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Tag: pain management with opioids

  • Patients On Opioids May Have A Harder Time Finding Primary Care

    Patients On Opioids May Have A Harder Time Finding Primary Care

    According to a new study, more than 40% of clinics said that they would not take a new patient who was using opioids to manage pain.

    Patients who use prescription opioids to manage their pain may have a harder time accessing primary care, according to a new study. 

    The research, published in the journal JAMA Network Open, found that primary care clinics who were accepting new patients were less likely to take a patient who said that they were using opioids. In fact, more than 40% of clinics said that they would not take a new patient who was using opioids to manage pain. 

    Finding Care

    “These findings are concerning because it demonstrates just how difficult it may be for a patient with chronic pain searching for a primary care physician,” lead study author Pooja Lagisetty told the blog of the University of Michigan. 

    For the study, researchers cold-called clinics that were accepting new patients. The callers said they were looking for a new provider for their parent, who took a Percocet (oxycodone) each day to manage pain. 

    The findings confirmed the researchers’ hypothesis that people on opioids have a harder time accessing primary care. Forty percent of the clinics said they would not take the patient, while two-thirds said they would require a preliminary visit before deciding. Seventeen percent said they would need additional information to make a decision. 

    Pain Refugees

    “Anecdotally, we were hearing about patients with chronic pain becoming ‘pain refugees,’ being abruptly tapered from their opioids or having their current physician stop refilling their prescription, leaving them to search for pain relief elsewhere,” Lagisetty said. “However, there have been no studies to quantify the extent of the problem.”

    Surprisingly, the researchers found that whether a patient had private insurance or Medicare did not make a difference in whether or not they were accepted as a new patient. 

    “Our results did not differ by insurance status, which was surprising because previous studies on primary care access have showed that patients on Medicaid tend to have lower access to primary care than those with private insurance,” Lagisetty said. “This may indicate that providers and clinics are not making these decisions to restrict access based upon reimbursement. Larger clinics and community health centers were more likely to accept new patients suggesting that there may be some system level factors that affect access to care.”

    The lack of access to primary care is especially concerning in this case because the researchers who called clinics said that the patient was also on medication for high blood pressure and high cholesterol, both of which require regular treatment from a provider.

    In addition, having a primary care provider can help people manage their use of opioids and taper off them, if possible. 

    “We hope to use this information to identify a way for us to fix the policies to have more of a patient-centered approach to pain management,” Lagisetty said. “Everyone deserves equitable access to health care, irrespective of their medical conditions or what medications they may be taking.”

    View the original article at thefix.com

  • Pain Patients Express Hope Amid Revised Opioid Policies

    Pain Patients Express Hope Amid Revised Opioid Policies

    Some medical professionals are finally starting to understand that cutting pain patients off opioids abruptly causes more harm than good. 

    After years of having their access to opioids restricted, some chronic pain patients feel that they are finally being heard, as the medical community becomes more open to the idea that tapering opioids, especially after long-term use, needs to be done slowly and carefully. 

    In April, the FDA warned that cutting off patients’ opioids too quickly could be detrimental to their health. The organization went so far as to recognize that not being able to control pain could lead to suicide in chronic pain patients. The Centers for Disease Control and Prevention (CDC) made a similar change in policy. 

    Andrew Kolodny, who co-directs Brandeis University’s Opioid Policy Research Collaborative at the Heller School for Social Policy and Management, recently told OZY that it is “exceptionally cruel to abruptly withdraw a patient from opioids.”

    Many pain patients feel that the medical community and regulatory commissions are just now beginning to talk about that openly.

    Lelena, a woman who was given opioids to deal with pain from fibromyalgia, was dismissed from her pain clinic after testing positive for heroin, a result that was later proved to be a false positive. Despite that, she was not able to access pain medications and had to go through opioid withdrawal, in addition to coping with her pain. 

    Laura Mills, who works with Human Rights Watch, said that experiences like Lelena’s are unnecessary and discriminatory. 

    “We always emphasize that the risk for harm [from suddenly stopping opioid medication] is huge, given that an approximate 13 million Americans are still on opioids long-term,” she said. 

    That’s why people like Kate Nicholson, a civil rights attorney who previously worked at the U.S. Department of Justice, turned their attention to helping people with legitimate medical needs access opioid medications. Although Nicholson said that the government’s new, more nuanced approach is needed, she also feels that there is a lot of work still to be done. 

    “It was hard in some ways to get the CDC to change,” she said. “And in some ways, it was the easiest first step.”

    Still, many people who have seen the negative impacts of opioids feel that it is only natural for prescribers to be extra cautious. Kolodny pointed out that Lelena, like many people on opioids, should never have been given the pills in the first place. 

    “There’s no debate,” he said. “You don’t give opioids for fibromyalgia. It’s the fault of this campaign that encourages people to prescribe opioids, a highly addictive drug you become easily dependent on.”

    View the original article at thefix.com