The Hidden Pain of the CDC’s Opioid Guidance

I don’t live with chronic pain.

I am fortunate to be in relatively good health these days to the point where I can manage my once horribly bad back with a couple of over-the-counter ibuprofen tablets. But that wasn’t always the case.

For a good two decades I suffered from constant back pain. You know when the doctor asks you to rank your pain on a scale of 1 to 10? I normally rated a 6; on a good day I was a 3 or 4; on a bad day, which happened all too frequently, I was off-the-scale writhing in agony. 

After shedding about 30 pounds and finally reaching the breaking point, I began to manage my back pain, through water aerobics (yes, I know; water aerobics are for old ladies and fat people. Whatever; it worked for me) and a twice-daily stretching regimen.

I also had a prescription of pain meds handy. I still do – and I keep a bottle at home and at work. Because there are days when my back pain flares up and there’s no way I’d be able to get home from the office without a prescription painkiller.

Though I know what it’s like to live with a back that registers as a 5 or 6 on the pain-o-meter, I cannot imagine living life in the 7 to 10 range, as millions of Americans do on a daily basis. In a lot of cases their only way to survive the workday is found inside a prescription bottle of opioids.

Yet we are also a nation gripped by an opioid addiction epidemic. According to the Centers for Disease Control and Prevention, 40 Americans die daily from overdosing on prescription painkillers. The CDC also estimated that in 2013, 1.9 million people abused or were dependent on prescription opiates.

Please read: Pain Points in the Workplace

The CDC released guidelines to primary care physicians for the rampant over-prescription of opioids for chronic pain. The guidance released March 16 is well thought out and sensitive to people suffering from chronic pain:

“While prescription opioids can be part of effective pain management, they have serious risks. The new guideline aims to improve the safety of prescribing and curtail the harms associated with opioids, including opioid use disorder and overdose. The guideline also focuses on increasing the use of other effective treatments available for chronic pain, such as non-opioid medications or physical therapy.”

Earlier this year I watched Public Broadcasting’s Frontline air its episode, “How Bad is the Opioid Epidemic?” The personal stories were horrifying; the nightmarish statistics frightening.

Through programs like Frontline as well as multiple stories on the subject in the pages of Workforce and numerous other publications, the opioid addiction epidemic is a mainstream issue that is resonating with presidential candidates.

But like climate change and vaccines, I’m sure there are those who contend that opioid addiction is just another liberal media-fueled conspiracy. It is not. But there is a flipside to its regulation.

Several months back a Workforce reader offered a thoughtful yet compelling comment on an opioid-related blog post by my colleague Sarah Sipek to not over-regulate opioids. Said “Martha” in her comment:

“It seems as though everywhere I look in the last few months I see references to the huge economic losses due to addiction to opioids; the tragedy of suicide by overdose; a teenager’s first step on the road to addiction due to the irresponsible storage of opioids. I would like to say that it is heartwarming that others are so concerned about the well being of others. EXCEPT, that no one seems to listen to those of us who live with chronic pain. I am able to function BECAUSE of opioids. “Now pain medications are more tightly controlled so I have to see a doctor every month, take a prescription to the drug store, go back and pick it up – oh, and let's not forget that we better make sure it is a small number of pills. So I get to do it all over again in a couple of weeks. And pay more office visit co-pays, more prescription co-pays, etc. Being in chronic pain is a really tough way to live your life. “To the unaware, it probably seems as though those in pain should – get it treated, get it fixed, or, more likely, suck it up.

“I do not deny that there are addicts. I don't dispute that there are likely people taking opioids to escape things other than physical pain. BUT I AM NOT ONE OF THEM. And the efforts to protect or address the ills of other has made my life far more difficult. Please stop protecting me with overly broad regulations.”

It appears the guidance of the CDC and concerns of politicians is well intentioned. But “Martha” makes a valid point: Stricter regulations could cause those who suffer from chronic pain even greater distress.

I can only hope doctors will pay heed to the CDC’s guidance and politicians won’t find the need to over-regulate prescription opioids. But that’s probably wishful thinking on my part.