Study led by researchers with USC Sol Price School of Public Policy and USC Leonard D. Schaeffer Center for Health Policy & Economics shows notifying doctors when their patients fatally overdose has a long-lasting impact on reducing opioid prescriptions.
There are no simple solutions to America’s deadly overdose epidemic, which costs 100,000 lives each year and is erasing gains in life expectancy. But a team of researchers at the University of Southern California (USC) has found one low-cost intervention can make a difference: a letter notifying providers their patient has died from an overdose.
A 2018 study by the team found that notifying clinicians through an informational letter from their county’s medical examiner that a patient had suffered a fatal overdose reduced the number of opioid prescriptions they wrote over the next three months. The team’s new study, published today (January 6, 2023) in JAMA Network Open, shows those notifications have a lasting impact up to a year later.
“Clinicians don’t necessarily know a patient they prescribed opioids to has suffered a fatal overdose,” said lead author Jason Doctor, Chair of the Department of Health Policy and Management at the USC Sol Price School of Public Policy and Co-Director of the Behavioral Sciences Program at the USC Schaeffer Center for Health Policy & Economics. “We knew closing this information loop immediately reduced opioid prescriptions. Our latest study shows that change in prescribing behavior seems to stick.”
A simple public health intervention with a lasting impact
Doctor and his team sent letters to 809 clinicians—predominantly medical doctors—who had prescribed opioids to 166 people who had suffered fatal overdoses in San Diego County. The letter was intended to be informative and respectful in tone while providing information about safer prescribing. The researchers compared prescribing patterns among these clinicians to those who had not received the letter.
While there was a gradual reduction in opioid prescribing across the board, study authors found the rate of the reduction was faster and more robust among those who received the letter. After one year, those who received the letter wrote 7% fewer prescriptions than clinicians who hadn’t received the notification.
“The new study shows this change is not just a temporary blip and then clinicians went back to their previous prescribing,” said Doctor. “This low-cost intervention has a long-lasting impact.”
Doctor acknowledged that attention to the number of deaths from drugs prescribed by clinicians has been eclipsed by the focus on rising deaths from illicit opioid use, particularly during the COVID-19 pandemic.
“The sad truth is, we never addressed the first problem of deaths from prescribed opioids. In fact, it’s all mixed together because nationally, approximately half of people who die of an illicit fentanyl drug overdose have also had an opioid prescription within the past year,” he explained.
Medical examiners are uniquely positioned to mitigate future opioid overdose deaths
The big takeaway, said Doctor, is the letters from the medical examiner provide a unique opportunity to get into communication with physicians in the wake of overdose deaths to save lives from both legal and illegal opioids.
“The letter is a nudge to providers that the opioid epidemic is in their community and affecting their patients. It is easy to read the headlines and assume you are not part of the problem,” said Doctor. “Doctors have an opportunity to talk to their patients and consider alternatives to opioids. I believe we can reach about half of the people in the illicit fentanyl epidemic through a doctor who has seen them.”
Doctor and other study authors are currently partnering with Los Angeles County on lessons from the research and looking at potential public policy interventions, including mandating such notifications from county medical examiners to clinicians.
Reference: “Effect of prescriber notifications of patient’s fatal overdose on opioid prescribing at 4 to 12 months” by Jason N. Doctor, PhD; Emily Stewart, MPH; Roneet Lev, MD; Jonathan Lucas, MD; Tara Knight, PhD; Andy Nguyen, PhD and Michael Menchine, MD, 6 January 2023, JAMA Network Open.
Additional study authors include Emily Stewart and Tara Knight of the USC Schaeffer Center; Roneet Lev of the Scripps Mercy Hospital San Diego; Jonathan Lucas of the Department of Medical Examiner-Coroner of the County of Los Angeles; Andy Nguyen of Global Blood Therapeutics, South San Francisco; and Michael Menchine of the Department of Emergency Medicine at UCLA. The work was supported by the California Health Care Foundation (grant 19413) to Doctor, Stewart and Knight; the National Institute on Aging (NIA) at the National Institutes of Health (grants R21-AG057395-01 and R33-AG057395 to Knight); National Institute on Drug Abuse (R01 DA046226) and the NIA Roybal Center for Behavioral Interventions (P30AG024968 to Knight).
