Health & Fit Doctors Are Taking Away Opioid Prescriptions From A Growing Number of Patients, Report Shows
U.S. urges shared decisions with pain patients taking opioids
HHS warned doctors against abandoning chronic pain patients by abruptly stopping their opioid prescriptions. The U.S. Department of Health and Human Services instead urged doctors to share such decisions with patients. The agency published steps for doctors in a six-page guide and an editorial in the Journal of the American Medical Association.
Yet another study indicates that patients are being tapered off prescription painkillers at "rapid" rates that surpass federal guidelines.
Among more than 100,000 patients enrolled in both commercial insurance and Medicare Advantage programs, researchers found that the annual percentage undergoing tapering doubled between 2008 and 2017.
In response to the opioid crisis, the Department of Health and Human Services (HHS) released a tapering guideline in 2016 that sent a chilling effect throughout the chronic pain community, experts say. It was recently, but not before physicians and hospital networks began removing pain patients from their medication or entirely.
This is how your cell phone is affecting your health
Americans are dependent on cell phones because their functions are convenient. However, these devices could be affecting your health.
HHS suggested tapering patients at gradual doses of about 10 percent a week or possibly less, but some clinicians and hospitals may have interpreted the guideline as a "hard stop," said the study, which was published November 15 in The Journal of the American Medical Association. In 2017, more than a fifth of patients experienced a 15 percent or greater reduction in average daily doses, according to the findings. That's up from just 10.5 percent of patients in 2008.
Video: What Is Fentanyl, The Opioid Drug 50 Times Stronger Than Heroin?
Nearly one in five people is tapered by more than 40 percent each month, the researchers found. For people physically dependent on the drugs, this kind of approach can cause crippling withdrawal symptoms, psychological distress and suicide, not to mention uncontrolled pain, according to a recent warning by the Food and Drug Administration (FDA).
Honest obit calls for more opioid addiction help for struggling moms
Megan Angelina Webbley was receiving addiction treatment in New Hampshire when she died of an overdose.OPIOID DOCTORS WARNED AGAINST ABRUPTLY ENDING TREATMENT FOR PAIN PATIENTS
Groups that are particularly at risk for getting kicked off their medication in this manner include younger people, women, minorities, people on higher doses of opioids, people who recently overdosed and people on commercial insurance, the study found.
"This study confirms that many chronic pain patients are receiving substandard care," said Dan Laird, a pain physician and medical malpractice attorney, in a statement. "The opioid crisis is largely driven by illegal fentanyl and heroin, yet chronic pain patients continue to be victimized," he added.
In another recent survey, which was conducted by Quest Diagnostics and the Center on Addiction, more than four out of five doctors said they were reluctant to take on patients using prescribed opioids. They also said the opioid crisis made it more difficult to treat patients in pain.
"The downstream effects of opioid tapering on pain, withdrawal, mental health, and overdose risk warrant careful evaluation," concluded the authors of the JAMA study.
Because that project was limited by its reliance on commercial insurance and Medicare Advantage programs, the results may not be generalizable to uninsured people or those enrolled in Medicaid. The data were also derived from administrative claims, which risks measurement error.
Coalition to Prevent Tampering with Medical Diagnoses
The coalition wants to put a stop to the manipulation of medical diagnoses. An amendment to the law is intended to prevent patients being rendered sicker in the accounting process than they are, as was announced on Friday from coalition circles. Thus, a "subsequent change or supplementation of diagnostic data" and an additional remuneration for diagnoses should be prohibited.
Also a consultation of the contract doctors by the health insurance companies with regard to the "allocation and documentation of diagnoses is inadmissible", as can be seen from the planned amendment to the Healing and Aids Supply Act.
So that the Federal Insurance Office (BVA) can check the bills, the health insurance companies are obliged to cooperate. Within a certain period of time, the funds must provide information and evidence, in particular, about the anonymized doctor numbers and the billed billing items. If funds do not comply, the BVA can impose a penalty of up to ten million euros.
The "Rheinische Post" had first reported about it. According to the report, the law will be introduced to the Bundestag next week.
SPD parliamentary group vice-president Karl Lauterbach stated that the health insurances received their money allocations according to age, sex and health of their insured persons. "The sicker and older a person is, the higher the allocations from the risk structure compensation tend to be." Therefore, many funds tried to influence medical diagnoses in such a way that they receive the highest possible allocations from the system.
"This leads on the one hand to distortions of competition, on the other hand, patients are often made sicker than they are to collect money from the risk structure compensation," said Lauterbach. He spoke of an "untenable condition".
statements by the head of the Techniker Krankenkasse (TK), Jens Baas, about manipulation of diagnoses had caused a stir in the past year. Baas then spoke in a newspaper interview about a competition of the health insurance funds about who manages to get the doctors to document as many diagnoses as possible for the patients. For example, the bazaars paid Baas premiums of ten euros per case for physicians if they made the patient on paper sicker. As a result, there is more money from the risk structure compensation (RSA).
Study: Limits on opioid prescriptions seem to send users to more dangerous drugs .
Less than 2 percent of overdose victims had active opioid prescriptions, study finds.Toxicology reports revealed that 61.4 percent of victims used heroin on or near the date of their overdoses, followed by fentanyl at 45.3 percent, according to the study, published in Public Health Reports. Of the 491 decedents who had at least one active opioid prescription, commonly prescribed painkillers like buprenorphine, oxycodone and methadone were frequently undetected in screenings, according to the study's authors.
"Intro to the Treatment of Pain with Opioid Medications" by Dr. Charles Berde, for OPENPediatrics
Dr. Berde's lecture presents a clinical approach to the treatment of pediatric patients with pain using a risk/benefit analysis approach, reviews the development of ...
CDC Guidelines for Opioid Prescribing: Recommendations and Outcomes
Amy Bohnert, PhD, MHS Associate Professor, Psychiatry Co-Director, Mental Health Innovations, Services and Outcomes University of Michigan.