015-0112-0001

Pain News Network website

http://www.painnewsnetwork.org/stories/2015/9/16/cdc-opioids-not-preferred-treatment-for-chronic-pain

Vital Signs: Overdoses of Prescription Opioid Pain Relievers, United States 1999 -2008

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm?s_cid=mm6043a4_w#fig2

 

 

28 Comments

  1. anonymous says:

    So they’re saying it’s all in our head basically about the pain when they say psychological counseling and as far as physical therapy it made me worse I don’t have weight that I have to lose nobody understands the nerve pain that we go through every single day of our lives not to mention the pain from the other autoimmune problems we have due to match

  2. kitty says:

    we have nothing to lose now I’m going to ask for CDC who they think they are trying to control doctors who are these people that are addicts where do they get their drugs fromthe lobbyists for acupuncturists and massage therapist probably involved

    • mary says:

      Im with you Kitty when you hurt we need something to ease the pain i will ask my doctor every time i go to her i have had 5 surgery’s on the mesh once they cut my colon into had to wait 5 month’s to reattach it i am really up set with these people.we dont need someone telling us what to do with our pain they have not been through this

  3. Linda says:

    I hope all of you go to the yahoo news page. Their is an article on J and J and all the money they are making. Now is our opportunity to post the truth.

  4. cybil says:

    Check out this doctor on the link below – Dr. Patrick M. O’Connor. He continues to perform TVT and tells his patients not to worry about any ADVERSE side affects being advertised on television because AND, I QUOTE “….you are not like THOSE women.”! Can you believe this guy? With ALL the knowledge we have today about the devastation these mesh slings cause to women, he is stating this? He also boasts to unsuspecting patients -“I’ve done thousands of these.” I guess “THOSE women” as he puts it are us victims. And, I would assume by this comment, he considers us “abnormal” in some way??? What an ego he must have to ignore what’s going on with mesh and still continues to perform J&J TVT!!!

    http://www.nfobgyn.com/physicians/bio/patrick_m_connor_md

  5. kitty says:

    Where does he practice? (Dr o connor)

  6. kitty says:

    Never mind I went to his sight. It’s disturbing to have an insensitive cad flaunching his wares.

  7. kitty says:

    THE problem with narcotic pain meds is withdrawal. After grueling withdrawal pain—then the principle pain remains Then the cost of massage and hydrothrerapy, antidepressants and daily pelvic floor therapy et al hundreds and thousands of dollars compared to $25.00/month for meds

    • Still Standing says:

      Its not quite that simple, Kitty. Opioids used long term for pain management impact your body in so many ways. It contributes to tooth decay, respiratory problems, bone loss, increased pain sensitivity, death from overdose, brain function cardiology issues, and much more. It would be irresponsible for doctors to precribe opioids without bringing in additional therapies that could reduce or replace the drug. Yes, the additional therapies are costly, but research is finding that they work better than opioids over the long term. Hopefully, when the new CDC guide is adopted, there will be incentives for insurance payment of these therapies. I believe Psychological counseling is one of the most important things you can do. Getting counseling doesnt mean the pain is all in your head at all. But there is of course an emotional component.associated with pain. Having a good pain therapist can help you learn self-soothing behaviors that reduce the experience of pain. I just hope you will remain open to the possibility of other pain managment interventions since that appears to be where the medical community is moving,thanks to the governments decision to limit opioids in order to reduce drug overdose deaths and addictions..

      • anonymous says:

        I think the government needs to stay out of my doctors office!one shoe does not fit everyone. I have been on pain meds for several years. Tried the counseling in the physical therapy and all the other crap they tried to push down my throat it’s not going to take away my nerve pain I’m very careful at how much I take so to make sure that I don’t become overdosed or addicted. But I need pain relief it is not all about mind over body. But I don’t need the government telling my doctor how to treat me he’s been my doctor for a very long time and only he knows how to treat me so I think like everything else the government is just putting its nose where it doesn’t belong give the government near channel take a mile pretty soon it will be telling you what you can eat what you can watch what you can wear do you really want a communist country then keep letting the government put more and more restrictions on us!!

