Massachusetts opioid prescription rates are falling

  | July 6, 2016

In the past three months, opioid prescriptions fell more quickly in Massachusetts than in the country as a whole — potential good news that follows increased attention to opioid abuse and a sweeping new state law that limits opioid prescriptions.
According to prescription records tracked on the athenahealth network, Massachusetts saw a 14 percent drop in the number of patients prescribed opioids between the first and second quarter of 2016, compared to an 8 percent drop nationwide.opioid prescribing rates down, athenaInsight
Experts say it's too soon to attribute the decline to any single measure, including the opioid bill that Governor Charlie Baker signed into law in March, just over 100 days ago. Still, they say the data could be a harbinger of a long-awaited turnaround, in a state that has seen a 162 percent increase in opioid-related deaths over the past five years.
“While it would be realistic to say that the governor signing that legislation and putting it on paper affected that change, the system doesn't change that quickly," says Jeffrey D. Baxter, M.D., an addiction specialist at University of Massachusetts Medical School. Still, he said, “I do have to credit the politicians and public health officials for really raising the public profile of this issue."
athenahealth researchers found that in the second quarter of 2016, 5.2 percent of patients in Massachusetts received at least one opioid prescription, compared to 8.3 percent of patients nationwide. This stayed true across insurance provider, age, and specialty group, based on a statewide sample of community practitioners. From the first to second quarter of 2016, prescriptions lowered by an average of about 15 percent for primary care providers and 11 percent for specialists in the state.
The data comes from an analysis of prescribing rates for more than 890 Massachusetts physicians and 500,000 Massachusetts patients on athenahealth's electronic health record network between 2015 and 2016. Those were compared to prescribing rates for more than 17,700 physicians and 8.8 million patients on the network nationwide.
Future athenahealth research will investigate prescribing rates nationwide among different specialities, practices, and demographics of doctors and patients.
Lower prescription rates could lead to better overall public health outcomes, says Angela Kilby, a Ph.D. candidate in economics at MIT who recently conducted research on the effectiveness of drug monitoring databases — and found that a 10 percent reduction in opioid prescriptions correlates with an approximately 8 percent reduction in opioid-related deaths.
But some have warned of a downside to an across-the-board reduction in opioid prescriptions, which can make it harder for patients in pain to receive medication and find relief.
"Are we restricting access to effective pain treatment that people really need and therefore, allowing people to suffer?" says Baxter. "We're shifting the burden, now, in my opinion. People are still getting opiates, and we still haven't dealt with the elephant in the room, and that's the lack of access to high-quality pain care."
Opioid prescription rates in Massachusetts have been falling since 2015 after being flat in 2014, athenahealth data shows, and Massachusetts physicians have been writing fewer prescriptions than physicians nationwide for years. But it's hard to attribute the most recent drop to the March opioid abuse bill alone — even one of the most celebrated portions of the bill, a seven-day limit on first-time opioid prescriptions. opioid prescribing down in Massachusetts, athenaInsight
It takes time for such laws to trickle through the system and actually change provider behavior, Baxter says. In meetings with physicians across the state, he has found that providers still don't know what the March law means for their day-to-day practice.
Still, over time, 7-day prescription limits are likely to impact prescribing trends. Studies show that when patients are prescribed more opioids, they tend to use more of them or share them, says Stephen W. Patrick, M.D., an assistant professor of pediatrics and health policy at Vanderbilt University School of Medicine and the lead author of a recent study on prescription drug monitoring databases.
“Anything that tackles the excess amount of opioids we have in our community is good news. People don't take back the opioid prescriptions they don't use, they often stay in medicine cabinets," Patrick says. “So for me, [limiting the number of pills prescribed] holds promise."
Researchers note that the 2016 law — which also includes guidelines for physicians and funding for community educational programs — joins several other interventions in Massachusetts, from a 2014 prescription monitoring database law to a working group on opioids that Baker established in 2015. In 2012, the Massachusetts Board of Registration in Medicine began tying licensing to mandatory educational programs on opioid abuse. Some insurers have begun to put limits on opioid prescriptions.
And the downward trend in Massachusetts tracks nationwide efforts to curb the opioid crisis. The Centers for Disease Control and Prevention released a set of primary care prescribing recommendations in March, cautioning doctors to think very carefully about prescribing opiate medications for patients with chronic, non-cancer pain.
The first half of 2016 also brought a tidal wave of attention to the epidemic — from nationwide coverage of the social ills of addiction to national policy debates to the death of Prince. A recent Kaiser Health poll found that the opioid epidemic was one of the top three healthcare stories people care about right now.
“The press coverage has influence on providers, as well as the public," says Patrick. “How might just the conversation that happens change behaviors for both providers, and for patients? All of those things, I think, are important things to consider."
It's possible that Massachusetts providers are following opioid news and trends particularly closely, says Alene Kennedy-Hendricks, Ph.D., a researcher at the Johns Hopkins Bloomberg School of Public Health, who published a recent study about how patients share, store, and dispose of opioid medications.
