Who are the unlikely casualties of the war against opioid addiction? 

A patient named Teresa Brewer suffers from debilitating chronic pain caused by retroperitoneal fibrosis that she was diagnosed with since 2003. She gets by with her methadone dosage of 100 milligrams per day but was shocked to hear that her doctor will have to reduce this to as little as 30 milligrams per day due to the recent crackdown on opioid prescriptions to seemingly help combat the opioid epidemic crisis.  

Teresa’s story of chronic pain is just one out of the estimated 100 million people suffering from it. These vulnerable demographics feel abandoned by the recent fight against opioid addiction. They became the other casualty in the opioid epidemic. 

According to the CDC guidelines, medications for an opioid prescription should be required to be tapered slowly to zero to comply with the measures used to reduce the use of opioid medications.  One likely victim of these stringent rules are veterans who suffer chronic pain due to job-related injuries they acquired through their years of service. Sadly, the risk of suicide in veterans with chronic pain increased as their access to opioid medication was reduced.  

Not only does the new opioid guideline affect the patients, but it also presents a challenge for the physicians prescribing them. Many physicians are punished for continuing to prescribe opioids to those who need them for their chronic pain. Leading them to feel trapped between the oath they have taken to take care and looming threat of going to prison.  

Teresa’s, the veteran’s, and the doctor’s story are all the product of the means of how we are handling the current opioid crisis, however, due to this there are unintended victims that need to be heard and that need our help in understanding.  

AAPM Facts and Figures on Pain 

http://www.painmed.org/patientcenter/facts_on_pain.aspx

Suicidal ideation and suicidal self-directed violence following clinician-initiated prescription opioid discontinuation among long-term opioid users. 

https://www.ncbi.nlm.nih.gov/pubmed/28807135