        • Still Standing says:

          I agree with keeping the governmrnt out of the patient/doctor relationship but Obamacare has created a monster that will be hard to tame in in that area. There are many docotrs who are not taking new medicare patients because of obamacare, so I advise anyone close to medicare to get established with a primary care physician before turning 65. I understand that pain is not a one size fits all, but science tells us that meditation, mindfulness, physical therapy,accupuncture, and cognitive behavior therapy can impact how you experience pain. Changing how you react to pain can change how you feel pain. I say this because I have been able to change the intensity of my pain by changing how I respond to it. Believe me, as an a+++ personality, I did not think I could ever get there. It takes some work. I have had eight major mesh surgeries and now experience deep continuous ulceration of my vaginal wall. Very, very painful but the days I intentionally change my response to pain are much better days. I teach pain management classes for a large hospital and I have seen some amazing results. A lot is about mindset. The plus to this is that it doesnt cost anything and it has no negative side effects. I just want this community to be ready for this change in how pain is treated with opioids. It is going to happen, doctors will be required to implement the plan. It is not going to be a good thing not just for mesh women, but for thousands and thousands of people who are well managed with opioids. Be mad about it, as you should, but also be prepared mentally to adapt to the new reality. A question: have you tried gabapentin and amitriptyline for neuropathic pain? If not, it might be a good add on. Also, my integrative doctor prescribed compounded low-dose naltraxone to reduce inflammation.,it has worked wonders for my pain, which has been at least a 7 plus for most days since I had mesh in 2008. It has also helped so much with sleep. Maybe your doctor could look at that option. However, you cannot take it if you are using opioids.

          • anonymous says:

            I have tried the second medicine that you name but it made me nauseous, dry mouth and headache the side effects were terrible I refused to try gabapentin cause it can cause seizures what the hell do I need with seizures ! the next president gets in Obamacare will be gone thank God. But I see you are a pain management specialist I am sure you want to try to encourage your specialty. But you know what all of those cost a lot of lot of money which I don’t have I am disabled and permanently damaged by mesh I am NOT on such a high doses of opiates that I will OD and I’m a responsible adult. I think the people that do that are people who have more problems than we do they are drug abusers. I have tried all the therapies you mentioned + music therapy Tai Chi acupuncture you name it I’ve tried it but I have several permanently damaged nerves. I’m sure that your ulcers are extremely painful so please understand that I am not dissing you perhaps there are people that have been helped by this mind control stuff but once again I’m telling you nerves are different they hurt all the time no matter what you do you can try to tell your brain that it’s not really there but for crying out loud that’s the way God made us if something is hurt our brain received messages from the nerves and tells us. It seems that all the doctors pain management people want to do is push more drugs down my body and that’s something I refuse to do I’ve learned a lot through having mesh in my body read the fine print check out what it’s going to do to you before you put it into your body I’m sure those on high doses of opiates have some of the problems that you have mentioned before but I do not I am able to function just fine on this do I want to do this long term know, NO and as soon as Obamacare is done I’ll be able to get ablation therapy and it will help I hope. But not you or anyone else is going to shove or force this other stuff down my throat it does not help physical therapy swim therapy acupuncture music therapy cognitive thinking therapy counseling I understand these are all tools to learn to live life with but right now remember this I have no money I cannot drive I cannot get to all these therapies anymore I did it for almost a year and went almost bankrupt from all the co pays and things that were not covered by my insurance company so I can tell you until you can pay for all my therapist get me a driver to take me to the appointments and be here afterwards when I’m in excruciating pain from physical therapy or acupuncture then no I’m not going to listen to you because you don’t know me and they may gave worked for your body it may work for the girl next doors body but it does not work for my body this is a prime example of the government putting their nose into my own personal body and my personal health thinking they know best when they don’t know jack ×%!&.my injuries are that bad and I know other people who are laying in bed all day long can’t even drive to get to appointments or what about all the money who’s going to pay for all the co pays and stuff we were the guinea pigs we are the pioneers in this so you people do not understand this injury at all yet so many doctors have their head in the sky just like a lot of) other people who believe all this stuff may work on everyone but until you become realistic in my situation don’t tell me what I need to do or what I should take I’m not taking anymore damn pills I’m sorry I don’t mean to offend you but it seems like once again you’re trying to tell me all this stuff works when you don’t even know who I am or what my injuries are and yes my dear I have tried everything even my doctors and nurses have said several times to me you have tried every last option we have to help you and have done everything possible to help youself. I was motivated at the beginning of this too and now I learn to accept this is my reality which is helped me a lot but please please quit trying to tell me these therapies work on everyone because they don’t I appreciate I think it was a sincere offer to help to get some advice but you have to remember all of this cost money the severely damaged people can’t drive they can’t sit for very long even after many surgeries I still can’t I’ve learned to live with that but I still have hope that someday a doctor will be able to help me somewhere but until these medical companies are forced to pay it so we can get the proper medical treatment then we are stuck in a nightmare of Hell each day some of us will learn to cope and function the best we can some of us want but don’t take away the one to that helps me get up every day and at least be able to face the day Obamacare has no business doing this Obama is a laughing joke and I’ll be glad when he’s out of office he pushes things down our throats that we don’t want and I’ve done nothing but hurt people with medical insurance. My co pays for everything have doubled and so now I have had to stop going to see doctors because I simply cannot afford it anymore