“… approximately half of people who die of an illicit fentanyl drug overdose have also had an opioid prescription within the past year, …”
Will reducing opioid prescriptions have any significant impact when illicit drugs are still available?
Even if ALL the overdoses were with prescription pills, a 7% drop in 100,000 deaths is a drop in the bucket. It is only a maximum of 7,000. The reality is that the 7% fewer prescriptions is going to result in a much smaller decrease in deaths. Many of the deaths are suicides. As long as the depression leading to suicide is not dealt with, substitutes such as a gun, or other drugs will achieve the same result. Whether dealing with firearm homicides and suicides, or suicide by poison, focusing on the agent rather than the reason(s) for the desire to kill will result in a substitution for the agent.
So sick of the blame the doctor game. I’m a chronic pain patient who is now under medicated because of the focus on doctors. Some people will abuse anything. Many OTC drugs are now abused, even anti diarrheal drugs. I can’t say I feel any sympathy for them and their poor me, I have no self control whining. It’s time for some personal responsibility.
“Will reducing opioid prescriptions have any significant impact when illicit drugs are still available?”
Yes. It certainly will, just not in the manner they intend. Criminalization & prohibition measures have been this country’s chosen approach to drugs (& drug users),for hundreds of years. And time & time again, the outcome is the same. It doesn’t stop much of anything, and certainly doesn’t help the already existent user get better or avoid overdose. Might it help *some* opioid naive patients avoid developing a dependency or addiction? Possibly a small number. But the much larger impact it’s certain to have, is that it will force the hand of those already struggling with opioids. Does nobody remember in 2010 when they changed the formulation of 80mg oxycontin? The addition of a polymer based coating on the pills was intended to be an abuse deterrent, supposedly making it more difficult for users to crush, snort/ or inject the pills. All that did was leave a massive number of opioid addicts turning to heroin, as their desperation to avoid painful withdrawal left them in a position where they saw little to no other option. So, it’s insanity if they think this will reduce overdoses. Because the majority of opioid overdoses actually arent new users, but current/former users who recently quit or lowered their dosage- or have access to their usual drug taken away, such as by a doctor for reasons like this article states. Nobody struggling with opioids addiction is going to wake up to find their access to prescription opioids has been restricted and say, “darn. Can’t get my pills so..Guess I’ll just quit now.” The sheer agony of withdrawal is so intense that quitting suddenly is not even an option for most. (And honestly that’s probably best-of those that try, over 90% WILL relapse, and due to a sudden & drastic drop in tolerance level, overdose becomes a HUGE risk). More people being pushed to the streets = the creation of more heroin & fentanyl addicts, ultimately raising the risks of drug related crime, incarceration, disease, overdose, and death.
I have tmj and my pain is unbearable but I cannot find a Dr who will give me an Rx when I really need it.
So True! They aren’t attacking supply or cause. Soooo, in reality this will do nothing or make it worse. Less prescriptions means more people who very well could be in severe suicidal pain, having to get help on the street.
Agreed. Obviously author is anti-narcotic. What he fails to mention is prescribed deaths are included in street addicts deaths BUT the prescribed rate was very low. Also CDC has rolled back there draconian guidelines probably because the current increase was due to pain patients suicides from lack of medicine. CDC is worthless. How about focusing on the real epidemic METH. METH IS FAR WORSE THAN OPIOIDS!
Im convinced that opiod deaths are not from prescribing them but from not doing so. At first ,pill mills , overperscribing, negligence , etc . Yes. When cut off by new recommendations not to prescribe, person are turning to the streets and then its heroin or fentanal. This unfortunatly happened with two people i know.. i am hard pressed to believe someone can die from a basic opiod script. Also , opiods have been around for centuries, hard to believe we only now know about the addictive, and withdraw of these drugs. Hello.!
I completely agree with you 100%
I too am also undermedicated actually 0% medicated.
6 failed back surgeries= 24/7/365 Continuous Never Ending Pain, No Repreve Ever, nothing. I truly Sucks and when seeing a Dr. For anything But, as soon as any Dr. See’s 6Failed Back Surgeries they freak out because they are afraid to prescribe anything for me because of the DEA.