"States that end up adopting new laws like this one are different from states that don't," she says. "Are some of these providers in Massachusetts more likely to be following what's going on with the opioid epidemic...than perhaps some of these other primary care providers in some of the other states?"
Chelsea Rice is a staff writer for athenaInsight. To keep up to date with athenahealth research into the opioid crisis, subscribe to the athenaInsight Weekly Brief
(Photo by John Moore/Getty Images)

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I have seen the other side with patients who are ready to commit suicide, because life is no longer worth living for them because of extreme pain. Dr’s hands are tied because of the strict laws and they want to keep their licenses. I want to know if the law makers have ever had extreme pain and have even considered how that would affect the people who do. These people are not sharing their meds or overusing them. They are just trying to make it from day to day. They cannot sleep because of the pain or do much of anything else. Some have begun drinking alcohol just to take the edge off the pain. That can affect their other health conditions and result in alcoholism. I think the law should be amended to help these people who really need the pain relief. The doctor should be able to do a case by case evaluation and decide who really needs it and then be allowed to prescribe adequately for those patients.
Name: 
Susan Wetzel
Email: 
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Susan, . You hit the nail on the head! Alcohol, heroin or suicide are the only other options.
Name: 
Erin Peck
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You are right. Try working or even grocery shopping when you have not slept in 3 days, other than naps.
Name: 
Greg Boltz
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Lawmakers get their meds, trust me. There are places that prescribe outside of DC. Many!
Name: 
Vicky Paige
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I completely agree with you. I personally feel the squeeze from the new insight of law makers and the doctors who fear repercussions of those law makers. I have a back injury which has caused me to be the unlucky recipient of chronic pain, three weeks ago my doc decided not to write any more pain med scripts for anyone. Over the years I have been to a rash of specialists with zero alternatives to pain meds, the past three weeks I have endured more pain than in the past few years combined, it is very clear to me why some overdoses occur. Some of the overdoes could be prevented if doctors would really listen to every patient individually instead of only hearing “I need pain meds”, because, if living in pain is the only answer then going to the street to get relief is going to become an alternative treatment.
Name: 
Rhonda
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test@test.com
I TOTALLY AGREE WITH YOU ON THIS AND I AM GOING THROUGH THE SAME THING AS YOU ARE AND I HAVE GONE TO THE STREETS FOR PAIN MEDICATION AS WELL ,ALL BECAUSE OF THIS SAME THING AND PROBLEM WITH THE DR.S AND MY BACK AND LEFT LEG WAS HUR IN A CAR ACCIDENT ???? BACK IN 2003 AND I TOLD THE DR WHAT IS GOING TO HAPPEN TO ME AND WHEN OTHER DR. DO NOT WANT TO GIVE ME THE MEDICATION FOR MY PAIN AND SHE TOLD ME DO NOT WORRY ABOUT THAT,THEY WILL NEVER CUTS ME OFF EVER ,WELL SHE IS TOTALLY 1000 % WRONG AND THEY DID CUT ME OFF AND NOW I HAVE TO FIND ANOTHER DR. TO GET BACK ON THE MEDICATION THAT I BEEN TAKEN FOR OVER 13 years now and IT is GETTING HARDER AND HARDER EVERY SINGLE TIME.BECAUSE OF TE RICH AND FAMOUS ANDIENG OF OVERDOSE OF THIS MEDICINE AND THIS IS TOTALLY 1000 % CRAZY AND TOTALLY BULL SHIT ???? ???? ???? ????.
Name: 
BONNIE GATES
Email: 
test@test.com
Susan – you are absolutely right!! This is insane that the government is allowed to direct doctors and patients in their medical needs. It is just WRONG! However, what is also wrong is that doctors are definitely too quick to prescribe Vicodin for “minor” pain – short term pain that can we’ll be helped by Advil or possibly codeine. In fact, codeine used to always be used for short term pain and has a way less addictive quality, especially for people who have never taken a narcotic. But Vicodin has replaced codeine for procedures such as dental work, minor ER situations and the like. Doing this causes almost immediate “addiction” or tolerance issues. If one is prescribed Vicodin for a ten day course, that is definitely a cause for addiction – a normal bodily reaction to the drug – unlike codeine. One more disturbing thing about this article is that researchers are using State drug reports of patients. This information should be covered under HIPPA and only my doctor, pharmacist and myself should have access to my personal prescriptions report. I wonder…….
Name: 
Lilly
Email: 
test@test.com
HIPPA information is not provided to the people doing the studies. Your personal opioid usage with your name is not provided. Think of it more like Walmart tracks its products when purchased and automatically orders new stock. Pharmacies can work in a similar fashion. Data can be taken from simple stock, number of meds handed out and never include a single name. Bottom line is that your prescription profile with your name and HIPPA information is not being used. More importantly I would like everyone to read the Surgeon General’s letter on opioids and the abuse, culture, and mind set of the people involved. This includes patients and providers. There is a huge opioid problem in this country and much of it is self induced. We have for too long been trying to tell people they should be pain free. That is a myth. A horrible myth propagated by big pharm that wants all of us addicted. I have chronic pain. I don’t use opioids. Never will. I have learned to live with it. There are other options out there. I am also a provider and deal with this daily. Giving up is not the answer. Opioids are not the answer. Continuing to try and waking up every day and taking it day by day until medicine improves is the answer.
