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About

Pertinet iudicium  ( Care before Judgement )

We are a small group dedicated to exposing the unethical experiment of forced tapering of opioids and pain medication being conducted on patients with chronic pain. This is not only happening in Australia but around the world. 
 
We respect and thank all those in the Health system that are trying to care for their patients in an ethical and compassionate way. Unfortunately we know not all those in the medical profession do this and chronic pain patients are being swept up in the ‘opioid epidemic‘ and left with little to no pain relief.
 
This is where you can help.
 
Your stories of treatment you have or haven’t received will help raise awareness of this mistreatment and neglect.
 
As US Pain expert Beth Darnell states “Number one rule: first do no harm.” 1. It is the core commitment of the medical profession.
 
“When a patient has little or no control, their pain and symptoms can be amplified, and they can feel abandoned and victimised by the medical profession. De-prescribing a patient that has been on a long term stable dose exposes them to new risks for opioid overdose, for suicidality, for actual suicide, for withdrawal symptoms, for increased pain.”
 
We want to help people understand how and why “scientific evidence and patient-centered approaches are critical elements of compassionate and ethical pain care, and why ignoring either of these puts patients at risk for poor outcomes and even grave harms.

And lastly, we must remember that being truly patient-centered means recognizing, fully, that not all patients should be tapered, and that not all patients benefit from tapering“.

Some 3.37 million people live in chronic pain in Australia today. By 2050 it is estimated there will be 5.23 million. A report by Deloitte put the annual cost of chronic pain in Australia at $139.3bn.
 
Ironically the Government and opposition are aware of the severe consequences of forced opioid tapering, yet they continue to ignore the plea‘s for help by patient’s, carers, advocates and family. They are aware that patients have been ignored, intimidated, demeaned, discriminated against and in some cases abandoned by doctors and specialists. Australia has followed the lead of the US in restricting the use of opioids in pain management. Unfortunately the US are now realising that their approach has not been in line with the intent of the recommendations by the CDC.
 
In a letter to the US Department of Health and Human Services September 24, 2018 , an International Stakeholder Community of Pain Experts and Leaders Call for an Urgent Action on Forced Opioid Tapering:
“We therefore call for an urgent review of mandated opioid tapering policies for outpatients at every level of healthcare—including prescribing, pharmacy, and insurance policies—and across borders, to minimize the iatrogenic harm that ensues from aggressive opioid tapering policies and practices“.2
 
From an Oxford Pain medicine article, The National Imperative to Align Practice and Policy with the Actual CDC Opioid Guideline:
“The CDC clarified this critical point today: Dose thresholds were designed only for the initiating of opioid therapy and were never intended to justify forcing patients taking long-term opioids down to these thresholds or denying these medications. However, health care organizations and states have cited the CDC guideline as a basis for policies and laws that extend well beyond its intended purpose. The guideline has been wrongly cited to substantiate proposed dose-based opioid prescribing policies that fail to account for the medical circumstances of the individual patient. At their core, these rigid opioid dose policies oppose the basic principles of patient-centered pain care.” 3.
 
As a community we cannot let this mistreatment of our loved ones continue. They deserve much better than this.
 
References
1 https://www.theguardian.com/australia-news/2020/feb/16/life-after-opioids-we-have-not-served-our-patients-well
2 Darnall BD, Juurlink D, Kerns RD, et al. International stakeholder community of pain experts and leaders call for an urgent action on forced opioid tapering. Pain Med 2019;20(3):429–33.
3 Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain—United States, 2016. MMWR Recomm Rep 2016;65(1):1–49.

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