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I am 40 years old, with two young boys. In 2011, I was diagnosed with ankloysing spondylitis, a severe auto-immune disease for which there is no cure. I have severe damage to my sacroiliac joints. They are fused together, and boy is that painful. It is now traveling up my spine.
I have tried every biologic on the market and almost died from Cosentyx after developing a severe intestinal infection. I also almost died from Humira. I’ve had many medicines over many years, but I am stable on opiates, no longer bedridden and able to keep my job. The opiates take my pain level from a 10 down to a 3 or 4. They’re very effective. Nothing else even comes close in relief.
Then the CDC opioid guidelines came out. Last month my doctor said to me, “According to the CDC, I have to taper you off all opiates.”
That is a guideline not a law. If the doctor is following DEA and state law about prescribing, he/she can go outside of guidelines. But that being said, unless this is a doc you have a strong personal relationship with, you likely won't win that argument with him. Opiates have become toxic, no doctor wants to touch them at this point.
That is a guideline not a law. If the doctor is following DEA and state law about prescribing, he/she can go outside of guidelines. But that being said, unless this is a doc you have a strong personal relationship with, you likely won't win that argument with him. Opiates have become toxic, no doctor wants to touch them at this point.
Deviation from guidelines is fine as long as the doctor is comfortable providing a explanation that a lawyer would not rule him over. CYA is the practice here. Prescribers do not know what to do. And no guidance has been given by the CDC other than taper off . perhaps this will lead to a national push to legalize marijuana because I cannot think of another solution at this time with the current drugs available on the market .
He should try CBD, AS sufferers have indicated it to be of great help.
There is not a single randomized, double blinded, prospective study showing efficacy of CBD oil for pain- not one.
One would have to know the specifics of this patient's situation, as the CDC guidelines recommend 90 mg equivilents of morphine (or 50mg if on benzos) per day. They do not suggest weaning off narcotics when the meds are indicated. Keep in mind that there is very little (if any) evidence supporting the long term use of narcotics for chronic pain, despite the widespread use of narcotics for that very purpose.
Perhaps this woman was inappropriately put on massive doses of opiates, which never been shown to reduce pain or increase activity long term, and they needed to wean (but not eliminate) the narcotic.
Perhaps the patient had never been rotated to a different narcotic and thus developed tolerance.
Perhaps the provider failed to use adjunctive medicines to help prevent "wind up".
The story sounds a little fishy, in that with ankylosing spondylitis, the joints progressively ankylose (fuse). A fused joint is immobile and thus should not be painful. AS is certainly painful, but it is not a death sentence.
Deviation from guidelines is fine as long as the doctor is comfortable providing a explanation that a lawyer would not rule him over. CYA is the practice here. Prescribers do not know what to do. And no guidance has been given by the CDC other than taper off . perhaps this will lead to a national push to legalize marijuana because I cannot think of another solution at this time with the current drugs available on the market .
The CDC guidelines DO HAVE GUIDELINES FOR MAINTENANCE ON OPIATES. THAT IS WHY THEY WERE WRITTEN. THEY ARE NOT GUIDELINES JUST TO TAPER MEDS. I just gave a chat on this very topic last week at a state work comp conference, so I am very familiar with it. I give talks on this subject all the time.
PS- pot is a very poor analgesic. The subtype of cannabinoid receptor to which THC binds is very poor at producing analgesia. In fact, Tylenol is a better analgesic at cannabinoid receptors. There are some cannabinoid receptors which could prove very useful in pain management. However, those drugs are in development; THC has failed to provide effective analgesia. There are several subtypes of cannabinoid receptors in our brain, and only a few mediate effective analgesia. There are many cannabinoid agonists in nature other than THC, including cinnamon and floral fragrances. That's why good cooks try to sneak cinnamon into many foods they prepare.
Regarding other options, I can think of several, as we prescribe them on a daily basis. Pot, however, is not one of them. If it was a good analgesic, I would fully support its use. I think it has a role in being a sedative hypnotic and appetite stimulant in cancer patients, but that is it.
The government's heavy-handed crackdown on opioids that started back in 2012 has killed many thousands of people, due to either accidental overdose from the street drugs patients turned to in desperation, or through suicide.
Please don't commit suicide, it is too selfish. If you can't find relief through legal methods, there are other options. The government can stick their deadly crackdowns where the sun doesn't shine.
There is not a single randomized, double blinded, prospective study showing efficacy of CBD oil for pain- not one.
Which is due to government prohibition. Not that it was studied and a link was not found. It has been demonstrated in animal studies though. Hopefully we will get more studies soon.
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