Thats Why for the last 6 years I have Refused to go to a Doctor.
Wow, what a great job the DEA havent done. Push the legitimate patients on to the the WildWildWest of the Streets! Yeah, that will take care that! Yup, thats gonna fix the issue.. Not, see how good that didnt work!
Wish Doctors could just be Doctors without fear of the DEA hovering over them. Last I checked the DEA did not attend med school.
Once again the Patient in the End is the one who pays the ultimate Price…
Thanks a Bunch!
So if you overdose on ILLEGAL Fentanyl, it’s the doctors fault? Stupid is strong in this one.
This war against c hronic pain patients is inhumane. So if a doctor prescribed a pain med in 2015 and said patient then ODs a year later, you thought process is to make this doctor feel bad about treating the patients pain in 2015? Do you really think that will help? So every operation a patient should suffer with little to no pain medication because the person may become an addict later in life? When will they leave us chronic pain patients alone and focus on the real problem. Why do people start to use and abuse drugs. Where are these drugs coming from? Who is selling these drugs. And most important make is affordable and easier for addicts to get the help they need. You all have been looking at the lowest and easiest fruit by attacking people who need these meds and their doctors. This has been the biggest cop-out in American history. All your work has produced the exact opposite results. People are still ODing and chronic pain patients are suffering to the point that some have committed suicide. This needs to end!!!
Opioid crisis? What about the Alcohol crisis, that kills more INNOCENT people than anything.
Re: Alcohol. Don’t let the perfect be the enemy of the good.
Yes, money for supporting withdrawal is essential, only cutting legal supply is like sending fire fighter without water.
My question is; now that we are creating awareness with the prescribers and initial opioid prescriptions are more limited. We still have a high population of people who are addicted, shouldn’t we be creating more access to treatment? Where did all the Sacklers money go, to the attorneys? Shouldn’t it be used for treatment so people can get a helping hand to crawl out of the hole they are in. Granted some won’t, but some will. Those that do improve our community for the future.
Well the country’s overdose deaths was and is directly responsible for this crisis is the usual government ignorance and mandating lame just blatantly stupid with restrictions making it impossible to citizens that really need pain medication it’s basically inhumane to make anyone suffer with extreme physical conditions like cancer patients I know I watch my brother suffer a slow painful death from cancer even with all the different pain meds they gave him he gain some level of relieve however the corupt hospice providers were killing him quicker with all the meds they were giving him that absolutely was killng him in a rapid pace I witness this first hand and did not want to see him in pain. The hospice is a crooked multi billion dollar industry they cause more premature deaths by giving patients way to much pain meds with a mix of toxic cocktail giving them oxytocin, morphine, benzos.like Xanax. Volumes at high milligrams. I personally don’t like to see anyone in severe pain but should be managed properly I fired 5 different hospice agencies for this and intentionally take advantage of fraudulent levels of the services they were doing like sending out a low level nurse out that was only a cna never once a doctor came by to physically evaluate him yet was giving him so many dam meds and I seen a bill from them for 1 month they were billing over 10k a month you talk about fraud this qualifies just that. I did some research on hospice rather in home or a nursing home they serviced was story after stories or family members telling them your giving them to much meds these patients were dying at a rapid pace once hospice took over their health most families fired them yank them out of these nursing homes and lowered there pain meds in all the patients got much better and lived longer before they finally passed on from this horrible disease of cancer. On average these patients lived much longer by reducing the ridiculous amount of meds they gave. Like my brother was deteriorated very quickly from lack of nutrition because he couldn’t even suck on a ice cube without choking he couldn’t eat nothing and I’m no way a medical trained person but just listening to the type of coughing he was experiencing sounded like when someone take a drink and it accidentally goes down the wrong pipe into your lungs. I stated to the nurse that came out of this she dismissed it quickly he was shutting down due to his cancer that one lung was already not functioning properly so by giving him tons of meds that attack your respiratory like opioid do causing overdose deaths was they stop your breathing and die from lack of oxygen my point is if someone has cancer and it has spread into your lungs giving tons of pain meds is just promoting early deaths counter productive.anyway I told the nurse I don’t think he is shutting down from organs failing could you have your doctor come out and check him out to confirm this she stated no he doesn’t do that I stated so he prescribes all this meds without seeing the patients. By the following week I woke up and check on him and I can tellyouhe