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