we all know that the opiate conversion tables are CRUDE ESTIMATES AT BEST…
We all know that defective CYP-450 opiate enzyme metabolism can greatly effect the therapeutic dose for the pt.
We all know that:
Here is four quotes from the CDC opiates guidelines:
https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
“The guideline is intended to ensure that clinicians and patients consider safer and more effective treatment, improve patient outcomes such as reduced pain and improved function.”
“Clinicians should consider the circumstances and unique needs of each patient when providing care.”
“Clinical decision making should be based on a relationship between the clinician and patient, and an understanding of the patient’s clinical situation, functioning, and life context.”
“This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.”
We all know that subjective disease are covered under The Americans with Disability Act and Civil Rights Act and discriminating against person in their protect class is consider a civil right violation.
We all know that the majority of the studies that the CDC used to come to the opiate dosing guidelines were rated “3′ or “4”… where “1” = good/excellent, “4” = poor/crap.
We all know that dosing for all disease states – except for subjective diseases – is based on adequate therapies that will return the diagnostic lab values to as close to acceptable values as clinically possible without inducing other adverse side effects. With subjective disease the only therapeutic outcomes can be based on input from the pt.
We all know that healthcare professionals will not use – or depend upon – testing equipment or any means of testing that will produce inconsistent results.
We all know that <1% of chronic pain pts treated with opiates will become addicted.
It would appear by this letter that the DOL has determined that does above 90 MME/day is a “concerning level of medication” and that will be working on “… curtailing (all) opiate usage …”
Filed under: General Problems
These people/agencies are interfering in the Dr./patient relationship and as Steve says so often, they are practicing medicine without a license! What about our HIPPA privacy laws? How were they able to obtain this information?
This is where we need for physicians like these to stand up for their patients and write reply letters to educate these ignorant, power mad people!
The suffering of patients with now intentional untreated pain from our doctors in America from fear of jail, economic loss or even complete loss of license is now widely accepted by the vast majority of lawmakers. It is appalling that there is not more compassion in our healthcare system. The true goal seems to be to drive the masses into patient addiction treatment centers, while we are now discovering many are owned by the lawmakers themselves. The attack on patients in need of treatment for pain seems to be unthinkable in a modern era. Even more egregious and troubling is the lack of media attention rebuking the outright manipulated and inflated numbers associated with deaths in America from PERSCRIBED medications under care of a doctor. It would seem the America would call out lawmakers for intentionally misleading the country with “slight of hand” numbers related to opioid deaths using all deaths with opioids in their system, with a vast overwhelming majority actually being non-prescribed care related deaths.
One, not very often discussed point is how complicated the understanding of long term chronic care patients taking opioid medications by the general public is and the lack of understanding by almost the entire population of people not living with pain. For those that have only had limited exposure to taking opioids for some acute pain, or no exposure at all, this segment has no understanding how a daily dosage treatment 90 mme is far different long term chronic patient care, vs the dramatic impact to a person that has never taken opioid medication. The experience is far different because of tolerance levels of a new patient vs a patient with sometimes years or decades of opioid treatment. It is this lack of understanding by the American public as a whole that is being intentionally exploited for the purpose of establishing positive public opinion in support of archaic laws now ravaging the lives of tens of millions of Americans now living with intolerable pain in America.
It would seem with many journalists being very young or inexperienced with the very different and pronounced experience related to a person taking opioids for the first time vs a patient with long term usage.
Ten, twenty, thirty, forty years ago, it would have been unthinkable that the medical community would intentionally allow almost inhumane suffering of patients with the lack of compassion now present in the medical industry as a whole. Where is the outrage by the community, AND our medical communities?