How will Trump's War on Opioid Abuse Affect Non-abusers in Pain?

[Emergent]

Trump: Opioid 'national shame' a public health emergency - BBC News

I read this article today, and on paper it makes sense and is needed. I also notice some other provisions that are positive es, like the expansion of telemedicine.

My fear is, the many people that aren't prone to addiction will be denied pain relief. It seems that the government goes from one extreme to another. 20 years ago they were pushing us to relieve pain, and chastising healthcare workers from even using the word addiction. Now they are seeing addiction under every rock.

I guess we'll have to wait and see, but I am cynical.

[wtbcrna, MSN, DNP, CRNA]

Kooky Korky said:

Do you consider the fractured wrist mentioned above to be chronic? What should be used to treat this person's pain?

A wrist fracture fracture would be acute pain. Generally after the fracture is stabilized most people should not need opioids.

[wtbcrna, MSN, DNP, CRNA]

LovingLife123 said:

I respectfully disagree. They work well for my chronic pain. But it's not my only form of treatment. Movement helps my chronic pain. But it sucks when it hurts too bad to move in the morning.

I won't comment on individual history, but there is a lot of problems that happen with chronic opioid use. What Tends to happen is people get an upregulation of the Mu/opioid receptors causing these patients to have to consistently increase the amount of opioids used to get the same effect. It also puts them at greater risk for the hyperalgesia/alloydonia and other side effects of opioids.

What most pain providers suggest Now is a multimodal approach to dealing with pain and to only use opioids for chronic pain as needed acutely for breakthrough pain control.

[Bonemma]

I think the greater concern is the pressure the DEA is putting on prescribers- justly on those who prescribe excessively, but also those MD's, DO's, PA's and NP's who are taking a responsible approach to pain management. To this point, the VA is now actively discouraging, if not prohibiting, their providers from continued opioid use for chronic conditions. Another concern (more of a prediction): an entire generation of medical students will see opioids demonized. As nurses, we know there is an appropriate approach for many conditions. I hope wiser heads prevail.

[wtbcrna, MSN, DNP, CRNA]

Bonemma said:

I think the greater concern is the pressure the DEA is putting on prescribers- justly on those who prescribe excessively, but also those MD's, DO's, PA's and NP's who are taking a responsible approach to pain management. To this point, the VA is now actively discouraging, if not prohibiting, their providers from continued opioid use for chronic conditions. Another concern (more of a prediction): an entire generation of medical students will see opioids demonized. As nurses, we know there is an appropriate approach for many conditions. I hope wiser heads prevail.

This is a typical pendulum approach. We have went to far one way now will likely go to far the other way.

My anecdotal experience dealing with VA patients on opioid is that the VA is notorious for over prescribing opioids.