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Offlinetacodude
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FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label
    #25925165 - 04/09/19 02:34 PM (2 months, 9 days ago)

[4-9-2019] The U.S. Food and Drug Administration (FDA) has received reports of serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased. These include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide.

While we continue to track this safety concern as part of our ongoing monitoring of risks associated with opioid pain medicines, we are requiring changes to the prescribing information for these medicines that are intended for use in the outpatient setting. These changes will provide expanded guidance to health care professionals on how to safely decrease the dose in patients who are physically dependent on opioid pain medicines when the dose is to be decreased or the medicine is to be discontinued.

Rapid discontinuation can result in uncontrolled pain or withdrawal symptoms. In turn, these symptoms can lead patients to seek other sources of opioid pain medicines, which may be confused with drug-seeking for abuse. Patients may attempt to treat their pain or withdrawal symptoms with illicit opioids, such as heroin, and other substances.

Opioids are a class of powerful prescription medicines that are used to manage pain when other treatments and medicines cannot be taken or are not able to provide enough pain relief. They have serious risks, including abuse, addiction, overdose, and death. Examples of common opioids include codeine, fentanyl, hydrocodone, hydromorphone, morphine, oxycodone, and oxymorphone.

Health care professionals should not abruptly discontinue opioids in a patient who is physically dependent. When you and your patient have agreed to taper the dose of opioid analgesic, consider a variety of factors, including the dose of the drug, the duration of treatment, the type of pain being treated, and the physical and psychological attributes of the patient. No standard opioid tapering schedule exists that is suitable for all patients. Create a patient-specific plan to gradually taper the dose of the opioid and ensure ongoing monitoring and support, as needed, to avoid serious withdrawal symptoms, worsening of the patient’s pain, or psychological distress (For tapering and additional recommendations, see Additional Information for Health Care Professionals).

Patients taking opioid pain medicines long-term should not suddenly stop taking your medicine without first discussing with your health care professional a plan for how to slowly decrease the dose of the opioid and continue to manage your pain. Even when the opioid dose is decreased gradually, you may experience symptoms of withdrawal (See Additional Information for Patients). Contact your health care professional if you experience increased pain, withdrawal symptoms, changes in your mood, or thoughts of suicide.

We are continuing to monitor this safety concern and will update the public if we have new information. Because we are constantly monitoring the safety of opioid pain medicines, we are also including new prescribing information on other side effects including central sleep apnea and drug interactions. We are also updating information on proper storage and disposal of these medicines that is currently available on our
Disposal of Unused Medicines webpage.

To help FDA track safety issues with medicines, we urge patients and health care professionals to report side effects involving opioids or other medicines to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of the page.

https://www.fda.gov/Drugs/DrugSafety/ucm635038.htm?utm_campaign=FDA%20MedWatch-Opioid%20Pain%20Medicines%3A%20Drug%20Safety%20Communication&utm_medium=email&utm_source=Eloqua

This isn't just a news story... This is an FDA report. If you've been discontinued pretty this to your doctor and tell them to deny you proper tapering is neglect tantamount to malpractice with this new FDA announcement.


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Offlinetacodude
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Re: FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label [Re: tacodude]
    #25925460 - 04/09/19 05:21 PM (2 months, 9 days ago)

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm635640.htm

Can someone copy this one over

Edit: This is a REALLY major development in the end of abandoning patients with chronic pain claiming addiction because there's dependency... This is a direct from FDA announcement. Seriously why is there no discussion? This is MAJOR


Edited by tacodude (04/10/19 10:13 AM)


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OfflineFractal420
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Re: FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label [Re: tacodude] * 1
    #25926802 - 04/10/19 12:00 PM (2 months, 8 days ago)

Withdrawal is news...and a new phenomenon? Were they unaware?


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Offlinetacodude
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Re: FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label [Re: Fractal420]
    #25926817 - 04/10/19 12:06 PM (2 months, 8 days ago)

The fact that the FDA is acknowledging the current neglect of patients contribute to high addiction diagnosis rates when those diagnosis aren't necessarily appropriate. This is really big for anyone who had recently been discontinued even after stable opiod use because of the social stigma that scared doctors who literally deny patients over fear of losing their license and the rational for giving diagnosis they are ready to admit it's wrong in a private session, but will not admit it elsewhere. This shit needs to end as it's fueling suicide rates as the statement pointed out.

