Misinterpretation of the Opioid Crisis

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The misinterpretation of the opioid crisis has led the U.S. Centers for Disease Control and Prevention to look for an avenue to clear the air with the fact that it has never advised involuntary dose reductions for chronic pain victims. Robert Redfield, CDC Director, stated in a letter to the physicians who had disregarded the misinterpreted prescription, that his agency “does not endorse mandated or abrupt dose reduction or discontinuation, as these actions can result in patient harm.” He further illustrated the different strategy that has been put in place to retrace the wrong notion that had been absorbed by the public which has led to unintended sufferings

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Stefan Kertesz, Pain and Addiction Specialist in the University of Alabama at Birmingham, confirmed that he had seen some victims of the widespread misinterpreted guidelines. He accepted the CDC’s reply that came in exactly the same day that the Food and Drug Administration (FDA) gave warning concerning the risks of following the involuntary or fast opioid tapering.

Kertesz commended the CDC and FDA on social media. He termed it “a great day for patients with pain” because two federal agencies had stood up against the ill-advised involuntary reductions in chronic pain victims. 

The CDC’s guidelines, which were supposed to be for the primary care physicians stated that doctors should avoid high dosage that is above 90 morphine milligram equivalents (MME) per day. Better still, doctors are to take precaution before deciding to titrate dosage above that level. The CDC had never said that patients taking above the said daily dosage and are doing quite all right should be mandated to go below the limit. But the CDC has said that clinics should collaborate with patients to minimize or halt the opioid dosage if the hazards are far more than the benefits.

According to Redfield, “The recommendation on high-dose prescribing focuses on initiation”. The Guidelines state that clinicians should join efforts with patients to minimize dosage if the harm on patients is higher than the benefits of opioid therapy. Also, “…the Guideline recommends that the plan be based on the patient’s goals and concerns and that tapering is slow enough to minimize opioid withdrawal, e.g., 10 percent a week or 10 percent a month for patients who have been on high-dose opioids for years.”

The FDA during its safety announcement confirmed that it had “received reports of serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased.” The agency further said that the consequences “include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide.”

Redfield confirmed that the CDC is engaging providers and health systems to explicate the content of its advice, to highlight the essentials of creating policies that go inline with the Guideline’s objective, and to emphasize directions within the Guideline which include options for non-opioid treatments for chronic pain, tapering guidance and liaising with patients. He also said that the CDC is reviewing the scientific literature that has been published since the Guidance was emancipated and sponsoring “four extramural research projects that are examining unintended consequences of tapering and discontinuation.”

So many patients across the country had complained bitterly concerning their health situations which were affected by the policy. Many of these reports were included in the March 6 letter to CDC. 

Accepting the March 6 letter with reports from patients across the country, the CDC Director said the agency concurs to the fact that patients suffering from chronic pain have the privilege to safe and effective pain management. 

He said the CDC is dedicated to tackling the needs of patients living with chronic pain and at the same time minimizing the risk of opioid-related overdose, misuse, and death.

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