Name: 
Douglas
Email: 
test@test.com
There are different levels of pain tolerance in individuals. I’m glad that you are able to get along in pain. Me? I’m the biggest pain wimp ever. When I feel pain, it’s so intense and draining I feel like I’m being totured. Because it is literally is torture. I fell off a truck halting my friend move and landed on a rock that bent my ankle in directions the human ankle does not like to go. and now for the last six years – 8 surgeries later – I’m still in chronic pain. I live in 4 hour increments, pill to pill. Recently some pharmacists threaten my pain management doctors with letter saying they are prescribing their patients too much. So they cut EVERYONE’S doses down by 1/3! Now I live in 6 hour increments – 4 feeling normal and 2 in excruciating pain . . . Everyday and every night. So now I can’t sleep all the way through the night. Ever. Does this make sense? Why should I be made to suffer 1/3 of my life, give up a 1/3 of my sleep, and be productive 1/3 of the day less? I am a single father of 2 adopted teenage girls. Now they get to experience their daddy writhing in pain everyday and night. It damaging their psyches. So let not assume government control of pain killers is an across the board good move for society. There is preventable, human suffering going on here. And someone in power needs to do something for those of us – there are millions – that legitimately depend on modern medical science to erradicate our daily suffering.
Name: 
Joe Solo
Email: 
test@test.com
Good for you, Douglas. As a recovering addict and someone who’s in chronic pain, I can tell all of you that it is possible to use alternative methods. Granted, they don’t always work, but why not try everything else before addictive pain meds? I believe this is what medical professionals should be doing, using other means such as physical therapy, acupuncture, massage, surgery, and other drugs like NSAIDS or even other narcotics, instead of setting us up for failure to become addicts. I refuse to take opiates no matter how horrible the pain. I’ve seen what these drugs have done to my community. I hope politicians in my area wise up and put forth a bill such as this one in Mass. Too many docs and pharms getting rich off of the suffering of others! Lily, Vicodin is made with codeine, dear. It’s just a brand name for it and acetaminophen mixed together. It also isn’t an opiate. So, I’m not sure what you’re talking about. There are many dental procedures, such as teeth extraction, where dentists don’t even prescribe meds. My daughter didn’t get any when they pulled two molars to make way for her braces. People need to suck it up, lose weight, get healthy, exercise, and try alternative methods to opiates.
Name: 
Julie B
Email: 
test@test.com
First, codiene IS an opiate. Secondly, Vicoden is Hydrocodone and Acetaminophen, not Codiene and Acetaminophen.
Name: 
Robert
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test@test.com
If I did not have opoids for pain due to very painful diseases, I would commit suicide! I know because when they lowered them by half, the pain was unbearable. Many nights I sat with all my sleeping pills praying to God that if I took them all to never feel the pain again, He would forgive me for killing myself !
Name: 
Valerie
Email: 
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Don”t give up. Hoping government let’s patients have the medication they need ! The more they control doctors and medicine l The more people give up and take their lives. That could be the governments plan to get you off the system. PLEASE HANG IN THERE ,DON”T GIVE UP .SOMEDAY SOON SOMEONE IN POWER WILL KNOW WHAT IT’S LIKE TO LIVE IN CONSTANT CHRONIC PAIN AND HELP US. I HOPE!
Name: 
Len
Email: 
test@test.com
I have a spinal cord injury from an avm. Since 1998 I have lived with pain every day. I know there are people with opioid addictions, but I am not one of them. I wish I could have these lawmakers live in my body for 1 day. See what severe chronic pain is really like. I’ve tried many different treatments and medications. The one drug that has helped this horrific nerve pain is methadone, which has been around forever, but is now at the top of the list for “bad” drugs, because of deaths with those who have combined it with other drugs. I would not be able to live without this medication. I wouldn’t want to. Even with it there are days I just don’t know if I can go on, the pain is so awful. After almost 20 years of this, I’m TIRED of pain MANAGEMENT. I want some pain relief. Yes, I want to be pain free damn it. I’m tired of suffering and tired of the stigma I have to deal with from people who don’t have a clue how bad this pain gets. I’m tired of the pharmaceutical industry who makes a fortune “managing” pain instead of curing it, which I believe CAN be done. Those of you who pat yourselves on the back because you can manage without medication need to get on your knees and thank God that your pain IS manageable. Before this injury I had no idea how bad pain can actually get. Before my surgery I had no idea that I was going to be left with this. I was told of all the other damage that spinal cord injury causes but no one mentioned that the pain might stay. Imagine my surprise. I gave birth to 2 children , that was tough, but nothing compared to this pain. These lawmakers need to realize that their actions always end up hurting those with a true need. Not the addicts, the abusers. They’re going to get their high no matter what laws are passed. And those in pain will suffer and struggle and be judged and damned through no fault of their own. Enough already.
