By Christine Kucera, guest columnist
The Centers for Disease Control and Prevention (CDC) is the primary national public health institute in the United States. The agency is responsible for protecting the public from health and safety threats.
In my opinion, the CDC has nothing to do with writing clinical guidelines! Medical guidelines for health care/disease management, medication management and clinical decision-making should be developed, reviewed and approved by a diverse team of clinical area specialists and key stakeholders, including medical specialists , medical groups, advisory teams, advocates and patients. Not regulatory agencies!
The CDC’s 2016 Opioid Directive, as it is currently written, has injured and damaged millions of lives and caused untold suffering. Indeed, the CDC has sanctioned torture by failing to promptly address and correct the negative impact of its guidelines on individual patient care, treatment, and substance abuse and pain management resources.
The CDC clearly exceeded its authority by creating a guideline intended to regulate the use of prescription opioids. Any regulatory measure that prevents patients from accessing prescription opioids indicated for their health and well-being is unethical and should be reconsidered, if not removed altogether.
The CDC continues to propagate the false narrative that all patients requiring prescription opioids for any type of pain are or will become addicts. And he goes on to claim – without any evidence – that if opioid prescriptions are limited in quantity, type, duration and dose, there will be a reduction in addiction, overdoses and deaths. The facts indicate otherwise. Overdoses are at record levels.
The real causes of addiction
Addiction exists because our government has failed to address its true causes, including lack of access to addiction treatment, unethical pain treatment, lack of standards of care quality in medical institutions and the absence of legislative laws that protect patients from unnecessary suffering.
Addiction is caused by preventable and manageable health disparities, untreated and undertreated mental and physical suffering, genetic metabolic variability, lack of resources, lack of all-inclusive health insurance, lack of health care provider-managed pain, lack of treatment centers, lack of access to appropriately prescribed medications, lack of medication monitoring systems, lack of access to mental health and pain treatment providers , lack of timely access to a comprehensive network of providers, and lack of individualized care.
Maybe if the CDC really focused on the health and safety issues above, we would have some guidance on fixing the real issues. The CDC has failed miserably to recognize that individual pain care is as unique as the patient with pain. Every person who suffers seeks relief.
Relief comes in many different forms, both healthy and unhealthy. These forms of relief may be self-directed and/or medically managed by clinical staff and providers, and include exercise, yoga, rest, mobilization, heat/ice therapy, massage, mindfulness, acupuncture, Chinese herbal medicine, bio-feedback, diet, weight loss, surgeries, hydrotherapy, cycling, bodybuilding/strength training, martial arts, immunotherapy, TENS, anti-inflammatories, anti-epileptic drugs, muscle relaxants, antidepressants, biologics, medical/recreational cannabis, CBD, kratom, prescription opioids, illicit/illegal drugs, and alcohol, to name a few.
Every patient is different
The journey of each suffering patient is individual. The pain you have experienced and lived with is different from mine and others.
The terms “acute pain” and “chronic pain” are also misleading and part of the false narrative. Pain is a symptom. Its management depends on its physical and/or psychological cause, and not on its duration. Pain is the body’s way of signaling that something is wrong.
Duration means nothing in the world of pain, because every minute of the day is different in type, location, and intensity. Pain goes through cycles and no one experiences pain the same way.
Until the people who wrote this horrible, evil guideline from God experience relentless, agonizing, non-stop pain, 24/7, all their lives, they should let go of the false narrative, return to their non-medical cave and leave. medical decision making to actual doctors who are trained to manage pain with all the tools available and in any amount a patient requires.
What the CDC should address are the sources of suffering, identifying those at risk and providing a framework for implementing resources and systems of care that are fluid and adaptable to each individual’s unique circumstances.
There are too many outstanding questions and issues that also continue to impact patients and providers. What are the roles and responsibilities of the FDA and DEA? How do their policies meet the goals of the CDC guideline to reduce addiction, overdoses, and deaths? What impact do they have on medical providers treating pain patients?
Addiction is the public health issue requiring CDC input, not the use of prescription opioids for pain treatment.