An article that ends with “I think we are dealing with a lost generation of patients”  sounds maybe just too depressing to read. But this article in Sunday’s New York Times, “Tightening the Lid on Pain Prescriptions,” which focuses on the effects of a Washington State law passed last year, provides a good summary of the opioid crisis nationwide and is well worth the read.

Opioid over-prescription is a subject MCNtalk has written about multiple times in the past year, and with good reason: High-strength painkillers known as opioids represent the most widely prescribed class of medications in the United States, and data suggests that hundreds of thousands of patients nationwide may be on potentially dangerous dosages.  Washington State has imposed new requirements on doctors to refer patients taking high dosages for evaluation by a pain specialist if their underlying condition is not improving. 

The clues were buried in the dullest of places: thousands of workers’ compensation claims.

A pain expert here in Seattle, Dr. Jane C. Ballantyne, said she now finds herself in the role of former believer turned crusading reformer.

“We started on this whole thing because we were on a mission to help people in pain,” she said of the medical profession’s embrace of opioids. “But the long-term outcomes for many of these patients are appalling, and it is ending up destroying their lives.”

The system is now examining how those changes have affected patients. Studies elsewhere suggest the benefits of lower opioid use may be significant for many patients. For example, Danish researchers have published a study indicating that chronic pain patients getting non-drug treatments recover at a rate four times as high as those on opioids.

So where does the “lost generation” fit into all this? Sadly, if the patients were taken off the medications, many would experience severe withdrawal or have to take addiction treatment drugs for years. Even avid believers in the new direction, like Dr. Ballantyne, suggest that it might be necessary to keep those patients on the opioids and to focus instead on preventing new pain patients from getting caught in the cycle. Read more…