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Opioid Crackdown Prompts ‘Sweeping Change’ on Pain

The Washington Post calls it “a sweeping change in chronic pain management — the tapering of millions of patients who have been relying, in many case for years, on high doses of opioids.” With nearly 70,000 people in the U.S. dying every year from drug overdoses, and prescription opioids blamed for helping ignite the catastrophe, the medical community has grown wary about the use of these painkillers. Chronic pain patients form a vast constituency, and millions of them take opioids for relief. Changes in medical guidance covering opioids have left many of them frustrated, confused and sometimes howling mad. There is little doubt among medical experts that opioids have been prescribed at unsound and dangerous levels. At this point there’s no easy way to dial those dosages back. Long-term use of opioids creates dependency. Tapering can cause extreme pain from drug withdrawal, regardless of the underlying ailment.

The U.S. is in the midst of a “national experiment” as misguided as the one it conducted 20 years ago, when doctors put millions of patients on opioids with little understanding of the consequences, says Tami Mark of RTI International, a North Carolina think tank. She has conducted one of the few formal studies of “forced tapering” of opioid patients. “This national effort at ‘de-prescribing’ is again being undertaken with limited research on how best to taper people off opioid medications,” Mark says. “You can’t just cut off the spigot of a highly addictive medication that rewires your brain in complex ways and not anticipate negative public health consequences.” Chronic pain patients describe their anxiety about the national reversal on opioids. They say they’re not drug addicts or criminals, they’re just people in pain who were following the doctor’s orders.