I rarely comment on political or policy issues, but the
recent FDA guidelines demand a response. They are absolutely terrifying and I
believe that they hinder medicine rather than help anyone at all. I am
furious.
I understand that there is a prescription drug problem in
this country. You will always have some people who are going to abuse
something, but I do not think that restricting access to pain control is an
answer. At one time, Alcohol was banned in this country. Still, many people
found ways around this. It simply drove drinking into the shadows for a few
years. It even led to the invention of cocktails to get rid of the horrible
taste of bootlegged alcohol. It did not work then, and it will not work now.
Prohibition did not stop alcohol consumption. It is clear to most people that
the roaring twenties were well lubricated.
Under the new guidelines, doctors would
prescribe painkillers only after considering non-addictive under the new
guidelines, doctors would prescribe painkillers only after considering
non-addictive pain relievers, behavioral changes and other options. The CDC
also wants doctors to prescribe the lowest effective dose possible. And doctors
should only continue prescribing the drugs if patients show significant
improvement
In many ways, this flies in the face of a
principle sacred in medicine- Doctor-Patient confidentiality. Not only does the
patient have to prove that they are in chronic pain. Doctors would not be able
to prescribe without sending the patients to more doctors for therapies that
are not covered by insurance. In addition, they would have to justify the
reason. Doctors should be able to prescribe medication without fear of being
prosecuted or losing their license. No one says to a diabetes patients- you are
taking too much insulin. “You can only use this amount- it doesn’t matter if
you have a seizure due to low blood sugar- you had it because you used too much
insulin.” This is essentially what is happening to pain patients right now. A
patient must have proof that the pain is chronic, try alternate therapies, sign
a pain contract, and beg the doctor for treatment. The doctor is now to
terrified to prescribe tome medications and sends you a specialist. The
specialist could then decide if you warranted pain medication. Then, you have
to go back to the pain doctor and hope that your medication will be there.
These guidelines do not just effect
patients in chronic pain, but those in acute pain as well. For short-term pain,
the CDC recommends limiting opioids to three days of treatment, when possible.
So if you are in the hospital for surgery
or have a broken arm, you might only be given pain medication for a few days
post op or event. This, more than anything else, is just wrong. If they can only
prescribe for three days, the patient will be in a great deal of pain and this
may actually hinder the healing process.
It will condemn some chronic pain patients
to a life of pain. Many pain patients learn to manage their pain and are able
to lead a relatively normal life. These guidelines would dramatically change
this and will have an adverse effect on the lives of many. Indeed, some chronic
pain patients would be disabled due to pain. This would increase the number of
people on disability and thus hurt the economy.
I really, really hope that someone starts
to see sense.
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