Tuesday, August 28, 2018

Opioid crackdown means some can't get needed meds

Because of crackdowns on opioid prescriptions to combat the opioid epidemic, some patients who say they legitimately need those prescriptions say they're unable to get them. "Some said they coped by using medical marijuana or CBD oil, an extract from marijuana or hemp plants; others turned to illicit street drugs despite the fear of buying fentanyl-laced heroin linked to soaring overdose-death numbers," Brianna Ehley reports for Politico.

Jon Fowlkes, a former law enforcement officer who took OxyContin to help with excruciating back pain from a motorcycle crash, said his doctor abruptly refused to renew his prescription. He told Ehley he contemplated suicide because he couldn't live with the pain, but was able to find a doctor willing to prescribe the drug blamed for starting the epidemic of addiction and overdoses. He worries what will happen if that doctor also stops -- not an idle fear, Ehly reports, since President Trump has set a goal of cutting prescriptions by a third over the next three years and has stepped up prosecution of doctors who inappropriately prescribe narcotics, including opioids (synthetic opiates).

Stories like Fowlkes' "illustrate the unintended consequences of efforts to suddenly reverse years of loose prescribing practices that fueled an addiction crisis — and why so many of the estimated 25 million Americans suffering from chronic pain feel angry and forsaken," Ehly reports. "While studies suggest that other therapies are safer and more effective for many chronic conditions, large numbers of these patients are now hooked on the narcotics and on the relief they say they get from constant, grinding pain."

Doctors and pharmacists acknowledged those fears, but told Ehly they're under great pressure to limit such prescriptions and fear losing their licenses or going to prison. Some said they chose to no longer treat patients with chronic pain because of those risks.

"Jianguo Cheng, president of the board for the American Academy of Pain Medicine, said that besides being scared, many doctors are also fed up with time-consuming requirements, including pill counting, where a patient brings her prescribed medication to the clinic so the doctor can make sure they aren’t being misused. Doctors also have to order regular urine tests to detect abuse," Ehly reports. "And few are trained how to safely wean someone off opioids. Some patients told him their doctors failed to treat their withdrawal symptoms, and they were sick for weeks after being tapered off their painkillers."

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