Another study shows that patients tap into prescription painkillers at "fast" rates that exceed federal guidelines.
Among more than 100,000 patients enrolled in both commercial insurance and Medicare Advantage programs, researchers found that the tapered annual percentage doubled between 2008 and 2017.
In response to the opioid crisis, the Department of Health and Human Services (HHS) released a tapered guideline in 2016 that sent a cooling effect throughout the chronic pain community, experts say. It was recently cured, but not before doctors and hospital networks began to remove pain patients from their medication or send them away completely.
HHS suggested tapered patients in gradual doses of about 10 percent a week or possibly less, but some clinics and hospitals may have interpreted the guideline as a "hard stop," says the study, published November 15 in The Journal of the American Medical Association . In 2017, more than a fifth of patients experienced a 15 percent or more reduction in average daily doses, according to the results. That's up from just 10.5 percent of patients in 2008.
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Nearly one in five people is tapered by more than 40 percent each month, the researchers found. For people who are physically addicted to the drugs, this type of strategy can cause devastating withdrawal symptoms, psychological distress and suicide, not to mention uncontrolled pain, according to a recent Food and Drug Administration (FDA) warning.
Groups that are particularly at risk of getting their medicine started in this way include younger people, women, minorities, people with higher doses of opioids, people who have recently overdosed and people on commercial insurance, the study found.
"This study confirms that many patients with chronic pain receive poor medical care," says Dan Laird, pain physician and medical malpractice lawyer, in a statement. "The opioid crisis is largely driven by illicit fentanyl and heroin, but patients with chronic pain continue "In another recent study, conducted by Quest Diagnostics and the Center on Addiction, more than four in five doctors said they were reluctant to take on patients using prescribed opioids. also that the opioid crisis made it more difficult to treat patients in pain.
"The downstream effects of opioid taper on pain, withdrawal, mental health and overdose risk justify careful evaluation," concluded the authors of JAMA study 19659005] Because that project was limited by its dependence on commercial insurance and Medicare Advantage programs, The results may not be generalized for uninsured people or those enrolled in Medicaid. The data also derives from administrative claims, which risk measurement errors.
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