Name: 
Barbara
Email: 
test@test.com
Chronic pain will always be an on-going problem and physicians’ who have no regard for their patient’s suffering shouldn’t be practicing medicine. Addiction to pain relievers is a very small price to pay for the person suffering. However, the people who abuse opoids need to be dealt with, not the legitimate sufferers.
Name: 
Frank
Email: 
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Susan and Valeri God bless you, I too suffer from CHRONIC pain. I got injured at work and have 3 herniated discs from the C4-C7 along with spinal stenosis and osteoarthritis since 2010 when I was diagnosed. Doctors at first refused to prescribe any pain mesds and thought it was a good idea to put me on muscle skeletal medications that I was allergic to (stopped breathing) and so then they put me on numerous other medication non narcotic that did absolutely nothing for my intense pain, until a year later they finally put me on the lowest dose possible of narcotic pain that helps but unfortunately only puts a small dent on my pain. Doctors will not increase and I don’t ask anymore because I’m scared they will take me off completely off my pain mess. I’m so young only 40, and I’ve been in so much pain, I’ve thought of ending it by committing suicide because the pain is so intense, most days I cry and can’t get out of bed or sleep. The only reason of why I don’t kill myself is because I have 2 daughters and don’t want to put them through the pain of my death. I’ve also been a Lab rat for the doctors, from them injecting me with all these shots that do not work. I’ve asked them for surgery, just to take me out of my misery , and surgeon advised me that I’m not a good candidate. I wish I could try marjuania for the pain, but unfortunately I can’t function on that stuff. It’s hopeless. I wish the government officials and president can hear some of these stories of real patients with real pain. I wouldn’t wish this on the devil himself! Best Regards
Name: 
In Pain
Email: 
test@test.com
Thank you, Susan, for writing that comment. As I read the article, I began to have tears rolling down my face because no one else seemed to be concerned about WHY anyone needs pain medication enough to take even a dangerous one. I am one who limits my use of the few Hydrocodone pills I have left to only on days that I have to leave the house. Those days are becoming fewer. Marijuana (which I haven’t tried but my in Colorado, with the same knees as I, says it helps when used properly) is still illegal in Louisiana. Hard alcohol is not, but I don’t like it. So, is anyone trying to find a pain medication that is legal, not so expensive that I can’t afford it, and not so stigmatized that the doctor I go to looks at me like an addict when I go to him and ask for a prescription?
Name: 
Nina Helfert
Email: 
test@test.com
There are over one hundred million Americans living with chronic pain. People such as myself who suffer with Chronic Pain are getting away from opioids and using #Cannabis to control our pain. We are all tired of being controlled by Pain Management doctors with their Big Pharma drugs. Tired of being treated and labeled drug addicts. With #MedicalMarijuana sweeping the nation, #Cannabis is now becoming our drug of choice for #Pain. #Marijuana doesn’t have to be smoked to get the benefits. There’s Edibles, oils, as well as weed in different strains to control our pain. We The People are taking control of our pain without the hassles. For us it’s always been about quality of life. As for the Addicts who abuse opioids, they are always going to be chasing that next high.
Name: 
AES
Email: 
test@test.com
129 days of no opiates after being on them TEN years!..#cannabis saves #opiateskill
Name: 
Gina Stephens
Email: 
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The Dealers are waiting with open arms. It is sad. As a nurse i remember patients crying in agony and pain.
Name: 
Elly
Email: 
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Yes Elly, they are! And the Doctors hands are tied because they are more worried about creating addicts then they are treating their patients, worried about their licenses because the Federal Government has mandated this new regiment, and the State Governments have followed suit blindly right behind them! I am one of those patients who are being taken off their meds after finally getting partial relief after almost 15 years of going to a Doctor for help! Now I am back to where I was 10 years ago, if not worse!!! And I am no slouch when it comes to work, I have worked since I was 10 years old, worked on a farm growing up, 2 jobs when I was 15 working over 70 hours a week, and construction since I was old enough to hit the work force in everything from concrete to foundations, sheetrock, masonry, framing & finish carpentry! A Master Framer Foreman by trade running multi-million dollar jobs on the coast is where I finally settled out at till I was injured in 2001. Now I am being told that the meds my body has come to depend on for pain management or no longer an option because some Doctor in DC or Governor in our State, who have probably never worked a strenuous says so??? No, it’s not right, and your just going to hear more patients crying in agony & pain before it is all over because not all patients are the same!!! There are genes in the body that break down narcotics and these genes are more prevalent in some patients then in others! I have been dealing with this since I was 7 years old with my first major trauma because local anesthesia, even thru a Dentist, has never worked correctly on me for some reason! It wasn’t until my 16 year old Daughter found the information on the CYP2D6 Gene that it started to make a little more sense! At 4 different levels of metabolizers, ultra rapid being the highest, I believe I am a level, if not 2, above that! I was told at 18 that my metabolism would slow down in a few years. Now at 51 years old it STILL has not, and I am paying the price because of it! And I am NO addict by any means and waiting to get the Gene Therapy done to SHOW there is a reason for my non susceptibility to narcotics, as well as local anesthetics!
