Doctors drop patients on painkillers amid federal opioid scrutiny, experts say

by Arjun Singh

Patients who rely on opioid medication for pain relief are increasingly being abandoned by their doctors due to government scrutiny of opioid prescriptions. Medical and legal experts have stated that physicians are fearful of being flagged by the Drug Enforcement Administration (DEA), which can revoke their approval to prescribe controlled substances and refer cases for prosecution. As a result, patients are being left to endure severe pain while they search for alternative healthcare providers.

The crackdown on opioid overdoses and addiction has led to a significant reduction in opioid prescriptions, which have fallen by 46% between 2012 and 2021. However, it is important to note that most opioid-related deaths are caused by illegally manufactured fentanyl, not prescription drugs. Patients who have been dropped by their doctors or have had their dosages significantly reduced feel like collateral damage in these efforts to combat the opioid crisis. They argue that they are being wrongly labeled as drug-seekers and pill-seekers.

There is an estimated 2.3 million people with prescription opioid use disorder in the US, according to federal data from 2020. The issue of healthcare providers abandoning patients who use opioids for pain relief is a widespread problem, with patient advocates reporting receiving around 600 messages per month from abandoned patients. However, federal guidelines prohibit the abandonment of patients, the abrupt discontinuation of opioids, or rapid dosage reductions.

Experts in the field agree that abandoning opioid patients can lead to serious harm, although they have differing opinions on the appropriateness of opioids for newly diagnosed chronic pain. The 2022 Centers for Disease Control and Prevention (CDC) opioid prescribing guidelines emphasize the need to avoid abandoning patients and advise against abrupt discontinuation or rapid dosage reductions. However, some healthcare professionals continue to be influenced by the older, more restrictive recommendations from 2016.

Dr. Charles Argoff, president-elect of the American Academy of Pain Medicine, argues that if opioids are helping patients, they should be continued and even prescribed to some new chronic pain patients. He states that opioids are a viable option for some chronic pain patients and that it is essential to find what works best for each individual.

Dr. Andrew Kolodny, president of Health Care Professionals for Responsible Opioid Prescribing, believes that new chronic pain patients should not be prescribed opioids. While he supports more cautious prescribing, he acknowledges that abandonment of patients is a serious issue. Some doctors may not fully understand how difficult it can be to taper patients off opioids, and these patients may be left without a viable alternative for managing their pain.

The abandonment of patients who rely on opioids can have devastating consequences. Studies have shown an increased risk of suicide, suicidal thoughts, and overdoses in patients whose opioid treatment was stopped. Desperate to regain the pain relief they experienced with opioids, some patients turn to street drugs, which can be laced with fentanyl, a highly potent and dangerous opioid.

The current situation leaves many patients in a state of suffering, feeling like no one cares about their pain. It is crucial for healthcare providers to approach the issue of opioid prescriptions with caution, considering the needs of individual patients and weighing the benefits against the risks. The goal should be to find effective pain management strategies that prioritize the health and well-being of patients without neglecting their legitimate need for pain relief.

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