was on his last breath I told him please let me take you to the hospital please but he was out of oxygen and I therefore called a ambulance the nurse came by and finally agreed with me and help persuade him to go. At the er finally a doctor came over and told me you got him here just in time he was on his way out nice doctor told me he needed to do some test and a x-rays and mri to know what’s going on . Later that evening the doctor said he had a hole in his esophagus from all the chemo treatments so when he tried to drink or eat it was going right into his lungs I hate to say so but I was right and that hospice staff don’t know what the hell they are doing. He came home after 4 weeks in the hospital were they reduce his meds slowly and he was like full of life again and he was going to be around much longer but eventually will pass due to the cancer. On point by the idiots in government overstepping there place which has no business in the health industry or health care to putting elderly people in a bad situation all sudden deny them needed pain meds that have been on for a long period of time and didn’t miss use them, trauma patients that sustain serious injuries that need help in the suffering they are going through or any surgery people have to tell them sorry go home and suffer due to the government over regulations that doctors are scared of the possibility of being fined loss of there lic. Jail time you can’t blame doctors there hands are tied by laws that are forcing people to go to the streets for some relive that was cut off by these overregulations and this is the biggest contributer to od deaths not from a managed pain program no the death rate has only got worse since they cut off the prescribed medication they like to blame its from prescribed pain meds is the cause in fact it only enforced people to go to the alternative of heroin, fentenyal which is the leading cause today of od deaths that again is a direct link of bidens open border policies that has created opportunities for cartels to capitalize on fentenyal was really never heard of and the amount of deaths it has caused is staggering it was never mentioned or started showing up until 2021 when Biden open the borders that has been a breeding ground for increase in crime level today I have never seen in this country. Almost everyday now there is news report of law enforcement busting us citizens for very large amount of fentenyal that could kill everyone in this country in these narcotics raids there is also large of amount of heroin. Methamphetamine, coke, morphine pills guns this is increasing the crimes associated with illegal drugs activity this again based on there coming from Mexico specially fentenyal that is far more deadly then any other illicit drug that only started circulation in our communities since 2021 until then Americans never seen before.sso this whole bullsh*t articles coming out like yours is not exactly accurate but the government leaders claim this is all from doctors issuing pain meds is a absolute joke the crisis is of their own creation and not because the over prescribed medication with opids don’t get me wrong there has been death related to someone over using there prescribed medication however that percentage of od stats is actually very small in the big scheme of the od deaths data I would safely say 75% of od deaths are from the influx of drugs entering in the us from Mexico mostly fentenyal leading the overall cause but the government will never admitt to there policies are the real cause of this mess and all there propaganda on opioid problem is doctors prescribing these meds proven numbers there has been a huge reduction of prescription for opioid medications and the fact is the od deaths are not being over used prescription get f… real the government needs to get the hell out of health care causing more damage to the us citizens in our country
My HMO MD has informed me their administrators have enforced a 10% decrease in my Norco rx.That is fine but don’t cut my Rx 10% monthly. For the first time in my life I am considering purchasing my pain meds from other countries. Is that safe? CDC government agency is telling Dr’s how to manage their practice.
Will doctors be notified when their patient commits suicide from untreated or under treated pain? Will they get a copy of the suicide note describing how doctors refuse to treat chronic pain patients and have abandoned them? Will they be held liable for cutting off patients cold turkey, throwing them into withdrawal and leaving them in unbearable pain? No of course not. We’ve decided to punish people in pain because others become addicts. We’ve decided to sacrifice chronic pain patients to lives of relentless, agonizing pain, losing homes, jobs, marriages, and any quality of life because others abuse medications and because of that, nobody should have them. Better to leave people to kill themselves, which is the only way to escape the pain. My guess is the system wants pain patients to die so they don’t have to waste any more time and money on them.
This. Everyone loves to tell me that I’m too young for chronic pain and that it isn’t as bad as I think it is. I’ve been told by a couple of different doctors that “because of the new laws I’m only giving you X per day”. Then, they treat you like a drug addict and not a pain patient. Plenty of patients at the clinic where I work that were former pain management patients who were cut off.
