Proposed 2016 Guideline for Prescribing Opioids for Chronic Pain
2015-12-23 2015-12-29 2015-12-17 2015-12-16 2015-12-16 2015-12-15 2015-12-16 2015-12-16 2015-12-15
CDC-2015-0112-0586 CDC-2015-0112-1247 CDC-2015-0112-0282 CDC-2015-0112-0089 CDC-2015-0112-0199 CDC-2015-0112-0031 CDC-2015-0112-0203 CDC-2015-0112-0202 CDC-2015-0112-0032
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https://api.regulations.gov/v4/comments/CDC-2015-0112-0586 https://api.regulations.gov/v4/comments/CDC-2015-0112-1247 https://api.regulations.gov/v4/comments/CDC-2015-0112-0282 https://api.regulations.gov/v4/comments/CDC-2015-0112-0089 https://api.regulations.gov/v4/comments/CDC-2015-0112-0199 https://api.regulations.gov/v4/comments/CDC-2015-0112-0031 https://api.regulations.gov/v4/comments/CDC-2015-0112-0203 https://api.regulations.gov/v4/comments/CDC-2015-0112-0202 https://api.regulations.gov/v4/comments/CDC-2015-0112-0032
Jeri Stacy Katerina Fredric Cyrynda Anonymous Elayne Patti K
Paull Watson Showalter Alegre Walker Anonymous Baumgart Plante S
My son died of a heroin overdose in 2014 that started with legitimate prescription use after an accident. He had a history of abusing drugs, yet the doctor was more than willing to prescribe him oxy until he was addicted, and then cut him off by yelling at him in the hallway of his offices that he was done with him. We are losing a huge part of a generation to this disease, and steps HAVE to be taken to stop the over prescription and careless prescription of these very dangerous drugs. This is a start. Please enact these very sensible guidelines. Thank you. My son Luke was polite, popular, multi-sport, all-star athlete. He was raised in a typical middle class home, we were very involved in our kids lives.  As a freshman catcher on his high school baseball team he was being scouted by colleges.  He had a wide network of friends, good morals and values, and  a great sense of humor. People would meet him and tell us what an exceptional youngman he was.  Then at 16, he suffered a serious sports injury, which required a meniscal transplant  and was prescribed painkillers. Seemingly overnight, he became one of the hundreds of thousands of teens in our country addicted to prescription (Rx) painkillers. His life CHANGED  SO DID OUR FAMILIES.  He went from being the person I described above to a stranger, the addiction devoured him and our family. It has been heartbreaking . He is 28 years old and now sits in a prison cell with a 17 year sentence ( as a non violent , never had a weapon or hurt anyone but himself) all related to his addiction to the pain killers which then became heroin. Our son is a smart, kind person he should not be in prison, along with so many other addicts. It all started with the pain pills and how freely the RX was written over and over again . I have included a picture of my son, because I want to remind you these are real people with real families  So many people are addicted to prescription painkillers that drug overdoses are now the leading cause of accidental death in America, surpassing car crashes. And Rx painkiller abuse has led to an increased use of an even more deadly, accessible, and cheaper opiate: heroin. Please do not allow the special interest groups to interfere with progress and saving lives.  I beg you to listen and do the right thingRespectfullyStacy Y WatsonMore folks effected by this epidemic  can be contacted at http://addictsmom.com/ Dear Maam or Sir,My name is Katerina Showalter and I am writing in response to Docket No. CDC-2015-0112 to ask for a change in the guidelines for how doctors can treat people in pain who need access to treatments including opioids.I need your help. I need you to listen to pain patients. I need you to include language in the guidelines that recognize patients as individuals who need access to effective pain management options, including opioids, sometimes for long periods of time or at high doses. I have a life-limiting progressive disease called mitochondrial disease. It causes severe pain, getting worse as more and more organs and muscles are affected. Since the rapid progression of my disease, I have tried many pain management options and even go to pain Cognitive behavioral therapy, but I was only able to leave my house regularly once I started opiod therapy. This semester was my first time going to school in 2 years. I am finally able to live out my life outside my bed. I understand that many less severe chronic conditions dont benifit from opiod therapy, but when you write these regulations you are also hurting my life as well. I want to participate in the community and be out of my bed. In fact on opiod therapy ive been able to do intensive Physical therapy and improve my autonomic function. Im now standing for the first time in years. Please dont send patients like me back to our beds. Our diseases are killing us, we dont need one more obstacle to enjoying our lives outside of the hospital.  