Relationship Between Patients Dispensed Prescription Opioids, Opioid Treatment Admissions and Overdose Deaths: 2006-2018 and Beyond
Main Article Content
Abstract
Background: In August 2022, a paper was published by Larry Aubry and L. Thomas Carr, assessing relationships between prescription opioid sales, opioid treatment admissions and drug-related accidental deaths. This paper refines and expands the previous work by analyzing the relationship between the patients dispensed an opioid prescription to drug overdose deaths and opioid treatment admissions. It evaluates whether there is a statistically significant relationship between opioid prescribing in the current year and the subsequent year (Year + 1) and the year after that (Year + 2) opioid treatment admissions or drug overdose mortality rates. 2020-2022 data are also examined to refine understanding of the primary driving factors in U.S. accidental drug mortality.
Aims: This paper seeks to more fully answer the question, "Have prevailing public health policies restricting the availability of prescription opioid analgesics been successful in reducing accidental drug overdoses, either from all drugs or specifically from prescription opioids?"
Methods: Linear regression analysis has been applied to data published by the US CDC and the U.S. Food and Drug Administration from 2006 to 2018 – six years before and six years after a peak in U.S. opioid analgesic prescribing. 2020-2022 data from the CDC State Unintentional Drug Overdose Reporting System have been examined for trends and consistency with earlier data. Four measures have been applied:
- statistical significance of the model (overall P-value),
- quality of the data fit (R-squared), and
- the sign of the linear slope coefficient (positive or negative correlation)
- proportion of patients dispensed an opioid prescription to opioid treatment admissions and to deaths attributed to prescription opioid drugs.
Results: No positive correlations were found between the number of patients dispensed an opioid prescription versus present-year, present-plus--year, or present-year-year+2 prescription opioid mortalities, opioid treatment admissions, and any opioid and total overdose deaths. Recent accidental drug-related deaths are dominated by non-prescription opioids, specifically illegal fentanyl and stimulants– not patients dispensed an opioid prescription.
Conclusions: Current public health policy restricting the availability of clinically prescribed opioid analgesics has had no discernable effect on opioid treatment admissions or drug overdose/poisoning mortality.
Keywords:
Prescription Opioid, Drug Addiction, Drug Overdose Deaths, Opioid treatment admissions
Article Details
How to Cite
AUBRY, Larry; LAWHERN, Richard.
Relationship Between Patients Dispensed Prescription Opioids, Opioid Treatment Admissions and Overdose Deaths: 2006-2018 and Beyond.
Medical Research Archives, [S.l.], v. 13, n. 3, mar. 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6440>. Date accessed: 09 apr. 2025.
doi: https://doi.org/10.18103/mra.v13i3.6440.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Jalal H, Buchanich JM, Roberts MS, Balmert LC, Zhang K, Burke DS. Changing dynamics of the drug overdose epidemic in the United States from 1979 through 2016. Science. 2018;361(6408):eaau1184. Figure 1b. http://dx.doi.org/10.1126/science.aau1184
2. National Drug Overdose (OD) deaths, 1999-2021. Live.com. National Institutes of Health on Drug Abuse. 2023. Accessed January 3, 2025. https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fnida.nih.gov%2Fsites%2Fdefault%2Ffiles%2FOverdose_data_1999-2021%25201.19.23.xlsx&wdOrigin=BROWSELINK
3. Centers for Disease Control and Prevention. U.S. overdose deaths decrease in 2023, first time since 2018. www.cdc.gov. May 14, 2024. Accessed January 3, 2025. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.
4. Mandell, BF. "The fifth vital sign: A complex story of politics and patient care." Cleveland Clinic Journal of Medicine, June 2016;83(6):400-401. https://doi.org/10.3949/ccjm.83b.06016
5. Scher C, Meador L, Van Cleve JH, Reid MC. Moving Beyond Pain as the Fifth Vital Sign and Patient Satisfaction Scores to Improve Pain Care in the 21st Century. Pain Management Nursing. 2018;19(2):125-129. https://doi: 10.1016/j.pmn.2017.10.010.
6. Duggam, G. "12 Million OxyContin Pills Shipped to a Town of 500: How Profit Fueled America's Opioid Crisis". CBC News, November 15, 2021. Accessed January 5, 2025. https://www.cbc.ca/documentaries/the-passionate-eye/12-million-oxycontin-pills-shipped-to-a-town-of-500-how-profit-fuelled-america-s-opioid-crisis-1.6247359
7. CDC archives. CDC Releases Guideline for Prescribing Opioids for Chronic Pain. Press Release. Para. 3. Accessed January 5, 2025. https://archive.cdc.gov/#/details?url=https://www.cdc.gov/media/releases/2016/p0315-prescribing-opioids-guidelines.html
8. Remarks by the President in panel discussion at the National Prescription Drug Abuse and Heroin Summit. National Archives and Records Administration. Whitehouse.gov. March 29, 2016. Paragraph 6. Accessed January 5, 2025. https://obamawhitehouse.archives.gov/the-press-office/2016/03/29/remarks-president-panel-discussion-national-prescription-drug-abuse-and
9. Operation Unite. Keynote Address CDC Director Dr. Tom Frieden. Lecture presented at the National Prescription Drug Abuse and Heroin Summit on March 30, 2016. Vimeo. Accessed January 5, 2025. https://vimeo.com/162843894.
10. Rudd, RA, Aleshire, N, Zibbell, JE, Gladden, RM. Increases in drug and opioid overdose deaths — United States, 2000–2014. Centers for Disease Control and Prevention. January 1, 2016. Accessed January 5, 2025. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm
11. Dowell D, Zhang K, Noonan RK, Hockenberry JM. Mandatory provider review and pain clinic laws reduce the amounts of opioids prescribed and overdose death rates. Health Affairs. 2016;35(10):1876–83. p.1879,1882. http://dx.doi.org/10.1377/hlthaff.2016.0448
12. Paulozzi, LJ. Jones, CM. Mack, KA, Rudd, RA. CDC. Vital signs: Overdoses of prescription opioid pain relievers --- United States, 1999--2008. Morbidity and Mortality Weekly Report (MMWR). November 4, 2011. Accessed January 5, 2025. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm
13. ASPE Issue Brief. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Opioid Abuse in the U.S. and HHS Actions to Address Opioid-Drug Related Overdoses and Deaths.2015. P. 1–2, 5. Accessed January 5, 2025. https://aspe.hhs.gov/sites/default/files/migrated_legacy_files/56406/ib_OpioidInitiative.pdf
14. Aubry L, Carr BT. Overdose, opioid treatment admissions and prescription opioid pain reliever relationships: United States, 2010–2019. Frontiers in Pain Research. 2022;3. http://dx.doi.org/10.3389/fpain.2022.884674
15. Supplementary Table 1 FDA FOIA Response 2021-2978 Estimated # of patients prescribed 2006 to 2018 data and letter.pdf. Google Docs. Accessed January 5, 2025. https://drive.google.com/file/d/1IrlA-joCihIWrhNzl-NHiqnykyJ9Bkvq/view?usp=sharing
16. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2000-2010. National Admissions to Substance Abuse Treatment Services. DASIS Series S-61, HHS Publication No. (SMA) 12-4701. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012. P. 5, 43, Table 1.1A, P. 72 Table 2.15. Accessed January 5, 2025. https://www.samhsa.gov/data/sites/default/files/2010_Treatment_Episode_Data_Set_National/2010_Treatment_Episode_Data_Set_National.pdf
17. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2008-2018. Admissions to and Discharges From Publicly Funded Substance Use Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2020. Table 1.1a, Table 2.18. Accessed January 5, 2025. https://www.samhsa.gov/data/sites/default/files/reports/rpt31097/2018_TEDS/2018_TEDS_Tables.html#Tbl1.1a
18. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports. 2016;65(No. RR-1): P. 2,16. 1–49. Doi: http://dx.doi.org/10.15585/mmwr.rr6501e1
19. Lawhern RA, Doctors 'overprescribing' opioids isn't the cause of the overdose epidemic — and it never was, STAT News, July 11, 2024. Accessed January 8, 2025. https://www.statnews.com/2024/07/11/doctors-overprescribing-opioids-didnt-cause-overdose-epidemic/
20. Centers for Disease Control and Prevention. State Unintentional Drug Overdose Reporting System (SUDORS). Preliminary and Final Data. Atlanta, GA: U.S. Department of Health and Human Services, CDC; December 12, 2024. Accessed January 9, 2025. https://www.cdc.gov/overdose-prevention/data-research/facts-stats/sudors-dashboard-fatal-overdose-data.html
21. Seth P, Rudd RA, Noonan RK, Haegerich TM. Quantifying the Epidemic of Prescription Opioid Overdose Deaths. American Journal of Public Health. 2018;108(4):500–502. http://dx.doi.org/10.2105/ajph.2017.304265
22. Peppin JF, Coleman JJ. CDC's Efforts to Quantify Prescription Opioid Overdose Deaths Fall Short. Pain and Therapy. 2021;10(1):25–38. http://dx.doi.org/10.1007/s40122-021-00254-z
23. O'Donnell J, Tanz LJ, Gladden RM, Davis NL, Bitting J. Trends in and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls — United States, 2019–2020. Morbidity and Mortality Weekly Report. December 17, 2021;70:1740-1746. P.1743,1745,1746. Accessed January 8, 2025. https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7050e3-H.pdf
24. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Instructions for Completing the Cause-of-Death Section of the Death Certificate. P.1. Accessed January 8, 2025. https://www.cdc.gov/nchs/data/dvs/blue_form.pdf
25. Kolodny A. Statement for the Record. Andrew Kolodny, MD chief ... Before the U.S. Senate Caucus on International Narcotics Control "America's addiction to opioids: Heroin and prescription drug abuse." May 14, 2014. P. 2. Accessed January 9, 2025. https://www.drugcaucus.senate.gov/wp-content/uploads/2022/11/Kolodny-Testimony.pdf
26. Kolodny A. Statement by Andrew Kolodny, MD ... on Combatting the Opioid Crisis before Committee on Energy & Commerce, Subcommittee on Health U.S. House of Representatives. February 28, 2018. P. 1, 2 Accessed January 9, 2025. https://docs.house.gov/meetings/IF/IF14/20180228/106915/HHRG-115-IF14-Wstate-KolodnyA-20180228.pdf
27. Kolodny A. Statement for the Record. Andrew Kolodny, MD … Before the U.S. Senate Committee on Homeland Security and Governmental Affairs "Unintended Consequences: Medicaid and the Opioid Epidemic." January 17, 2018. P.1. Accessed January 9, 2025. Testimony-Kolodny-2018-01-171.pdf (senate.gov)
28. Reason. X.com (formerly Twitter). The war on pain drugs has turned out to be a colossal failure. pic.twitter.com/7lnhr5tfxb [Internet]. Twitter. 2023. Accessed January 9, 2025. https://twitter.com/i/status/1712183836711256216
29. Bhandari P. Correlation vs. Causation | Difference, Designs & Examples. Scribbr. June 22, 2023. Accessed February 10, 2025. https://www.scribbr.com/methodology/correlation-vs-causation
30. Freakonomics Radio Network. Correlation vs. Causality: The Debunked Link Between Ice Cream and Polio | Freakonomics. YouTube. August 2011. Accessed January 9, 2025. https://www.youtube.com/watch?v=lbODqslc4Tg.
