Addiction psychiatrist questions involuntary tapering of opioids

(SATEL 10:09:45) "TO TAKE A PATIENT WHO'S DOING WELL OFF OF MEDICATION ABRUPTLY AND WITHOUT THEIR PERMISSION IS NOT UNFAIR, I ACTUALLY THINK IT'S MALPRACTICE" STRONG WORDS TONIGHT ABOUT EFFORTS BY THE DEPARTMENT OF VETERANS AFFAIRS AND OTHER INSTITUTIONS ACROSS THE COUNTRY TO TAPER PATIENTS OFF OPIOIDS AGAINST THEIR WILL

MOUNTAIN HOME V-A'S DECISION TO REDUCE OPIOID PRESCRIPTIONS REMAINS CONTROVERSIAL, MORE THAN A YEAR AFTER THE INITIATIVE STARTED TODAY, THE FACILITY IS PRESCRIBING HALF AS MANY OPIOIDS AS IT DID IN 2012BUT NATE MORABITO UNCOVERED NEW CONCERNS ABOUT THE WAY THE DEPARTMENT OF VETERANS AFFAIRS AND OTHER INSTITUTIONS ARE CUTTING THE PAIN MEDS

IT'S NOT SO MUCH ABOUT WHY THEY'RE CUTTING BACK, IT'S THAT THEY'RE DOING SO WITHOUT GIVING PATIENTS A CHOICE RENOWNED AUTHOR AND ADDICTION PSYCHIATRIST DR SALLY SATEL SAYS SHE'S ALL FOR REDUCING OPIOID DOSES AS LONG AS PATIENTS AND DOCTORS WORK COLLABORATIVELY TOWARD THAT GOALBUT AS WE'VE REPORTED MULTIPLE TIMES, VETERANS FEEL LIKE THEY DON'T HAVE A SAY IN THE MATTER (HUGHES 03:43:15) "IT BOTHERS ME, BECAUSE AS MANY YEARS AS I'VE PUT IN, THEY NEED TO TAKE CARE OF ME" SINCE DECEMBER 2016 (ROSE 06:37:18) "WE TOOK AN OATH TO DEFEND THIS COUNTRY, TO DEFEND THEM" MULTIPLE VETERANS HAVE VOICED A COMMON FEELING OF BETRAYAL (DAUGHERTY 06:16:04) "IF THEY TAKE AWAY THE REST OF MY PAIN MEDICATION, WHICH I'M SURE THEY WILL, I WILL BE TOTALLY PHYSICALLY DISABLED

" ALL THE RESULT OF WHAT THEY CALLED MOUNTAIN HOME V-A'S MANDATORY REDUCTION OF THEIR OPIOID DOSES (SATEL 10:11:21) "WITHOUT THE PATIENT'S CONSENT, THE RESULTS ARE OFTEN DISATEROUS" DR SALLY SATEL SAYS MANY INSTITUTIONS HAVE MISINTERPRETED THE CENTERS FOR DISEASE CONTROL'S PAIN MANAGEMENT GUIDELINESINTEPRETING THEM AS MANDATES RATHER THAN RECOMMENDATIONS (SATEL 10:07:47) "I THINK IT IS AN OUTRAGE WHEN YOU HAVE A PERSON WHO'S DOING WELL ON A DOSE OF MEDICATION, HIGHLY FUNCTIONAL, THEIR PAIN IS UNDER GOOD CONTROL, THIS IS WHAT YOU WANT, THIS IS THE CLINICAL OUTCOME" THE ADDICTION PSYCHIATRIST IS A RESIDENT SCHOLAR AT AMERICAN ENTERPRISE INSTITUTE AND A LECTURER AT YALE UNIVERSITY SHE'S A VOCAL OPPONENT OF INVOLUNTARY TAPERING OF CONTROLLED OPIOIDS

(SATEL 10:12:41) "IT SHOULDN'T BE DONE WITHOUT THEIR PERMISSION" FOR DECADES, V-A AND OTHER DOCTORS PRESCRIBED PAIN MEDICATIONS BECAUSE THEY THOUGHT, AT THE TIME, THAT'S WHAT PATIENTS NEEDEDBUT IN RECENT YEARS, THEY CHANGED THE APPROACH WHEN NEW RESEARCH FOUND OPIOIDS CAN BE DANGEROUS AND INEFFECTIVE

(EASON 02:57:03) "I UNDERSTAND THEIR FEAR, THEIR ANXIETY AND THEIR ANGER, BUT I WANT THEM TO UNDERSTAND THIS IS DRIVEN BY OUR CONCERN FOR THEIR SAFETY" MOST RECENTLY, MOUNTAIN HOME V-A'S CHIEF OF STAFF TOLD US THE FACILITY'S PROUD OF ITS 49% DECREASE IN OPIOID PRESCRIPTIONS SINCE 2012ADDING, DOCTORS CONSIDER EVERY PATIENT'S NEED ON A CASE-BY-CASE BASIS

AND TAPER VETERANS OFF OPIOIDS IN A SAFE WAY (HECHT 05:21:00) "MANY VETERANS HAVE REALLY UNDERSTOOD AND BOUGHT INTO IT AND IT HAS HELPED US" BUT OTHERS HAVE NOT

AND DR SATEL SAYS IT'S DANGEROUS TO FORCE THEIR HAND (SATEL 10:09:45) "TO TAKE A PATIENT WHO'S DOING WELL OFF OF MEDICATION ABRUPTLY AND WITHOUT THEIR PERMISSION IS NOT UNFAIR, I ACTUALLY THINK IT'S MALPRACTICE

" THE V-A MAINTAINS IT'S TAKEN PATIENTS OFF OPIOIDS GRADUALLY AND GIVEN VETERANS THE OPPORTUNITY TO APPEAL THEIR TAPERING DECISIONSADDIN G, THE PAIN MEDS MAY HELP WITH SHORT-TERM PAIN, BUT ARE NOT APPROVED TO TREAT CHRONIC PAIN IN NON-CANCER PATIENTS MOUNTAIN HOME'S NOW ENCOURAGING VETERANS TO TRY SAFER AND MORE EFFECTIVE ALTERNATIVES

AS WE REPORTED EARLIER THIS MONTH, V-A REPRESENTATIVES PLAN TO DICUSS PRELIMINARY DATA THAT SHOW A LINK BETWEEN OPIOID DISCONTINUATION AND SUICIDES AT AN UPCOMING SUMMIT DR SATEL HAS AUTHORED SEVERAL PUBLISHED WORKS ALONGSIDE ONE OF THOSE SPEAKERS

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