Pubdate: Sun, 27 Mar 2016 Source: New York Times (NY) Copyright: 2016 The New York Times Company Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html Website: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Author: Lois Ambash Referenced: http://www.mapinc.org/drugnews/v16/n162/a06.html OPIOID USE AND ABUSE Patients and Doctors Discuss the Management of Drugs That Can Be Helpful or Harmful. To the Editor: For many people with chronic pain, opioid painkillers are a lifeline. The new guidelines from the Centers for Disease Control and Prevention, while perhaps reasonable as a first approach, are unrealistic for patients who have done well (sometimes for years) on carefully monitored opioid doses under continuing medical care. As The Times has reported, these longtime patients must now be subjected to humiliating "pain contracts" and random drug tests. Acetaminophen and ibuprofen are just short of laughable: If they worked for severe pain, no legitimate patient would be taking opioids. Nonpharmacological solutions like physical therapy and acupuncture may be effective for those who can afford them but are subject to strict, onerous insurance limitations or not covered at all. It's hard not to conclude that the politics of the very real and tragic opioid addiction crisis are drowning out the cries of people in pain. The medical profession only recently began to give serious attention to complaints of chronic pain, which not incidentally affects many more women than men. Sadly, it looks as if a return to the bad old days will be upon us very soon. LOIS AMBASH Needham, Mass. - --- MAP posted-by: Jay Bergstrom