31. Chambliss DF, Schutt RK. Causation and Experimental Design;106-109. P.108. Sagepub.com. Accessed January 9, 2025. https://www.sagepub.com/sites/default/files/upm-binaries/23639_Chapter_5___Causation_and_Experimental_Design.pdf
32. Clarke P. Office of Communications, CDER. U.S. Food & Drug Administration. Accessed January 10, 2025. https://www.fda.gov/drugs/special-features/adverse-event-reporting-valued-information
33. Statista. Number of annual opioid prescriptions in the U.S. 2006-2023. Statista. Accessed January 5, 2025. https://www.statista.com/statistics/753149/total-number-of-opioid-rx-prescriptions-in-us/
34. Volkow ND, McLellan AT. Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies. The New England Journal of Medicine. 2016;374(13): 1253–1263. P. 1256. http://dx.doi.org/10.1056/nejmra1507771
35. Gisev N, Buizen L, Hopkins RE, et al. Five-Year Trajectories of Prescription Opioid Use. JAMA Network Open. 2023;6(8):e2328159. P.1. doi:10.1001/jamanetworkopen.2023.28159
36. Oliva EM, Bowe T, Tavakoli S, et al. Development and applications of the Veterans Health Administration's Stratification Tool for Opioid Risk Mitigation (STORM) to improve opioid safety and prevent overdose and suicide. Psychological Services. 2017;14(1):34-49. doi:10.1037/ser0000099
37. Left behind in pain: extent and causes of global variations in access to morphine for medical use and actions to improve safe access. Geneva: World Health Organization; 2023. License: CC BY-NC-SA 3.0 IGO. P.2. Accessed January 8, 2025. https://iris.who.int/bitstream/handle/10665/369294/9789240075269-eng.pdf
38. Dowell D, Haegerich T, Chou R. No shortcuts to safer opioid prescribing. The New England Journal of Medicine. 2019;380(24):2285–7. http://dx.doi.org/10.1056/nejmp1904190
39. CDC Newsroom. CDC. CDC advises against misapplication of the guideline for prescribing opioids for chronic pain. 2019. Accessed January 10, 2025. https://archive.cdc.gov/www_cdc_gov/media/releases/2019/s0424-advises-misapplication-guideline-prescribing-opioids.html
40. Center for Drug Evaluation and Research (CDER). U.S. Food and Drug Administration (FDA). The Voice of the Patient. Chronic Pain. FDA.gov. 2019. Accessed August 29, 2024. https://www.fda.gov/media/124390/download
41. Center for Drug Evaluation and Research. FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering. U.S. Food and Drug Administration. FDA. 2019. Accessed January 10, 2025. https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes
42. 2023-1490 FDA FOIA 4 19 2019 FDA Drug Safety Communication.pdf. Google Docs. Accessed January 10, 2025. https://drive.google.com/file/d/1k1koTUzby4teiGCNMo08ZmygdUEh4Kv4/view
43. Report to Congress on Opioid Prescribing Limitations. Department of Health and Human Services. 2020. p.3,4,10,11,13,14,15,19,22,23. Accessed January 10, 2025. https://www.fda.gov/media/147152/download
44. Best Practices Pain Management Best Practices Inter-Agency Task Force Report Updates, Gaps, Inconsistencies, and Recommendations Pain Management Draft Final Report.; 2019. https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf.; 2019. HHS.gov. P.12, 18. Accessed January 11, 2025. https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf
45. First Do No Harm: The DEA targets Physicians who treat their patients pain. Petition2Congress. Accessed January 12, 2025. https://www.petition2congress.com/ctas/first-do-no-harm-dea-targets-physicians-who-treat-their-patients
46. American Medical Association. Physicians' Progress toward Ending the Nation's Drug Overdose and Death Epidemic OPIOID TASK FORCE 2020 PROGRESS REPORT.; 2020. P.4. https://www.ama-assn.org/system/files/2020-07/opioid-task-force-progress-report.pdf
47. National Council on Independent Living. NCIL.org. Accessed January 13, 2025. 6-25-19-Chronic-Pain-Sign-On-Letter.pdf (ncil.org)
48. Madara JL. MD. AMA-assn.org. Walmart.com. Accessed January 16, 2025. https://corporate.walmart.com/content/dam/corporate/documents/newsroom/2020/12/22/a-misguided-department-of-justice-lawsuit-forces-pharmacists-between-patients-and-their-doctors/2019-09-24-ama-letter-to-walmart-regarding-opioid-stewardship.pdf
49. Madara JL. AMA-assn.org. Docket No. CDC-2020-0029. June 16, 2020. Accessed August 30, 2024. https://searchlf.ama-assn.org/undefined/documentDownload?uri=%2Funstructured%2Fbinary%2Fletter%2FLETTERS%2F2020-6-16-Letter-to-Dowell-re-Opioid-Rx-Guideline.pdf
50. American Medical Association. AMA backs update to CDC opioid prescribing guidelines. American Medical Association. Published July 22, 2021. https://www.ama-assn.org/press-center/press-releases/ama-backs-update-cdc-opioid-prescribing-guidelines
51. Jesse M. Ehrenfeld, American Medical Association. Overdose Epidemic Physicians' Actions to Help End the Nation's Drug-related Overdose and Death Epidemic—and What Still Needs to Be Done.; 2023. P.14. Accessed January 23, 2025. https://www.ama-assn.org/system/files/ama-overdose-epidemic-report.pdf
52. American Board of Pain Medicine. Second Annual Survey of Pain Medicine Specialists Highlights Continued Plight of Patients with Pain, and Barriers to Providing Multidisciplinary, Non-Opioid Care Impact of Prior Authorization for Non-Opioid Therapies on Clinical Outcomes. Accessed January 16, 2025. https://abpm.org/uploads/files/abpm%20survey%202019-v3.pdf
53. Health Professionals for Patients in Pain (HP3). Professionals Call on the CDC to Address Misapplication of its Guideline on Opioids for Chronic Pain through Public Clarification and Impact Evaluation. March 6, 2019. Google Docs. Accessed January 22, 2025. https://docs.google.com/document/d/1RzQDSppUKhjiAsEmhW2WbTXlP5V8vJ4M_vBPQLKhK_8/edit?tab=t.0#
54. 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 Medicine, Volume 20, Issue 3, March 2019, Pages 429–433, https://doi.org/10.1093/pm/pny228.
55. Fenton JJ, Magnan E, Tseregounis IE, Xing G, Agnoli AL, Tancredi DJ. Long-term Risk of Overdose or Mental Health Crisis After Opioid Dose Tapering. JAMA Network Open. 2022;5(6):e2216726. doi:10.1001/jamanetworkopen.2022.16726
56. Magnan EM, Tancredi DJ, Xing G, Agnoli A, Jerant A, Fenton JJ. Association Between Opioid Tapering and Subsequent Health Care Use, Medication Adherence, and Chronic Condition Control. JAMA Network Open. 2023;6(2):e2255101. doi:10.1001/jamanetworkopen.2022.55101.
57. Agnoli A, Xing G, Tancredi DJ, Magnan E, Jerant A, Fenton JJ. Association of dose tapering with overdose or mental health crisis among patients prescribed long-term opioids. JAMA. 2021;326(5):411–9. doi:10.1001/jama.2021.11013
58. Rose ME. Are prescription opioids driving the opioid crisis? Assumptions vs facts. Pain Medicine. 2017.;19(4):793–807. http://dx.doi.org/10.1093/pm/pnx048
59. Mills L. "Not Allowed to Be Compassionate." Human Rights Watch. December 18, 2018. Accessed January 12, 2025. https://www.hrw.org/report/2018/12/18/not-allowed-be-compassionate/chronic-pain-overdose-crisis-and-unintended-harms-us
60. Szalavitz M. We're overlooking a major culprit in the opioid crisis. Scientific American. 2021. Accessed January 12, 2025. https://www.scientificamerican.com/article/were-overlooking-a-major-culprit-in-the-opioid-crisis/
61. Ari M, Alexander JT, Weyer G. Prescribing Opioids for Pain. JAMA. 2023;329(20):1789–1790. doi:10.1001/jama.2023.6539
62. Lawhern RA. Resources for Clinicians in Pain Medicine: Correcting Medical Mythologies on Prescription of Opioid Analgesics. Medical Research Archives, [S.l.], v. 11, n. 12, dec. 2023. ISSN 2375-1924. doi: https://doi.org/10.18103/mra.v11i12.4860.
63. Szalavitz M. Opinion. 'Entire Body Is Shaking': Why Americans With Chronic Pain Are Dying. The New York Times. January 3, 2023. Accessed January 12, 2025. https://www.nytimes.com/2023/01/03/opinion/chronic-pain-suicides.html
64. Satel S, Mead LM, Moe TM. The truth about painkillers. National Affairs. Accessed August 29, 2024. https://www.nationalaffairs.com/publications/detail/the-truth-about-painkillers
65. Benintendi A, Kosakowski S, Lagisetty P, Larochelle M, Bohnert ASB, Bazzi AR. "I felt like I had a scarlet letter": Recurring experiences of structural stigma surrounding opioid tapers among patients with chronic, non-cancer pain. Drug Alcohol Dependence. 2021;222:108664. doi:10.1016/j.drugalcdep.2021.108664
66. Lagisetty P, Kehne ARH, Thomas J, et al. Improving Access to Care for Patients Taking Opioids for Chronic Pain in Michigan: Findings from an Expert Panel. 2021. Accessed January 13, 2025. P.3-5. https://dx.doi.org/10.7302/1699
67. Lagisetty P, Healy N, Garpestad C, Jannausch M, Tipirneni R, Bohnert ASB. Access to primary care clinics for patients with chronic pain receiving opioids. JAMA Network Open. 2019;2(7):e196928. http://dx.doi.org/10.1001/jamanetworkopen.2019.6928
68. Singer JA, Sullum JZ, and Schatman MS, "Today's nonmedical opioid users are not yesterday's patients; implications of data indicating stable rates of nonmedical use and pain reliever use disorder" Journal of Pain Research, February 7, 2019, Accessed January 13, 2025. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369835/
69. Whitehead S, Miller A. Chronic pain patients struggle to get opioid prescriptions filled, even as CDC eases guidelines. CNN. March 17, 2023. Accessed January 13, 2025. https://www.cnn.com/2023/03/17/health/opioid-chronic-pain-cdc-guidelines-khn-partner/index.html
70. Saccò M, Meschi M, Regolisti G, et al. The relationship between blood pressure and pain. Journal of Clinical Hypertension. 2013;15(8):600-605. http://dx.doi.org/10.1111/jch.12145
71. Iliades C. MD. Can pain cause high blood pressure? University Health News. 2021. Accessed January 13, 2025. https://universityhealthnews.com/daily/pain/can-pain-cause-high-blood-pressure/
72. Harvard Health. Chronic pain linked to higher risk of heart attack and stroke. Accessed January 13, 2025. https://www.health.harvard.edu/heart-health/chronic-pain-linked-to-higher-risk-of-heart-attack-and-stroke
73. Rothstein MA, Irzyk J. The opioid crackdown leaves chronic pain patients in limbo. The Hill. November 29, 2021. Accessed January 13, 2025. https://thehill.com/opinion/healthcare/583332-the-opioid-crackdown-leaves-chronic-pain-patients-in-limbo/
74. Achenbach J, Bernstein L. Opioid crackdown forces pain patients to taper off drugs they say they need. The Washington Post. September 10, 2019. Accessed January 13, 2025. https://www.washingtonpost.com/health/opioid-crackdown-forces-pain-patients-to-taper-off-drugs-they-say-they-need/2019/09/10/3920f220-c8da-11e9-a4f3-c081a126de70_story.html
75. Cowan B, Tibbitts J. A program tried to cut opioid addiction among veterans. Did it cause suicides? The Washington Post. August 24, 2021. Accessed January 13, 2025. https://www.washingtonpost.com/outlook/2021/08/24/opioids-veterans-suicides-interventions-safety/
76. Oliva EM, Bowe T, Manhapra A, et al. Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in U.S. veterans: Observational evaluation. The BMJ. (Clinical research ed.). 2020 Mar 4;368:m283. Accessed January 13, 2025. doi:10.1136/bmj.m283.
