Doctors in Wisconsin are cutting back on how many prescriptions they write for pain meds. It's one way the state is battling the opioid crisis, but it may be leaving some patients who face crippling pain with fewer options.
It is something that's happening in quite a few states. Last week patients with chronic conditions, who rely on opioids, begged the FDA for more options. They feel new government guidelines are actually harming them.
Kimberly Rogers has been using opioids to function for more than 15 years.
"This is not a take an Advil and you're all better type of pain," she told us.
An accident that caused a spinal injury, along with some medical issues, led her down this road
Before that Kimberly was an active mom and loved to sky dive. She explained without her pain meds she would not have a life, "literally I would have to go in the hospital."
A new way for doctors to treat pain, sales of prescription opioids in the U.S. almost quadrupled between 1999 to 2014. Two years later, in 2016, the Centers for Disease Control and Prevention laid out guidelines for primary care doctors to reduce overdose and addiction risk.
But Dr. Nilesh Patel, with Advanced Pain Management, says Wisconsin and other states have turned those guidelines into standard of care.
"We have to take care of the patients that are in front of us and give them medications and simultaneously deal with the opioid crisis," Patel said.
In our state, there's a limit on the dosage primary care docs can prescribe. But Dr. Patel feels "one size fits all" isn't the best approach, "there are many conditions that are chronic, severe whole body conditions where we do not have solutions for these patients."
Some doctors are now turning patients away, afraid of crossing prescribing lines.
That happened to a local woman who doesn't want to be identified in our story. She told us after 10 years of being treated her pain doctor dropped her. Now in the Advanced Pain Management group, her new pain specialist suggested a different treatment option, physical therapy.
"It's releasing the pain; it's kind of making it not so central," she said.
Cindy Marti owns Spinal and Body Dynamics. She sees PT playing a big role in the opioid crisis and said, "we can change that dependency on opioids. We can change the brain's perception of pain."
Trying other alternatives to treat pain first is included in the CDC guidelines.
Marti told us, "research shows upwards of 80 percent of opioid prescriptions could be reduced or eliminated by accessing PT first."
The patient we interviewed has had some success. Along with starting PT, her doctor scaled back her pain meds from 4 pills a day to 2. Something she says would not be possible without physical therapy.
But non-opioid treatments don't work for everyone. Kimberly is one of those. She told us she's tried everything. Kimberly's doctor recently lowered the dose on one of her pain meds. Kimberly says she can't do any less.
"I would rather die. That's just the truth, because it hurts so bad without them," she said.
We reached out to the CDC. It told us the guideline is a set of recommendations, not a regulation, and that it's intended to give providers guidance on how to effectively and safely treat pain.
Some of what's been mandated in Wisconsin, Dr. Patel feels is a good strategy.
- Doctors have to check the Prescription Drug Monitoring Program (PDMP) to see if patient's are prescription shopping.
- They have to screen the patient for O.D. and addiction risk.
- And try alternative treatments first before prescribing opioids.
For many patients trying these other therapies is not affordable. Insurance doesn't always cover it. The CDC told us it hopes the guidelines will lead to policy change.