Specifics of the Study
Data from the OptumLabs Data Warehouse for commercial insurance and Medicare Advantage enrollees, representing adults with a diverse mixture of ages, races, ethnicities, and geographical regions across the US who underwent opioid dose tapering from 2008 to 2017 after a 12-month baseline period of stable daily dosing of 50 morphine milligram equivalents or higher.
They identified tapers on the basis of a 15% or more dose reduction relative to the stable baseline dose during 6 overlapping 60-day periods following the end of the 12-month baseline period of stable dosing. They defined overdose or withdrawal events as emergency department visits or inpatient hospital admissions for any drug overdose, alcohol intoxication, or drug withdrawal. They defined mental health crisis events as emergency department or inpatient hospital admissions with depression or anxiety diagnosis codes in the primary diagnosis position or suicide attempt or intentional self-harm in any diagnosis position.
Results
19, 377 patients were in the study with a median age of 56.9 years, a little more than half were women, and 38.2% had commercial insurance. From 2008 to 2017, there were 30 255 tapering events. Baseline MMEs were as follows:
- MME 50 to <90: 22.7%
- MME 90 to <150: 23.8%
- MME 150 to <300: 31.5%
- MME ≥300: 22.0%
Rates of overdose/withdrawal were 3.5% during the pre-taper period versus 5.4% in the postinduction period—a 57% higher rate. For mental health crises rates were 3.0% during the pre-taper period and 4.4% in the postinduction period—a 52% higher rate. The mean opioid dose reduction during the first 60-day postinduction period was 39%; Incidence rates of overdose or withdrawal, and mental health crisis were each increased significantly in the postinduction period compared with the pretaper period.
Adjusted incidence rate ratios (IRRs) for postinduction adverse events were highest for patients in the highest baseline dose group (300 MME). Adjusted IRRs of overdose withdrawal and overdose during the postinduction period compared with the pretaper period were greater among patients whose postinduction doses were 50% to 114% of their baseline doses compared with patients who discontinued opioids or sustained a dose reduction of 1% to 49% of baseline. For mental health crises, there was no significant difference in adjusted IRRs by achieved dose.
Conclusion of the Study
The increased rates of overdose and mental health crisis observed during the first year after tapering persist through the end of the 24-month follow-up. No achieved tapered dose was associated with significantly reduced posttaper rates of adverse events compared with the pretaper period, and findings suggest that, for most tapering patients, elevated risks of overdose and mental health crisis may persist for up to 2 years after taper initiation.
Solution
It should become obvious that attacking pain management by withholding appropriate opioid treatment is causing more harm than good. The entire purpose of the attacks on opioids is purely a government agenda created by the DOJ and DEA to preserve their jobs. We hold the answer on Doctorsofcourage.org and Sevenpillarstotalhealth.com. No drug causes addiction. By continuing the propaganda that opioids (or any drug) is the cause of addiction is only going to make the situation worse, because the REAL cause (toxicity) is being ignored.
We also know how to get to the cause of pain or musculoskeletal injury and heal the problem, removing the need for opioids. It was because of this that Dr. Cheek was attacked by the government and prevented from treating patients. But she can explain the healing techniques to you through her ecourses. So sign up for our newsletter so you get notices of our next ecourse offering.
Linda Cheek is a teacher and disenfranchised medical doctor, turned activist, author, and speaker. A victim of prosecutorial misconduct and outright law-breaking of the government agencies DEA, DHHS, and DOJ, she hopes to be a part of exonerating all doctors illegally attacked through the Controlled Substance Act. She holds the key to success, as she can offset the government propaganda that drugs cause addiction with the truth: The REAL Cause of Drug Abuse.
Get a free gift to learn how the government is breaking the law to attack your doctor: Click here to get my free gift
CAN ANYONE WITH HUMANITY HELP ME! I AM SUFFERING FROM THE FORCED TAPER THAT HAS BEEN CAUSING MY INCURABLE DEBILITATING BONE DISEASE TO SPREAD FURTHER DOWN MY SPINE = IT IS INHUMANE WHAT IS BEING DONE TO ME!!