77. VA study uncovers critical link between pain intensity and suicide attempts - VA News. VA News. October 30, 2019. Accessed January 13, 2025. https://news.va.gov/67708/va-study-uncovers-link-pain-intensity-suicide-attempts/
78. Gotbaum R. Pain Patients Say They Can't Get Meds After Illegal Rx Drug Crackdown. MedpageToday. August 6, 2015. Accessed January 20, 2025. https://www.medpagetoday.com/painmanagement/painmanagement/52960
79. Ming K. Call Kurtis Investigates: Kaiser cuts pain prescriptions, impacting patients. CBS News.com October 27, 2022. Accessed January 20, 2025. https://www.cbsnews.com/sacramento/news/call-kurtis-investigates-kaiser-cuts-pain-prescriptions-impacting-patients/
80. Sullum J. People Rarely Die After Using Opioids Prescribed for Them. Reason .com February 2020. Accessed January 20, 2025. https://reason.com/2020/01/23/people-rarely-die-after-using-opioids-prescribed-for-them/
81. Knopf T. Hundreds of N.C. Doctors Say They've Stopped Prescribing Opioids. North Carolina Health News. October 15, 2018. Accessed January 21, 2025. https://www.northcarolinahealthnews.org/2018/10/15/nc-doctors-stop-prescribe-opioids/
82. Parker LJ, MD. What the DEA does not understand or does not care about medication cessation decisions. Journal of Medicine. Nursing Journals: American Society of Registered Nurses. NAMD.org. 2024. Accessed January 20, 2025. https://www.namd.org/journal-of-medicine/3191-what-the-dea-does-not-understand-or-does-not-care-about-medication-cessation-decisions.html
83. Jewett C, Gabler E. Opioid settlement hinders patients' access to a wide array of drugs. The New York Times. March 13, 2023. Accessed January 20, 2025. https://www.nytimes.com/2023/03/13/us/drug-limits-adhd-depression.html
84. Whitehead S, Miller A. Kaiser Health News. CDC's new opioid guidelines are too little, too late for chronic pain patients, experts say. NBC News. March 13, 2023. Accessed January 20, 2025. https://www.nbcnews.com/health/health-news/cdcs-new-opioid-guidelines-little-late-chronic-pain-patients-rcna74248
85. Llorente E. As doctors taper or end opioid prescriptions, many patients driven to despair, suicide. Fox News. December 10, 2018. Accessed January 20, 2025. https://www.foxnews.com/health/as-opioids-become-taboo-doctors-taper-down-or-abandon-pain-patients-driving-many-to-suicide
86. Miller K. Why people with chronic pain may die earlier. Men's Health. June 8, 2017. Accessed January 20, 2025. https://www.menshealth.com/health/a19519524/risks-chronic-pain-early-death/
87. Grand-Gassaway A. They call me a drug seeker. Here's what their opioid policies did to me. Filter. March 3, 2023. Accessed January 20, 2025. https://filtermag.org/drug-seeker-pain-patients/
88. The misinformed & misguided prescription abuse prevention act: A response to Delfino. Yale Law and Policy Review. Yalelawandpolicy.org. 2020 Accessed January 20, 2025. https://yalelawandpolicy.org/inter_alia/misinformed-misguided-prescription-abuse-prevention-act-response-delfino
89. Hayward M. Feds to target doctors for overprescribing; Medical Society cries foul. The New Hampshire Union Leader. Yahoo News. June 29, 2022. Accessed January 19, 2025. https://www.yahoo.com/news/feds-target-doctors-overprescribing-medical-225200574.html
90. Grant M. Special report: Pharmacies denying legitimate prescriptions. WESH 2 News. 2015. Accessed January 19, 2025. https://www.wesh.com/article/special-report-pharmacies-denying-legitimate-prescriptions/4439866
91. Sheets C, Blakinger K. Feds knew for years fentanyl-tainted pills from Mexican pharmacies were killing Americans. The Los Angeles Times. March 11, 2023. Accessed January 19, 2025. https://www.latimes.com/world-nation/story/2023-03-11/feds-have-known-for-years-fentanyl-tainted-pills-from-mexican-pharmacies-are-killing-americans
92. Friedman J, Godvin M, Molina C, et al. Fentanyl, heroin, and methamphetamine-based counterfeit pills sold at tourist-oriented pharmacies in Mexico: An ethnographic and drug checking study. Drug and Alcohol Dependence. 2023;249:110819. doi.org/10.1016/j.drugalcdep.2023.110819
93. Pischke P. The CDC has abandoned pain patients. Its new opioid guidelines are all for show. USA Today. January 5, 2023. Accessed August 29, 2024. https://www.usatoday.com/story/opinion/voices/2023/01/05/cdc-opioid-guidelines-leave-pain-patients-suffering/10962261002/
94. Anson P. Forced opioid tapering: 'the next great experiment'. Pain News Network. May 22, 2019 Accessed August 29, 2024. https://www.painnewsnetwork.org/stories/2019/5/22/forced-opioid-tapering-the-next-great-experiment
95. Zeltner B. The Plain Dealer. Suffering and abandoned: Chronic pain patients cut off in the opioid era. Cleveland. April 22, 2018. Accessed August 29, 2024. https://www.cleveland.com/healthfit/2018/04/suffering_and_abandoned_chroni.html
96. Coons C. Tapering may have negative impacts for patients taking opioids long term. UC Davis Health. February 14, 2023. Accessed August 29, 2024. https://health.ucdavis.edu/news/headlines/tapering-may-have-negative-impacts-for-patients-taking-opioids-long-term/2023/02
97. Amon JS, Lohman D. Denial of Pain Treatment and the Prohibition of Torture, Cruel, Inhuman or Degrading Treatment or Punishment. Human Rights Watch (Hrw.org). Volume 16. Number 4; 2011:172. Accessed January 21, 2025. https://www.hrw.org/sites/default/files/related_material/2011.12%20InterRights%20Bulletin%20Article_only.pdf
98. Said C. How a crackdown on opioids is leaving patients in agonizing pain. San Francisco Chronicle. March 18, 2023. Accessed January 21, 2025. https://www.sfchronicle.com/health/article/pain-opioid-prescription-medication-17816793.php
99. Darbha V, King L, Westbrook A. They live in constant pain, but their doctors won't help them. The New York Times. August 17, 2023. Accessed January 21, 2025. https://www.nytimes.com/2023/08/17/opinion/opioids-chronic-pain-patients.html
100. Libby R. Treating Doctors as Drug Dealers the DEA's War on prescription painkillers. 2005. Accessed January 21, 2025. https://www.academia.edu/77092772/Treating_Doctors_as_Drug_Dealers_The_DEAs_War_on_Prescription_Painkillers?email_work_card=title
101. Schatman ME, Ziegler SJ. Pain management, prescription opioid mortality, and the CDC: is the devil in the data? Journal of Pain Research. 2017; 10:2489-2495. https://doi.org/10.2147/JPR.S153322
102. Atkinson TJ, Schatman ME, Fudin J. The damage done by the war on opioids: the pendulum has swung too far. Journal of Pain Research. May 2014; 7:265. http://dx.doi.org/10.2147/jpr.s65581
103. Loria K. Has the Pendulum Swung Too Far Against the Use of Opioids? Managed Healthcare Executive. 2022;32. Accessed January 22, 2025. https://www.managedhealthcareexecutive.com/view/has-the-pendulum-swung-too-far-against-the-use-of-opioids-
104. Brookes L MSc. The pendulum has swung too far. Treating Pain in Primary Care. Medscape. February 22, 2019. Accessed January 22, 2025. https://www.medscape.com/viewarticle/909303?form=fpf
105. Stoeltje MF. Has the opioid pendulum swung too far? San Antonio Express. November 5, 2018. Accessed January 22, 2025. https://www.expressnews.com/news/local/article/Has-the-opioid-pendulum-swung-too-far-13362604.php
106. Freyer FJ. Doctors are cutting opioids, even if it harms patients. The Boston Globe. January 3, 2017. Accessed January 22, 2025. https://www.bostonglobe.com/metro/2017/01/02/doctors-curtail-opioids-but-many-see-harm-pain-patients/z4Ci68TePafcD9AcORs04J/story.html
107. Schrecengost L. The other opioid crisis: A failure of care. Discourse. August 15, 2022. Accessed January 22, 2025. https://www.discoursemagazine.com/p/the-other-opioid-crisis-the-crisis-in-care
108. Ghei, N. The other opioid crisis: How false narratives are hurting patients. Discourse. Published July 18, 2022. Accessed January 22, 2025. https://www.discoursemagazine.com/p/how-false-narratives-about-opioids-are-hurting-patients
109. Oliva, JD. Dosing Discrimination: Regulating PDMP Risk Scores. January 18, 2021. 110 California Law Review 47 (2022). Accessed January 22, 2025. http://dx.doi.org/10.2139/ssrn.3768774
110. Sedney CL, Haggerty T, Dekeseredy P, et al. "The DEA would come in and destroy you": a qualitative study of fear and unintended consequences among opioid prescribers in WV. Substance Abuse Treatment, Prevention, and Policy. 17,19 (2022). http://dx.doi.org/10.1186/s13011-022-00447-5
111. Rigorous guidelines on opioid prescriptions are being abused by insurers and harming pain patients, hundreds of experts say. KFF Health News. March 7, 2019 Accessed January 22, 2025. https://kffhealthnews.org/morning-breakout/rigorous-guidelines-on-opioid-prescriptions-are-being-abused-by-insurers-and-harming-pain-patients-hundreds-of-experts-say/
112. Hicks JP. Doctor sues Michigan-based health system after acquitted of charges he killed terminal patients. MLive. April 14, 2023. Accessed January 23, 2025. https://www.mlive.com/public-interest/2023/04/doctor-sues-michigan-based-health-system-after-acquitted-of-charges-he-killed-terminal-patients.html
113. Reynolds CA, Minic Z. Chronic pain-associated cardiovascular disease: The role of sympathetic nerve activity. International Journal of Molecular Sciences. 2023;24(6):5378. doi:10.3390/ijms24065378
114. Forgrave R, Star Tribune. Woman's battle vs. chronic pain expands to Minnesota's opioid laws. Star Tribune. February 15, 2020. Accessed January 21, 2025. https://www.startribune.com/farmington-woman-battles-chronic-pain-and-opioid-laws/567911242/
115. Anson P. Pain News Network. Pharmacies under 'extreme pressure' to give patient records to law enforcement. Pain News Network. December 12, 2023 Accessed January 23, 2025. https://www.painnewsnetwork.org/stories/2023/12/12/pharmacies-under-extreme-pressure-to-give-prescription-records-to-law-enforcement
116. Controversial CDC opioid guidelines – ICA responds. Interstitial Cystitis Association. October 2, 2015. Accessed January 23, 2025. https://www.ichelp.org/controversial-cdc-opioid-guidelines-ica-responds/
117. Anson P. Survey: CDC guideline Having 'Horrendous' Impact on pain patients. Pain News Network. March 15, 2019. Accessed January 23, 2025. https://www.painnewsnetwork.org/stories/2019/3/12/cdc-guideline-horrendous-impact-on-patients
118. Anson P. 2021 CDC survey — Pain News Network. Pain News Network. Accessed August 30, 2024. https://www.painnewsnetwork.org/2021-cdc-survey
119. Kiesel L. Chronic pain: The "invisible" disability. Harvard Health. April 28, 2017. Accessed January 23, 2025. https://www.health.harvard.edu/blog/chronic-pain-the-invisible-disability-2017042811360
120. Brennan, F., Lohman, D., Gwyther, L. (2019). Access to Pain Management as a Human Right. December 19, 2018. American Journal of Public Health. Para. 8. 2019;109(1):61-65. https://doi.org/10.2105/AJPH.2018.304743
121. Brennan F, Carr DB, Cousins M. Pain Management: A Fundamental Human Right. Anesthesia & Analgesia 105(1):p 205-221, July 2007. Doi: 10.1213/01.ane.0000268145.52345.55
