The CDC, DEA and Physicians: My Thoughts and Opinions

Heroin and Pills Framed

For the past year, when I’ve gone to see my Pain Management Physician, I’ve been told at each visit that my medication has to be decreased. I didn’t say too much the first time they did this, but I did speak up on my recent visits. The response I got from the M.D. and the N.P. was the same. They both said, “Due to the CDC Guidelines, we have to start cutting all patients back on their medication.” I asked them why they were following guidelines that were written for Primary Care Physicians and are voluntary? He then explained to my husband and I that they were afraid of losing their license, home, employment, income, and that they could face jail time up to a life sentence if anything went wrong with one of their patients. He continued by saying, the DEA is “Watching them”, and they could get into a lot of trouble if one of their patients misused or abused their medication, then overdosed and died. He also told us the CDC guidelines were addressing the “Opioid Epidemic,” and it was recommended that doctors reduce the amount of medication their patients are taking. Apparently, since the guidelines were made public, the DEA has been watching doctors like a hawk to make sure they follow the guidelines and will find anything they can to get a doctor in trouble. This means anywhere from checking the amount of prescriptions and the number of pills in each prescription they write, to their documentation on a patients chart.

I understand that we have a problem with addiction, drug use, abuse, misuse, overdose, and death from overdose in the US, but I think most of this comes from the vast availability of illegal drugs in our country. What I mean by illegal drugs is, anything which is not prescribed by a doctor. It is fairly easy to get anything you want on the streets in our country, and this is because the DEA and our government has failed at keeping them off the streets. The “War On Drugs.” has failed miserably when it comes to illegal drugs. An example of this is the illegal Opioid Fentanyl, that was introduced to the streets not long ago. This illegal drug has been mixed with other drugs and made into a pill form as well as being put into the heroin supplies on the street. This is a very potent, powerful drug that has killed a lot of people recently because they are unaware of it being in their “supply” that they buy on the street or from their dealer. There is no reason to have a drug like this or any kind of drug being bought or sold on our streets. Apparently the DEA cannot control situations like this so they go after doctors because it is an easier target for them.

Since many Chronic Pain Patients continue to have their medications reduced and/or taken away completely, this  “Opioid Epidemic” as it is called, will continue to get worse. I fear that many patients with chronic pain will resort to the streets to find pain relief and will overdose and die, or they will commit suicide to relieve their pain and daily suffering. Those who make the decision to take their life, depending upon the method they use, could be counted as one of the CDC’s statistics. Speaking of statistics, there are rumors going around on social media saying the way the CDC did their investigation was bogus. Apparently they counted the death of a person from overdose twice if they had any prescription pain medication, as well as illegal drugs in their system. There are also deaths from heroin that were counted as opioid medication deaths because the body quickly metabolizes heroin into morphine. So I guess the question on the minds of so many people, especially those who suffer with chronic pain, is how do they know if it was actually a legitimate “Opioid Medication Overdose”, or was it really an illegal substance that metabolized into an opioid? Somehow I find these rumors to be legitimate, and wonder how many deaths were counted wrong just to make the CDC’s recommendations valid. Nevertheless, I do understand that there is a problem going on, but I think the CDC blew this all out of proportion. I think the first thing they should have addressed was the addiction to illegal drugs. This by far is more pronounced than the addiction to opioid medications. There have been various studies done stating that less than 1-3%, (depending upon the study), of people treated with opioid medications become addicted to them. And most of these opioid medication addictions were due to the person misusing or abusing their medication. 

Before I close my ranting thoughts, I have included a letter that is going around the internet. A Registered Pharmacist wrote a letter to the CDC in reference to his Chronic Pain Conditions. The letter attached below is from Dr. Houry M.D. an ER doctor that works for the CDC at the National Center for Injury Prevention and Control. If you have read my ranting thoughts, please go one step further and read the letter from her. This patient highlighted areas in the letter that contradict what most doctors have been telling their patients in reference to the CDC Guidelines. It makes one wonder just who should we believe?

CDC Letter to a Chronic Pain Patient

*If you are a Chronic Pain Patient on Opioid medication to control your pain conditions, and you have had problems since the “Guidelines” came out, please write to the CDC and other government agencies and/or officials and tell them what its like to live with your daily pain. It can be a brief letter as long as you get your point across to them. One thing to remember is to be as polite as you can. We will not get through to them if we write a letter when we are angry. I know this can and will be a chore for a lot of us to do, but please know that I understand how one feels when you suffer with unbearable, debilitating daily pain. 

Take Care of Yourselves! 

Karla Rabel, 
Disabled Nurse, Chronic Pain Patient, Pain Advocate,
and Mom at Rabel Ranch Kitty Rescue.

