The Visible Few: An Imperfect Burden on Patients and Providers

Forced downward titration has been broadly implemented throughout the country as a direct result of the CDC Guideline for Prescribing Opioids for Chronic Pain.

Prescribing clinicians feel pressured to follow the CDC’s recommendations of dose limits to avoid regulatory sanctions, and pharmacists feel a corresponding obligation to intervene in accordance with the CDC guideline and corporate policies. In many instances, prescribers have refused to treat opioid-requiring pain patients, resulting in the patients’ discharge from the specialist’s practice or a consult refusal—the latter of which, by default, often leaves the most medically complex and challenging patients with only their primary care providers to manage their pain. Some patients have chosen to leave their existing providers because of mistrust, cynicism, disbelief, and abandonment, but they then find it difficult to secure any other provider willing to treat their pain.

This presentation will chronicle the events that have delivered an unreasonable burden on patients and providers.