122. Berlatsky N. The Opioid Crisis Is Also a Crisis of Speech. Pacific Standard. August 24, 2018. Accessed January 23, 2025. https://psmag.com/social-justice/the-opioid-crisis-is-also-a-crisis-of-speech
123. Singer JA. Study: Blame the war on drugs (and not prescriptions) for America's opioid crisis. The National Interest. January 5, 2020. Accessed January 25, 2025. https://nationalinterest.org/blog/buzz/study-blame-war-drugs-and-not-prescriptions-americas-opioid-crisis-110546
124. Potential complications of untreated chronic pain. Painscale.com. Accessed January 25, 2025. https://www.painscale.com/article/potential-complications-of-untreated-chronic-pain
125. Petrosky E, Harpaz R, Fowler KA, et al. Chronic pain among suicide decedents, 2003 to 2014: Findings from the national violent death reporting system. Annals of Internal Medicine. 2018;169(7):448-455. doi:10.7326/m18-0830
126. Fine PG. Long-Term Consequences of Chronic Pain: Mounting Evidence for Pain as a Neurological Disease and Parallels with Other Chronic Disease States, Pain Medicine. 2011;12(7):996–1004. https://doi.org/10.1111/j.1526-4637.2011.01187.x
127. Smith D., Wilkie R., Croft P. and McBeth J. (2018), Pain and Mortality in Older Adults: The Influence of Pain Phenotype. Arthritis Care & Research, 70: 236-243. https://doi.org/10.1002/acr.23268
128. Tandoğan M, Emektar E, Dağar S, et al. The effect of severe pain on transmyocardial repolarization parameters in renal colic patients. Eurasian Journal of Emergency Medicine. 2022;21(3):188–92. Accessed January 26, 2025. https://www.thefreelibrary.com/The+Effect+of+Severe+Pain+on+Transmyocardial+Repolarization...-a0721308957
129. Foreman J. Chronic pain and the risk of suicide. Psychology Today. November 24, 2015. Accessed August 30, 2024. https://www.psychologytoday.com/us/blog/nation-in-pain/201511/chronic-pain-and-the-risk-suicide
130. Chriss R. An Epidemic of Undertreated Chronic Pain. Pain News Network. May 20, 2017. Accessed January 26, 2025. https://www.painnewsnetwork.org/stories/2017/5/20/an-epidemic-of-undertreated-chronic-pain
131. Whitlock EL, Diaz-Ramirez LG, Glymour MM, Boscardin WJ, Covinsky KE, Smith AK. Association between persistent pain and memory decline and dementia in a longitudinal cohort of elders. JAMA Internal Medicine. 2017;177(8):1146-1153. doi:10.1001/jamainternmed.2017.1622
132. Glod SA. The other victims of the opioid epidemic. New England Journal of Medicine. 2017;376(22):2101–2102. http://dx.doi.org/10.1056/nejmp1702188
133. Cheek L. Charles Szyman, MD acquitted by jury in Wisconsin. Doctors of Courage. Nov. 2017. Accessed January 26, 2025. https://doctorsofcourage.org/charles-szyman-md/
134. Hamilton K. The DEA shut down a pain doctor. Now three people are dead. VICE. January 5, 2023. Accessed January 26, 2025. https://www.vice.com/en/article/dy7qqv/dea-beverly-hills-doctor-shut-down-opioids
135. Hamilton K. This couple died by suicide after the DEA shut down their pain doctor. VICE. November 30, 2022. Accessed January 26, 2025. https://www.vice.com/en/article/wxnyb9/dea-fentanyl-doctor-patient-suicide
136. Parker LJ. The persecution of pain management doctors. National Association of Medical Doctors. Journal of Medicine. August 1, 2023. Accessed January 26, 2025. https://www.namd.org/journal-of-medicine/3104-the-persecution-of-pain-management-doctors.html?fbclid=IwAR2QgCOVF7ggbzomehr0VUbmLF26ORLXKVrb_nvsBp4gFmG_ZhTftibX2vg_aem_AW1QKRPfIrWyCPGb6rm3UvI5j7jKVmz6EPTpYvbxZAIFJqh3lr6U-oNGd6RO4GtKQqk
137. Parker LJ. Doctor charged after treating a DEA agent. KevinMD.com. March 14, 2024. Accessed January 26, 2025. https://www.kevinmd.com/2024/03/doctor-charged-after-treating-a-dea-agent.html.
138. Parker LJ. AI enforcement in health care: Unpacking the DEA's approach to the opioid epidemic. KevinMD.com. January 2, 2024. Accessed January 26, 2025. https://www.kevinmd.com/2024/01/ai-enforcement-in-health-care-unpacking-the-deas-approach-to-the-opioid-epidemic.html
139. Parker LJ. Real pain deserves real treatment. KevinMD.com. March 29, 2024. Accessed January 26, 2025. https://www.kevinmd.com/2024/03/real-pain-deserves-real-treatment.html
140. Rubin R. Limits on Opioid Prescribing Leave Patients With Chronic Pain Vulnerable. JAMA Network. 2019;321(21):2059–2062. doi:10.1001/jama.2019.5188
141. Kang HA, Wang B, Barner JC, et al. Opioid Prescribing and Outcomes in Patients With Sickle Cell Disease Post–2016 CDC Guideline. JAMA Internal Medicine. 2024;184(5):510-518. doi:10.1001/jamainternmed.2023.8538
142. Metz VE, Ray GT, Palzes V, et al. Prescription opioid dose reductions and potential adverse events: a multi-site observational cohort study in diverse U.S. health systems. Journal of General Internal Medicine. 2024 May;39(6):1002-1009. doi: 10.1007/s11606-023-08459-y.
143. Singer JA. The War on Drugs Is Also a War on Pain Patients. CATO Institute. April 1, 2024. Accessed January 26, 2025. https://www.cato.org/blog/war-drugs-also-war-pain-patients
144. Anson P. 90% of pain patients have trouble filling opioid prescriptions. Pain News Network. January 11, 2024. Accessed January 26, 2025. https://www.painnewsnetwork.org/stories/2024/1/11/nbsp-90-of-us-pain-patients-have-trouble-filling-opioid-prescriptions
145. Parker L. J. The opioid crisis: profits, lawsuits, and pharmaceutical influence. KevinMD.com. February 29, 2024. Accessed August 30, 2024. https://www.kevinmd.com/2024/02/the-opioid-crisis-profits-lawsuits-and-pharmaceutical-influence.html
146. Votta A. How the Opioid Crackdown Is Hurting Chronic Pain Patients. SAPIENS. November 26, 2019. Accessed January 27, 2025. https://www.sapiens.org/biology/chronic-pain-opioid-crackdown/.
147. Molton IR, Terrill AL. Overview of persistent pain in older adults. American Psychologist. 2014;69(2): 197-207. doi:10.1037/a0035794
148. Anson P.' Misplaced and Dangerous' Opioid Study Debunked by Critics. Pain News Network. www.painnewsnetwork.org/stories/2024/6/4/misplaced-and-dangerous-opioid-study-debunked-by-critics. June 4, 2023. Accessed January 31, 2025. https://www.painnewsnetwork.org/stories/2024/6/4/misplaced-and-dangerous-opioid-study-debunked-by-critics
149. Anson P. Where Have All the Pain Doctors Gone? Pain News Network. January 24, 2025. Accessed February 1, 2025. https://www.painnewsnetwork.org/stories/2025/1/24/where-have-all-the-pain-doctors-gone
150. LeBaron C. Is the Opioid Epidemic Really Ending? Pain News Network. January 29, 2025. Accessed February 1, 2025. https://www.painnewsnetwork.org/stories/2025/1/28/is-the-opioid-epidemic-really-ending#google_vignette
151. Nadeau SE, Wu JK, Lawhern RA. Opioids and chronic pain: An analytic review of the clinical evidence. Frontiers in Pain Research. 2021;2.(721357). http://dx.doi.org/10.3389/fpain.2021.721357
152. Dasgupta N, Beletsky L, Ciccarone D. Opioid crisis: No easy fix to its social and economic determinants. American Journal of Public Health. 2018;108(2):182–186. http://dx.doi.org/10.2105/ajph.2017.304187
153. Irving P. The national opioid settlement is causing drug shortages —. Pain News Network. September 11, 2023. Accessed January 31, 2025. https://www.painnewsnetwork.org/stories/2023/9/11/the-national-opioid-settlement-is-causing-drug-shortages
154. Martinez J. Amid opioid crisis, chronic pain patients are struggling to fill their needed prescriptions. Hawaii News Now. March 14, 2024. Accessed January 31, 2025. https://www.hawaiinewsnow.com/2024/03/15/amid-opioid-crisis-chronic-pain-patients-are-struggling-fill-their-needed-prescriptions/
155. Shults T. Hundreds of Longview residents are unable to get opioid medication for chronic pain from local pharmacies. KGW. March 5, 2024. Accessed January 31, 2025. https://www.kgw.com/article/news/local/longview-doctor-patients-prescriptions-filled-opioid-medication/283-68c540c3-ce39-45a7-a452-7e651fd37d18
156. Swetlitz, I. Bloomberg. Secret limits to stop 'suspicious' Xanax and Adderall orders are forcing some legitimate patients to scramble. Fortune. April 3, 2023. Accessed January 31, 2025. https://fortune.com/2023/04/03/xanax-adderall-rules-patients-opiods-pain-medication/
157. Bishari N. 'I'm being treated like an addict': A new kind of drug crisis is descending on the Bay Area. San Francisco Chronicle. March 22, 2023. Accessed January 31, 2025. https://www.sfchronicle.com/opinion/article/bay-area-drug-prescription-painkillers-opioid-17841947.php
158. Jewett N., Gabler E. Opioid Settlement Hinders Patients' Access to a Wide Array of Drugs. NYTimes.com. March 13, 2023. Accessed January 31, 2025. https://www.nytimes.com/2023/03/13/us/drug-limits-adhd-depression.html
159. Aboulenein A. Insight: U.S. opioid crackdown hampers some patients' access to psychiatric drugs. Reuters. December 12, 2022. Accessed January 31, 2025. https://www.reuters.com/business/healthcare-pharmaceuticals/us-opioid-crackdown-hits-some-patients-access-psychiatric-drugs-2022-12-12/
160. Battista C. Federal charges against Louisville pain management doctor leaves patients in limbo. WDRB. July 15, 2024. Accessed January 31, 2025. https://www.wdrb.com/news/federal-charges-against-louisville-pain-management-doctor-leaves-patients-in-limbo/article_e044f33a-4085-11ef-bf38-6fe49681e197.html
161. Singer JA. The Chilling Effect: How Fear Drives Doctors Away from Pain Patients. Cato Institute. February 25, 2025. Accessed February 25, 2025. https://www.cato.org/blog/chilling-effect-how-fear-drives-doctors-away-pain-patients
162. DePaul's Center for Journalism Integrity and Excellence. Chronic pain patients suffer from opioid epidemic overcorrection. WTTW News. March 12, 2024. Accessed January 31, 2025. https://news.wttw.com/2024/03/12/chronic-pain-patients-suffer-opioid-epidemic-overcorrection
163. CBS Mornings. Sickle cell anemia patients react to breakthrough treatment. YouTube. Minutes 2:05-3:02 of 9:27. March 2019. Accessed January 31, 2025. https://www.youtube.com/watch?v=8_gU2qt3Ro0&t=150s
164. Enzinger AC, Ghosh K, Keating NL, et al. Racial and ethnic disparities in opioid access and urine drug screening among older patients with Poor-Prognosis cancer Near the end of life. Journal of Clinical Oncology. 2023;41(14):2511-2522. doi:10.1200/jco.22.01413
165. Enzinger AC, Ghosh K, Keating NL, Cutler DM, Landrum MB, Wright AA. U.S. Trends in Opioid Access Among Patients With Poor Prognosis Cancer Near the End-of-Life. Journal of Clinical Oncology. 2021;39(26):2948-2958. https://doi.org/10.1200/jco.21.00476
166. Azizoddin DR, Knoerl R, Adam R, et al. Cancer pain self-management in the context of a national opioid epidemic: Experiences of patients with advanced cancer using opioids. Cancer. 2021 Sep 1;127(17):3239-3245. doi: 10.1002/cncr.33532.
167. Schenker Y, Hamm M, Bulls HW, et al. This Is a Different Patient Population: Opioid Prescribing Challenges for Patients with Cancer-Related Pain. JCO Oncology Practice. 2021 Jul;17(7):e1030-e1037. Accessed January 13, 2025. doi: 10.1200/OP.20.01041.
168. Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports.2022;71(No. RR-3): P. 3, 15-54.1–95. Doi: http://dx.doi.org/10.15585/mmwr.rr7103a1
169. 21-01554 CDC FOIA letter and response.pdf. "all information on adverse healthcare events and patient harm associated with the 2016 'CDC Guideline for Prescribing Opioids for Chronic Pain.' [01/01/2012 to 01/01/2021]." Google Docs. Accessed March 1, 2025. https://drive.google.com/file/d/12T3uF1A_fAhvNw_CyX0BFs3mckCym6zA/view
170. 23-00280-FOIA Opioid Rapid Response Final Response.pdf. "all information on adverse healthcare events and patient harm associated with the 2016 'CDC Guideline for Prescribing Opioids for Chronic Pain.' [01/01/2012 to 01/01/2021]." Google Docs. Accessed March 1, 2025. https://drive.google.com/file/d/1tM7cJ9apn0cvEcj5z2kIquRLEwssAqQ8/view?usp=drive_link
171. Frontline physicians call on politicians to end political interference in the delivery of evidence-based medicine. American Academy of Family Physicians. May 15, 2019. Accessed January 31, 2025. https://www.aafp.org/news/media-center/more-statements/physicians-call-on-politicians-to-end-political-interference-in-the-delivery-of-evidence-based-medicine.html
2. National Drug Overdose (OD) deaths, 1999-2021. Live.com. National Institutes of Health on Drug Abuse. 2023. Accessed January 3, 2025. https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fnida.nih.gov%2Fsites%2Fdefault%2Ffiles%2FOverdose_data_1999-2021%25201.19.23.xlsx&wdOrigin=BROWSELINK
3. Centers for Disease Control and Prevention. U.S. overdose deaths decrease in 2023, first time since 2018. www.cdc.gov. May 14, 2024. Accessed January 3, 2025. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2024/20240515.
4. Mandell, BF. "The fifth vital sign: A complex story of politics and patient care." Cleveland Clinic Journal of Medicine, June 2016;83(6):400-401. https://doi.org/10.3949/ccjm.83b.06016
5. Scher C, Meador L, Van Cleve JH, Reid MC. Moving Beyond Pain as the Fifth Vital Sign and Patient Satisfaction Scores to Improve Pain Care in the 21st Century. Pain Management Nursing. 2018;19(2):125-129. https://doi: 10.1016/j.pmn.2017.10.010.
6. Duggam, G. "12 Million OxyContin Pills Shipped to a Town of 500: How Profit Fueled America's Opioid Crisis". CBC News, November 15, 2021. Accessed January 5, 2025. https://www.cbc.ca/documentaries/the-passionate-eye/12-million-oxycontin-pills-shipped-to-a-town-of-500-how-profit-fuelled-america-s-opioid-crisis-1.6247359
7. CDC archives. CDC Releases Guideline for Prescribing Opioids for Chronic Pain. Press Release. Para. 3. Accessed January 5, 2025. https://archive.cdc.gov/#/details?url=https://www.cdc.gov/media/releases/2016/p0315-prescribing-opioids-guidelines.html
8. Remarks by the President in panel discussion at the National Prescription Drug Abuse and Heroin Summit. National Archives and Records Administration. Whitehouse.gov. March 29, 2016. Paragraph 6. Accessed January 5, 2025. https://obamawhitehouse.archives.gov/the-press-office/2016/03/29/remarks-president-panel-discussion-national-prescription-drug-abuse-and
9. Operation Unite. Keynote Address CDC Director Dr. Tom Frieden. Lecture presented at the National Prescription Drug Abuse and Heroin Summit on March 30, 2016. Vimeo. Accessed January 5, 2025. https://vimeo.com/162843894.
10. Rudd, RA, Aleshire, N, Zibbell, JE, Gladden, RM. Increases in drug and opioid overdose deaths — United States, 2000–2014. Centers for Disease Control and Prevention. January 1, 2016. Accessed January 5, 2025. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm
11. Dowell D, Zhang K, Noonan RK, Hockenberry JM. Mandatory provider review and pain clinic laws reduce the amounts of opioids prescribed and overdose death rates. Health Affairs. 2016;35(10):1876–83. p.1879,1882. http://dx.doi.org/10.1377/hlthaff.2016.0448
12. Paulozzi, LJ. Jones, CM. Mack, KA, Rudd, RA. CDC. Vital signs: Overdoses of prescription opioid pain relievers --- United States, 1999--2008. Morbidity and Mortality Weekly Report (MMWR). November 4, 2011. Accessed January 5, 2025. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm
13. ASPE Issue Brief. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. Opioid Abuse in the U.S. and HHS Actions to Address Opioid-Drug Related Overdoses and Deaths.2015. P. 1–2, 5. Accessed January 5, 2025. https://aspe.hhs.gov/sites/default/files/migrated_legacy_files/56406/ib_OpioidInitiative.pdf
14. Aubry L, Carr BT. Overdose, opioid treatment admissions and prescription opioid pain reliever relationships: United States, 2010–2019. Frontiers in Pain Research. 2022;3. http://dx.doi.org/10.3389/fpain.2022.884674
15. Supplementary Table 1 FDA FOIA Response 2021-2978 Estimated # of patients prescribed 2006 to 2018 data and letter.pdf. Google Docs. Accessed January 5, 2025. https://drive.google.com/file/d/1IrlA-joCihIWrhNzl-NHiqnykyJ9Bkvq/view?usp=sharing
16. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2000-2010. National Admissions to Substance Abuse Treatment Services. DASIS Series S-61, HHS Publication No. (SMA) 12-4701. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012. P. 5, 43, Table 1.1A, P. 72 Table 2.15. Accessed January 5, 2025. https://www.samhsa.gov/data/sites/default/files/2010_Treatment_Episode_Data_Set_National/2010_Treatment_Episode_Data_Set_National.pdf
17. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2008-2018. Admissions to and Discharges From Publicly Funded Substance Use Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2020. Table 1.1a, Table 2.18. Accessed January 5, 2025. https://www.samhsa.gov/data/sites/default/files/reports/rpt31097/2018_TEDS/2018_TEDS_Tables.html#Tbl1.1a
18. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports. 2016;65(No. RR-1): P. 2,16. 1–49. Doi: http://dx.doi.org/10.15585/mmwr.rr6501e1
19. Lawhern RA, Doctors 'overprescribing' opioids isn't the cause of the overdose epidemic — and it never was, STAT News, July 11, 2024. Accessed January 8, 2025. https://www.statnews.com/2024/07/11/doctors-overprescribing-opioids-didnt-cause-overdose-epidemic/
20. Centers for Disease Control and Prevention. State Unintentional Drug Overdose Reporting System (SUDORS). Preliminary and Final Data. Atlanta, GA: U.S. Department of Health and Human Services, CDC; December 12, 2024. Accessed January 9, 2025. https://www.cdc.gov/overdose-prevention/data-research/facts-stats/sudors-dashboard-fatal-overdose-data.html
21. Seth P, Rudd RA, Noonan RK, Haegerich TM. Quantifying the Epidemic of Prescription Opioid Overdose Deaths. American Journal of Public Health. 2018;108(4):500–502. http://dx.doi.org/10.2105/ajph.2017.304265
22. Peppin JF, Coleman JJ. CDC's Efforts to Quantify Prescription Opioid Overdose Deaths Fall Short. Pain and Therapy. 2021;10(1):25–38. http://dx.doi.org/10.1007/s40122-021-00254-z
23. O'Donnell J, Tanz LJ, Gladden RM, Davis NL, Bitting J. Trends in and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls — United States, 2019–2020. Morbidity and Mortality Weekly Report. December 17, 2021;70:1740-1746. P.1743,1745,1746. Accessed January 8, 2025. https://www.cdc.gov/mmwr/volumes/70/wr/pdfs/mm7050e3-H.pdf
24. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Instructions for Completing the Cause-of-Death Section of the Death Certificate. P.1. Accessed January 8, 2025. https://www.cdc.gov/nchs/data/dvs/blue_form.pdf
25. Kolodny A. Statement for the Record. Andrew Kolodny, MD chief ... Before the U.S. Senate Caucus on International Narcotics Control "America's addiction to opioids: Heroin and prescription drug abuse." May 14, 2014. P. 2. Accessed January 9, 2025. https://www.drugcaucus.senate.gov/wp-content/uploads/2022/11/Kolodny-Testimony.pdf
26. Kolodny A. Statement by Andrew Kolodny, MD ... on Combatting the Opioid Crisis before Committee on Energy & Commerce, Subcommittee on Health U.S. House of Representatives. February 28, 2018. P. 1, 2 Accessed January 9, 2025. https://docs.house.gov/meetings/IF/IF14/20180228/106915/HHRG-115-IF14-Wstate-KolodnyA-20180228.pdf
27. Kolodny A. Statement for the Record. Andrew Kolodny, MD … Before the U.S. Senate Committee on Homeland Security and Governmental Affairs "Unintended Consequences: Medicaid and the Opioid Epidemic." January 17, 2018. P.1. Accessed January 9, 2025. Testimony-Kolodny-2018-01-171.pdf (senate.gov)
28. Reason. X.com (formerly Twitter). The war on pain drugs has turned out to be a colossal failure. pic.twitter.com/7lnhr5tfxb [Internet]. Twitter. 2023. Accessed January 9, 2025. https://twitter.com/i/status/1712183836711256216
29. Bhandari P. Correlation vs. Causation | Difference, Designs & Examples. Scribbr. June 22, 2023. Accessed February 10, 2025. https://www.scribbr.com/methodology/correlation-vs-causation
30. Freakonomics Radio Network. Correlation vs. Causality: The Debunked Link Between Ice Cream and Polio | Freakonomics. YouTube. August 2011. Accessed January 9, 2025. https://www.youtube.com/watch?v=lbODqslc4Tg.
