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Federal government has overreached in cracking down on the opioid overdose epidemic. In order to cut off the supply of prescription drugs falling into the wrong hands, new regulations have crippled the ability of our doctors

US Government's Crackdown On PrimaryCare Physicians


By —— Bio and Archives--March 14, 2018

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 US Government's Crackdown On PrimaryCare Physicians
To understand how the government has stepped over the line with their current crackdown on primary healthcare physicians, we must look at how the politicians responded to the opioid crisis when it first reared its ugly head.

In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to opioid pain relievers and encouraged healthcare providers to prescribe them at greater rates. All the more profits for the Big Pharma shareholders, right?

According to a report written by the HHS, “Increased prescription of opioid medications led to widespread misuse of both prescription and non-prescription opioids before it became clear that these medications could indeed be highly addictive.”

Opioid overdoses accounted for more than 42,000 deaths in 2016

“Opioid overdoses accounted for more than 42,000 deaths in 2016, more than any previous year on record. An estimated 40% of opioid overdose deaths involved a prescription opioid.”

“Opioid-involved deaths are continuing to increase in the United States. More than three out of five drug overdose deaths involve an opioid. Opioids—prescription and illicit—are the main driver of drug overdose deaths. Opioids were involved in 42,249 deaths in 2016, and opioid overdose deaths were five times higher in 2016 than in 1999.”

In 2017 HHS declared a public health emergency and announced a “5-Point Strategy To Combat the Opioid Crisis”.

The HHS’s five-point plan:

  1. better addiction prevention, treatment and recovery services
  2. better targeting of overdose reversing drugs
  3. better data
  4. better pain management
  5. better research

The National Institutes of Health (NIH) has joined with private partners to launch an initiative in three research areas to address the Opioid crisis:

  1. overdose reversal
  2. addiction treatment
  3. pain management.

What does legitimate pain management have to do with overdoses?

The FDA also weighed in with a two-part plan called the “Timeline of Selected FDA Activities and Significant Events Addressing Opioid Misuse and Abuse Testimony on the Federal Response to the Opioid Crisis”. What a mouthful.

It has two parts:

  1. Officials from CDC, FDA, SAMHSA, and NIH appeared before Senate Health, Education, Labor and Pensions (HELP) Committee in October 2017 to report on HHS activities in response to the Opioid Crisis.
  2. Pain Management Best Practices Inter-Agency Task Force”

If you look at these plans carefully, you can clearly see that “pain management” plays a part in all of them. What does legitimate pain management have to do with overdoses? This is where the government and other big players in the medical industry have crossed the line.

The FDA Task Force mentioned above as the 4th step in their opioid management plan, made into law by the Comprehensive Addiction and Recovery Act of 2016, is assigned the following responsibilities:

  1. Determining whether there are gaps or inconsistencies in pain management best practices among federal agencies.
  2. Proposing recommendations on addressing gaps or inconsistencies.
  3. Providing the public with an opportunity to comment on any proposed recommendations.
  4. Developing a strategy for disseminating information about best practices.

This is nothing more than an attempt by the federal government to step in and play doctor, a role that every American needs to be concerned about.

Additionally, the federal government has come up with a bundle of new regulations called “A Comprehensive Population Health-Level Strategy for Pain

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HHS, the FDA and Congress has increased the regulatory burden on primary heath care physicians

According to the HHS,

“This strategy outlines the federal government’s first coordinated plan for reducing the burden of chronic pain that affects millions of Americans. A diverse team of experts from around the nation drafted the National Pain Strategy as a roadmap toward achieving a system of care in which all people receive appropriate, high quality, and evidence-based care for pain.”

It seemed like a good idea at the time. The politicians had nothing but the best intentions in drafting these plans and regulations. Like all good intentions of the federal government, the bureaucratic mess the politicians have created to prevent overdoses has resulted in the halting of the supply of prescription opioid medication to those who really need it.

All those plans described above by the HHS, the FDA and Congress has increased the regulatory burden on primary heath care physicians to the point where it is now impossible for them to treat their chronic pain patients because they can no longer prescribe opioid-based pain medication to them.

In order for these patients to get their medication, they now need to be referred to a psychiatrist, who may or may not give them the medication they need. (Medscape)

Where is the logic behind taking normal, hard-working Americans who need opioid pain medication to function normally and transferring them away from their primary healthcare physicians to psychiatrists? Have a they all suddenly become mentally ill as well?

 


“There’s a civil war in the pain community”

For Thomas P. Yacoe, the word is “terrifying.” Leah Hemberry describes it as “constant fear.” For Michael Tausig Jr., the terror is “beyond description.”

All three are patients struggling with chronic pain, but the reason for their agony is not physical, it is mental because what they are describing is a war inside the medical community that is threatening their access to painkillers. Without them, these patients will lose their jobs and their quality of life.

It’s been two years since the drug overdose epidemic hit the US and doctors and regulators are sharply restricting access to drugs like Oxycontin and Vicodin, leaving the patients who genuinely need drugs to manage their pain without them.

“There’s a civil war in the pain community,” said Dr. Daniel B. Carr, president of the American Academy of Pain Medicine. “One group believes the primary goal of pain treatment is curtailing opioid prescribing. The other group looks at the disability, the human suffering, the expense of chronic pain.” (Stat News, Jan. 17, 2017)

Pain specialists say there is nothing civil about this war.

“There’s almost a McCarthyism on this, that’s silencing so many people who are simply scared,” said Dr. Sean Mackey, who oversees Stanford University’s pain management program. (StatNews)

“The thing is, we all want black and white. We don’t do well with nuance. And this is an incredibly nuanced issue.”

“Nuance doesn’t matter to people like Tausig, 43, who has been unable to work or socialize since 2008, when his five spinal reconstruction surgeries left him in constant pain.

“A few years ago, his pharmacy’s corporate parent imposed opioid-distribution limits, forcing him to find a new one, which caused him to go 3 days without his medication.

“Those three days were among the worst of my life,” he said. “I wandered the house at night, legs shaking like a whirling mass of putty, sleepless and without respite from the pain.”

 

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Mountain of new regulations from the opioid epidemic

Now, with government regulators and health industry leaders continuing to crack down on opioids, Tausig’s worries have deepened. “It’s put the fear of God in me,” he said.

The consequences of this are enormous. Many patients in the US rely on their pain medication to remain productive, hard-working Americans. Now that the government is taking that away, they will become very ill to the point of being bedridden or worse and will become a burden on society and to their families.

Instead of contributing to society and taking care of their families, they will now be reduced to the level of minute by minute survival with no quality of life. This will be devastating to them.

It will be devastating to their families as well, especially when those affected lose their jobs because they can’t work anymore and will no longer be able to provide for their families. This will take a huge toll on their families economically, emotionally and physically.

To make matters even worse, a primary care physician may face liability lawsuits from alleged medical malpractice,  revocation of their medical license by the medical board, federal programs exclusion, criminal charges, even felonies, fraud charges by federal or state attorneys for claims for services and prescriptions paid by the government on behalf of patients, exclusion from participation in state programs, lawsuits from private third party insurance providers for breach of contracts, hospital peer review, and stripping the physician of membership or special status by other organizations.

Just one investigation with a finding of liability can trigger an avalanche of consequences, making it impossible to practice medicine.

You add all of that onto the mountain of new regulations from the opioid epidemic, and you get doctors, who have spent a fortune on their education in order to obtain their medical licenses, finding themselves bankrupt with no way to pay off their student loans.


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Robert Steven Ingebo -- Bio and Archives | Comments

Robert Steven Ingebo, is president of FRI Corporation


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