Patients on opioid medication are facing abandonment by their doctors due to increased government scrutiny of opioid prescriptions, according to medical and legal experts. The fear of being flagged by the Drug Enforcement Administration (DEA) and potential legal repercussions has led many physicians to stop prescribing opioids, leaving patients in severe pain as they search for alternative healthcare providers.
The issue has arisen amid efforts to reduce opioid overdoses and addiction, resulting in patients being dropped by doctors, physician assistants, and nurse practitioners. Many of these patients are regarded as “collateral damage” in the crackdowns and feel stigmatized as drug-seekers. Patients like Steve Dlag, who has severe back pain, have been abandoned and are left immobile and in constant pain. Dlag highlights the unfairness of being labeled a drug-seeker after years of responsible opioid use.
Federal guidelines prohibit the abandonment of patients or sudden reductions in opioid dosages. However, patient advocates claim that this practice is common. An estimated 2.3 million people suffered from prescription opioid addiction in 2020. Over the past decade, opioid prescriptions have decreased by 46%, but opioid overdoses and deaths persist, with the majority attributed to illegally manufactured fentanyl.
While experts agree that abandoning opioid patients can cause harm, there is disagreement regarding whether opioids are suitable for newly diagnosed chronic pain. The 2022 Centers for Disease Control and Prevention (CDC) opioid prescribing guidelines warn against abandoning patients but state that there is insufficient evidence to demonstrate the long-term benefits of prescription opioids for chronic pain. The guidelines recommend trying non-opioid therapies and continuing opioid treatment if the benefits outweigh the risks.
Dr. Charles Argoff, president-elect of the American Academy of Pain Medicine, believes opioids should be continued if they are beneficial and prescribed to new chronic pain patients. However, Dr. Andrew Kolodny, president of Health Care Professionals for Responsible Opioid Prescribing, argues that new chronic pain patients should not receive opioid prescriptions, emphasizing that the United States still has the highest opioid prescription rate globally.
Patients affected by the abandonment issue face significant challenges in finding new providers who understand the complexities of tapering patients off opioids and alternative pain management. The lack of adequate pain relief can result in patients turning to street drugs, leading to increased overdose risks, including accidental fentanyl exposure.
The stories of patients like Kristin Kirell, who was “dumped” by her pain-management doctor, highlight the plight of those suffering from severe and chronic pain. Kirell has tried various alternatives to opioids but finds no relief comparable to that provided by the medication. Frustration and a sense of abandonment are common among these patients who are left with limited options and minimal understanding from healthcare providers.
Doctors’ concerns about the potential legal liability of opioid prescription harm and the “aggressive overprescribing” of opioids in the past have contributed to the abandonment issue. The DEA has also contacted doctors flagged as high opioid prescribers, causing them to reconsider their prescribing habits. However, experts like Dr. Edward Rubin emphasize the importance of careful scrutiny of patients and individualized treatment plans to safely manage pain.
The abandonment of patients on opioid medication is a serious issue that requires a delicate balance between addressing the opioid crisis and providing necessary pain management. Both patient advocates and healthcare providers agree that more comprehensive solutions and guidelines are needed to ensure the well-being of chronic pain patients while also addressing the broader issues of opioid misuse and addiction.