You are correct. IMO, trying to scare Drs., Doesn’t help we the people who manage every day from responsible opiate use for pain management. It’s absolutely true, if you want to Tottally F#@k Everything up, bring in the Government! Government Please leave Drs alone in regards to their Professional Judgement.
This is the conclusion I arrived to as well. If the people costing the state money, die, then they have more money. Wether its pain patients killing themselves, people OD’ing, or the fallout causing a suicide, they don’t care. Our deaths means more money for them. They want us to die.
Dr’s wrote less opoid scripts for 3 months after getting a letter. Here we go, making legitimate chronic pain patients suffer.
I’ve been taking Percocet 4 times a day since my second back surgery was performed 4 years ago but did not relieve my excruciating pain. The Percocet has worked very well for me and I have not had any addiction problems.
I hate to tell you but you may not have had an addiction problem but if you were cut off tomorrow and told you couldn’t have another you would very quickly know that you are certainly dependent on them because you would go into withdrawal and I promise you would be looking for the withdrawal to stop somehow!
Stop prohibition of pain medicine. Stop prescribing brain medicine instead of pain medicine. People have pain. Doctors should be allowed to treat them. Who is running the CDC ??
It’s not prescribed opiods that are causing deaths. It’s the fake pills with fentanyl in them that are killing people. They wouldn’t be playing Russian Roulette Roulette with street drugs if their Doctors would treat their pain adequately with the only thing that works , opiods. Demonizing opiods and not treating legitimate pain patients with them is what’s caused so many deaths. If people in pain have to buy street drugs to try to have some quality of life they will continue to die like they have for the last few years. Being dependent on a medication is far preferable to a life of pain and misery. If only the people making the laws and rules could live a day in my body they might not be so cruel. It’s criminal to make people live in pain when a simple opiod prescription can give them some quality of life.
They where just not passing out opioids to anyone.Documented medical conditions had to be proven along with monthly urine drug screens and sometimes pill counts.Sure they where greedy shady Doctors as in any other business. Who is CDC to judge anyone pain 30 mg. a day for chronic pain sufferer shame on our country and God forgive the greedy states who sued big Pharma it’s called Extortion, torture,abuse of fellow mankind have some compassion.One day they will answer and the elevator of justice will send them to eternity of pain in Hell!
Cutting down prescriptions yearly yet the illicit fentanyl crisis worsens? Interesting. It’s almost as if you’re leaving a huge part of the population with untreated pain to suffer and roll the dice instead of getting their medication from their Dr’s. How are they supposed to know the difference when the cartels make them look the same. The cdc admitted they messed this up. They admitted that this is an illicit fentanyl crisis yet they haven’t even begun to halt all of this junk science and take out the cartels. Un jailing Dr’s that studied how to properly care for their patients would be a great start. You people are not helping anybody with this messy opinion piece. I’m not seeing any clear statistical analysis that hasn’t already been disproven publicly. Cutting back on opiate prescriptions and scaring off pain doctors is creating a suicide crisis! It looks as it we have a mass culling on our hands and pain patients are being left to die. Don’t save the addicts who do not want to be saved! It’s simple. I’ve known many who quit their drug of choice when ready. You cannot force them until they choose it! If they don’t, they want to die. Let them find their solace in eternal sleep. Pain management patients aren’t addicts! We depend on our medication to work and survive. If I had enough pain medication maybe I could work but I’ll be a 31 yr old on ssi since 23 because nobody cares about my wellbeing. Pain management isn’t even allowed to practice the way they deserve. It’s a sick joke!
Each doctor is assigned a license number, and when a patient on opioids dies from opioid overdose or does something illegal like selling them, the incident is noted on record with the doctor’s number. This has been true for many, many years. The doctor knows.
So now someone has thought to send a letter to the doctor, so that the doctor knows what is already known.
Doctors are already terrified of the legal ramifications.
Who is the effing genius that thought of sending an “oh by the way” letter? SMH
I am in agreement with all the concerns mentioned by others in previous replies.