        • Bejah Blue says:

          Agree wholeheartedly. I have been taking narcotic pain medication since 2004 and I have never had withdrawal issues. I did start to have constipation so now I eat prunes every day. My new pain med doctor is great. She said that the suggested substitutions for our pain med are too expensive and not one size fits all so she is continuing with the narcotic pain medication and is very supportive. First they butcher us and then they want to take our pain medication away. No way.

          Bejah

      • kitty says:

        SS. How old are u? Are u an elderly mesh victim? Are you in your fifties?

        • Still Standing says:

          I will be 65 this summer. Never thought I would make it to there. Im grateful.

        • Bejah Blue says:

          Kitty, We are never supposed to ask a lady her age! Having said that, please define elderly? Per AARP we are elderly when we turn 50! I don’t think so. I believe in the “real age” vs “Chronological age” school of thought. Most women who are candidates for this horrific mesh are probably older in general but not necessarily elderly. My heart goes out especially to women who have young children at home and are facing this. Finally, does it matter what our age is really?

          Bejah

  8. Still Standing says:

    Im so sorry if you took my comments as not understanding your pain. Believe me, I have severe nerve damage, poorly functioning bladder because I cant feel it, mesh in my rectum, migrated mesh arms into my thigh, my doctor considers my injuries one of the worst which has been confirmed by other doctors. I could not sit at all and almost died in my last surgery in October. So, while I Dont know your pain, I certainly know mine and the ulcers are just the lastest mess Im dealing with, so dont trivialize my experience. My treating doctor says he is amazed that I can get out of bed. I have done much research on how to still live with hope in the midst of despair. One of those ways is to change my response to pain signals. This is doesnt take away pain, it just reduces the suffering that comes with it. It is one thing that I can control. I will submit some interesting scientific journal research for you to read if you are interested. There are significant brain studies that confirm this premise. I realize you have great pain and low financial resources. That is why intentionally changing how you respond to situations can have great benefit since it doesnt cost anything . If you or any other reader ever feel that you would like to try some of these fairly simple techniques. I will be glad to share. It has helped me check my anger, not all the time, but enough, and find positive ways to care for myself and interact differently with others. Just changing one response to pain in your day can change your day. Im not here to judge you at all so please dont take it that way. I just think that we cant spend our lives waiting for settlement money or a magic surgery that will take away our pain. We only have today. Choosing how to move through this day can make a difference. Again, I apologize if I offended you. Not my intention. I would personally love to hear from others about things they have learned to help manage their pain. Obamacare repeal will not change the new opioid policy. Once again readers, it is going to happen, have the conversation with your doctor now to be prepared for any impact it will have on your medical care.