Our care is only supportive, please dont take away one of our only supports. Thank you for your interest in my well being. Included are pictures of me in the hospital on TPN and 2 months later with opiod therapy out visiting a lake. Sincerely,Katerina Showalter Society is really trained to deal with things that have a beginning and an end,Either you get better or you are supposed to die. You are not supposed to have something that goes on and on, like chronic pain.Patients report that their doctors often dismiss their pain and send them away without providing any other options.Pain is experienced individually and is more than just a physical symptom and is not always resolved by curing the underlying disease. A third of the nation experiences chronic pain. ... Its more than we pay as a nation on cardiovascular disease and cancer.An estimated 116 million adults experience chronic pain, much of it preventable.The nations health care system has largely failed Americans in pain and calls for a cultural transformation of the way in which the United States approaches and manages patients with pain. Chronic pain also is the most common cause of work loss and disability.Why Not Prevent Chronic Pain?While major efforts are underway to prevent heart disease and diabetes, preventing chronic pain remains an elusive goal.Serious, chronic pain affects at least 116 million Americans each year, many of whom are inadequately treated by the health-care system, according to a new report by the Institute of Medicine (IOM). Im shocked and surprised at the magnitude of [the problem].There is abuse that occurs when individuals are drug-seeking and abuse that occurs in that people who need pain medications may not have access because physicians wont prescribe or the state has regulatory barriers.Making matters worse is the media and political attention that has been devoted to painkiller abuse and addiction. Conversely, very little attention is given to chronic pain, which affects a far greater number of people. About 9.3% of the population has drug or alcohol problems serious enough to require treatment, while severe chronic pain affects at least one in three Americans. (And yet, two national institutes are devoted to the research of addiction: the National Institute on Alcoholism and Alcohol Abuse and the National Institute on Drug Abuse.Although prescribing of opioids has almost doubled  going from 3.2% of the population in 1988-94 to 5.7% in 2005-08  its not clear that this is out of line with the rise in pain in the population or that the drugs are going to the right people.Its extraordinary how many patients describe themselves as feeling like collateral damage in the war on drugs because of extraordinarily burdensome [requirements to get opioid medications].There Are Many patients who had been on a stable and effective low dose of medication for years were suddenly cut off by their doctors for no apparent reason.Many pain patients, in fact, are paying the price for a policy not designed for their benefit.Doctors said they prescribed less than they thought was appropriate because of fear that law enforcement was looking over their shoulder.The majority of people with pain use their prescription drugs properly, are not a source of misuse, and should not be stigmatized or denied access because of the misdeeds or carelessness of others.Ironically, while many people with pain have difficulty obtaining opioid medications, nonmedical users appear to obtain them far too easily.But the barriers to appropriate care go beyond the issue of painkiller misuse. There are only about 3,000 to 4,000 pain specialists in the entire U.S., which means that primary-care physicians, whose numbers are also dwindling and who are not educated specifically about pain, are left to treat most pain with little specific guidance about effective care. In medical school, students receive only a few hours at most of education on pain treatment.Meanwhile public and medical misperceptions are widespread about the nature of pain, its causes and the way it affects individual patients. Misinformation is fueled by the fact that comprehensive research is lacking, even on basic questions like how many people suffer from disabling chronic pain and how well existing drugs like opioids treat long-term pain.The most important message to get out is the concept of pain itself as a disease. The majority of primary care physicians do not agree with this even though there is overwhelming research in both humans and animals [showing that] pain causes damage to the nervous system. Its dangerous not to treat pain.People can Die from Chronic Pain. Therefore we must not take away the rights from People who suffer from Chronic Pain Daily to receive the Medications they need to Better Their Quality of Life!!! I Stand for All the People who live in Chronic Pain and have to be worried Day in and Day out weather theyll be able to get their Medications. This is a Travasty to those who suffer from Debilitating Chronic Pain! Keep us out of Pain! Its our right as People World Wide whom Suffer from Chronic Pain! Again dont take away our Right to Live a Quality Life or the Best We Can!Sincerely Yours,Fred Alegre Doctors and nurses and research scientists have no knowledge about what it is like to suffer from a chronic illness or to require opioid medication for chronic pain.  Do you think we actually like to take these medications, with all their side effects?  You want to limit the amounts our doctors can prescribe, and limit the amounts we can take because you worry we will become addicted and use the medications to get high.  But what you dont understand is that people with severe chronic pain never get high from these medications.  The pain-numbing effect of the medication gets all used up fighting the pain, and there is nothing left over to actually make us high.  I have fibromyalgia and chronic migraines, and I have taken hydrocodone for years, and never once have I experienced any kind of high from taking it.  A little drowsiness, yes.  A lot of constipation, yes.  But a drug induced euphoria?  Never.Please, reconsider these so-called guidelines.  