Any doctor in First World Countries who doesn’t already know this is far behind the times.
the Feds record it BUT don’t inform the Physician until they want to prosecute them!
the feds regard it as evidence, again another problem of letting morons take part in Society
Until the People demand morons need to be supervised at all times and not allowed to make decisions for others, Morons WILL be elected to Office and Morons will be hired to OVERSEE the People
Doctors should be forced to write letters of apology to families of people who died because they were forced to the street to buy meds for pain relief.
Prescriptions are not killing people, not even drug addicts. 6 percocet per day is not the problem.
IF a drug addict gets a script by whatever means, at least they are getting a safe drug, not fentanyl laced fakes.
People in real pain do not overdose on a prescription.
Refusing to treat pain, does kill people. People I know.
Any doctor who let’s a chronic pain patient run out of meds should be criminally liable.
If you have never witnessed (or gone through it yourself) someone with underlying severe pain go through withdrawal on top of the chronic pain, then you cannot possibly talk intelligently about the crisis that has been created.
It is a dangerous situation in more than one way.
Yes 100% THIS. The DEA created this by cutting legitimate chronic pain sufferers off of their prescribed meds. I now know 5 people who have died because they were cut off of their PRESCRIBED meds and were forced to look elsewhere for some kind of PAIN RELIEF and got their hands on that fake crap that was laced with fentanyl. My beautiful friend died at the young age of 25 because docs told her she was too young to have that kind of chronic pain. She worked 2 jobs to cover her basic needs while living in constant pain. She turned to the streets for her PAIN RELIEF, it cost her her life. This is what should be sent to the doctors. The PATIENT that you DENIED MUCH NEEDED pain RELIEF HAS DIED because as her doctor YOU FAILED HER and she went elsewhere to find it. Shame on our government and SHAME on the DEA as YOU are the ones to blame for this crisis.
I honestly hate to say this But when and if I am CUT off the pain meds that make my life liveable, unfortunately my only solution will be suicide. Because living life in CONSTANT PAIN, IS NOT LIVING. ALL doctors should also receive a letter when one of their patients commits SUICIDE because they were taken off the pain meds that made their life liveable.
Right, my broken leg is the problem. Lets stop the dr from helping me. 7 years ago, Gov dismantle pain management and overdose deaths sky rocket…. Man, dis da dumbest sh*t i eva reed.
I taje out my 4 Norco for the day and 1 dilaudid for breakthru.. used to be 2 but dr. didnt down dose to 1 1/2 and so on, just cut me to one. No problem, not wild about them anyway, but my Norco, its what keeps me functioning to a degree.. I get by but the MME is ridiculous. Id like yo see one pf these jokers try to do my day according to their rules..THEY’D NEVER MAKE IT!!! BEEN ON PAIN MED 35+ YRARS.. 17 BACK SURGERIES.. YEAH.. GO AHEAD AND TRY TO LIVE BY THE LAWS YOU’RE SETTING FOR US CHRONIC PAIN SUFFERS.
I watched my best friend die of cancer moaning in pain because there was nothing for her. I watched my brother in law screaming in pain till he died. This stupid plan will do nothing. People being forced off pain meds are committing suicide outside their doctors office so the doctor knows. I’m tired of being treated like a criminal for 2 5mg percocet when Philadelphia is covered with living zombies that need help.
This article is crap did you ever consider zero tolerance gets people off pain medications but doesn’t mean the problem isn’t there anymore no they turn to street drugs and I guarantee that the number of cases of overdoses for those people is twice that than those getting a prescription from a doctor. And before you ask how I know we’ll because I had a problem with pain medications after 8 back surgeries it was a given but I sought the help of a medically assisted drug treatment I needed help to control my taking of medications and it saved my life I now have the control back that’s what is needed more treatment centers to help those dependent on pain medications people that understand addiction and the need of control not scare tactics that just make patients find a new doctor or have to seek help in the streets
Stop blaming the doctors this is so wrong more if not all is heroin laced with fentanyl people in chronic pain will never overdose on their medications they do pill counts and random urine test put the blame were it belongs fentanyl is killing people with serious drug addictions go and arrest these murderers it’s not an overdose it’s murder it’s not the doctors it’s the drug dealers
Everybody is forgetting how many people get pain relief with opioid, for some it is the difference between living a somewhat normal life and no life at all. People abuse drugs all the time from heroine to Cocaine and nobody cares and it isn’t used to treat, but because a doctor is prescribing medicine you don’t agree with or need you try and make others suffer. How about if you don’t like opioid don’t take them but don’t hurt others in the process, people don’t need you to try and save them.
