Patient Outcomes Not Being Monitored
Even more concerning is that the CDC does not appear to be tracking — or caring — about the correlation between opioid prescribing and overdoses, even as it prepares an update to its 2016 guideline. As PNN has reported, the CDC ignored warnings from its own consultants that the agency “should consider conducting more research” about the guideline’s impact on pain patients, many of whom were abruptly tapered or abandoned by their doctors after the guideline’s release.
“Reasonable judgment would dictate tracking and reporting of chronic pain patient outcomes (deaths, suicides, returns in benefits, reported pain, function, etc.) for individuals since the guideline or the guideline update. However, there appears to be no publicly available evidence that a monitoring process is required or is planned to measure and confirm outcomes,” Aubry and Carr wrote.
PROP is not following the data either. In a recent debate, PROP board member Adriane Fugh-Berman claimed that pain patients addicted to prescription opioids were still fueling the overdose epidemic, even though illicit fentanyl and other street drugs are involved in the vast majority of deaths.
“Those patients went to the street. They got addicted to heroin. The reason those deaths went up is because the illicit supply of opioids has become laced with fentanyl and has become highly dangerous,” Fugh-Berman said, without citing any evidence. “It’s not that prescription opioids have nothing to do with it. Many patients started on prescription opioids ended up on the streets looking for heroin. They’re dying because the illicit opioid products have become extremely dangerous. That’s what’s killing people.”
Fugh-Berman is not an unbiased observer. She and at least five other PROP board members have testified as paid expert witnesses in opioid litigation cases, making as much as $850 an hour for their testimony blaming drug makers for the opioid crisis.
A recent analysis of overdose deaths in 2020 found that prescription opioids ranked well behind illicit fentanyl, alcohol, cocaine, methamphetamine and heroin as the leading cause of drug deaths.
At least one critic of opioid prescribing feels it’s time to change the focus on why so many Americans are overdosing, now estimated at 107,000 people a year. Beth Macy, who wrote the best-selling book “Dopesick,” thinks it’s time for a reassessment.
“At this point, too much attention is focused on stemming the oversupply of prescription opioids,” Macy writes in her new book, “Raising Lazarus.” “We now have a generation of drug users that started with heroin and fentanyl.”
As for the CDC, a spokesperson tells PNN the agency won’t publish its guideline revision until late this year, nearly seven years after the original guideline was released.
“CDC is currently in the process of revising the draft update to the 2016 Guideline based on comments received during the public comment period and peer review. We anticipate the final Guideline will be released later this year,” the spokesperson said.
