Is Suicide a Consequence of the CDC Opioid Guideline?
By Lynn R. Webster, MD
The law of unintended consequences states that the actions of people, and especially of governments, always have effects that are unanticipated, as when legislation and regulation aimed at righting a problem go wrong in other ways (Unintended consequences. http://tinyurl.com/?8p8g). An example may be the guideline issued by the Centers for Disease Control and Prevention (CDC) discouraging the use of opioids in treating chronic pain, excluding cancer and end of life (MMWR Recomm Rep 2016;65:1-49).
The guideline was not intended to be mandatory; yet, as I predicted in a previous roundtable discussion, the stature of the CDC appears to have resulted in it being viewed by many as more than a guideline (“Draft CDC Opioid Guideline: Pain Medicine Experts Discuss,” Pain Medicine News January/February 2016). A growing number of reports suggest that the guideline is responsible for people with chronic pain throughout the country being tapered or withdrawn from opioids or dropped entirely from physicians’ practices, even if the patients have been on stable doses of opioids for years with attendant improved pain and quality of life (Chronic pain patients are suffering because of the US government’s ongoing War on Drugs. Quartz. http://qz.com/?694616).
Pain News Network reports that dozens of patients have contacted the editor since March, when the guideline was made public, to say that their doctors have “fired” them on flimsy excuses, or that their doctors suddenly are weaning them off opioids or abruptly cutting them off from the medications (Are CDC Opioid Guidelines Causing More Suicides? Pain News Network May 27, 2016).
Worse is that some patients are so despondent and in so much pain that they have given up and looked to suicide as a way out. As Pain News Network reports, nearly 43,000 Americans committed suicide in 2014, more than twice the number of deaths that have been linked to overdoses of opioid pain medications. Anecdotal reports that chronic pain contributes greatly must not be dismissed. I am certain this is not a consequence intended or anticipated by the CDC, but tragically it is playing out.
‘Everyone Has a Breaking Point’
The following are passages from a message I received from a person in pain, in response to one of my blogs. (They have been edited for clarity.)
“After this Easter, my life turned off a cliff and nosedived. My best friend in the world, who suffered with chronic pain, checked out because he was tired of living with pain, doctors and judgment. He was just tired of it all. So many people are disgusted with the CDC’s guidelines—as am I—as they cast far too wide of a net and caught a lot of innocent victims in it.”
This man, a veteran, goes on to write of his personal involvement and knowledge of the opioid crisis as a sufferer of chronic pain and father who lost a 21-year-old daughter to—as he puts it—“the OxyContin Express that roared through Florida.”
“Persons in power too often see the world in black and white. They forget there is a gray area where most of us live—reality.”
The Department of Veterans Affairs is adopting the guideline, which was written to be voluntary, “as law,” he writes, “ripping 12-year–compliant patients off meds.” He is one of those patients with many years of passed urine drug screens and prescription drug monitoring checks behind him.
“This is the kind of foolishness that pushed my pal to the point he felt backed in a corner, put a gun to his chest, and pulled the trigger. I knew this man 35 years. … Everyone has a breaking point.”
This friend had shared his fears of having his treatment taken away.
“He asked me if I would forgive him if he took his own life. I told him I would. This has been a heavy burden to carry. But loving someone unconditionally comes with a heavy load.”
Now 58, the man who wrote this letter said he flinches now when he hears of anyone taking his or her life due to untreated pain. Further, he is steeling himself to deal with his own pain issues as changes to his medical treatment appear inevitable and also—as he puts it—impersonal.
“So now at 58 years old, here we go again. … The way my medical conditions were being treated for the past 12 years was about to change. … I’m no doctor, no pharmacist, no rocket scientist, but even I know you can’t do that to a human being without reprisal. So here I am picking up the pieces. I hope and pray others make it through the changes OK. I hope I make it OK.” Making it through is all he wants.
Innocent Victims
Undeniably, the country is experiencing a serious opioid crisis, which must be addressed. However, the steps to reverse the opioid crisis should not cause greater harm to the innocent and those hurting the most in our society. Our politicians and policymakers must be advised that their actions have unintended consequences. If the unintended consequences of the guideline cause greater harm than the intended positive consequences, then the only rational and compassionate path forward is to change the focus and direction. Perhaps it is time to recognize the needs of people in pain with an urgency equal to that for people with opioid addictions.
Filed under: General Problems
I totally agree that this is a purposely deadly act against chronic pain patients. My quality of life, while it wasnt perfect on fairly high doses of both fentanyl and dilaudid, has gotten worse with the slow decrease of my pain meds. Soon there will be little or no quality. My husband, who is the strongest person i have ever known, has a pinched nerve in his neck for which he takes an occasional percocet and less than once a year gets an injection in his neck for, told me today that if he had to do without relief from his pain would commit suicide! I am in that kind of pain daily and hold on only because of my husband and son tho i dont know for how long. We are less than human in the eyes of these vigilantes! This is what the Nazis did to the weak and ill, those who in their eyes were not perfect, The future looks bleak for all too many of us. Someone said “may God have mercy on their souls” and i dont agree, I hope they rot in a very special corner of hell!!!