Name: 
Shawn Coston
Email: 
test@test.com
Shawn, Have you ever been given lidocaine? It was given locally to my son’s forehead when he needed stitches, but it didn’t work. He still felt everything! I wonder if he has this type of gene. Is it hereditary? I guess it’s research time, lol. Thx for the post!
Name: 
Julie B
Email: 
test@test.com
How can you write about, “…a sweeping new state law that ‘limits’ opioid prescriptions.” And then say, “Experts say it’s too soon to attribute the decline to any single measure?” What it boils down to is because of a nationwide push to discredit legal pain medication and because of the fearful propadanda forced onto an ignorant public, cruel, unfair laws are being passed and the federal government is making the decision for legitimate doctors to alter the treatment provided to their patients. Thousands of chronic pain sufferers are denied the help they need because doctors fear prosecution from writing what is a legitimate prescription. It’s a travesty that there is effective medication, designed to limit pain and so many sufferers are denied the help they need. I hope every one of these ignorant psychos and lawmakers pushing to expand the regulation or banning of legitimate, pain medication are someday refused that relief while suffering the tortures of hell from physical pain.
Name: 
Brian Stoltz
Email: 
test@test.com
It really is appalling that lawmakers are disingenuously taking credit for “turning around” the problem by intimidating doctors to the point that they slash their patients’ pain meds. This article asumes that the poeple being denied pain medication to bring down percentages may be in real pain and suffering.
Name: 
elle2elle2
Email: 
test@test.com
What an absolutely disgusting article. Are these idiots aware that depriving people in pain of their medicine does not lessen the pain?
Name: 
Ross
Email: 
test@test.com
Veterans are being denied pain medication for injury in combat. Fight for the country and doctors turn their backs on you because the government threatens them. This is people and money control,NOT control of medicineSad,what government will do to control sick humans.
Name: 
Len
Email: 
test@test.com
I have arthritis pain for close to 12 years,or more,at first I was given Tylenol 3for my pain,I could not tolerate the medicine,I could not function,it made me feel as if the room was spinning,could not do anything other than stay in bed,made me nauseous. Then my doctor gave me Norco,finally I could function,house work,walking my dog,all the things a normal person does,there is no euphoria,just able to do things such as shopping,house work etc,I have serious arthritis,unrelenting pain,hands,back,arms,X-ray show it will not get better,only worse,but with the Norco,I can live halfway normal life! I know it is addictive,but I have not asked my doctor for a higher dose,never,the dosage I started with keeps my pain manageable! Since I lost both my sons to stroke,and heart attact my pain sometimes is worse,but I stay on my doseage,I sometimes take a medical antidepressant,it helps my sleeping so I don’t obsess about being alone,as I have no other children!
Name: 
Mattie Hardy
Email: 
test@test.com
Mattie Hardy, you know those two drugs are basically the same thing, right? The dose may have been different, but it’s all the same…acetaminophen with codeine/hydrocodone. Fyi, does your doc know about the antidepressant? Some of those drugs don’t do well with narcotics and especially don’t do well with NSAIDS, which can cause internal bleeding.
Name: 
Julie B
Email: 
test@test.com
Anyone really listening? The % population of people who abuse remain a steady number. The increase in number of people is due to increase in population. Every few months this intimation is sprinkled into reporting. Reports are grant/money driven. Universities prime source of income is research, altruistic bs about higher education is simply not true. Yes, we attend these places obtain educations, go on with out lives. Wherever money can be garnered/sidelined from the population of people and siphoned off to support academia it will continue to be done. The industrial revolution is over. The new reality post capitalism v communism is dead. Who are rages of journals kidding? Or, who are they slowly poisoning by slowly indoctrinating everyone in order to shift away from pain management for those who do not abuse, but maintain a healthier life because they have ‘opioids’ used judiciously in order to live as pain free as possible. Squeaky wheel gets the grease. No longer informative journalism here. Just more bs.
Name: 
Ma
Email: 
test@test.com
I ask you, how are legislators to know who is abusing these drugs and who is not? You’re wrong about this not being an epidemic. The number of opiate related infractions, which includes overdose and criminal, has drastically increased over the last few years, especially in certain areas. Just because you may not see it doesn’t mean it doesn’t exist! Why don’t you take a drive to that part of town where you know you won’t go? How do you know every person posting on here won’t be addicted and using heroin by next year? I’d be willing to bet at least half of them will, if not already abusing their meds in some way. How can you be so naive not to see this is a real problem? People will still get their meds. There will just be stricter mandates. Idk why everyone posting is acting like they won’t get their precious narcotics anymore. You all sound like addicts to me. Have any of you ACTUALLY tried alternative forms of pain management? Do you realize what those meds are doing to you? Wait til you stop. It’s not going to be a fun month!
