CDC “waiting till hell freezes over” to realize that legal opiates and OD’s: NO RELATIONSHIP

liarliarFewer Pain Meds but More Overdoses in Massachusetts

Apparently CDC is putting “common sense” ON HOLD.. when it comes to finally admitting that legal opiates and OD… have little in common..  Only 8.3 percent of those who died had a prescription for an opioid drug
Where is a recent article from the BOSTON GLOBE that stated that ONLY 8.3% of the people ODing on opiates … had a legal prescription for the opiate that toxicology showed in their system.

By Pat Anson, Editor

Opioid prescribing fell by 15 percent for members of Blue Cross Blue Shield of Massachusetts after the insurer adopted policies that discourage the dispensing of opioid pain medication, according to a new analysis by the Centers for Disease Control and Prevention.

The CDC’s Morbidity and Mortality Weekly Report found that 21 million fewer opioid doses were dispensed to Blue Cross Blue Shield members from 2012 to 2015. But the new policies failed to slow the growing number of opioid overdose deaths in Massachusetts, which more than doubled during the same period.

The CDC said it will “take time” before overdoses start to decline.

“Reducing the level of opioid prescribing is a long term strategy to limit exposure to these drugs. Mortality outcomes would not be expected to change for several years after implementation, and impact would be complicated by the increasing supply of illicit opioids,” Courtney Lenard, a CDC spokesperson, said in an email to Pain News Network.  

“Long-term strategies like the one outlined in the report take time to make an impact and therefore no immediate impact can be expected during the first several years of program implementation. Assessing what happened before and after the policy at the mortality level is inappropriate.”

Blue Cross Blue Shield (BCBS) of Massachusetts is the state’s largest insurer, with about 2.8 million members.

In 2012, the insurer adopted policies that discourage opioid prescribing by requiring doctors to develop treatment plans that consider non-opioid therapies; requiring pre-authorization for all opioid prescriptions after an initial 30 day supply; and limiting some pain patients to use of a single pharmacy.

The effect was immediate, with an average monthly decline of 14,000 prescriptions for both short and long-acting opioids.

Although cancer patients were exempt from the policies, there was a 9% decline in opioid prescriptions to BCBS members with a cancer diagnosis. The CDC attributed that to a “sentinel effect” in which doctors implement the same policies for all of their patients regardless of diagnosis.

“I think oncologists were becoming more thoughtful and maybe more vigilant about how much narcotics they were prescribing and I think that’s why we saw that decrease in cancer patients,” said Tony Dodek, MD, associate chief medical director for BCBS of Massachusetts. “We’ve only received one complaint about the program in terms of people having access to necessary pain medications.”

Like the CDC, Dodek said it may take years before the stricter prescribing policies start to have an impact on overdoses. So far the signs are not encouraging.

Opioid overdoses in Massachusetts rose from 698 deaths in 2012 to 1,659 deaths in 2015. The trend has continued in the first six months in 2016, with nearly a thousand opioid overdoses reported. Two-thirds of this year’s deaths were related to fentanyl, a synthetic opioid that is increasingly appearing on the black market. Illicit fentanyl is often combined with heroin and cocaine, or used in the manufacture of counterfeit pain medication.



“It’s not surprising to me that overdoses have not gone down because there is still a lot of drugs in circulation,” said Dodek. “What we did was slow the supply of new medication that’s in circulation. The fact is there is already way too much medication sitting in people’s medicine cabinets at home and that is what was available to start this epidemic.”

The Drug Enforcement Administration has said the U.S. is being “inundated” with counterfeit painkillers and there are anecdotal reports of some patients turning to street drugs for pain relief as opioid medication has become harder to get. But Dodek says it is recreational users – not pain patients – who are resorting to the black market.

“Any pain patient isn’t having access problems to getting opioids,” he said. “Those who may be using it for recreational purposes or for diversion probably are having a more difficult time (getting prescriptions). We still need to figure out what to do about illicit drugs, but I think decreasing the amount of prescriptions drugs will only be a good thing in the end.”

And what about the effect on pain patients as these policies are adopted? The CDC report ends with this telling statement:

“Finally, it is not known from these data how patient pain and function were affected by limiting access to opioid prescriptions.”

4 Responses

  1. What exactly are the CDC’S evaluation criteria and parameters for success/failure of their policy and what is the timeline because reasonable and prudent health professionals are required to evaluate and revise on an ongoing basis until goals are met not just ignore ongoing catastrophe of conditions until it’s too late, that’s just plain irresponsible. If decreasing the amount of controlled prescriptions was the only measure of success for decreasing mostly illicit and mixed drug overdoses than I can state they have identified the wrong problem paired with the wrong solution.

  2. I am a pain patient. I have CRPS of the jaw and face following botched dental implant surgery. I also have major back and hip pain following a bad car accident that resulted in several surgeries and bilateral hip replacements, C3-C6 spinal fusion and two surgeries for a torn labrum in my shoulder. The CDC guidelines, reclassification of opiate pain medication and DEA mandated reduction of opiate production has impacted my life in a major way. I have gone from having a fairly decent quality of life on opiates as well as medication for my nerve pain to a life that has closed in on me more and more as these changes have occurred. I had a wonderful pain management doctor and practice that truly understood my pain. Unfortunately, he and two other doctors and two NP left the practice in the spring leaving one doctor behind. Now the order of the day is pain injections – injections that at best have been ineffective and at worst have made the pain more intense. I have been told the nerve pain medication should be fine for all of my pain. It is not. The most recent requirement is neuropsychological testing. My doctor most recently put me on Nucynta. The pharmacist told me that I can’t take it because there is a major drug reaction with one of the meds I’m on for nerve pain and a moderate drug reaction with the other. The doctor does not care. It’s that or nothing. I can’t go off of Lyrica and Cymbalta for nerve pain as this is the only combination I have found to be effective for that pain. It doesn’t seem to matter to the doctor at all that the pain in my spine and hips (not to mention the pain in my jaw from osteomylitis) is not touched by lyrica. I can’t tell you how depressing it is to live in constant intense pain. Now I spend most days in bed. My quality of life has taken a nose dive. And still the CDC is ignorant to the fact that their overly stringent guidelines in addition to everything else that is happening in the “drug war” is ignoring pain patients such as myself. I strongly doubt that time will prove what they are doing is effective in ending overdoses. They are in effect throwing the baby out with the bath water. Likely this will all result in ever increasing overdoses as desperate pain patients are driven to extremes turning to the black market or even suicide seeking relief. This month my pain management doctor chastised me for ranking my pain level as wavering between 9 and 10+. He insisted that I use descriptive words instead of numbers in ranking the pain level. He REALLY didn’t like when I told him “suicidal level pain”. But it is what it is. Hopefully hell will freeze over soon.

  3. What a crock! Pills aren’t like dollar bills, they don’t circulate for years until they get worn out! My hubby says that the rise in deaths that are prescribed medication is from pain not being properly treated and that number will go down when all who suffer severe pain have killed themselves! Every time I read another bull sh** article like this I get more angry! When is karma going to get to work and put these idiots in pain?

  4. Another grerat article for my ,”packet,”,,,it proves what all of us w/1/2 a brain have been sayen,,The government has no rite being Dr.Government and they are committing torture and genocide onto the medically ill w/ chronic medically painfull conditions,,THANK U M,r.Steve,,,again,,,mary

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