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Some patients have taken opioids too abruptly in the midst of opioid battle, lobbyist says



SALT LAKE CITY – While Utah and the country are targeting the opioid epidemic, many with chronic pain have suffered as doctors take away or tape them off their medications, and lobbyists told legislators Monday. getting their prescriptions from pharmacies and others being "force-tapered" or having their opioid prescriptions suddenly discontinued, which can cause severe opioid withdrawal symptoms, said Amy Coombs, who has worked with substance use patients and serves as executive director of Prestige Government Relations and

Coombs presented to the members of the Health Reform Task Force as the group discussed opioids, health care costs and Medicaid expansion during a Monday legislative interim meeting

In April, the Centers for Disease Control and Prevention announced its 201

6 opiate guidelines have been "widely misapplied" to include those using opioids for palliating care, chronic pain and illnesses

There is a "broad brush stroke" of tapering or cutting people off opioids, according to Coombs, but opioids should be considered on a person-to-person basis. April, the Food and Drug Administration issued a warning and required labeling changes after receiving "reports of serious harm in patients who are physically dependent on opioid pain medications suddenly having these medications discontinued or the dose rapidly decreased. These include severe withdrawal symptoms, uncontrolled pain, psychological distress and suicide. "

Many have benefited from opioid therapy, Coombs said, and she has heard" more and more of those particular stories "about people in Utah who have taken their lives or (19659002) Some have turned to illegal drugs, according to Coombs, "People are not getting the care that they need."

Those who need opioids now "They have been on opioids for years, they have to wait for pharmacists to reach their doctors before dispensing prescriptions – and suffer withdrawal symptoms while they wait,

Rep. Jim Dunnigan, R-Taylorsville, asked what could cause that delay

Senate Majority Leader Evan Vickers, R-Cedar City, himself a pharmacist, ex that is a "disconnect" between decisions being made by health plans and pharmacy benefit managers that are "not necessarily medically based" but are instead "financially based."

Health insurance plans have taken the fight against the opioid crisis as well as a hard, fast rule and they do not allow a lot of leeway, "Vickers said.

Opioid patients prescribed high amounts of opiates need to be tapered off slowly to get long-term results, according to Vickers.

"And that forces (the patients) into making choices that they would probably not normally do," including finding drug sources on the streets, said Vickers. Sen. Allen Christensen, R-North Ogden, noted that the opioid issue was "beat to death." But opioids have "miracle drugs," he said.

"We have to move the pendulum back and forth a little bit … We have to regulate it, but do not overreact with it. "

Coombs said patients have also suffered because doctors have been incentivized to taper patients off opioids and de-incentivized to treat pain patients with opioids

She urged the task force to work on the creation of a palliative care or relief to help those who need long-term opioids to receive them. She also encouraged the creation of "bridge" opportunities for patients to receive supplies of two to four days so that they would not suffer withdrawals while doctors and pharmacists work out issues such as authorization

Several of the legislators agreed that Coombs brought up a real problem , but the potential course of action was not discussed in the meeting.

"I think it's a problem." "You have to find someone who thinks it's enough of a problem to try and do something about it," Christensen said, quipping that "and pharmacist" legislator would be a good person to deal with it.

Rep. Suzanne Harrison, D-Draper, said: "I think this raises the issue of: We need to ensure that we provide evidence-based care and sufficient access to those care providers who have the qualifications."

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