Name: 
Julie B
Email: 
test@test.com
This is insane that the government is allowed to direct doctors and patients in their medical needs. It is just WRONG! I seriously hope it never ever becomes the norm for doctors to not prescribe what a patient truly needs! However, what is also wrong is that doctors are definitely too quick to prescribe Vicodin for “minor” pain – short term pain that can well be helped by Advil or possibly codeine. In fact, codeine used to always be used for short term pain and has a way less addictive quality, especially for people who have never taken a narcotic. But Vicodin has replaced codeine for procedures such as dental work, minor ER situations and the like. Doing this causes almost immediate “addiction” or tolerance issues. If one is prescribed Vicodin for a ten day course, that is definitely a cause for addiction – a normal bodily reaction to the drug – unlike codeine. One more disturbing thing about this article is that researchers are using State drug reports of patients. This information should be covered under HIPPA and only my doctor, pharmacist (not so sure about that one though) and myself should have access to my personal prescriptions report. I wonder…….
Name: 
Lilly
Email: 
test@test.com
Lilly, you can become addicted to codiene just like one can become addicted to hydrocodone(generic for Vicodin andNorco) plus codiene is rough on the gut. Many are unable to tolerate the nausea and irritation it causes the GI tract.
Name: 
Susan
Email: 
test@test.com
This is a horrible thing for those of us that are now bedridden. No doctor can understand. It seems no one cares. Pain causes depression, then no rest, then severe pain. Then the vicious cycle over and over, etc,,, Americans has treated disabled citizens.
Name: 
Lorrie A Henson
Email: 
test@test.com
The government needs to get out of peoples lives. Because what were curing today for a small percentages of the country.The Attics are just going to something leaving in tract people that really need the pain relief. 4 herniated disk got afford surgery before you can have surgery. Take 3 a day for the last two years taken months off no addiction. Its the personal choice of the attics.
Name: 
Marshall Craig
Email: 
test@test.com
The reason opioid medication is declined is because everyone that was taking the pills are now doing Heroin.
Name: 
Dorianne Beaupre
Email: 
test@test.com
I said it years back. Those who are dependent for pain will find a good DR or suffer. Others will quit an d suffer and take boatloads of NSAIDS. Those who can’t handle pain or have addiction gene with goto snatch, H, Heroin and eventually overdose and die. Success.
Name: 
Charles Maggio
Email: 
test@test.com
The laws in most if not all states all say it is against the law to practice medicine without a license. Government is not licensed hence they are breaking the law in prohibiting people from getting the medication they need to live life. Law suits all over the nation should rectify this. If not then no law is valid in this nation. Think about it and change things. You sue for money and for the law to do its job. Sue BIG!! Remember, No one is above the law. Not even law makers. If they have immunity from the law, everyone has immunity. Passing a law that puts Drs. in jail or gets licenses taken away is literally practicing medicine without a license when they are not Drs. Law makers or not most are not Medical Drs. File charges and have them arrested. If the police do not do their job it is legal to sue them personally. Same goes for any law enforcement agency and people that work for them. If city police do not make arrest it is time to sue them personally as well as the mayor for hiring the police chief for not enforcing the law. You can sue the city for not enforcing the law. Think big money for each lawsuit as well as making them do their job by prosecuting those that practice medicine without a license. Best Wishes
Name: 
Bill
Email: 
test@test.com
Dr patrick given your professions great failure to deal with people in pain and addiction no one should find your statements credible. Only one thing iis sure government and doctors have failed the American public.
Name: 
david becker
Email: 
test@test.com
NOT EVERYONE WOULD TAKE THIS MEDICINE TO KILL THEMSELVES AND THOSES WHO SAYS THIS IS TOTALLY 1000 % FULL OF SHIT ????,I BEEN TAKE THIS SAME MEDICATION FOR OVER 13 YEARS AND I AM NOW GOING THOUGH A VERY,VERY HARD TIME FINDING A GOOD DR. TO KEEP ME ON THIS MEDICATION AND GIVEN ME AS WELL AND THIS REALLY PISSED ME OFF TO NO END ,JUST BECAUSE OTHER PEOPLE TAKE IT AND END UP DEAD BECAUSE OF OVERDOSEING ,THEY CAN NOT SAY EVERYONE ELSE WOULD DO THE SAME THING AS THEY DID. AND I LIVE IN CALIFORNIA AND I AM GETTING VERY ,VERY TRIED OF EVERY SINGLE DR. THAT I HAVE SEEN FOR THIS,TRY TO MAKE ME GO THROUGH ALL THE HOOP AND EVERYTHING ELSE TO GET BACK ON THE MEDICATION THAT HELPS ME OUT WITH THE PAIN AND SUFFERING AND MAKES ME HAVE TO BECOME SICK AND THROW UP AND ETC. BECAUSE THEY DON’T WANT TO GIVE ME THE MEDICATION TO BE NORMAL AGAIN.THE DR.S ARE THE ONES WHO IGNORE PEOPLE THAT IS WHY PEOPLE LIKE ME END UP GOING TO THE STREETS TO GET SOME KIND OF DRUG ???? TO GET OUT OF PAIN AND SUFFERING AND THIS IS TOTALLY 1000 % WRONG WITH THIS PICTURE ????,THE RICH PEOPLE CAN GET ANYTHING THEY WANT BECAUSE THEY HAVE THE ABILITY AND THE MONEY ???? ???? ???? ???? ???? ???? TO BUY IT FROM THE DR.S AND OTHER PEOPLE WHO HAVE IT AND THEY ARE THE ONES WHO IS MAKING IT DIFFICULT AND HARD FOR US NORMAL PEOPLE TO GET THE MEDICATION WE NEED .AND THE D.E.A. AND ANYONE ELSE WHO HAS CONTROL OVER THIS NEED TO STOP FUCKING US OVER AND OVER AGAIN AND AGAIN .ALL I AND SO MANY OTHER PEOPLE WANT IS TO BE TREATED FAIRLY AND STOP TRYING TO BLAME IT ON ALL OF US ALL THE TIME AND ALLOWED THE D.S TO HELP US THAT REALLY DO NEED THE MEDICATION AND LET US GO ON WITH OUR LIFE AND BE PAIN FREE AND UNTIL THEY DO THAT ALOT OF PEOPLE LIKE ME ARE GOING TO SUFFER FROM THIS AND THIS IS NOT RESPONSIBLE AND RIGHT FOR US AT ALL.