I sure do think what the government is doing is intentional, they know dam well by lowering our stable doses or suddenly stopping them is going to cause many to go into severe withdrawal on top of severe pain, they know dam well by denying pain medication to long term chronic intractable pain pts, that many will turn to the streets for relief and many will take thier life. With my lowered doses the pain is unbearable. I remember a time years ago the dr I was with at the time had me on oxycodone every four hours. He would say that if the pain isnt to bad to wait to take it but by all means do not wait until I was at a 7,8,9 to take it cuz it won’t be as effective and may only bring the pain down a notch and the medication would have to work twice as hard. He told me by keeping it on a schedule by taking the meds at the same time every day, it should keep the pain to a minimum. He was the ONLY dr who had my pain at a tolerable level and boy did I enjoy my family and my life. Then he was targeted by the DEA , they shut his office down and left us pts out to fend for ourselves. It was a nightmare trying to find a dr to prescribe what I required for a QUALITY OF LIFE. Eventually I did find a neurologist, my meds were cut back on the first day to every six hrs. Then about a year ago, cut back more to every eight hrs. Now my life is a living hell. I have given up on so much I use to enjoy, I hardly leave the house as it requires much effort to shower, do my hair, and get dressed. I have no friends and I don’t blame them for no longer calling, heck even my siblings I hardly talk to, chronic intractable pain kills when left undermedicated. How nice of the government to make sure that pain pts are stigmatized as addicts. How nice of them to deny lifesaving pain medication to those who truly need it. Every day Im reading horror stories from legit pain pts. There have been many times I should have gone to the ER, but i refuse to be treated like a drug addict, The medical community has turned thier backs on the suffering, im sure the governments plan is going according to schedule, population control, ….
Besides the Obama “Healthcare Reform Act” and it’s resulting “Shortages”, I am having SEVERE QUALITY CONTROL ISSUES In N.Y. The GOV, CDC, FDA, has-not only cut the active pain ingredient in Oxycodone and other pain meds by 40% but has added STAINS & DYES, A SLEEP DEPRIVING COMPONENT SO SEVERE I HAVE NOT SLEPT IN MONTHS. Also, I’m having a left-sided bruxism issue that has chipped my teeth and caused a left ear infection. TERRORISM AND TORTURE. My 12 year ADHD MED had mysteriously been transformed without notice or warning beginning with the first “shortage”. I returned 4 , and have only been offered “Wellbutrin” after writing the N.Y.S. commissioner of mental health and being punished because it forced them to have a team meeting. My dextroamphetamine sulphate was misrepresented and nonstandardized; when I contacted the manufacturer TEVA, [formerly BARR pharma in N.J he said that “I am not the same person as I was last week; that they have not altered, adjusted, mis-configured the medication in any way. He lied. I turned-out positive for 3 heavy metals: Trioxide, Cadmium, and Cephalon. The Teva manufacturer admitted on-line that they had added ARSENIC in the Dextroamphetamine Sulphate, and that “We can’t be sued”.
I have no life. My only beloved family member has chronic Lyme disease, [by CDC standards], and infectious disease specialists now don’t accept medicare and/or say they can’t treat because the insurance companies are too powerful.
The non-profits say they can’t help with medication issues. I am SO ANGRY and more disabled than I have ever been. I have never felt so hopeless. This is SADISM, it’s surreal and a nightmare that has to end-SOON.
