The Use of Opioids and Pain Management
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While Dr Jones short article is sympathetic to the concerns of chronic pain patients, it is unfortunately incomplete. There is ample evidence of fraud and inappropriate influence in the 2016 CDC Guidelines on prescription of opioid analgesics in adult non-cancer pain. To put the case bluntly, the guidelines employed cherry-picked research to support an anti-opioid political agenda unsupported by science. The small number of long-term studies of opioid pain relievers was deliberately mis-construed to claim that opioids don’t work for chronic pain — a claim unsupported by medical evidence.

Liberalized prescription policy of the 1990s may have brought more pain pills into street circulation by theft or diversion. But “the problem” that CDC set out to solve is largely a mythology. Contrary to the prevailing public hype on this subject, pills prescribed to people in pain and managed properly over time never were and are not now a major cause of an “opioid epidemic” of deaths by overdose. CDC statistics for 2010–2015 reveal that much of the rising death toll was actually the direct result of FDA action to force reformulation of Oxycontin into “abuse resistant” form. In the three years immediately following this action, prescriptions for Oxycontin dropped by two-thirds and deaths involving heroin more than doubled. The relationship was not accidental. Addicts who had started abusing in their teens went into the streets as Oxycontin became more expensive and harder to obtain.

The CDC guidelines and the related DEA witch hunt against pain management doctors are directly responsible for hundreds of deaths by suicide in the 18 months since their publication. I see the reports every week in social media, and medical professionals confirm this trend in published work. The only morally defensible way forward in this important public health issue is for CDC to immediately withdraw the guidelines for a major rewrite led by pain management doctors rather than addiction therapists; participation by pain patients and their advocates should be considered mandatory.

Richard A. Lawhern, Ph.D.
Patient Advocate and Healthcare Writer

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