More Study, More Flexibility Called For
“Given that chronic pain has many different underlying conditions, with great patient variability in metabolism, risk for abuse and medical conditions, further studies are needed to assess the value of long-term opioids when other measures have failed to relieve a patient’s pain, coupled with risk assessment and periodic reevaluation,” the draft report says, recommending studies and clinical trials to drill down into pain and pain management problems scientifically.
PDMP Change Recommendations
The report strongly supports PDMPs but says most have a long way to go as modern computer systems.
It cites a 2010 Ohio study saying that when a PDMP was used in an emergency department, 41% of all opioid prescriptions were changed. Of that 41%, 61% of patients ended up receiving no or smaller opioid doses based on PDMP data, and 39% received more because prescribers were able to determine that the patient didn’t have a recent history of controlled substance abuse.
The report notes that PDMPs work well only when the data is real-time, and issued nine recommendations for improving them, including integrating the activity of checking the PDMP into the workflow in the electronic health record (EHR).
I have endured chronic pain since 2009 due to a rear end collision on an interstate highway. After my third back surgery I was informed by my surgeon I would need to take morphine for the rest of my life. I had great care and enough pain meds to recover, eventually reduced my intake to 2 30mme morphine and 2 30 mme ir morphine tablets. My pain Dr. cited a “new” law that required a reduction in my medical regimen, and immediately reduced me to 90 mme per day, a 25% decrease. I went into a detox that lasted nearly two months. I have had ten additional surgeries (rotatoar cuffs and torn muscles in my both shoulders, torn labrums in both hips, knee scope surgery, knee replacements of both knees) and deal with a great deal of pain on a daily basis since my regimen has been reduced, even though I was able to function at an acceptable level with what I had been described for years. After my last surgery, knee replacement, I was one day away from suicide. If I woke up the next day in as much pain as I had been suffering, I was ready to go. I’m still here, bit I am disgusted by the process, misapplication of CDC regulations by my pain doctors, and most of all, the DEA involvement in what should be a patient/doctor relationship. ADDRESS THESE FAILURES NOW, AMERICANS ARE SUFFRING NEEDLESSLY, NO QUALITY OF LIFE.