Dont make it harder than it already is for doctors to treat their chronic pain patients. I think it is absolutely ridiculous that the patients that actually need meds for chronic pain have to suffer because of all the drug addicts. I take tramadol and have already been made to drop down to half of my normal Rx. And I suffer everyday!!! I think Drs need to do their jobs and give us the meds that we need and actually monitor patients and do surprise drug tests and drug tests every time a patient has an appointment. And also do random pill counts. And if u r caught abusing even once then no more meds. Then it would be the patients fault that they have to suffer. I also really think that the increase in heroin deaths is because u guys are taking away pain meds from pts that need them. I think a pt that wouldnt normally ever do heroin is doing it because they need pain relief. Just my opinion. Please u cannot take all opiod pain meds away. I think if u do, then ur gonna have really bad results. I was in so much pain at one point and hadnt been put on pain meds yet and I tried to kill myself because I was in so much pain. Please dont make us all suffer because of all the addicts!!!!! Im writing to comment on your proposed rules for prescribing opiates.  I would like you to know the experience my daughter had from age 18 to 25, when she was killed by a physician who performed an endoscopy without anesthetic, tore her throat and led her to aspirate on blood in her throat.My daughter had POTS and Ehlers Danlos Syndrome (EDS). The POTS made her vomit multiple times per day.  The EDS allowed her synovial joint in her chest to sublux resulting in excruciating and acute constant pain each time she vomited.  She also had other joints that subluxed at various times and unremitting migraines.  Because of this she had chronic and acute pain on an ongoing basis.  One particularly good summer after she had gone to London for treatment, she insisted on remaining opiate free the following fall.  She ended up remaining in bed from September through the end of December, undoing all of he therapy she had done in London.Prior to becoming ill my daughter was a straight A student, planning to attend college the next year, popular with both males and females her age.  She was known as a very happy young girl and teenager.  None of the above was typical of her until she became ill.  Without the help of a physician who knew her prior to becoming ill, and was willing to prescribe her opiates, she would not have functioned at all during what proved to be the last 8 years of her life.It would be one thing to remove opiates if you had something with which to replace them.  Something that would effectively manage pain.  But, you dont.  Even with opiates my daughter, and most EDS patients, utilize additional forms of pain management--meditation, cortisone shots,TENS units, heating pads, physical therapy, Tramadol, etc.  None of it really alleviates the pain from EDS, but the combination usually makes it bearable.  Bearable for many means able to live and sometimes participate in activities.  It often does not mean being able to hold down a job, even beloved jobs.  I choose to believe you really do not want to make people suffer that much.  By the way, never did the opiates make my daughter high and that is what I understand from other chronic pain sufferers.Yours truly,Elayne Baumgart, Ph.D. I have to say that I have been in pain from Spinal Stenosis, sciatica and scoliosis for the last 14 years. I have been under an Orthopaedic Surgeons care along with a Pain Management doctor for most of that time. I have had four major back surgeries in the past two years to correct the issues with just my lower spine. I have never taken more medication than my doctor instructed. Im on Lyrica, Skelaxin  Percocet. I try every remedy before taking pain medication. Im told I will be on these meds for a long time because of the problems with my spine but my goal is to take a minimum of  any medication. Ive signed a contract with my primary care physician and receive my prescriptions just through her and receive them at one pharmacy. I dont feel the need to be policed. If there was something as effective as the Percocet I would happily change to it but for now it works best and I take very few of the minimum dose. I just dont want my choice taken away so that Im house bound.  I am 47 years old, I have health issues that cause me to use pain medications.  I have never had a problem with alcohol or any type of drugs in my life.  I have 4 children and a husband; a wonderful job and great friends.  I am on pain medication so that I can function.  I know that my life has changed and Ive come to the understanding that pain is my new normal so I dont expect to live without it.  I only hope to continue to have the opportunity to be able to have these medications available to me and help me when I cannot walk.  When I cannot stand, cannot go to the restroom, cannot shower myself, cannot sit down by myself and cannot take the pain.  No one expects that this to happen to their life; one day you are okay and the next you cannot move and you dont remember what it feels like to not be in pain.  Just like you the reader, I too have a family, a grandson Id love to carry.  School plays Id love to attend, vacations Id love to be on.  I dont want to take any medications.  I dont want to visit the doctor.  I dont want to be looked at as if I am a drug addict.  I dont want to deal with the harsh judgement  every time I walk into my pharmacy.  I dont want to be terrified that today I am able to work, but tomorrow what helps me work may be taken away.  How will I live and help support my family?  How will I do anything?  I dont have a record.  I follow rules.  I pay my bills.  I am a good person.  Must we really be treated this way because life has dealt us issues that have caused us to need pain medication?  Please stop and understand that all I want is to continue to be apart of life and amongst the living.  I dont want to just exist in my room being take care of.  I want to take care of me for as long as I possibly can.  Please know that I am a responsible person; I am human.  I am only asking that you allow my doctor to take care of me the way he sees fit.