can u direct me to thee articvle that shows this 40 % cut??I was wondering about this,,recently my normal oxycodone medicine was switched to this pink pill,,,I cut them in half,,10ml,,,it just seemed less effective,,and I was wondering???????,,or was it because its hay time at our house?but thanks 4 the info,,,mary
I have taken this opportunity to share my heartbreaking story in hopes these witch hunting Opiate ill informed skeptics will read and understand that I would have no life without Medically prescribed Opiates by a physicians care and strictly monitored monthly urine and blood test. Please remember that An Opinion Before A Thorough Investigation Is The Epitome Of Ignorance! And that a little more compassion from the Medical Field and its representatives could have saved my beautiful Stepdaughters life. Let me say this! A person who has an addictive personality will abuse anything that helps them feel better. I have taken Oxycontin for 14 years , I have had 24 major surgery’s in 10 years. I have so much physical pain I can not even get out of bed with out pain meds and when I run out I run out and just lay in bed praying the Lord relieve me of this horrible condition and I pray God you pain medicine( Opiates) skeptics never go through what I go through everyday of my life when the only thing you have to do is threaten what help I get, Shame on you! There will always be drug abuse and as the so called war on drugs has failed as this will! All you do is stoke and aid the drug pushers business to new heights in the Black Market of Heroin while depriving legitimate Chronic Pain Patients as myself of the much needed medicines and the relief it brings temporarily ! My Stepdaughter committed suicide 4 years ago because of being treated like a drug addict by some of her family and doctors when all along she suffered from Lupus and Fibromyalgia which I believe was brought on by a deadly car crash at 18 , she told me between that which I was being put through and what they were putting her through she was not going to live her life in such a hell brought on by people like these Opiate Witch Hunters that are on a witch hunt to out law Opiates and pain meds that give us some sort of a life . As a retired Police officer and worked indirectly close to the DEA, you people do not have a clue how thrilled you are making the illegal Heroin trade and think of my Late Stepdaughter as you continue on with this ( 2016 Version of the 1940s Propaganda movie named REEFER MADNESS) movement to outlaw opiates! Just like the slaughter of children at Sandy Hook if there would have just been gun laws , my God they were Gun Laws , the guns that murdered all those 20 children were all registered and owned by a school teacher! You fight Drug Addiction beginning in Elementary education by teaching all children the dangers of Booze and Tobacco which if these witch hunters want for us to know the real truth but they do not. I miss my Stepdaughter so much and some of us will continue on the fight to protect our right to feel better and function without fear of these witch hunters trying to convince us to commit suicide . And they are trying to do exactly THAT!
The under line real truth( It’s Beginning To Seem ) is THESE witch hunters would rather us Chronic Pain sufferers commit suicide are and DRINK all the BOOZE we can drink! The Federals legalized it ( ALCOHOL) knowing its a more deadly drug than Strychnine. And just because the DEA has miserably failed with their ( Richard Nixon and Elvis Presley’s )War on drugs why do they want and are trying to deprive us sick people of our Constitutional Rights to be Happy in that pursuit of with Professional Physicians to take medicines that give us temporary relief of this horrible malady of Chronic Pain ! May God have mercy on their miserable souls they that seek to destroy us Chronic Pain Sufferers only and little hope of temporary relief of this horrible sickness.
I AM TRULY SORRY FOR YOUR LOSS SIR!!!Would u repeat your story to a International Court Of Law??maryrw
When my practice was shut down by the government I had 15 people die that I know of. That was out of 150 patients, or 10%. I agree–this result is intended by the government. Legal genocide of the expendable populations–elderly, disabled, Medicare, Medicaid and uninsured.
2 of my patients are dead.
One suicided
One used alcohol when the pain meds stopped.
He fell and had a brain hemorrhage.
Sickened and saddened.
Who says they are unintended? I think it is very much intended.
Amen,,I also agree this is intended..In April of 2015 a handful of us got together and I wrote a formal complaint to the United Nation Humane Right Commisioner,,because people were/are dieing,,and the hope was/is to stop 1 more good soul from being forced into choosing death as their only option to stop their physical pain from untreated physical pain from medical illness.,,At that time that petition 2 congress ,”due no harm,” only had 6,000 letters sent to our senators and thee president .I sent every letter to the U.N in Geneva,,they are heartbreaking..Now,,their are 30,000 letters sent to our elected officials..They know full well the willfull sufferings and torture and GENOCIDE they have caused..
The U.N responded to our letter by stating that denying access to medicine needed to lessen physical pain was inhumane and should not be allowed..as it is essential to proper medical care..They further their message in April 2016 infront of all countries including the United States,,in a Emergancy session addding this very issue to thee agenda of that meeting,,Again,the U.N Commision on human rights reiterated DO NOT deny access to needed medical treatment .AND IT SHOULD never be acceptable TO DENY MEDICAL CARE TO THE PHYSICALLY ILL IN PHYSICAL PAIN FROM MEDICAL ILLNESS,…,,However,,,’our”’ country in jmo,,spit in their faces,,with bringing out the cdc guidelines after the U.N stated NOT to deny us the medical care we need,,and all individual states did the exact same thing..I personal informed my senators,,ie Tammy Baldwin,,that I had written the U.N,,about denying us care and furthermore to please allow on allll death certificates a option for all coroners to put ,”death due to untreated physical pain from medical illness,” I was told,,”PROVE IT,”!!N ow thank god,,by doctor has not taken my meds away,,,or I would of done just that,,,proved it,,,..Our government knows exactly what their doing,,,and they simple don’t care,,and will not stop until they are stopped,,,Prohibition was wrong in the late 1800 ,,and it is still wrong in 2016,,,klondyn,,the cdc,dea,hhs, all of them,,should face a Interational Court Of Law for crimes against humanity and the medically ill,,,,,Klondyn should rot in prison,,,along w.those in the dea who went after our good innocent Doctors,,!!!,,,maryw
pss,,,this is another Pennhurst thrust upon the medically ill,,,just like before,,a shrink,,,has started it all!!!!PENNHURST was wrong then and it wrong now,mary