To Reduce Opioids or Not? California Doctor Fights

How serious are the effects of the opioid epidemic in this country? According to official mortality statistics, the death count from opioid use has been on the rise. The numbers for about the last 20 years tell the story. Let’s focus on the recent ones alone. In 2015, more than 33,000 people died from opioid overdoses. The toll rose to more than 42,000 in 2016. And in 2017, opioids claimed the lives of more than 47,000 Americans.

All of this demanded action. The Centers for Disease Control and Prevention (CDC), the federal agency tasked with the mission of improving public health, answered this call as the numbers started to tick upward. Dubbing the opioid situation a “public health crisis,” the CDC set to work on the issue.

The organization took a multifaceted approach. It focused on a wide span of touchpoints; these included health care systems, payers, consumers, states, local communities and public safety groups. The CDC devised major strategies. Then it initiated programs to prevent opioid abuse, overdoses and deaths. These efforts spawned many forms of attack. The arsenal included information campaigns and monitoring initiatives. There also was a push to stem the use of controlled substances.

Related to that last point, the agency targeted the medical community as part of its plan. It developed a series of recommendations for primary care physicians to use with patients at least 18 years of age. And it published them in the CDC Guideline for Prescribing Opioids for Chronic Pain. The contents focused on the use of opioids in treating pain lasting longer than three months.

What did the CDC seek to achieve with the report? Through this advisory notice, the agency tried to ensure that doctors and patients go the route of safe, yet effective treatment and outcomes. Suggestions related to timing considerations of beginning and continuing treatment; selection of opioids as well as dosage and duration; and risks. They all pointed to: using less, lower doses and shorter times.

What If?

A case in California points out the potential hazards aligned with this tactic. A recent report in Pain News Network discussed how a doctor with a primary care practice in the small northern city of Arcata is in jeopardy. This physician may lose her medical license based on allegations by the state medical board. The reason? Overprescribing opioid medication.

The formal complaint centers on five patients. The doctor has been treating them with relatively high doses of opioids. Even though she lowered their doses, the amounts still are deemed excessive. In light of other meds the M.D. has prescribed for these patients, e.g., benzodiazepines, the charges against her contend that the combination enhances the risk for overdose and death. Here’s the rub: the physician followed the CDC standards for tapering; however, some doses exceeded recommendations, but for complex reasons.

Is this one isolated instance? According to news about this case, the new rules for prescribing opioids are affecting primary care physicians across the state. A pain specialist, who is chair of the California Medical Association’s Board of Trustees, explained, “What we’re finding is that more and more primary care doctors are afraid to prescribe and more of those patients are showing up on our doorsteps.” Some physicians are deciding to retire. In other words, the guidelines are inflicting real pain on members of the medical profession and their patients who may have to seek help elsewhere. These options may be limited in smaller and rural locations.

Another Call to Action: Medically-Oriented Recovery Treatment

Opioids pose a life-threatening risk to those dependent on them. Laguna Treatment Hospital, located in Alisa Viejo, California, has a message to share with you. That is: “Your Recovery Begins Here.” This detox and drug treatment facility in Orange County is a member of the American Addiction Centers network. As part of this highly trusted group, Laguna offers proven results with a guarantee. Complete our 90-day treatment program to stay clean and sober or return for 30 days… on us.

Using evidenced-based practices, the treatment team works with clients on a customized basis. They create a plan that addresses your needs. For these and many other reasons, Laguna Treatment Hospital carries the Gold Seal of Approval from The Joint Commission of Healthcare Organizations as an accredited drug and alcohol treatment facility. Visit our admissions page to take the first step. It will help in a small way to halt the opioid epidemic and in the biggest to reclaim your life.


Read More from Sherry M. Adler:

Rx for Trouble: Opioids for Teens and Young Adults in Pain

Wheels Matter on the Road to Recovery