    • anonymous says:

      Its okay sis I understand and I kind of said that in my post I’m sure you meant well sometimes anger and frustration boils out but not at you more the situation I’d learn more mind control in the last few months and I ever had if it wasn’t for that I wouldn’t be here because some days I do sit down and cry and cry just to get it out because of the pain but then I was raised with no whining get up and keep moving on with life and that’s what I do to the best of my ability I’m sure you mean well but I really don’t want to have anything more to do with the medical community at all right now I need a season of rest

    • Bejah Blue says:

      SS, I believe we all welcome all of your posts, your wisdom, experience, the extensive research you have done and consider you a treasured resource and member of this community. I for one welcome any information you are willing to share with us. To say that I admire your courage and dignity in the face of Hellish circumstances is a profound understatement. Thank you for blessing us with your presence dear friend.

      Bejah

  9. kitty says:

    Anounamous–just read your post” aThis is pain hoetnd I feel your pain. SS is no doubt a skilled practitioner who is a progressive in her field. OMG– just listened to Hillary Clinton debate-she can’t wait to get in office and shut um down.

    I’m from the Masters and Johnson Era– ive been in and out of psycodrama– i will pass on your advice. BEEN THET- DONE IT. This is pain honey– and real pain needs a narcotic.

    • anonymous says:

      Thank you kitty so much I don’t mean to be rude or disrespectful to anybody I just know that they can’t dump me into one general pool that says if we do thear therapies everybody will feel better they don’t know me they don’t know my situation I’m sure she was trying to help but I just question because she’s in that profession whether or not she’s ever experienced the excruciating pain of nerve pain do you know that that will work on this kind of pain that the severely injured who have pudendal neuralgia there’s a lot of things we don’t know all I’m asking is for people not to lump everybody into one category because that’s just not fair I fight the establishment and doctors anyways who because they don’t know what to do throw pills and every other kind solution ask us to take them without question all these therapies may work for some others but I’ve tried everything and they don’t work on me I wish they did I’m very open to any new ideas but there does come a time when people keep saying you got to keep trying it that I just get angry and say enough is enough its not working or the drug you’re asking me to take is too dangerous I want a season of peace a season of hope the season that is not full of despair I’m trying to find that season in my life right now and the last thing I need is someone telling me how I should feel and what I need to do I know my body I know what I need to do, I know it works for me and I know what doesn’t work for me so to the government and everyone else I say thank you but please stay out of my business the only one that I will lean on and trust is Jesus that’s the other thing that has been permanently stolen from me the trust in the medical community god bless you kidding I know you probably understand my pain – from previous writings stay strong my sister

      • Bejah Blue says:

        It seems safe to say these are very sensitive subjects for all of us and we need not agree but it is important that we listen to each other respectfully and with heart.

        Bejah

  10. Jan Varnes says:

    I need to comment on this post as I had moved to another state as Obama care or as the Opiate change took hold. My family members have their pain medications just like nothing happened they have other various issues unrelated to Mesh but I too have those as well. I however was not able to even get help to slowly be taken off of Xanax and an Opiate I have been taking together with a few other medications that my Dr. and I were able to create a type of cocktail if you will that covered my pain, muscle spasms, hypothyroidism, and a sleep medication to get to sleep if needed.

    I was treated like a Drug seeker, had five drug tests , panic set in early of course so my fear of a seizure while in the care of my Husband was causing me to hyperventilate and feel like throwing up all day and all night until I finally went to the ER only to find that I was in such a state as this was a never going to end Drug Vacation. All my self soothing had turned to anger and such disrespect of a field I had worked in for many years side by side Dr.’s as a Patient was given bad news, directions and other things that may have been very upsetting but my job was to hold their hand as best as I could for the time we would be talking.