Living With Daily Pain On Facebook and Google+
Twitter @karlarabel1

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My Reaction to Tizanidine (Zanaflex) & Other Issues

So, due to the CDC guidelines, which states a patient should not be on Benzodiazepines while taking Opioids, my Pain Management Doctor decided to change my low dose medication that I taking and was working for muscle spasms. I was on Diazepam (Valium) 5mg (1) tablet twice daily and was changed to Zanaflex (Tizanidine) 4mg (1) tablet three daily. I was tapered off the Diazepam and started on the Tizanidine last week. I took it two days, (6.5 doses) of this new medication and had terrible side effects from it! This was an experience I will never forget.

The first couple of doses I didn’t have any problems. But, by the time I was due for the third dose on the first day, I started feeling as if the muscle spasms in my neck and shoulders were getting worse. I just thought maybe the Tizanidine needed a little more time to get into my system and “start working”. On the morning of the second day, the spasms were actually causing increased pain, but I still thought that the medication needed more time to get into my system to work. I thought the increased spasms were due to not taking the Diazepam any longer. By the late afternoon on the second day, I was in extreme pain from the spasms, very sleepy, started having blurry vision, was lightheaded and dizzy, started having nausea, had a terrible headache and started having some confusion and concentration issues. I had my husband gently touch my shoulder muscles and he stated the spasms felt like “bricks”. I had a terrible night and could not sleep. I was up all night long because of how bad I was feeling. Even though the medication made me sleepy, the pain kept me awake!

I only took half of the dose on the third morning because by now I was thinking maybe the 4mg dose was too much. A few hours after the morning dose of Tizanidine, the problems I was having the night before escalated to a point that I couldn’t stand to have anyone or anything touch me. My skin was so sensitive to touch, the spasms were worse, blurry vision was worse, when I tried to turn my head I got so lightheaded I thought I was going to pass out while sitting down. I swear the pain was so bad, it was worse than giving birth! Even though my vision was blurry, my head hurt and the confusion and concentration had gotten worse, I told myself that there was something wrong, seriously wrong… I shouldn’t be feeling like this! I looked up the side effects of Tizanadine and found out that most of the things I was feeling were on the side effect list. I had my husband call the pharmacy, since it was close to the weekend and my doctors office was already closed. He was told I should immediately stop taking the medication. We would have called the “On Call” Doctor at the clinic, but we have had bad experiences with doctors and nurses NOT getting back to us until the next week, or when they felt like they had the time… and I was not going to continue this medication until they found the time to call me back!

The last dose of Tizanidine I took was mid-Friday morning, and it was only half a dose. It took the next three days for this medication to completely get out of my system. It is now Monday, March 28, 2016, and I finally feel like my normal self. I’m not having anymore symptoms like I was having before… thank goodness! Now I’m just having my normal pain issues. I never want to go through something like this again. It was scary, painful and confusing all at the same time.

What I don’t understand is, why would the CDC want pain patients to get off medications and cut down the doses of medications when they are working for them? If a person is taking their medications CORRECTLY and NOT abusing or misusing them, they should be able to stay on or get what helps them. I understand that we have a problem with addiction in the US, but, our government and their corrupt agencies are making hard for legitimate chronic pain patients! A doctor can tell if we are using our medication correctly by looking at the Prescription Drug Database and urine drug testing that they do. And speaking of doctors, there are not many of them that are out there standing up for us chronic pain patients. There are a few, but not many!

Very soon, if it’s not happening already, pain patients are going to go looking to the streets for pain relief. This is only going to cause the addiction and death rate to go up! If the CDC thinks the rates are bad now, give it a few months… it will certainly get worse! Most legitimate pain patients know nothing about using street drugs (such as myself), and they will be the one’s that will get something off the street that is not pure, and not know the first thing about how they should to use it. These patients are going to and will die! Then you have other pain patients that will take another way out. They will commit suicide. It has already happened in this State, and probably in many other States too. Either way, the addiction, overdose, and suicide rates will go up and I personally don’t think our government gives a shit about it!

Chronic pain patients deserve to have at least somewhat of a normal life. We deserve to be able to get out of the house and visit family and friends. We deserve to go shopping. We deserve to have a relationship with our spouse. We deserve to see our kids and grandchildren grow up. We deserve to be able to go out to eat or to a movie. WE DESERVE TO HAVE OUR PAIN BE ADEQUATELY TREATED! WE DESERVE TO BE TREATED WITH RESPECT, DIGNITY, AND AS A HUMAN BEING! We deserve the things that “normal” people take for granted! But until this happens, and we get proper treatment, I will go on to fight for my rights, and the rights of others that suffer with Chronic Pain…!

~~~~~~~~~
Karla Rabel,
~Disabled Nurse, Self Advocate, Advocate for Others Living With
Chronic Pain, Owner/Admin at Living With Daily Pain Facebook
Group and Fan Page, and Chronic Pain Patient Fighting For My
Rights and The Rights of Others~