Name: 
BONNIE GATES
Email: 
test@test.com
Some of us saw this coming. Pain was to be the ‘fifth vital sign’ and was to be documented from every patient in every encounter. Patients’ complaints of pain were to be taken seriously and treated aggressively, using any and all means possible. For the majority of untrained physicians, that meant Flexeril, Toradol IM, Depo- Medrol IM and Lortab 5 mg for three days and instructions to ‘contact your primary provider as soon as possible’. Doctors and hospitals were being sued for under-treatment of pain. A national campaign was undertaken with the central premise being that there is NO REASON anyone had to suffer with ANY pain if only your doctor is smart enough and willing to prescribe the right amount of strong pain medications. No room in the process for drug seeking behaviors; history of narcotic abuse and divergence; no room for over exaggerated complaints of pain in the total absence of any historical or physical findings to explain it and no room for the absence of any pathology identified by diagnostic imaging and testing. Pain complaints were to be believed and acted upon or face lawsuit and sanction. Family practitioners, gynecologists, internists all of a sudden became pain specialists. Every patient who had a pain complaint got the same four drugs above; and of course, 1 mg Xanax three or four times a day for their ‘nerves’. One patient told me she asked her FP to help her taper off her Xanax she had been taking for decades and he told her it would be “too dangerous” to stop and she should plan on taking it for the rest of her life. When the Lortab and later Norco became ineffective because of the inevitable development of tolerance, the doctors suddenly becam ‘uncomfortable’ prescribing the drugs and refer them to me and my pain clinic. They tell the patient they can have exactly enough tablets to get to my doorstep and that I will continue to prescribe the same drugs that cased the problems in the first place. They lie to their patients telling them it is now ‘illegal’ for them to prescribe narcotics or that the law limits the doses they can prescribe. They give their patients just enough narcotics to get them physically dependent then refuse to prescribe any more stating they “…don’t prescribe narcotics in their practice.” I have the choice of perpetuating the problem or committing the patient to withdrawal. Insurers have cut back reimbursement for procedural pain treatments, physical therapy, massage, acupuncture and have never paid for counseling as alternatives to narcotics while the govermnment assesses taxes on implantable devices used to treat chronic pain. Third party companies hired by the insurers to pre-screen doctors’ requests for procedures have made the authorization process so onerous that they are getting the desired effect; fewer specialists are attempting to provide non-opiate treatments for their patients because it’s easier to prescribe narcotics and the patients can afford them. An oncologist referred an elderly man to my clinic with painful bone metastases using high dose fentanyl patches. We gave him an appointment within on week but he would run out of his patch prescription before then. He asked the oncologist for just one more refill until he could get to my pain clinic and he was told, “You are a pain clinic patient now and you will receive no more prescriptions from us.” Rather than go through withdrawal, the man went home, took his shotgun and put a sleeping bag over himself to spare his family the mess and solved the problem the best he knew how. In response, the oncologists asked us to develop a mechanism so referred patients could be prescribed narcotics from our practice BEFORE THEY HAVE EVER BEEN SEEN IN OUR CLINIC! Now the country is up in arms because there are too many opioids being prescribed to too many patients and too many prescriptions are being diverted or are the cause of too many overdose deaths. Primary care practitioners are ‘uncomfortable’ prescribing the narcotics they started their patients on but still hand out 4, 5, 6, 8 mg Xanax, Ativan or Valium per day. “Something has to be done!”, is the cry now, suddenly. Maybe the practice of medicine should be left to physicians and the politicians and administrators should stay out of it. Sure we have a problem; it’s a big one. Anyone in the business could have seen it coming when the whole thing started with the ‘fifth vital sign’.
Name: 
Michael T. Grier, MD, Pharm.D.
Email: 
test@test.com
Drs also cut people off who have been on them for 10+ yrs with no withdrawal plan. No suggestions on where to go to get help. This is wrong. What are these people supposed to do when withdrawal symptoms hit? I understand the drs view, but yanking them from someone who had legitimately used them for years without a withdrawal plan is morally wrong also.