    I was told as a New Patient in the ER that there is a terrible drug problem in this area and in order to take care of this we no longer give pain medications to anyone except for those who need three days to deal with a broken bone and even end stage Cancer Patients were also being declined. How cruel can this be and where am I anyway ? This is like some 25 years ago. Or a very confusing twilight zone that is going to have an ending. I also went from Kaiser a very sterile organized practice model to a very aggressive , negative ” I don’t care where you came from but the records on your phone mean nothing to us, you could have created them all by yourself. I was so not goin to be ok. Do you think I would ever see a URO/GYN in this town? I would seriously doubt it and if I did what is the bet they won’t touch me and I will Catherize myself for the rest of my painful, confusing, fearful life waiting to see just what happens when you place something that is dangerous inside your Woman parts.

    I am still here two years later. I accept this I have no choice but can I say one thing about where and how I am doing? I live in a quiet area, I do not see people often, I am at home, I sit in the car at the Grocery store, rarely do I see a Dr. I go for my yearly blood work and if I feel a UTI coming about, but I quit. I quit doing and talking about it. I quit fighting for anything, It’s a joke with a very, very dark punch line.

    One more thing I have no idea why this is a good way to cure a very disturbing drug problem? Heroin is a serious problem and I have no idea why disallowing more comfortable lives for those who want to live and catering to those who already know their addiction to this drug is a killer have Narcan in the hands of Parents and Wives and other non medical personnel is advantageous to this condition that is for some reason been unable to contain. I lived in a huge City, drug problems all over but they are going to ask for help there to get it , here I don’t see anyone ask for anything but trouble all day long…..

  11. Kitty says:

    CDC…vial organization. An add for whooping cough showing a disgusting and scarey wolf gelding a baby. Senior citazens are now responsible for killing children.

    • Jane Akre says:

      Not sure what you are referring to Kitty other than that television commercial with a senior citizen holding a baby and dressed like a wolf which is a frightening commercial.

  12. JACK ARRINGTON says:

    I have been in severe chronic pain for 28 and a half years now. No fault of mine. In 88 the man-made left hand turn in front of me I hit him head-on hit 55. This last drop in my pain medicine has caused me severe pain and put me into a severe depression. I do not and never have what illegal drugs or even know anything about them. I am 56 years old now. I have done so many procedures too many operations and Hope of controlling this pain. I’ve always listened to my doctors and taking my medicine as prescribed and never vast for early refill or ever flunked a urine test. I am a Lutheran and I am Baptized. I’m sure the good Lord will receive being with open arms. I find no be no solution to this problem in my lifetime. I will not and cannot live in this excruciating pain the rest of my life. Yes I have any other medical problems as well and the pain complicates all of it. It looks like my left leg is going to be amputated because of lack of circulation due to a L5 vertebrae slipping forward to a stage 2 and compressed off my left nerve root and the right nerve root is 1/2 compressed. My Mobility is very limited and my overall quality of life I don’t really find it anymore. It looks like I am going to have to go to street drugs to control my pain which I’m definitely against doing. I do not know what I’m doing outside of my doctor’s prescriptions. The fact is the first time I have to buy drugs off the street will most likely be my last time because I’ll end up dying. After all that is the only solution to my pain problem. I just want to thank you all to CDC for completely destroying what little life I had left I really do appreciate that. God bless you all and may the Lord forgive you for your transgressions. Thank you

    • Jane Akre says:

      I’m so sorry Jack. Are you seeing other specialists such as chiropractor? We have a pain specialist who writes here frequently. I will send your story on to her…. again I”m so sorry. Standard medicine does not always know the latest is my impression, so I urge you to look outside the box of conventional treatments.

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