Patients with Cauda Equina Syndrome (CES) and other chronic pain conditions who rely on opioid medications to relieve their pain have been caught in the middle of the government’s recently declared “war” on opioids.
CES occurs when pressure is applied to the cauda equina, a bundle of nerves located at the base of the spine, causing damage and impairing nerve function. Spinal injuries, infections, birth defects and stenosis are a few of the causes of CES. Cauda Equina Syndrome is a serious medical condition that requires immediate treatment. That’s why it’s so important that healthcare professionals correctly diagnose the condition as soon as the symptoms present themselves.
As soon as a healthcare professional confirms their diagnosis of CES, it’s crucial that the patient undergo treatment – usually surgery – immediately. Even a delay in treatment of 48 hours could have devastating, lifelong effects for the patient: chronic pain, incontinence, impotence and even paralysis.
Opioids Help CES Patients Cope With Their Pain
The extent of recovery from Cauda Equina Syndrome depends on the severity of a patient’s symptoms and how long the nerves were compressed before surgery was performed. Some patients face severe, long-term pain.
To help them cope with the excruciating pain caused by conditions like CES, healthcare professionals often prescribe a wide range of painkillers, including drugs classified by the government as “opioids.” These drugs block pain signals sent from the brain to the body and release large amounts of dopamine throughout the body, relaxing the body and relieving pain.
The Opioid Epidemic
The problem for CES patients and others with chronic pain conditions? America is in the grips of what law enforcement says is an opioid “epidemic.” There has been a rapid increase in the use and abuse of opioid medications in the U.S. since the 1990s. Their easy availability has made them popular as recreational drugs. According to the CDC, about 40 Americans die due to opioid overdoses each day.
In an effort to combat this, the Drug Enforcement Administration (DEA) has been cracking down on the distribution and manufacture of these medications. Doctors and pharmacists have been arrested. The DEA has even ordered the production of opioid medications be reduced by about 25 percent. Some insurance companies have stopped paying for opioid medications, and many doctors are only prescribing them as a last resort.
Some states are even suing pharmacies in opioid-related cases. A recent filing by Kentucky’s attorney general against Walgreens alleges that the pharmacy directly contributed to the state’s opioid crisis because of a failure to properly monitor its shipping operations. It is the state’s sixth opioid-related lawsuit.
CDC Recommendations on Opioid Prescriptions
Opioids have two dangerous side effects: they are physically addictive; and, in high enough doses, they can cause a fatal overdose. Because of these dangers, the U.S. Centers for Disease Control and Prevention has outlined recommendations that urge caution when increasing a patient’s dosage to greater than 90 MME (morphine milligram equivalents) per day. The recommendations suggest that medical providers carefully evaluate and justify their rationale for exceeding this level, but they do not explicitly prohibit going over the 90 MME per day dose.
The DEA, however, is targeting physicians who exceed these limits as thought it was a binding rule — even when the patients in question are suffering from severe, chronic pain conditions like CES.
Who Should Make Decisions on Prescribing Opioid Medications?
The DEA crackdown on prescription opioid use has drawn outrage from patients with CES and those suffering from other chronic pain conditions who use opioids responsibly and feel that they are the only treatments that get them through the day with a minimum of pain.
Many doctors and patients believe it is their decision, not the government’s, to determine what types of drugs at what doses are best to deal with a patient’s chronic pain. However, faced with increased DEA scrutiny and the possibility of being sued or even arrested, many medical practitioners are afraid to prescribe these medications to the patients who need them.
As this crackdown continues, patients not only worry that they will have to take reduced dosages but that restrictions on the production and distribution may make it difficult to even obtain the medications they need to alleviate their pain.
While controlling the use and abuse of opioids may be important, eliminating the public health dangers of medications like opioids doesn’t have to be achieved by denying them to patients who suffer from chronic and debilitating pain.
Has an Accident Left You with Chronic Pain?
Lisa S. Levine P.A. is a nationwide Cauda Equina Syndrome attorney who has handled and consulted on more than 60 cases across the U.S., including in Georgia, South Carolina, Florida, New Jersey, Massachusetts, Rhode Island, Connecticut, North Carolina, Vermont, Maine, New Hampshire, Delaware, Maryland, Virginia, Pennsylvania and New York. In Florida, she has helped CES patients throughout the state, including in Fort Lauderdale, West Palm Beach, Miami, Tampa, Orlando and Ocala.
The intense pain many of her clients must endure after their injuries drives Lisa to use every bit of her experience and resources to ensure they receive the compensation they deserve for the damages caused by their injuries.
If you suffered Cauda Equina Syndrome as a result of medical malpractice, call the law offices of Lisa Levine today.