Publication date: Sep 11, 2019
(Salwan Georges/The Washington Post) Carol and Hank Skinner of Alexandria, Va. , can talk about pain all day long.
That’s when a chronic pain patient has to switch to a lower dosage of medication.
He is part of a sweeping change in chronic pain management – the tapering of millions of patients who have been relying, in many case for years, on high doses of opioids.
With close to 70,000 people in the U. S. dying every year from drug overdoses, and prescription opioids blamed for helping ignite this national catastrophe, the medical community has grown wary about the use of these painkillers.
Chronic pain patients form a vast constituency in America, and millions of them take opioids for relief.
Even medical experts who advocate a major reduction in the use of opioids for chronic pain have warned that rapid, involuntary tapering could harm patients who are dependent on these drugs.
There is little doubt among medical experts that opioids have been prescribed at unsound and dangerous levels, particularly in their misuse for chronic pain.
The United States is now in the midst of a -national experiment” as misguided as the one it conducted 20 years ago, when doctors put millions of patients on opioids with little understanding of the consequences, says Tami Mark, senior director of behavioral health financing and quality measurement for RTI International, a North Carolina think tank.
In interviews and correspondence with The Washington Post in recent days, chronic pain patients have described their anxiety about the national reversal on opioids.
They say they’re not drug addicts or criminals, they’re just people in pain who were following the doctor’s orders.
Other chronic pain patients complain of how hard it is to get any pills at all.
Last year she was tapered to zero, because her insurance company wouldn’t pay for the drug testing required by the pain clinic.
A handful of research studies in the 1990s seemed to support a benign view of opioids as a chronic pain treatment, but the research was often funded by drug companies.
Some of the most vocal advocates for opioids were doctors who accepted fees from drug companies for speeches.
Documents cited in a massive lawsuit by the state of Oklahoma against Johnson Johnson showed the company targeted physicians that prescribed high volumes of opioids: -Our objective is to convince them that DURAGESIC is effective and safe to use in areas such as chronic back pain, degenerative joint disease, and osteoarthritis,” the company wrote.
But by that point an entire generation of pain doctors had been trained to view opioids as a safe, effective, relatively nonaddictive treatment for chronic pain from common ailments such as bad backs, torn rotator cuffs, headaches and arthritis – and millions of pain patients had become dependent on opioids.
What she and many others found was that opioids simply didn’t work very well when it came to relieving pain over long periods of time.
(Salwan Georges/The Washington Post) A flood of opioids In July, The Post published a Drug Enforcement Administration database that revealed drug companies had flooded the U. S. with 76 billion oxycodone and hydrocodone pills in a seven-year period, from 2006 to 2012.
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