Imagine living with a rare genetic bone disease that has no cure and causes excruciating pain. Then imagine the medication that effectively alleviated that pain for 29 years is abruptly tapered and you are forced to take only half the dosage your body has become dependent on.
Not only is the pain unbearable, but the resulting stress placed on the body prevents you from exercising or participating in physical therapy, which is vital to someone with Ochronosis/Alkaptonuria (AKU) to prevent chronic joint pain and inflammation.
AKU is known as “Black Bone Disease” because it turns bones black and brittle. It is the oldest metabolic disease on earth and has even been found in Egyptian mummies!
After being diagnosed with AKU, I was placed on a very high dosage of morphine to stop my body from producing Homogentisic Acid (HGA). People like me born with AKU are missing an enzyme that prevents them from fully breaking down HGA. At high levels, HGA devours my bones, turning them black and stripping the cartilage and cushions between them.
My former physician of 32 years identified morphine as a pain medication that helped without causing side effects. I was able to function again and live a decent life, in spite of having a debilitating disease.
But in 2017, the CDC opioid guideline was adopted in Hawaii as state law, and my doctor was driven out of practice. I cannot find a doctor to replace him. They all see my need for morphine, but they do not want to risk their livelihoods by taking me on as a patient. I am being harmed by the state and no one will do anything to help me! Due to the morphine being reduced to half of my original dosage, the HGA accumulation has eaten two holes into my heart valves, resulting in a life-threatening heart condition. HGA has also spread to my upper cervical spine, my lower cervical spine, along with my liver and kidneys.
I have endured irreparable damage by being forced off my old dosage of medication in such an inhumane manner. Every doctor I have been referred to has refused to accept me as a patient once they look over my medical records and see I have a rare genetic bone disease that requires opioids.
Only when I was forced on a lower dosage did AKU start to spread. I have had four failed surgeries on a non-operative disease, and no doctor wants to put their livelihood on the line to help keep this disease from hurting me more!
I have never abused drugs or alcohol in any form. I have comprehensive medical records, including MRIs and x-rays documenting my illness and treatment history. It will also show that for 29 years on the original morphine dose, my liver stayed strong and clean, compared to a patient who has been on a toxic medicine like Suboxone that is just as addictive, as well as, being severely damaging to the liver and kidneys.I am being tortured for only taking what was prescribed to me. FIRST,DO NO HARM, I HAVE BEEN VERY BADLY HARMED BY THIS OPIOID CRISIS FORCED OFF A MEDICINE THAT GAVE ME QUALITY OF LIFE< TO NOW BEING BED RIDDEN BY BEING FORCED OFF IT WHEN IT HAD DONE NO HARM TO ME!
Please help me obtain the help I need before this disease spreads even more than it has. I am totally bedridden and need help to regain my quality of life.
I pray that a revision of CDC guideline will allow doctors to do their jobs again without being persecuted, and will give me back my life so that I can grow old with dignity. Legitimate pain patients who had never abused drugs are getting treated like addicts, demonized for taking prescribed medicines from licensed doctors.
Please watch this video if you have any questions about my disease: https://www.youtube.com/watch?v=7PpQU3wrdlM&t=30s
Gigi Brandford lives in Hawaii.
As you know, Gigi, from comments on FB groups, I am a firm believer that chasing the CDC guidelines will do no good whatsover, and that people need to learn what I teach to get opioid pain management back. But, of course, it is up to the individual to do that. I know you are suffering, and I empathize with you. Try to get people that you know to learn that the government agenda against opioids is pure propaganda and that no drug causes addiction. Share with them what is on my website, and the ecourse I offer to turn this propaganda around. If enough people learned in a short time, we could end this, get the CSA repealed, and practice medicine again.
Great article Linda. Tapering and withholding opiate meds is a cruel practice. Opiates are a very necessary part of medical treatment for pain. Ongoing mental health support, faith in health care providers is so important for all pain patients to live a quality life.
I wish government would concentrate on eradicating suicide, drug cartels, illegal drug activity. Leave medicine to doctors and patients and respect all providers roles.