It’s High Time to Stop the Hurt

By Leslie Bythewood, Guest Columnist

Imagine waking up one morning with the worst pain you could ever dream up.

That’s what happened to me in 2000, only it would take another seven years before my now retired doctor broke the news that I had Arnold-Chiari malformation, a rare and incurable disease that causes unrelenting head pain.

A brain MRI revealed that my skull was squeezing my brain like a sponge, putting extreme pressure on the arteries in my brain. “It herniates out,” my doctor explained.

Fortunately, he was willing to prescribe opiates and my pain was well-managed for the next decade.

But in 2017, the year I became eligible for Medicare, I learned my doctor had opted out of that federal program, forcing me to find a new primary care physician. That’s when my life suddenly took a nosedive.

For the next year, four different physicians would attempt to taper me off opiates without my consent, causing my chronic pain to escalate exponentially and inflicting all sorts of adverse side effects from the anticonvulsants and antidepressants they prescribed.

I eventually found a caring doctor who understood my pain and immediately put me back on the tried-and-true opiate treatment plan that enabled me to function.

LESLIE BYTHEWOOD

One year later that doctor was forced to abruptly surrender his DEA license without justification, preventing him from prescribing opiates to any of his patients, including me. Nevertheless, undeterred and refusing to leave his patients in the lurch, he provided a soft landing by referring all of us to new doctors, enabling me to carry out my daily activities with no pain or intolerable side effects.

Opiates are the only class of medication that work for me and millions of other Americans with intractable pain, but it’s hard for many of us to find doctors willing to prescribe them. What caused the vast majority of doctors to go running the other way with their tails tucked between their legs was the 2016 CDC opioid guideline, which encourages cautious prescribing and arbitrary 90 MME dose limits.

Almost immediately after the guideline was released, patients could no longer count on their doctor to make informed clinical decisions about whether to prescribe opiates. The CDC had driven a big fat wedge between the doctor and the patient.

Many doctors never considered the CDC guideline as voluntary and viewed it as an unbending rule that tolerates no wiggle room. They gave their patients two choices: either taper off opiates or be dismissed for good.

The truth of the matter is that only a small percentage of patients become addicted to opiates. The vast majority take their medications as prescribed and are never at risk for addiction or overdosing. And that’s exactly why, despite the fact that opioid prescribing is at a 20-year low, the number of U.S. overdose deaths continues to soar, driven by street drugs such as heroin, cocaine, illicit fentanyl and methamphetamines, not pain medication.

The blame for this lies squarely with the CDC, DEA, Department of Justice and the news media, who continue to point the finger at doctors for “overprescribing” when the real culprit is street drugs. We don’t have an “opioid epidemic” at all. What we have is a street drug overdose epidemic, plain and simple.

The harm that’s been inflicted on millions of chronic pain patients needs to be rectified by throwing out the misguided CDC guideline and leaving it to the Food and Drug Administration to publish a new set of guidelines that do not encourage arbitrary dosage limits and restore the doctor-patient relationship.

But scrapping the CDC guideline doesn’t go far enough.

We desperately need federal and state laws that protect doctors and patients from the unwarranted, overreaching scrutiny of the DEA and ensure that patients with serious and debilitating diseases get adequate care without delay. Forced tapering and leaving people to suffer in pain are not the answer.

Once and for all, the war on drugs must come to a screeching halt. Restricting legitimate patients from access to opiates is not going to end the street drug overdose epidemic.

Leslie Bythewood is a freelance writer who lives in North Carolina.

PNN invites other readers to share their stories with us. Send them to editor@painnewsnetwork.org.