Do you even know what's going on these days?


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OfflineFractal420
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Re: FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label [Re: tacodude]
    #25928013 - 04/11/19 02:27 AM (2 months, 7 days ago)

If youre asking me, my area is dope/fent flooded, one of the worse hit parts of the country.

My point is, things like withdrawal, increased risk of suicide, addiction, etc etc, thats stuff everyone from law enforcement to the FDA to some guy on the corner, that is not a new development. Maybe the wording of the article confuses me. If the FDA is admitting that "its worse than they let on" thats great but also, its fucking 2019.

I also know that at least in my area, pharma pushed many people onto heroin and fentanyl by discontinuing or severely limiting access to previously cheap and plentiful rx, leaving people in withdrawal with nowhere to turn.

Nowadays even benzos for real anxiety disorder are getting harder with a legit script. Adderall tho is schedule 2 and that they throw at you, many generics tasting like candy for the kiddies, and the pamphlet telling you how to put adderall xr beads in a baby's apple sauce


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Grinning wide
And comforting me with it's three warm and wild eyes.

Prying open MY third eye



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Offlinetacodude
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Re: FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label [Re: tacodude]
    #25928015 - 04/11/19 02:30 AM (2 months, 7 days ago)

ANYONE who was involuntarily discontinued from their pain medication over the CDC guidelines and are suffering without access to sufficient if any opiod pain meds. This could help a lot to restart odds pain management that was stable and successful.

https://docs.google.com/document/d/1RzQDSppUKhjiAsEmhW2WbTXlP5V8vJ4M_vBPQLKhK_8/edit?usp=sharing

Https://docs.google.com/document/d/1RzQDSppUKhjiAsEmhW2WbTXlP5V8vJ4M_vBPQLKhK_8/mobilebasic

https://www.fiercehealthcare.com/practices/cdc-s-opioid-guideline-misapplied-by-doctors-and-insurers-to-detriment-chronic-pain

Edit: This has NOTHING to do with the fent on the street.... Yes it's made the repercussions of this situation worse, but that's not what this is about. This is about doctors misdiagnosing a dependency as an addiction to force patients off their medications even knowing it pushed them to street drugs and suicidal ideation as the rationalization is they were addicted so they were bound to do it where the reality is the combination of the physical dependency and chronic pain could lead to addictive tendencies such as making the wrong choices for relief, but that's different from having an addiction and being in that mindset whether or not a physical dependency or stress from physical rehabilitation that's ignored while still demanded to maintain responsibilities on top of ADL. It's nothing to do with street use really even though that's the result of the situation being explained.

Edit 2: benzos have a similar situation.... Besides many turning to overly potent RCs there's just turning to alcohol. The physical dependency is similar in the end and both will kill you if it's strong enough where opiods it's only if ones not strong  enough


Edited by tacodude (04/11/19 02:48 AM)


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OfflineFractal420
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Re: FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label [Re: tacodude]
    #25928033 - 04/11/19 03:12 AM (2 months, 7 days ago)

I need to take legit benzos. They dont get me high, and i dont fiend for them like back in the day for oxycodone. But sure, youre right, many people are now using pressed fake alprazolam and test results show that its actually flualprazolam like half the time (ecstasydata). I stay away from xanax, just take rx klonopin as needed.

And yes withdrawal is dangerous and these pharmacies are quick to just say "no" sometimes due to some insurance technicality, which makes me realize they dont give a fuck if a "customer" has seizures. Even tho they are taught never to leave a person on benzos in withdrawal. It sucks that there arent many truly effective medicines for panic. Even benzos are just band aids that help for a few hours and thats it. I would also say most of the people buying fake street sticks are doing it out of recreation or to "get fucked up" (real GAD patients usually have a script, they are afterall schedule IV and for years have been given out like candy. And some people cant do without them.

Also people that take things like adderall tend to also be prescribed some amount of benzos. Makes sense to me. Hard to sleep after, and when it ends can get pretty panicky


--------------------
Dreaming of That face again.
It's bright and blue and shimmering.
Grinning wide
And comforting me with it's three warm and wild eyes.

Prying open MY third eye



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