News New CDC guidelines a ‘corrective’ for opioid prescriptions, specialist says

[thegreenhand]

New CDC guidelines a ‘corrective’ for opioid prescriptions, specialist says ​

Alvin Powell
Harvard Gazette
21 Nov 2022

Excerpt:

In 2016, as the U.S. overdose epidemic raged, the Centers for Disease Control and Prevention issued prescribing guidelines that aimed to reduce excess, unused, and misused opioids. Physicians, health care systems, insurance companies, even state legislatures seized on the guidelines to reduce dosages, shorten prescriptions, or cut off patients from the drugs. But critics viewed the steps as too rigid, affecting treatment for patients dealing with severe pain.

This month, the CDC issued new guidelines that emphasize non-opioid alternatives when available, but also flexibility. Scott Hadland, chief of the Division of Adolescent and Young Adult Medicine at MassGeneral for Children and Harvard Medical School, treats substance abuse among children and adolescents. We talked to him about the new CDC guidelines in a conversation edited for clarity and length.

GAZETTE: What’s the word you would use to describe the revised guidelines, in contrast to 2016?

HADLAND: “Corrective.” The CDC has gone to great effort to highlight the flexibility that clinicians and health systems have with these 2022 guidelines, to make clear that the intent is not for people to stop receiving opioids. The guidelines expound the harms of discontinuing opioids or rapidly tapering them in someone who has been on them long-term. The 2022 guidelines focus on patient-centered care. They ask physicians to exercise caution when they prescribe opioids, and to maximize other pain treatments that are available before using opioids, but to still make opioids available in cases of acute or chronic pain in which the benefits of opioids outweigh their potential risks.

 

[neversickanymore]

How the opiate epidemic should have been handled… in a few words. (And go
fuck yourselves on hindsight 20 20 as your ship of utter fools still has many sails to the wind)

New practices for prescribing pain meds are implemented for new incoming patients, long term patients are “grandfathered” in as reducing their doses or cutting them off at this point does nothing positive and often sends a suffering person to even greater pain, peril and extreme risk.

The truth is is that most medical professionals are wholly untrained and thus largely wholly ignorant or even worse grotesquely erroneous about addiction.

They created the opiate epidemic and arguably couldn’t have responded worse to their monumental tragic blunder.

It’s clear that significant changes needed to happen, but they only needed to start with new patients. Old patients needed to be grandfathered in as reducing or cutting off patients accustomed to high level long term opiate therapy is a morons path that sends patients right to the fentanyl dealer and tragically often to the morgue.

What should have been done is prescribing practices should have been properly adjusted for new patients and patients before the adjustment should have been able to continue their accustomed treatment.

When you look at how the medical professionals created and subsequently miss handled the epidemic, combined with how poorly they are trained and understand substance abuse it’s heartbreaking.

Loose a whole bunch of the arrogance and add a whole bunch of skill and knowledge.