31. Chambliss DF, Schutt RK. Causation and Experimental Design;106-109. P.108. Sagepub.com. Accessed January 9, 2025. https://www.sagepub.com/sites/default/files/upm-binaries/23639_Chapter_5___Causation_and_Experimental_Design.pdf
32. Clarke P. Office of Communications, CDER. U.S. Food & Drug Administration. Accessed January 10, 2025. https://www.fda.gov/drugs/special-features/adverse-event-reporting-valued-information
33. Statista. Number of annual opioid prescriptions in the U.S. 2006-2023. Statista. Accessed January 5, 2025. https://www.statista.com/statistics/753149/total-number-of-opioid-rx-prescriptions-in-us/
34. Volkow ND, McLellan AT. Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies. The New England Journal of Medicine. 2016;374(13): 1253–1263. P. 1256. http://dx.doi.org/10.1056/nejmra1507771
35. Gisev N, Buizen L, Hopkins RE, et al. Five-Year Trajectories of Prescription Opioid Use. JAMA Network Open. 2023;6(8):e2328159. P.1. doi:10.1001/jamanetworkopen.2023.28159
36. Oliva EM, Bowe T, Tavakoli S, et al. Development and applications of the Veterans Health Administration's Stratification Tool for Opioid Risk Mitigation (STORM) to improve opioid safety and prevent overdose and suicide. Psychological Services. 2017;14(1):34-49. doi:10.1037/ser0000099
37. Left behind in pain: extent and causes of global variations in access to morphine for medical use and actions to improve safe access. Geneva: World Health Organization; 2023. License: CC BY-NC-SA 3.0 IGO. P.2. Accessed January 8, 2025. https://iris.who.int/bitstream/handle/10665/369294/9789240075269-eng.pdf
38. Dowell D, Haegerich T, Chou R. No shortcuts to safer opioid prescribing. The New England Journal of Medicine. 2019;380(24):2285–7. http://dx.doi.org/10.1056/nejmp1904190
39. CDC Newsroom. CDC. CDC advises against misapplication of the guideline for prescribing opioids for chronic pain. 2019. Accessed January 10, 2025. https://archive.cdc.gov/www_cdc_gov/media/releases/2019/s0424-advises-misapplication-guideline-prescribing-opioids.html
40. Center for Drug Evaluation and Research (CDER). U.S. Food and Drug Administration (FDA). The Voice of the Patient. Chronic Pain. FDA.gov. 2019. Accessed August 29, 2024. https://www.fda.gov/media/124390/download
41. Center for Drug Evaluation and Research. FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering. U.S. Food and Drug Administration. FDA. 2019. Accessed January 10, 2025. https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes
42. 2023-1490 FDA FOIA 4 19 2019 FDA Drug Safety Communication.pdf. Google Docs. Accessed January 10, 2025. https://drive.google.com/file/d/1k1koTUzby4teiGCNMo08ZmygdUEh4Kv4/view
43. Report to Congress on Opioid Prescribing Limitations. Department of Health and Human Services. 2020. p.3,4,10,11,13,14,15,19,22,23. Accessed January 10, 2025. https://www.fda.gov/media/147152/download
44. Best Practices Pain Management Best Practices Inter-Agency Task Force Report Updates, Gaps, Inconsistencies, and Recommendations Pain Management Draft Final Report.; 2019. https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf.; 2019. HHS.gov. P.12, 18. Accessed January 11, 2025. https://www.hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf
45. First Do No Harm: The DEA targets Physicians who treat their patients pain. Petition2Congress. Accessed January 12, 2025. https://www.petition2congress.com/ctas/first-do-no-harm-dea-targets-physicians-who-treat-their-patients
46. American Medical Association. Physicians' Progress toward Ending the Nation's Drug Overdose and Death Epidemic OPIOID TASK FORCE 2020 PROGRESS REPORT.; 2020. P.4. https://www.ama-assn.org/system/files/2020-07/opioid-task-force-progress-report.pdf
47. National Council on Independent Living. NCIL.org. Accessed January 13, 2025. 6-25-19-Chronic-Pain-Sign-On-Letter.pdf (ncil.org)
48. Madara JL. MD. AMA-assn.org. Walmart.com. Accessed January 16, 2025. https://corporate.walmart.com/content/dam/corporate/documents/newsroom/2020/12/22/a-misguided-department-of-justice-lawsuit-forces-pharmacists-between-patients-and-their-doctors/2019-09-24-ama-letter-to-walmart-regarding-opioid-stewardship.pdf
49. Madara JL. AMA-assn.org. Docket No. CDC-2020-0029. June 16, 2020. Accessed August 30, 2024. https://searchlf.ama-assn.org/undefined/documentDownload?uri=%2Funstructured%2Fbinary%2Fletter%2FLETTERS%2F2020-6-16-Letter-to-Dowell-re-Opioid-Rx-Guideline.pdf
50. American Medical Association. AMA backs update to CDC opioid prescribing guidelines. American Medical Association. Published July 22, 2021. https://www.ama-assn.org/press-center/press-releases/ama-backs-update-cdc-opioid-prescribing-guidelines
51. Jesse M. Ehrenfeld, American Medical Association. Overdose Epidemic Physicians' Actions to Help End the Nation's Drug-related Overdose and Death Epidemic—and What Still Needs to Be Done.; 2023. P.14. Accessed January 23, 2025. https://www.ama-assn.org/system/files/ama-overdose-epidemic-report.pdf
52. American Board of Pain Medicine. Second Annual Survey of Pain Medicine Specialists Highlights Continued Plight of Patients with Pain, and Barriers to Providing Multidisciplinary, Non-Opioid Care Impact of Prior Authorization for Non-Opioid Therapies on Clinical Outcomes. Accessed January 16, 2025. https://abpm.org/uploads/files/abpm%20survey%202019-v3.pdf
53. Health Professionals for Patients in Pain (HP3). Professionals Call on the CDC to Address Misapplication of its Guideline on Opioids for Chronic Pain through Public Clarification and Impact Evaluation. March 6, 2019. Google Docs. Accessed January 22, 2025. https://docs.google.com/document/d/1RzQDSppUKhjiAsEmhW2WbTXlP5V8vJ4M_vBPQLKhK_8/edit?tab=t.0#
54. 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 Medicine, Volume 20, Issue 3, March 2019, Pages 429–433, https://doi.org/10.1093/pm/pny228.
55. Fenton JJ, Magnan E, Tseregounis IE, Xing G, Agnoli AL, Tancredi DJ. Long-term Risk of Overdose or Mental Health Crisis After Opioid Dose Tapering. JAMA Network Open. 2022;5(6):e2216726. doi:10.1001/jamanetworkopen.2022.16726
56. Magnan EM, Tancredi DJ, Xing G, Agnoli A, Jerant A, Fenton JJ. Association Between Opioid Tapering and Subsequent Health Care Use, Medication Adherence, and Chronic Condition Control. JAMA Network Open. 2023;6(2):e2255101. doi:10.1001/jamanetworkopen.2022.55101.
57. Agnoli A, Xing G, Tancredi DJ, Magnan E, Jerant A, Fenton JJ. Association of dose tapering with overdose or mental health crisis among patients prescribed long-term opioids. JAMA. 2021;326(5):411–9. doi:10.1001/jama.2021.11013
58. Rose ME. Are prescription opioids driving the opioid crisis? Assumptions vs facts. Pain Medicine. 2017.;19(4):793–807. http://dx.doi.org/10.1093/pm/pnx048
59. Mills L. "Not Allowed to Be Compassionate." Human Rights Watch. December 18, 2018. Accessed January 12, 2025. https://www.hrw.org/report/2018/12/18/not-allowed-be-compassionate/chronic-pain-overdose-crisis-and-unintended-harms-us
60. Szalavitz M. We're overlooking a major culprit in the opioid crisis. Scientific American. 2021. Accessed January 12, 2025. https://www.scientificamerican.com/article/were-overlooking-a-major-culprit-in-the-opioid-crisis/
61. Ari M, Alexander JT, Weyer G. Prescribing Opioids for Pain. JAMA. 2023;329(20):1789–1790. doi:10.1001/jama.2023.6539
62. Lawhern RA. Resources for Clinicians in Pain Medicine: Correcting Medical Mythologies on Prescription of Opioid Analgesics. Medical Research Archives, [S.l.], v. 11, n. 12, dec. 2023. ISSN 2375-1924. doi: https://doi.org/10.18103/mra.v11i12.4860.
63. Szalavitz M. Opinion. 'Entire Body Is Shaking': Why Americans With Chronic Pain Are Dying. The New York Times. January 3, 2023. Accessed January 12, 2025. https://www.nytimes.com/2023/01/03/opinion/chronic-pain-suicides.html
64. Satel S, Mead LM, Moe TM. The truth about painkillers. National Affairs. Accessed August 29, 2024. https://www.nationalaffairs.com/publications/detail/the-truth-about-painkillers
65. Benintendi A, Kosakowski S, Lagisetty P, Larochelle M, Bohnert ASB, Bazzi AR. "I felt like I had a scarlet letter": Recurring experiences of structural stigma surrounding opioid tapers among patients with chronic, non-cancer pain. Drug Alcohol Dependence. 2021;222:108664. doi:10.1016/j.drugalcdep.2021.108664
66. Lagisetty P, Kehne ARH, Thomas J, et al. Improving Access to Care for Patients Taking Opioids for Chronic Pain in Michigan: Findings from an Expert Panel. 2021. Accessed January 13, 2025. P.3-5. https://dx.doi.org/10.7302/1699
67. Lagisetty P, Healy N, Garpestad C, Jannausch M, Tipirneni R, Bohnert ASB. Access to primary care clinics for patients with chronic pain receiving opioids. JAMA Network Open. 2019;2(7):e196928. http://dx.doi.org/10.1001/jamanetworkopen.2019.6928
68. Singer JA, Sullum JZ, and Schatman MS, "Today's nonmedical opioid users are not yesterday's patients; implications of data indicating stable rates of nonmedical use and pain reliever use disorder" Journal of Pain Research, February 7, 2019, Accessed January 13, 2025. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369835/
69. Whitehead S, Miller A. Chronic pain patients struggle to get opioid prescriptions filled, even as CDC eases guidelines. CNN. March 17, 2023. Accessed January 13, 2025. https://www.cnn.com/2023/03/17/health/opioid-chronic-pain-cdc-guidelines-khn-partner/index.html
70. Saccò M, Meschi M, Regolisti G, et al. The relationship between blood pressure and pain. Journal of Clinical Hypertension. 2013;15(8):600-605. http://dx.doi.org/10.1111/jch.12145
71. Iliades C. MD. Can pain cause high blood pressure? University Health News. 2021. Accessed January 13, 2025. https://universityhealthnews.com/daily/pain/can-pain-cause-high-blood-pressure/
72. Harvard Health. Chronic pain linked to higher risk of heart attack and stroke. Accessed January 13, 2025. https://www.health.harvard.edu/heart-health/chronic-pain-linked-to-higher-risk-of-heart-attack-and-stroke
73. Rothstein MA, Irzyk J. The opioid crackdown leaves chronic pain patients in limbo. The Hill. November 29, 2021. Accessed January 13, 2025. https://thehill.com/opinion/healthcare/583332-the-opioid-crackdown-leaves-chronic-pain-patients-in-limbo/
74. Achenbach J, Bernstein L. Opioid crackdown forces pain patients to taper off drugs they say they need. The Washington Post. September 10, 2019. Accessed January 13, 2025. https://www.washingtonpost.com/health/opioid-crackdown-forces-pain-patients-to-taper-off-drugs-they-say-they-need/2019/09/10/3920f220-c8da-11e9-a4f3-c081a126de70_story.html
75. Cowan B, Tibbitts J. A program tried to cut opioid addiction among veterans. Did it cause suicides? The Washington Post. August 24, 2021. Accessed January 13, 2025. https://www.washingtonpost.com/outlook/2021/08/24/opioids-veterans-suicides-interventions-safety/
76. Oliva EM, Bowe T, Manhapra A, et al. Associations between stopping prescriptions for opioids, length of opioid treatment, and overdose or suicide deaths in U.S. veterans: Observational evaluation. The BMJ. (Clinical research ed.). 2020 Mar 4;368:m283. Accessed January 13, 2025. doi:10.1136/bmj.m283.
