It is exactly this attitude that cost me 2.5 years of my life. After moving in July 2020 I resumed care at the practice I had been previously working with in Illinois.  During the 8 years in Alabama,  I worked with my physician carefully reducing my opioid dosage to the minimum required for adequate pain management. I was able to take walks maintain my household responsibilities such as shopping,  cooking,  laundry,  etc. Upon returning to Illinois my medication regimen was reduced by 50% from 60 mmeq daily (30 mmeq extended release and 30 mmeq immediate release.) to 30mmeq daily immediate release only. I steadily lost muscle tone, strength, and stamina which at 63 is not easy to recover.  I became less and less functional and eventually,  unable to find a pain management doctor who would restore my stable, carefully planned regimen, I became extremely depressed and suicidal.  Once I was able to obtain different insurance at 65, I was able to begin over again with a caring, compassionate physician who is using a combination of opioid treatment with both extended and immediate release medications in conjunction with facet injections and aspirin to target the inflammation.  I have other medical issues that prevent me from using NSAIDS or antidepressants. And after seeing this physician, 6 months later I am beginning to feel that there is hope that I will once again be able to resume the basic activities and responsibilities that define what having a good quality of life means to me.  I am even able to visit with my granddaughters for more than 30 minutes which had become impossible.

I lost everything when my opioid regimen was cut. I am a knowledgeable,  responsible and compliant patient who has been in pain management since 2007. I dealt with, survived and corrected the rampant overprescribing Oxycontin period where it was a miracle that I didn't end up an overdose victim.  I willingly welcome my physician's input and recommendations however my opioid use is stable and coupled with reasonable physical activity I have a good life. Your attempt to regulate treatment regimens using a one size fits all mentality without any accommodations for stable,  long term patients with managed pain using opiods in conjunction with appropriate additional targeted therapies is destroying lives needlessly.  Many patients who are older, such as myself,  get the clear message that if we csn deal with the new guidelines we should have the sense to sit or lay in bed and wait to stop breathing.

If opioids are working and are not being abused,  patients being effectively treated with an opioid based regimen should be allowed to have a life and not suffer needlessly day in and day out,  waiting for their suffering to end.

What you've done is grouped pain management patients in with people who are suffering from a substance abuse disorder.  You create an environment of refill instability which causes pain patients to demonstrate many behaviors that are difficult to distinguish from drug seeking behavior in an addict.  You have destroyed the hopes and lives of so many. And although the CDC went to great lengths explaining that these guidelines were not to be applied across the board to chronic pain patients who had stable,  effective regimens in place, nowhere in the new guidelines is caution to physicians included for such patients.  No where is it acknowledged that achieving an effective pain management regimen that allows for a reasonably good quality of life takes time and months of collaboration between the patient and the physician and that disruption of such a regimen can and does destroy both physical and psychological well being.

It appears that once again,  the ability of the physician to develop an individualized, effective pain management regimen has been unforgivably interfered with and ultimately the decisions regarding the most appropriate treatment options are being dictated by governmental agencies and non-clinical medical professionals who have no interaction at all with the patients involved. Their primary concern is not patient wellbeing and improved quality of life,  but adherence to politically and socially acceptable guidelines.

You have implemented so many reporting requirements that doctors often refuse to consider opioid therapy,  even in patients with long standing regimens,  for fear of accidental document violations in an extremely demanding, fast paced clinical environment.

I had hoped you would correct the mistakes made with your first set of guidelines.  No I simply pray that my current doctor doesn't retire until after I die.