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While national attention on the opioid crisis is focused on the repression of excessive prescribing practices and treatment of addicts, Senator Lamar Alexander, chair of the Upper House Health Committee, highlights a crucial aspect of the debate that has been neglected – suffer from chronic debilitating pain.
The Tennessee Republican legislator holds hearings – one in February, and another could be held this summer – to hear people suffering from disabling pain who, in the last two years, have reported being forcibly reduced or outright abandoned by doctors treat them.
AS DOCTORS TAPERS OR END OF OPIOID PRESCRIPTIONS, MANY PATIENTS CONDUCT SUICIDE
The senator stated that he was determined to be more interested in opioids, while other federal and national officials have begun to recognize that many doctors are taking radical and medically dangerous measures for fear of To be targeted by the authorities in the current anti-opioid climate. .
The result is what public health experts call a "pain crisis": many patients across the country are outsourced for intense pain that has led to a lot to consider or commit suicide, and d & rsquo; others to turn to heroin.
"As we approach the opioid crisis, we must keep in mind the millions of Americans who suffer in chronic pain," Alexander said in an email to Fox News.
Alexander said that the next hearing before the Senate Committee on Health, Education, Labor and Pensions will resume the recommendations of a federal task force on how to reconcile the needs of patients with Alzheimer's disease. pain and policies tightening opioid prescribing practices. The task force is an advisory committee of the Ministry of Health and Social Services, empowered by the Addiction and Recovery Act, which came into effect in July 2016.
"I am grateful for the work of this working group and am in the process of reviewing the final report," said Alexander. "Earlier this year, the Senate Health Committee held a hearing on the causes of pain and ways to improve the care provided to patients with pain, and I plan to hold another hearing this year to discuss the recommendations of the working group. "
Patients with chronic pain represent 50 million people, and for at least half of them, prescription opioids are the only treatment – or a crucial part of this treatment – that gives them enough relief for their condition. to get out of bed without suffering. They are medically dependent on legal opioids, without being dependent on them.
But the drug overdose epidemic that claimed the lives of tens of thousands of people has led to a fierce war against prescription painkillers, even though most deaths or emergencies have involved black market opioids such as as illicit fentanyl and heroin.
"The primary motivation for the hearing," said Alexander in a phone interview with Fox News, "was to know that in a country where more than 50 million Americans suffer from chronic pain and 20 million people If you make a concerted effort to remove the most effective pain killers, you will have problems. "
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Alexander said that it was revealing to learn the unintended consequences of radical actions aimed at combating the overdose epidemic.
"There is no doubt that the goal was not to stop the use of opioids, which are effective painkillers," Alexander said. "Our goal was to stop opioid abuse, caused by over-prescription of drugs by doctors or diversion by people who had opioids and used them for misguided purposes.
According to the National Conference of State Legislators, at least 33 states have enacted statute of limitations. Many of the policies and regulations put in place are based on a revised 2016 directive from the Centers for Disease Control and Prevention (CDC), designed as a resource and not a mandate for primary care physicians prescribing opioids for patients taking them for the first time.
Earlier this month, the Food and Drug Administration (FDA) and the CDC warned doctors not to abruptly stop prescribing opioid pain medications to patients who take them for debilitating chronic pain duration generally greater than three months.
The FDA is also changing the labels of opioids, which tell doctors how to reduce them.
"We found that there was a lot of misunderstanding about the purpose of the CDC directive," Alexander said. "They are not supposed to substitute for the individual decision of a physician as to the proper prescription for a patient.We have this problem when the federal government or a government agency issues guidelines.They become suddenly A "law." Insurance companies refuse to reimburse their prescriptions for opioids, it is easier to follow them. [the guidelines] rather than making your own decision. "
In legislation that he co-sponsored to fight the overdose epidemic, Alexander said, "We have resisted the federal rules on opioid prescribing limits … It was the wisest thing we have done in all legislation. That's why our audience [in February] was important and why another hearing on the HHS working group review and possible revision of the CDC guidelines, [is] in order."
CLICK HERE TO SEE THE VIDEO OF THE FEBRUARY SENATE HEARING
"Now that we have started to change trains and take a different approach to the use of opioids, everyone, doctors, nurses, insurers and patients, will have to think about the different ways of treating and managing the pain, "he said.
Although they are an accepted tool for treating severe pain caused by serious injuries, surgery and cancer, opioid medications can be addictive and dangerous even under medical prescription. In the United States, prescriptions have fallen by almost a quarter since the peak of more than 255 million prescriptions reached in 2012.
But health care experts and patients with pain argue that the targeting of legal opioids did nothing to address the overdose mortality rate, which has continued to increase.
One of the most common complaints heard by prescribers about why they are outsourcing or abandoning pain patients who have long been treated with opioids for their health problems is that they fear that the Drug Enforcement Administration (DEA) does not pursue them, which occurs more frequently when the agency suspects that a doctor may prescribe beyond what is necessary.
The DEA did not respond to requests for comment, but in previous interviews, she told Fox News that, contrary to critics, she was not targeting doctors or other prescribers.
Alexander said officials asking the DEA to attend the next hearing to respond to speculation from prescribers and explain how they decide who to pursue "seems to be in good standing".
Dr. Sherif Zaafran, president of the Texas Medical Board and a member of the HHS working group, said it would be an important decision for Alexander to have DEA representatives testify.
"It would be very helpful for the audience and Congress to hold them accountable," Zaafran said. "The doctors know that they prescribe correctly, but they are afraid to continue.They say," Yeah, but the DEA is running down my neck. "This creates a lot of confusion, the DEA puts them in a dead end, the DEA is practicing unlicensed medicine."
"Congress can ask the DEA to work more closely with the state regulatory agencies," he said. "There needs to be a clear direction to ensure that patients' needs are balanced with the illicit use of drugs that are on the market."
Many pain patients, along with the doctors who treat them and advocacy groups – long frustrated by discussions of prescription opioids that exclude their voices – are beginning to be optimistic that their experience with painkillers is safe. and crucial for their ability to get a quality of life is finally attracting attention.
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"Things are really starting to change," said Kate Nicholson, a former federal prosecutor who believes her opioid treatment has helped her work after years in bed. "There is the work of the HHS working group, the HHS and other federal agencies who say that there is a problem with the CDC guidelines."
"Senator Alexander has been a leader on the issue, he is brave and he kindly listened to people suffering from chronic pain," said Nicholson, who met with the senator's advisers on the subject.
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