77. VA study uncovers critical link between pain intensity and suicide attempts - VA News. VA News. October 30, 2019. Accessed January 13, 2025. https://news.va.gov/67708/va-study-uncovers-link-pain-intensity-suicide-attempts/
78. Gotbaum R. Pain Patients Say They Can't Get Meds After Illegal Rx Drug Crackdown. MedpageToday. August 6, 2015. Accessed January 20, 2025. https://www.medpagetoday.com/painmanagement/painmanagement/52960
79. Ming K. Call Kurtis Investigates: Kaiser cuts pain prescriptions, impacting patients. CBS News.com October 27, 2022. Accessed January 20, 2025. https://www.cbsnews.com/sacramento/news/call-kurtis-investigates-kaiser-cuts-pain-prescriptions-impacting-patients/
80. Sullum J. People Rarely Die After Using Opioids Prescribed for Them. Reason .com February 2020. Accessed January 20, 2025. https://reason.com/2020/01/23/people-rarely-die-after-using-opioids-prescribed-for-them/
81. Knopf T. Hundreds of N.C. Doctors Say They've Stopped Prescribing Opioids. North Carolina Health News. October 15, 2018. Accessed January 21, 2025. https://www.northcarolinahealthnews.org/2018/10/15/nc-doctors-stop-prescribe-opioids/
82. Parker LJ, MD. What the DEA does not understand or does not care about medication cessation decisions. Journal of Medicine. Nursing Journals: American Society of Registered Nurses. NAMD.org. 2024. Accessed January 20, 2025. https://www.namd.org/journal-of-medicine/3191-what-the-dea-does-not-understand-or-does-not-care-about-medication-cessation-decisions.html
83. Jewett C, Gabler E. Opioid settlement hinders patients' access to a wide array of drugs. The New York Times. March 13, 2023. Accessed January 20, 2025. https://www.nytimes.com/2023/03/13/us/drug-limits-adhd-depression.html
84. Whitehead S, Miller A. Kaiser Health News. CDC's new opioid guidelines are too little, too late for chronic pain patients, experts say. NBC News. March 13, 2023. Accessed January 20, 2025. https://www.nbcnews.com/health/health-news/cdcs-new-opioid-guidelines-little-late-chronic-pain-patients-rcna74248
85. Llorente E. As doctors taper or end opioid prescriptions, many patients driven to despair, suicide. Fox News. December 10, 2018. Accessed January 20, 2025. https://www.foxnews.com/health/as-opioids-become-taboo-doctors-taper-down-or-abandon-pain-patients-driving-many-to-suicide
86. Miller K. Why people with chronic pain may die earlier. Men's Health. June 8, 2017. Accessed January 20, 2025. https://www.menshealth.com/health/a19519524/risks-chronic-pain-early-death/
87. Grand-Gassaway A. They call me a drug seeker. Here's what their opioid policies did to me. Filter. March 3, 2023. Accessed January 20, 2025. https://filtermag.org/drug-seeker-pain-patients/
88. The misinformed & misguided prescription abuse prevention act: A response to Delfino. Yale Law and Policy Review. Yalelawandpolicy.org. 2020 Accessed January 20, 2025. https://yalelawandpolicy.org/inter_alia/misinformed-misguided-prescription-abuse-prevention-act-response-delfino
89. Hayward M. Feds to target doctors for overprescribing; Medical Society cries foul. The New Hampshire Union Leader. Yahoo News. June 29, 2022. Accessed January 19, 2025. https://www.yahoo.com/news/feds-target-doctors-overprescribing-medical-225200574.html
90. Grant M. Special report: Pharmacies denying legitimate prescriptions. WESH 2 News. 2015. Accessed January 19, 2025. https://www.wesh.com/article/special-report-pharmacies-denying-legitimate-prescriptions/4439866
91. Sheets C, Blakinger K. Feds knew for years fentanyl-tainted pills from Mexican pharmacies were killing Americans. The Los Angeles Times. March 11, 2023. Accessed January 19, 2025. https://www.latimes.com/world-nation/story/2023-03-11/feds-have-known-for-years-fentanyl-tainted-pills-from-mexican-pharmacies-are-killing-americans
92. Friedman J, Godvin M, Molina C, et al. Fentanyl, heroin, and methamphetamine-based counterfeit pills sold at tourist-oriented pharmacies in Mexico: An ethnographic and drug checking study. Drug and Alcohol Dependence. 2023;249:110819. doi.org/10.1016/j.drugalcdep.2023.110819
93. Pischke P. The CDC has abandoned pain patients. Its new opioid guidelines are all for show. USA Today. January 5, 2023. Accessed August 29, 2024. https://www.usatoday.com/story/opinion/voices/2023/01/05/cdc-opioid-guidelines-leave-pain-patients-suffering/10962261002/
94. Anson P. Forced opioid tapering: 'the next great experiment'. Pain News Network. May 22, 2019 Accessed August 29, 2024. https://www.painnewsnetwork.org/stories/2019/5/22/forced-opioid-tapering-the-next-great-experiment
95. Zeltner B. The Plain Dealer. Suffering and abandoned: Chronic pain patients cut off in the opioid era. Cleveland. April 22, 2018. Accessed August 29, 2024. https://www.cleveland.com/healthfit/2018/04/suffering_and_abandoned_chroni.html
96. Coons C. Tapering may have negative impacts for patients taking opioids long term. UC Davis Health. February 14, 2023. Accessed August 29, 2024. https://health.ucdavis.edu/news/headlines/tapering-may-have-negative-impacts-for-patients-taking-opioids-long-term/2023/02
97. Amon JS, Lohman D. Denial of Pain Treatment and the Prohibition of Torture, Cruel, Inhuman or Degrading Treatment or Punishment. Human Rights Watch (Hrw.org). Volume 16. Number 4; 2011:172. Accessed January 21, 2025. https://www.hrw.org/sites/default/files/related_material/2011.12%20InterRights%20Bulletin%20Article_only.pdf
98. Said C. How a crackdown on opioids is leaving patients in agonizing pain. San Francisco Chronicle. March 18, 2023. Accessed January 21, 2025. https://www.sfchronicle.com/health/article/pain-opioid-prescription-medication-17816793.php
99. Darbha V, King L, Westbrook A. They live in constant pain, but their doctors won't help them. The New York Times. August 17, 2023. Accessed January 21, 2025. https://www.nytimes.com/2023/08/17/opinion/opioids-chronic-pain-patients.html
100. Libby R. Treating Doctors as Drug Dealers the DEA's War on prescription painkillers. 2005. Accessed January 21, 2025. https://www.academia.edu/77092772/Treating_Doctors_as_Drug_Dealers_The_DEAs_War_on_Prescription_Painkillers?email_work_card=title
101. Schatman ME, Ziegler SJ. Pain management, prescription opioid mortality, and the CDC: is the devil in the data? Journal of Pain Research. 2017; 10:2489-2495. https://doi.org/10.2147/JPR.S153322
102. Atkinson TJ, Schatman ME, Fudin J. The damage done by the war on opioids: the pendulum has swung too far. Journal of Pain Research. May 2014; 7:265. http://dx.doi.org/10.2147/jpr.s65581
103. Loria K. Has the Pendulum Swung Too Far Against the Use of Opioids? Managed Healthcare Executive. 2022;32. Accessed January 22, 2025. https://www.managedhealthcareexecutive.com/view/has-the-pendulum-swung-too-far-against-the-use-of-opioids-
104. Brookes L MSc. The pendulum has swung too far. Treating Pain in Primary Care. Medscape. February 22, 2019. Accessed January 22, 2025. https://www.medscape.com/viewarticle/909303?form=fpf
105. Stoeltje MF. Has the opioid pendulum swung too far? San Antonio Express. November 5, 2018. Accessed January 22, 2025. https://www.expressnews.com/news/local/article/Has-the-opioid-pendulum-swung-too-far-13362604.php
106. Freyer FJ. Doctors are cutting opioids, even if it harms patients. The Boston Globe. January 3, 2017. Accessed January 22, 2025. https://www.bostonglobe.com/metro/2017/01/02/doctors-curtail-opioids-but-many-see-harm-pain-patients/z4Ci68TePafcD9AcORs04J/story.html
107. Schrecengost L. The other opioid crisis: A failure of care. Discourse. August 15, 2022. Accessed January 22, 2025. https://www.discoursemagazine.com/p/the-other-opioid-crisis-the-crisis-in-care
108. Ghei, N. The other opioid crisis: How false narratives are hurting patients. Discourse. Published July 18, 2022. Accessed January 22, 2025. https://www.discoursemagazine.com/p/how-false-narratives-about-opioids-are-hurting-patients
109. Oliva, JD. Dosing Discrimination: Regulating PDMP Risk Scores. January 18, 2021. 110 California Law Review 47 (2022). Accessed January 22, 2025. http://dx.doi.org/10.2139/ssrn.3768774
110. Sedney CL, Haggerty T, Dekeseredy P, et al. "The DEA would come in and destroy you": a qualitative study of fear and unintended consequences among opioid prescribers in WV. Substance Abuse Treatment, Prevention, and Policy. 17,19 (2022). http://dx.doi.org/10.1186/s13011-022-00447-5
111. Rigorous guidelines on opioid prescriptions are being abused by insurers and harming pain patients, hundreds of experts say. KFF Health News. March 7, 2019 Accessed January 22, 2025. https://kffhealthnews.org/morning-breakout/rigorous-guidelines-on-opioid-prescriptions-are-being-abused-by-insurers-and-harming-pain-patients-hundreds-of-experts-say/
112. Hicks JP. Doctor sues Michigan-based health system after acquitted of charges he killed terminal patients. MLive. April 14, 2023. Accessed January 23, 2025. https://www.mlive.com/public-interest/2023/04/doctor-sues-michigan-based-health-system-after-acquitted-of-charges-he-killed-terminal-patients.html
113. Reynolds CA, Minic Z. Chronic pain-associated cardiovascular disease: The role of sympathetic nerve activity. International Journal of Molecular Sciences. 2023;24(6):5378. doi:10.3390/ijms24065378
114. Forgrave R, Star Tribune. Woman's battle vs. chronic pain expands to Minnesota's opioid laws. Star Tribune. February 15, 2020. Accessed January 21, 2025. https://www.startribune.com/farmington-woman-battles-chronic-pain-and-opioid-laws/567911242/
115. Anson P. Pain News Network. Pharmacies under 'extreme pressure' to give patient records to law enforcement. Pain News Network. December 12, 2023 Accessed January 23, 2025. https://www.painnewsnetwork.org/stories/2023/12/12/pharmacies-under-extreme-pressure-to-give-prescription-records-to-law-enforcement
116. Controversial CDC opioid guidelines – ICA responds. Interstitial Cystitis Association. October 2, 2015. Accessed January 23, 2025. https://www.ichelp.org/controversial-cdc-opioid-guidelines-ica-responds/
117. Anson P. Survey: CDC guideline Having 'Horrendous' Impact on pain patients. Pain News Network. March 15, 2019. Accessed January 23, 2025. https://www.painnewsnetwork.org/stories/2019/3/12/cdc-guideline-horrendous-impact-on-patients
118. Anson P. 2021 CDC survey — Pain News Network. Pain News Network. Accessed August 30, 2024. https://www.painnewsnetwork.org/2021-cdc-survey
119. Kiesel L. Chronic pain: The "invisible" disability. Harvard Health. April 28, 2017. Accessed January 23, 2025. https://www.health.harvard.edu/blog/chronic-pain-the-invisible-disability-2017042811360
120. Brennan, F., Lohman, D., Gwyther, L. (2019). Access to Pain Management as a Human Right. December 19, 2018. American Journal of Public Health. Para. 8. 2019;109(1):61-65. https://doi.org/10.2105/AJPH.2018.304743
121. Brennan F, Carr DB, Cousins M. Pain Management: A Fundamental Human Right. Anesthesia & Analgesia 105(1):p 205-221, July 2007. Doi: 10.1213/01.ane.0000268145.52345.55
122. Berlatsky N. The Opioid Crisis Is Also a Crisis of Speech. Pacific Standard. August 24, 2018. Accessed January 23, 2025. https://psmag.com/social-justice/the-opioid-crisis-is-also-a-crisis-of-speech
123. Singer JA. Study: Blame the war on drugs (and not prescriptions) for America's opioid crisis. The National Interest. January 5, 2020. Accessed January 25, 2025. https://nationalinterest.org/blog/buzz/study-blame-war-drugs-and-not-prescriptions-americas-opioid-crisis-110546
124. Potential complications of untreated chronic pain. Painscale.com. Accessed January 25, 2025. https://www.painscale.com/article/potential-complications-of-untreated-chronic-pain
125. Petrosky E, Harpaz R, Fowler KA, et al. Chronic pain among suicide decedents, 2003 to 2014: Findings from the national violent death reporting system. Annals of Internal Medicine. 2018;169(7):448-455. doi:10.7326/m18-0830
126. Fine PG. Long-Term Consequences of Chronic Pain: Mounting Evidence for Pain as a Neurological Disease and Parallels with Other Chronic Disease States, Pain Medicine. 2011;12(7):996–1004. https://doi.org/10.1111/j.1526-4637.2011.01187.x
127. Smith D., Wilkie R., Croft P. and McBeth J. (2018), Pain and Mortality in Older Adults: The Influence of Pain Phenotype. Arthritis Care & Research, 70: 236-243. https://doi.org/10.1002/acr.23268
128. Tandoğan M, Emektar E, Dağar S, et al. The effect of severe pain on transmyocardial repolarization parameters in renal colic patients. Eurasian Journal of Emergency Medicine. 2022;21(3):188–92. Accessed January 26, 2025. https://www.thefreelibrary.com/The+Effect+of+Severe+Pain+on+Transmyocardial+Repolarization...-a0721308957
129. Foreman J. Chronic pain and the risk of suicide. Psychology Today. November 24, 2015. Accessed August 30, 2024. https://www.psychologytoday.com/us/blog/nation-in-pain/201511/chronic-pain-and-the-risk-suicide
130. Chriss R. An Epidemic of Undertreated Chronic Pain. Pain News Network. May 20, 2017. Accessed January 26, 2025. https://www.painnewsnetwork.org/stories/2017/5/20/an-epidemic-of-undertreated-chronic-pain
131. Whitlock EL, Diaz-Ramirez LG, Glymour MM, Boscardin WJ, Covinsky KE, Smith AK. Association between persistent pain and memory decline and dementia in a longitudinal cohort of elders. JAMA Internal Medicine. 2017;177(8):1146-1153. doi:10.1001/jamainternmed.2017.1622
132. Glod SA. The other victims of the opioid epidemic. New England Journal of Medicine. 2017;376(22):2101–2102. http://dx.doi.org/10.1056/nejmp1702188
133. Cheek L. Charles Szyman, MD acquitted by jury in Wisconsin. Doctors of Courage. Nov. 2017. Accessed January 26, 2025. https://doctorsofcourage.org/charles-szyman-md/
134. Hamilton K. The DEA shut down a pain doctor. Now three people are dead. VICE. January 5, 2023. Accessed January 26, 2025. https://www.vice.com/en/article/dy7qqv/dea-beverly-hills-doctor-shut-down-opioids
135. Hamilton K. This couple died by suicide after the DEA shut down their pain doctor. VICE. November 30, 2022. Accessed January 26, 2025. https://www.vice.com/en/article/wxnyb9/dea-fentanyl-doctor-patient-suicide
136. Parker LJ. The persecution of pain management doctors. National Association of Medical Doctors. Journal of Medicine. August 1, 2023. Accessed January 26, 2025. https://www.namd.org/journal-of-medicine/3104-the-persecution-of-pain-management-doctors.html?fbclid=IwAR2QgCOVF7ggbzomehr0VUbmLF26ORLXKVrb_nvsBp4gFmG_ZhTftibX2vg_aem_AW1QKRPfIrWyCPGb6rm3UvI5j7jKVmz6EPTpYvbxZAIFJqh3lr6U-oNGd6RO4GtKQqk
137. Parker LJ. Doctor charged after treating a DEA agent. KevinMD.com. March 14, 2024. Accessed January 26, 2025. https://www.kevinmd.com/2024/03/doctor-charged-after-treating-a-dea-agent.html.
