Wednesday, July 5, 2017

Collateral Damage in the Opioid Epidemic

I wish I were writing this blog to report good news. Unfortunately, things are no different today than they were in 2011 when the Institute of Medicine (IOM) report “Relieving Pain in America” was written. Instead, and even though the IOM report spirited the drafting and publishing of the National Pain Strategy, things have gotten much worse. Hardly a week goes by that I don’t read about a fellow patient taking their life because the source of the physical pain was inadequately treated and their emotional pain unbearable because of feeling judged, many times by those they seek for help and support. – Powered by GoDaddy

The opioid epidemic is very real and I do not mean to minimize that fact in any way. However, it is now painfully obvious that the CDC guidelines for opioid prescribing have not helped those who live with addiction. In fact, the guidelines have led to more deaths, not fewer. The forgotten, stigmatized, and judged, people living with persistent pain are now joining the death toll. That’s why I am sharing an article I wrote a year ago for my website, Guidelines for Pain Warriors. If you have been injured, I encourage you to use the links you find in the following letter. Or if you know someone like a recent victim, please encourage his or her family to take action.

Because of the volume of requests for help and the need to meet the demands for my own care, I share the following.

It’s important to understand what is happening. Physicians are caught in the middle. The DEA crackdown on prescribing opioids has made them fearful of because of perceived threats to their livelihood. On the other hand, if patient harm results from negligence or abandonment, the provider can be liable for that too. When a patient is fired, the physician has an ethical obligation to ensure a patient’s care is uninterrupted. However, the very people who impose edicts on physicians--the DEA, the CDC, the Center for Medicare and Medicaid, and or other government agencies are not accountable for their actions. 

We have the ability to hold the right people accountable by providing factual evidence. Evidence includes things, such as:

·        A written letter from your physician stating his/her reasons for stopping your pain care. (If you don’t have one, demand it.)
·        Chronological documentation your physician failed to provide ample notice for finding another provider. (The treating physician is obligated to continue your established care for a reasonable amount of time.) 

Following are other things to consider:

·        Is your physician negligent if no one is willing to continue your care?
·        Is your provider fearful to bridge the gap because of the CDC Opioid Prescribing Guidelines or other governing bodies?
·        Is your provider using the changes as an excuse to abandon care?" Pain that does not abate is a reason to seek medical care, but physicians often feel helpless because treating chronic pain is complex. 
·        When the standard of patient care is breached (i.e. abandonment, negligence, or malpractice) and that breach causes harm, there is legal recourse. Currently, three things affect the changing standards, as I see it, (1) the influence of government agencies (2) lobbying by PROP--follow the Phoenix House money trail, and (3) the American Medical Association's decision to cut pain as the 5th vital sign from routine assessment, affecting the standard of pain care negatively…  

*If you are forced to sign a contract, read it. A contract is between TWO people and may be litigated if either party fails to uphold their part of the contract. The physician’s responsibilities toward your care should also be provided.

·        The physician must provide evidence as to why they withdraw care. Yet, some may feel protected by the CDC guidelines. They are not. The guidelines are not LAW!
·        Failure to provide information such as copies of relevant medical records, treatment notes, tests, etc. to those who are continuing your care is a breech.
·        Voice recordings or notes in your medical record that the DEA or other government agency created a burden on the physician’s ability to treat pain are helpful for both the physician and patient, but difficult to obtain unless a case is being litigated.
·        Documentation of refused emergency care, such as treatment, hospital admission for withdrawal symptoms, suicidal ideation, or any other untoward effect is mandatory. (This is not the same as expecting an ER to continue your outpatient pain care.) 
·        Your loved one has committed suicide and there is documentation abandonment or untreated/undertreated pain was the cause.

*As a patient, you also have a duty. If you are unreasonably demanding, non-compliant (i.e. abusing, diverting, or misusing opioids), or threatening to the physician or staff, you are not protected.

Helpful links for finding your senator, representative, and governor; medical organizations, and government health related websites, your states attorney general, your state’s pain care laws and more can be found at the bottom of page, Sample Advocacy Letter.

Additional Reading:
Patient Shoots Two at Las Vegas Pain Clinic (and comments)
Neat, Plausible, and Generally Wrong: A Response to the CDC Recommendations for Chronic Opioid Use

In healing,,Celeste

"Adversity is only an obstacle if we fail to see opportunity."

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website:

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.

All blogs and comments are based on the author's opinions and are not meant to replace medical advice.

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