Last updated : December 16, 2024
Nearly a decade has passed since the Centers for Disease Control and Prevention (CDCP) released its original guidelines for physicians and pharmacies working with patients suffering from chronic pain. The CDCP’s suggestions were intended to help battle against opioid addiction, which had reached epidemic proportions. However, the CDCP may have created a “one bad apple” scenario in trying to weed out those who were knowingly prescribing medications to addicts and, far more than likely, drug dealers, who then went on to the next shady spot to repeat the process.
Honest physicians, in fear of being arrested for overprescribing these medications, put a halt to using them for pain treatment. This left millions of Americans dealing with chronic pain high and dry—not to mention hurting.
The CDCP realized the error of its ways. It released another set of guidelines in November 2022, in hopes of rectifying the situation. However, many in the medical community and the patients it treats believe it was too little, too late.
Why won’t the new guidelines help?
Some physicians have expressed they fear the new guidelines will take too long to have a meaningful impact.
Reasons for this line of thinking include, but aren’t limited to:
- Lack of coordination with other federal agencies
- Ongoing fear of legal consequences among providers
- State policymakers are dragging their feet to change the current laws
- Widespread stigma surrounding opioid medication
Physicians are reluctant to jump back on the bandwagon, even when the CDCP added the suggestion to treat each prescription written on a case-by-case basis.
Meanwhile, people continue to die from opioid overdose in unprecedented numbers. Today, many of these deaths are caused by the illicit drug, fentanyl, flooding into the country. Drug cartels are responsible for smuggling the drug across our open borders utilizing every drug possible, and worse, it’s unbeknownst to users.
Dr. Jeanmarie Perrone, director of the Penn Medicine Center for Addiction Medicine and Policy, co-authored the new guidelines. She knew that physicians were afraid to continue prescribing opioid medications, such as oxycontin or methadone, for fear of repercussions. However, the negative impact the 2016 guidelines made on the quality of life of chronic pain patients impacted her too. In an interview with NBC News, she stated, “I hope we just continue to spread caution without spreading too much fear about never using opioids.”
Patients who are unable to obtain prescriptions for the opioid medications that helped them manage their pain hope so as well. Even those with a prescription in hand are being turned away from pharmacies. Many have stopped carrying these types of medications. It’s a conundrum that we need to get sorted out. And, pronto, because some of these people grow desperate and turn to the streets to seek relief—and they’re dying.
And from the patient’s perspective
In addition to the CDCP’s guidelines making it extremely difficult for chronic pain sufferers to obtain prescriptions for opioids, Prescription Drug Monitoring Programs (PDMPs) are pulling law enforcement into the picture which is—to say the least—intimidating.
PDMPs were established as one response to the growing number of opioid-related deaths in the United States. A PDMP is a database tracking prescriptions of controlled substances, like morphine or oxycodone. They gather data documenting and flagging doctors who overprescribe opioids to patients. Moreover, they identify patients who visit several doctors obtaining multiple prescriptions.
The information is available to law enforcement agents, prosecutors, physicians, and pharmacists. Not only can physicians face arrest and prosecution—that could result in jail time—but patients are under surveillance as well. This, of course, is raising eyebrows due to the constitutional issue of a person’s right to privacy. So far, the main outcome seems only that law-abiding citizens who use opioids as a means of managing their pain are being refused care.
Associate Professor of Sociology at Saint Louis University, Liz Chiarello, doesn’t believe this is fair. In her book, Policing Patients: Treatment and Surveillance on the Frontlines of the Opioid Crisis, she addresses instances of patients being denied care and the negative effect it has on their lives. She tells of physicians being prosecuted for overprescribing these medications. It has devastated lives.
Chiarello, ultimately, leans toward PDMPs being a negative force to contend with because anyway you look at it, it’s being used as more of a surveillance tool. This fact, she said, is becoming more apparent now that some states have added drug arrest data to the mix.
In hindsight though
Opioid overdose is still raging out of control. Fentanyl is mixed into all manner of illicit drugs being smuggled into the country. It’s extremely toxic, causing some to die of overdose after taking one dose of what they thought was a black-market prescription medication.
Meanwhile, people suffering from constant chronic pain are unable to obtain relief using bonified prescription medications.
Regardless of the privacy argument, the fact that doctors and everyday citizens are being intimidated, even harmed, by the laws and processes being put in place due to the CDCP opioid guidelines is something that must be resolved.
While there are other ways to deal with chronic pain, people should have the right to obtain a medication that provides them with relief. Most wouldn’t abuse them and in fact, you may know someone who reserves their pain pills for the “really bad days.” Yes, some people form addictions that can, ultimately, devastate their lives.
Education can help prevent that from happening though because nobody wants to become a drug addict. Let’s start with a firm focus on continued education, CDCP, and keep moving forward as we hope for the best.
