Chronic pain is a serious symptom of many diseases, conditions, and other medical diagnoses. According to Reason Magazine, the CDC has released a set of “voluntary” guidelines for prescribing authorities (mainly doctors) regarding the prescribing of painkillers like Oxycontin, Vicodin, Percocet and Tylenol #3 [read the transcript or listen to the briefing CDC gave on their new guidelines, following this post below]. This could set off unintended consequences for people who suffer from daily chronic pain.
“The Centers for Disease Control and Prevention issued guidelines for medical professionals to discourage them from prescribing these medicines to relieve pain,” the piece in Reason states. The reason? Prescription overdose is said to be the leading cause of accidental death in the United States, and attempts at curbing painkiller abuse through messaging–such as via public service announcements on radio & tv–have not been very successful.
Doctors have been more aggressive in treating pain. According to an article reviewed by Dr. Brunilda Nazario, Associate Medical Director at WebMD, the most common conditions warranting a painkiller prescription are:
- Low back pain
- Arthritis, especially osteoarthritis
- Multiple sclerosis
- Nerve damage (neuropathy)
In many cases, pain from chronic pain disorders is subjective and there aren’t foolproof ways to measure the discomfort someone may be experiencing, or gauge their specific need for a certain type of drug or other treatment. With this understanding, and increasing scientific evidence of the debilitating nature of pain to some people, doctors have taken pain control more seriously over the last twenty years. Some doctors admit there’s a certain level of compassion that takes over when faced with the decision to reduce someone’s discomfort or deprive them of available remedies. Reason continues, “Experts also concluded that the danger of those patients becoming addicted had been exaggerated. The word went out, and over the past twenty years, prescriptions for opioid painkillers have more than doubled.”
This was a blessing to chronic pain sufferers. However, the CDC now believes the side effects outweigh the benefits of prescribing opioids. “CDC advises physicians to limit such prescriptions for short-term pain to three days or less. As for chronic, persistent pain, it recommends that patients first be treated with ordinary [mainly over-the-counter] painkillers, physical therapy, or antidepressants.”
The need to prevent opioid overdoses is understandable, and there is a danger of over-prescribing. However, these new CDC guidelines pose a real risk to those who have genuine, severe chronic pain. Under these new guidelines, such sufferers may face under-prescribing. The human body is amazing at responding to any number of stressors, but it also has limits.
Pain affects the body in many ways.
If not properly interrupted, pain doesn’t just manifest as discomfort–it can be detrimental to all the body systems. When a person is in pain, their body systems work against them. While it differs with each person, without effective treatment, it is common to develop additional medical problems as a result of pain.
Some common side effects of pain can include fever, high blood pressure, migraines, immobility, increased heart rate, difficulty breathing, malabsorption, and many other health issues. This can lead to missed workdays, which could result in a loss of job, and spiral from there. The sufferer may start to have interpersonal difficulties, and experience a worsening financial picture, wrought with high medical bills from return trips to hospitals and clinics. A 2011 report, commissioned by the Federal Institute of Medicine, found “pain affects millions of Americans; contributes greatly to national rates of morbidity, mortality, and disability; and is rising in prevalence.”
Surely there are instances where a doctor may prescribe narcotic painkillers when it is not needed, but the new CDC guidelines raise the possibility practitioners will deny medication to people who do need it. The guidelines are voluntary, however, prescribers may find themselves under scrutiny from regulators, insurance companies, and the Drug Enforcement Administration (DEA) if they go against the grain.
One point argued by those opposed to this move is that if a chronic pain sufferer is not getting the right treatment, they may turn to illicit options like heroin, which can open a dangerous can of repercussions for the patient and their community. We agree with that statement. In any case, pain control is better monitored by a physician who can watch for side effects and evaluate the effectiveness of the treatment. Restricting access to care for chronic pain sufferers, in order to prevent the misuse of prescription opiates by a small population of bad apples, will cause unnecessary distress. We will be surprised if these new CDC guidelines aren’t revised over the next months.
H/T: Reason Magazine, [Read the transcript or listen to the briefing CDC gave on their new guidelines]