Name: 
Rebecca
Email: 
test@test.com
I have had cancer and also spinal stenosis. I see a pain clinic every 8 weeks and that is expensive. Yes, I have tried acupuncture and massage but that does not do much and that is expensive also. Without my oxycodone I would be on disability-with pain management I can hold down a full time job. I would try cannabis or CBD oil but it is still illegal in NC unless you are a child with seizures. I would rather use cannabis than oxycodone, but there you go. There are days that I don’t need or take it, then there are days that I have to. Much better than being unemployed and on disability. very limited on my choices and a lot of that is due to expensive insurance that also pays little.
Name: 
Susan
Email: 
test@test.com
Here in Silicon Valley you need to be at death’s door to get a pain pill. The doctors are so anti pain meds now that they are actually denying people in severe pain the proper medication or else cutting it down so low hat the person suffers. People are talking about how averse the doctors are now. I think abusers will go on getting their pain pills somehow or turn to heroin — but law abidfing people will have to just gut it out. The rates of Rx may drop but you need more information before seeing a statistic as something beneficial to the patients.
Name: 
elle2elle2
Email: 
test@test.com
Again the democrat machine working, and always working, for the ways of the few vs the many. This article is so misleading. Why don’t you do a study to determine how many legitimate patients can no longer get medication they need ? Which is probably most of the Rxs no longer being written as doctors fear fear for their careers. What a hoax these laws are.
Name: 
Paul
Email: 
test@test.com
Please will somebody speak up for us? For most of us chronic pain sufferers are debilitated to the point that we can barely speak up for our selves. It’s not just withdrawal that we must go thru- we also return to the stark pain for which we were given the medication for…I have come down from high doses to much smaller doses (sometimes initiated by my self) yes, they can be dangerous….but heroin and suicide is even more dangerous. Now I can barely get the small amounts. I am bedridden now. I have no access to the streets.I have been sick since a young age and I have worked hard to improve it. But it appears it was mostly for naught.( It is a auto immune disorder with chronic mild porphyria) And it’s amazing how a formerly sympathetic Drs, who once prescribed higher doses than I was comfortable with, tells me that they are so dangerous that that they don’t feel comfortable with prescribing them anymore. And that’s that. Yes, dependency happens, but most of us were told that if used carefully we could expect that relief and help for the rest of our lives. For most of us chronic pain sufferers just getting up every morning is an act of bravery even as it was. I never entertained suicide even when it was worst…but now…?? For some of us now…it is the only option….
Name: 
Patient x
Email: 
test@test.com
So wow ! Sorry to read this. My sister goes to a big pain place outside DC and sees Senators and big politicians there all the time! They get there’s. Just makes more $ on the streets which line politicians pockets, incarcerate more people, destroy more lives. Doctors usually know the difference of a real pain patient versus drug seekers. Sad If you do get the scripts, pay out of pocket. A way to keep you out of their statistics and help your doctor.
Name: 
Vicky Paige
Email: 
test@test.com
I am one of the unlucky ones whose pain meds dosage has been cut in half. I have degenerative disc disease, severe osteoarthritis, fibromyalgia & Crohn’s disease. I never wanted to have to take pain medication because of the stigma associated with people who do, but I had no other choice so I could function at work & get any sleep. at my last dr’s visit my dr told me she was only going to be able to prescibe a certain number of milligrams of opioid medications, which cut my dosage in half. Now I’m only able to sleep about 2 hours a night, & I can absolutely see why people turn to heroin or other street drugs. I never took more than my prescribed dosage or ran out of meds between dr visits or dr shopped or anything like that. I know the people who put this new “law” into effect have never experienced intractable pain or had a loved one who did; surely they wouldn’t have done this; it punishes those of us who follow our prescribed dosages. The news yesterday showed alternatives to pain meds like massages & accupuncture, but when your insurance won’t cover these options & you live on a small fixed income, they’re not really valid alternatives if you can’t afford to pay for them. Feeling very frustrated & angry…
Name: 
Dana
Email: 
test@test.com
I have Bilateral Peripheral Neuropathy, which creates a great deal of pain. I have tried everything else, Lyrica, Cymbalta, Nortriptyline, Tramadol, Gabapentin (which I already take for disc issues). I now take Percocet, which alleviates some of the pain, but not all. Without the this pain med I would most likely do an alternative like alcohol, or street drugs, which I do not want to do. I was an alcoholic in my past life, and I do not want to go back to that, because I would most likely die… This pain med provides me a bit of quality of life.
Name: 
Jim
Email: 
test@test.com
We physician want to treat the patient as well as they can. We have a small armament of medications to use I try to offer alternative non-opioids as much as possible. I wean medications when able. There are a few resources for chronic pain in the community that cannot take all of the patients we have. I use the state prescribing database to make sure that my patient is not doctor hopping for meds. I assess that the patient is not using other drugs, or not taking the ones I prescribe with a urine drug screen. I assess the patient with the Brief Pain Inventory for efficacy of the medication. I use a depression score to try to see if depression is an issue to be dealt with. I use a questionnaire to see if there is risk for misuse. However, I still have patients who I don't think I can do a good job with as my tools are mediocre at best.
Name: 
Ron
Email: 
ronald.hertz@ascension.org

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