Year of the Locusts
The CDC guidelines have caused controversy and spurred heated discussion. Produced with a paucity of evidence based medicine, they were never evaluated and iterated in the manner of more appropriate guidelines. In this course, we will examine the guidelines and their effect on practitioners—primary care physicians, pain specialists, etc—and chronic pain noncancer patients as well as some chronic cancer patients. Many functioning patients have had their opioid dosages diminished, either in concert with their physician or forcibly, without any say in the matter. This, along with a marked reduction in the amount of legal opioid medications that can be produced, has led to significant unintended consequences: practitioners are leaving the field; some refuse to even prescribe opioids, mostly due to fear of overregulation; once-functional patients are being abandoned by the medical field; patients are searching for something to return them to functionality, which can lead to overdose and death, particularly from heroin and illicit fentanyl. Indeed, the opioid crisis has now become the heroin and fentanyl crisis. During this presentation, solutions, and the changes necessary to bring them about, will be discussed. (Recorded at PAINWeek 2018)
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