One patient’s story of how her life is now miserable without adequate medication
Editor’s Note: The following article was acquired from the online facebook page, painpainandmorepainCathyKean, and all rights are reserved by the author. Minor edits have been made for the purposes of style.
I am 57 years old and live in Hemet, California. I have suffered from chronic, intractable pain for over 25 years. The primary causes of my pain are diagnosed as early severe degenerative cervical spine disease, Chiari malformation, spondylosis and subsequent nerve damage, and spinal cord impingement by bone spurs. I have worked with two pain management doctors through all available step therapies without success. Managed pain medication is the only treatment that has afforded me a reasonable quality of life, allowing me to work and volunteer part time.
In 2017, my pain management doctor began reducing my dosages of pain medication and intentionally under-treating my intractable pain. He has admitted that this was medically contraindicated, since my condition is worsening. But pressures from the DEA to comply with CDC dosing “guidelines” are making him taper all his patients, regardless of condition or impact on their quality of life.
Fearing the DEA
He fears DEA [U.S. Drug Enforcement Administration] actions that would lead to prosecution if he treats under prevailing best practices. In addition, he has shared that scrutiny from the Medical Board of California under the Death Certificate Project has further restricted his ability to provide safe, adequate, medical treatment to relieve suffering. His attorney has advised him that deviating from forced tapering of patients could lead to closure of his practice, leaving hundreds of patients with no treatment. He has shared that several of his colleagues have expressed to him a similar concern, and many have closed their pain management practices as a result of draconian government regulation.
For me, this unwarranted reduction in pain medication dosing is forcing me into an unbearable quality of life (unrelenting pain, lack of sleep, limited activity, poor appetite, depression). Due to my worsening condition, I have been accepted in a palliative care program with the Visiting Nurses Association. Unfortunately, after eight months, I have yet to find a pain management physician who will adequately treat my pain under the palliative care exemption frequently stated in the 2016 CDC guidelines. All of the doctors I have consulted with declared concerns with DEA and Medical Board sanctions as reasons for not providing treatment. Without adequate pain treatment, I will not be able to make the monthly 140-mile-round trip to my pain management physician. I will have to quit my part-time job and volunteering and will end up bed-ridden.
Pharmacies are nervous
Additionally, the pharmacy I have used for over fifteen years has declined to fill my legitimate, controlled medication prescriptions, stating that they fear scrutiny from the DEA. Even the administrators for our insurance carrier are interpreting the CDC prescribing guidelines as strict regulations, causing my physician to spend an inordinate amount of time securing medication pre-authorizations and justifying a medical diagnosis to people with no medical training. The CDC dosing guidelines state they do not necessarily apply to patients being treated for long-term, chronic pain, and cancer/palliative/hospice patients, yet innocent doctors are being bullied and threatened. The broad brush of government regulations and misapplied guidelines is causing unnecessary suffering for countless, law-abiding intractable pain sufferers. Even cancer patients who only have a short time to live are dying or have died in agony. Intractable pain is very individualized and should be controlled by pain management physicians.
[The above is from the patient , but the below material is from a comment by Pharmacist Steve (pharmaciststeve.com)]
I have stated before and this letter from a patient seems to validate my conclusions. I have always suspected that the CDC was doing some of the “dirty work” for the DEA…because the DEA could never get by with publishing things like the opiate dosing guidelines, and many believe that the CDC does not have the statutory authority to do it either…but…so far they have gotten by with this ILLEGAL ACTIVITY…
Make it the standard
The end goal – IMO – was to get [more than] 50 percent of the healthcare community to adopt these guidelines, and once that happened, then they could be considered to be the “standard of care” and “best practices” for ALL HEALTHCARE PROVIDERS, and it would then be EASY for the DEA to get one of their “experts” to testify against prescribers that the DEA wanted to TAKE DOWN … that they were providing opiates greater than “standard of care and best practices” suggest are not appropriate… and thus could come to the conclusion that the prescriber was treating/maintaining a person who suffers from opiate use disorder, substance abuse or opiate addiction. Seems very easy for the DEA to FABRICATE a storyline for a jury to find a prescriber GUILTY.
There is a lot in the news media that is accusing President Trump with the MANUFACTURED CRISIS AT THE BORDER… but they can’t see how the war on drugs seems to be equally MANUFACTURED/FABRICATED since it began in 1970 with the passage of the Controlled Substance Act.