Get Involved: CDC Opens Comments for New Opioid Guidelines
The Center for Disease Control is taking public comments until January 13th about their guidelines on opioid prescribing. While the majority of the guidelines are targeted at general practitioner who have had less education on who and how to prescribe these pain drugs. Below is the letter I wrote. Please feel free to copy and use certain paragraphs if you wish to weigh in on his matter. Deadline is this Wednesday!
National Center for Injury Prevention and Control
Centers for Disease Control and Prevention
4770 Buford Highway NE., Mailstop F-63
Atlanta, GA 30341
Attn: Docket CDC-2015-0112
Agency: Centers for Disease Control and Prevention (CDC)
Parent Agency: Department of Health and Human Services (HHS)
January 9, 2016 (via email)
To Whom It May Concern:
Opioids are often prescribed to Chronic Migraine patients, of which there are 4 Million Migraine patients that fit in this category. Opioids tend to be the last resort after trying a plethora of preventative and abortive medications. This population experience more than 15 headache days per month. Many never have a day without pain. Opioids do not cure Migraines because there is NO cure at this time. Opioids help patients to relieve the constant pain. The Migraine community is concerned that access to opioids will be restricted even more with these new guidelines.
In 2014, the US National Institutes of Health spent $0.55 per migraine patient on research. Meanwhile, for each person diagnosed with Multiple Sclerosis the research is funded at $291.42. There are 400,000 individuals with MS in the United States compared to 36 million Migraine sufferers.
I have been plagued with Chronic Migraines since 2011. I never have a moment of relief, but over time have learned to manage the pain more effectively. I worked for 15 years in the community banking industry as a VP of commercial real estate lending. After trying many therapies both medically and naturally with the top headache specialists in the US, this disabling disease left me unable to return to my beloved job. In 2013, I was awarded Social Security Disability Benefits. Along with other medications, both preventative and abortive, 5mg-325mg of Percocet is a drug that I use about once a week when pain levels spike over 7 to 9 on a 10 pain scale.
Realizing that you should never let your pain go to waste, I pivoted to become a writer and patient advocate for Migraine.com to share my experiences with hundreds of thousands of patients who use our social media. My motto is “Living a Fulfilled Life While Managing Chronic Migraines.” This is not an easy task, but one that I strive to achieve daily. I also believe in a balance of medication (including Percocet) and self-healing measures such as yoga and deep-breathing. I have successfully used long-term opioid therapy for 4 years without becoming either dependent or addicted to the drug. I am not the only one who responsibly uses opioids.
The CDC Guidelines state that “almost 2 million Americans, age 12 or older, either abused or were dependent on opioid pain relievers in 2013.” However, this number is inflated because there is a difference between dependence and addiction. The National Institute of Drug Abuse states that addiction constitutes “failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal. “ While with dependency “the body adapts to the drug, requiring more of it to achieve a certain effect (tolerance) and eliciting drug-specific physical or mental symptoms if drug use is abruptly ceased.” Simply put, dependent users are functional with minimal issues during withdrawal, while addicts do not contribute to society and become physically sick without its use. There is a difference between dependency and addiction, therefore the 2 million number is misleading.
The CDC clearly has a bias against opioid usage by sponsoring a social media campaign called “When the Prescription Becomes the Problem.” Absent from the CDC website are stories of people who have responsibly used long-term opioid therapy. There is no dispute that opioid use can turn into addiction, which can then turn into a heroin addiction. 14% of opioid users graduate to using heroin. Not publicized are the other 86% who responsibly used these medications.
By no means am I dismissing the need for better controls when prescribing opioids. I personally have a friend who is currently in rehab due to an opioid addiction that turned into a heroin addiction. Educating primary care physicians is crucial. Drug testing, frequent doctor’s visits to monitor use, explaining risks to patients and using pain contracts are all great examples of changes that need to be made in our healthcare system and are addressed in the Guidelines.
There is no mention of creating a national registry of opioid users that would decrease the number of abusers who doctor shop or go to multiple pharmacies across state lines to obtain additional pills. Some states have created their own registries but only a nation-wide program could have the biggest effect on the fight against addiction.
I urge the CDC to consider the patients who responsibly use opioids to manage their chronic pain issues and not to focus solely on those who become addicts. Restricting access through these guidelines will leave more people in constant pain while their quality of life suffers.
Katie M. Golden
Do you feel the same way I do? If you are so compelled, please take the time to send your comments to the CDC. Below are the links you’ll need to submit your response. And again, feel free to steal anything I’ve said (except for my personal experiences).
How much has your migraine disease changed or evolved over time?