138. Parker LJ. AI enforcement in health care: Unpacking the DEA's approach to the opioid epidemic. KevinMD.com. January 2, 2024. Accessed January 26, 2025. https://www.kevinmd.com/2024/01/ai-enforcement-in-health-care-unpacking-the-deas-approach-to-the-opioid-epidemic.html
139. Parker LJ. Real pain deserves real treatment. KevinMD.com. March 29, 2024. Accessed January 26, 2025. https://www.kevinmd.com/2024/03/real-pain-deserves-real-treatment.html
140. Rubin R. Limits on Opioid Prescribing Leave Patients With Chronic Pain Vulnerable. JAMA Network. 2019;321(21):2059–2062. doi:10.1001/jama.2019.5188
141. Kang HA, Wang B, Barner JC, et al. Opioid Prescribing and Outcomes in Patients With Sickle Cell Disease Post–2016 CDC Guideline. JAMA Internal Medicine. 2024;184(5):510-518. doi:10.1001/jamainternmed.2023.8538
142. Metz VE, Ray GT, Palzes V, et al. Prescription opioid dose reductions and potential adverse events: a multi-site observational cohort study in diverse U.S. health systems. Journal of General Internal Medicine. 2024 May;39(6):1002-1009. doi: 10.1007/s11606-023-08459-y.
143. Singer JA. The War on Drugs Is Also a War on Pain Patients. CATO Institute. April 1, 2024. Accessed January 26, 2025. https://www.cato.org/blog/war-drugs-also-war-pain-patients
144. Anson P. 90% of pain patients have trouble filling opioid prescriptions. Pain News Network. January 11, 2024. Accessed January 26, 2025. https://www.painnewsnetwork.org/stories/2024/1/11/nbsp-90-of-us-pain-patients-have-trouble-filling-opioid-prescriptions
145. Parker L. J. The opioid crisis: profits, lawsuits, and pharmaceutical influence. KevinMD.com. February 29, 2024. Accessed August 30, 2024. https://www.kevinmd.com/2024/02/the-opioid-crisis-profits-lawsuits-and-pharmaceutical-influence.html
146. Votta A. How the Opioid Crackdown Is Hurting Chronic Pain Patients. SAPIENS. November 26, 2019. Accessed January 27, 2025. https://www.sapiens.org/biology/chronic-pain-opioid-crackdown/.
147. Molton IR, Terrill AL. Overview of persistent pain in older adults. American Psychologist. 2014;69(2): 197-207. doi:10.1037/a0035794
148. Anson P.' Misplaced and Dangerous' Opioid Study Debunked by Critics. Pain News Network. www.painnewsnetwork.org/stories/2024/6/4/misplaced-and-dangerous-opioid-study-debunked-by-critics. June 4, 2023. Accessed January 31, 2025. https://www.painnewsnetwork.org/stories/2024/6/4/misplaced-and-dangerous-opioid-study-debunked-by-critics
149. Anson P. Where Have All the Pain Doctors Gone? Pain News Network. January 24, 2025. Accessed February 1, 2025. https://www.painnewsnetwork.org/stories/2025/1/24/where-have-all-the-pain-doctors-gone
150. LeBaron C. Is the Opioid Epidemic Really Ending? Pain News Network. January 29, 2025. Accessed February 1, 2025. https://www.painnewsnetwork.org/stories/2025/1/28/is-the-opioid-epidemic-really-ending#google_vignette
151. Nadeau SE, Wu JK, Lawhern RA. Opioids and chronic pain: An analytic review of the clinical evidence. Frontiers in Pain Research. 2021;2.(721357). http://dx.doi.org/10.3389/fpain.2021.721357
152. Dasgupta N, Beletsky L, Ciccarone D. Opioid crisis: No easy fix to its social and economic determinants. American Journal of Public Health. 2018;108(2):182–186. http://dx.doi.org/10.2105/ajph.2017.304187
153. Irving P. The national opioid settlement is causing drug shortages —. Pain News Network. September 11, 2023. Accessed January 31, 2025. https://www.painnewsnetwork.org/stories/2023/9/11/the-national-opioid-settlement-is-causing-drug-shortages
154. Martinez J. Amid opioid crisis, chronic pain patients are struggling to fill their needed prescriptions. Hawaii News Now. March 14, 2024. Accessed January 31, 2025. https://www.hawaiinewsnow.com/2024/03/15/amid-opioid-crisis-chronic-pain-patients-are-struggling-fill-their-needed-prescriptions/
155. Shults T. Hundreds of Longview residents are unable to get opioid medication for chronic pain from local pharmacies. KGW. March 5, 2024. Accessed January 31, 2025. https://www.kgw.com/article/news/local/longview-doctor-patients-prescriptions-filled-opioid-medication/283-68c540c3-ce39-45a7-a452-7e651fd37d18
156. Swetlitz, I. Bloomberg. Secret limits to stop 'suspicious' Xanax and Adderall orders are forcing some legitimate patients to scramble. Fortune. April 3, 2023. Accessed January 31, 2025. https://fortune.com/2023/04/03/xanax-adderall-rules-patients-opiods-pain-medication/
157. Bishari N. 'I'm being treated like an addict': A new kind of drug crisis is descending on the Bay Area. San Francisco Chronicle. March 22, 2023. Accessed January 31, 2025. https://www.sfchronicle.com/opinion/article/bay-area-drug-prescription-painkillers-opioid-17841947.php
158. Jewett N., Gabler E. Opioid Settlement Hinders Patients' Access to a Wide Array of Drugs. NYTimes.com. March 13, 2023. Accessed January 31, 2025. https://www.nytimes.com/2023/03/13/us/drug-limits-adhd-depression.html
159. Aboulenein A. Insight: U.S. opioid crackdown hampers some patients' access to psychiatric drugs. Reuters. December 12, 2022. Accessed January 31, 2025. https://www.reuters.com/business/healthcare-pharmaceuticals/us-opioid-crackdown-hits-some-patients-access-psychiatric-drugs-2022-12-12/
160. Battista C. Federal charges against Louisville pain management doctor leaves patients in limbo. WDRB. July 15, 2024. Accessed January 31, 2025. https://www.wdrb.com/news/federal-charges-against-louisville-pain-management-doctor-leaves-patients-in-limbo/article_e044f33a-4085-11ef-bf38-6fe49681e197.html
161. Singer JA. The Chilling Effect: How Fear Drives Doctors Away from Pain Patients. Cato Institute. February 25, 2025. Accessed February 25, 2025. https://www.cato.org/blog/chilling-effect-how-fear-drives-doctors-away-pain-patients
162. DePaul's Center for Journalism Integrity and Excellence. Chronic pain patients suffer from opioid epidemic overcorrection. WTTW News. March 12, 2024. Accessed January 31, 2025. https://news.wttw.com/2024/03/12/chronic-pain-patients-suffer-opioid-epidemic-overcorrection
163. CBS Mornings. Sickle cell anemia patients react to breakthrough treatment. YouTube. Minutes 2:05-3:02 of 9:27. March 2019. Accessed January 31, 2025. https://www.youtube.com/watch?v=8_gU2qt3Ro0&t=150s
164. Enzinger AC, Ghosh K, Keating NL, et al. Racial and ethnic disparities in opioid access and urine drug screening among older patients with Poor-Prognosis cancer Near the end of life. Journal of Clinical Oncology. 2023;41(14):2511-2522. doi:10.1200/jco.22.01413
165. Enzinger AC, Ghosh K, Keating NL, Cutler DM, Landrum MB, Wright AA. U.S. Trends in Opioid Access Among Patients With Poor Prognosis Cancer Near the End-of-Life. Journal of Clinical Oncology. 2021;39(26):2948-2958. https://doi.org/10.1200/jco.21.00476
166. Azizoddin DR, Knoerl R, Adam R, et al. Cancer pain self-management in the context of a national opioid epidemic: Experiences of patients with advanced cancer using opioids. Cancer. 2021 Sep 1;127(17):3239-3245. doi: 10.1002/cncr.33532.
167. Schenker Y, Hamm M, Bulls HW, et al. This Is a Different Patient Population: Opioid Prescribing Challenges for Patients with Cancer-Related Pain. JCO Oncology Practice. 2021 Jul;17(7):e1030-e1037. Accessed January 13, 2025. doi: 10.1200/OP.20.01041.
168. Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports.2022;71(No. RR-3): P. 3, 15-54.1–95. Doi: http://dx.doi.org/10.15585/mmwr.rr7103a1
169. 21-01554 CDC FOIA letter and response.pdf. "all information on adverse healthcare events and patient harm associated with the 2016 'CDC Guideline for Prescribing Opioids for Chronic Pain.' [01/01/2012 to 01/01/2021]." Google Docs. Accessed March 1, 2025. https://drive.google.com/file/d/12T3uF1A_fAhvNw_CyX0BFs3mckCym6zA/view
170. 23-00280-FOIA Opioid Rapid Response Final Response.pdf. "all information on adverse healthcare events and patient harm associated with the 2016 'CDC Guideline for Prescribing Opioids for Chronic Pain.' [01/01/2012 to 01/01/2021]." Google Docs. Accessed March 1, 2025. https://drive.google.com/file/d/1tM7cJ9apn0cvEcj5z2kIquRLEwssAqQ8/view?usp=drive_link
171. Frontline physicians call on politicians to end political interference in the delivery of evidence-based medicine. American Academy of Family Physicians. May 15, 2019. Accessed January 31, 2025. https://www.aafp.org/news/media-center/more-statements/physicians-call-on-politicians-to-end-political-interference-in-the-delivery-of-evidence-based-medicine.html