This is ridiculous! People that want to take too many drugs for purposes other than pain relief will still get their drugs from somewhere.
All this will do is make it even worse for chronic pain sufferers that already can’t get the few pills they need to get through a few days of pain. They will turn to the streets eventually and get illegal drugs that will turn them into addicts or kill them due to laced drugs.
Making things harder for people to get doesn’t stop them from getting it. It only stops the people that need it and won’t go through extremes to get it until it gets bad enough.
Ideas like this make problems worse! Stop being stupid!
I keep seeing the Same problem constantly
the Opioid problem is simple education and dealing with simple laziness
Opioids are for ACUTE Pain ONLY – Period!!!
the Medical industry is FILLED with Fundies bent on PUNISHING those in Pain because their GOD wants them to SUFFER!!!!
When you remove the Stupid from all of Science and don’t allow the Stupid to have a Voice in Science they will start using the substances that actually relieve pain constantly without tolerance od physical addiction
ALL Mu Receptor Agonists are Physically adictive and should NOT be used beyond Acute pain, the lis of the substance’s that work on the other receptors of the Opioid family have a list that make most dictionary’s look small
they simply can’t make excessive PROFITS on them as they don’t have the ability to make analogs that the plants don’t already make that function properly, so no PATENTS can be made
As I said, the Stupid NEED to be removed from the Game
Speaking of Stupid. Opiates are NOT for acute pain only!! Listen Buster, Pain is Relentless and cannot just be Wished away. Deal with the facts Pal.
100 percent agree!!
I pray the right people in government are reading these comments from chronic pain sufferers because I agree with every one of them. People could be addicted to lots of things that can threaten their lives including fast food. Drug cartel Fentanyl is the problem, not prescription painkillers taken as prescribed.
Someone wasted time and money for a study that came up with this bull****!!!A letter is not going to stop anything!Are they going to write letters to the street dealers with the pressed blue 30’s??
This was an idiotic idea to start and this simply aggravates.
It’s a form of aggressive-aggressive behavior by a government agency whose task it is to accurately assess causes of death and – dispassionately – report the data.
As a prosecutor of homicide and drug cases for over 30 years, the only purpose of this is to threaten largely honest physicians into curtailing,or more likely severely limit or cease prescribing opiates.
A tiny number of (usually corrupt) doctors USED to prescribe inappropriately large doses of narcotics.
PDMP programs now allow Medical Boards and pharmacies (who themselves are terrified of being sued) to red-flag inappropriate prescribers.
The 90 MME “limit” was never intended as a “hard edit,”but it’s become just that. For a patient like me, 90 MME would be very sufficient, but for other patients, 300 MME might not be nearly enough to treat horrible (non cancer) pain.
More significantly prescription opiates play a tiny role in drug trafficking as fentanyl analogues are killing more people than prescription drugs ever did!
Wonder how many of these letters will go to doctors who titrated their pain patients down on opioids (I’d guess it would be an overwhelming majority). Instead of realizing that they (the doctor) caused the death by forced titration (which their God complexes would never allow for) they will blame the patient (as usual.) Totally F**KED up situation. We have far more alcohol and tobacco addicts and deaths than opioids, but 50+ years of the totally failed “War on Drugs” has made people opioid-phobic, tortured legitimate pain patients, vastly increased crime (just like Prohibition gave rise to vast Mafia control) and corruption. It’s bad enough that the CIA, Government, Arms Industry and Banks flooded the US with crack cocaine in the 80s to fund the off the books war in Nicaragua (Iran/Contra) and then repeated the process to fund private contractors with opioids in the 90s/00s to fund the wars in Afghanistan and Iraq. Our health care system is 3rd world at best and deteriorating quickly. All the current version of the War on Drugs has done is to ensure that Fentanyl is now prevalent in almost all street drugs, yet doctors are now looking into magic mushrooms and LSD to treat psychiatric disorders.