Why the term “opiod crisis” bothers me so much… heroin crisis and/or illegal prescription usage, or something else more targeted to an abusive population, please. Be precise.
There are many chronic illness sufferers who need heavily regulated medications to fuction. If the government must “intervene”, regulate, label, and restrict, please offer us an alternative such as legal medical marijuana; I don’t want to smoke it, quite the contrary, however I do want to contribute to society, there are plenty of non-smoking options that assist with chronic pain and illness that could be made available in a legal and affordable manner (Colorado and California come to mind). In New Jersey the list of “acceptable” diseases is frustratingly limited, and even if I were a candidate, the dispersal facility is out of my transportation range, and since it’s not covered by insurance, I’m told it’s expensive. Nothing in this current model helps a chronic pain patient who would like another legal option.
I have been with the same doctor since 2010, I think he has a pretty good handle on my medical needs. Yet, because of several medications I take, he and I are both subjects of special scrutiny; in 2016, the paperwork I had to fill out was almost as much as when I bought my house (really). Now, I must go every three months, even though he books three months in advance; so if I’m not feeling well that day or my ride falls through (county bus now says it’s out of my ride service, even though it’s in the county and they used to take me there), if I have no choice but to reschedule, i usually cant get another appointment until three months later. Because I don’t drive, I can’t take same or even next day cancellations. In addition, he doesn’t accept insurance so I have to pay out of pocket for each visit, simply to pee in a cup and document I was there. This is a chronic illness (actually multiple), it’s not going away in three months.
Someone might ask, why not find someone closer who takes my insurance? Because he has been my one constant since 2010 after my initial diagnosis. He found my gallbladder infection and helped me get through the system to get it removed last summer. None of my other doctors caught the problem. He has tested me for other, rare problems because he knows me and can see when something isn’t right. Having said all that, I would like to spend the time and energy I am forced to see him in searching for a new neurologist, as I have been without one since December (she no longer takes insurance, is much more $ and in Manhattan).
Rigid medical guidelines can cause harm.
“Potential limitations and harms of guidelines:
“The most important limitation of guidelines is that the recommendations may be wrong (or at least wrong for individual patients). Apart from human considerations such as inadvertent oversights by busy or weary members of the guideline group, guideline developers may err in determining what is best for patients for three important reasons.
“Firstly, scientific evidence about what to recommend is often lacking, misleading, or misinterpreted. Only a small subset of what is done in medicine has been tested in appropriate, well designed studies. Where studies do exist, the findings may be misleading because of design flaws which contribute to bias or poor generalisability. Guideline development groups often lack the time, resources, and skills to gather and scrutinise every last piece of evidence. Even when the data are certain, recommendations for or against interventions will involve subjective value judgments when the benefits are weighed against the harms. The value judgment made by a guideline development group may be the wrong choice for individual patients.”