Charles Lane’s May 1 op-ed, “Do rules on opioids violate human rights?,” challenged a Human Rights Watch inquiry into the effects of opioid limits on the treatment of pain. Opioid restrictions might sound reasonable, but there are legitimate questions regarding their efficacy and harms.
Although the 2016 guidelines issued by the Centers for Disease Control and Prevention are flexible and non-mandatory, legislators and policymakers have seized on numbers in the guidelines, adopting rigid, one-size-fits-all dosage and supply limits into law in half of the states and as a mandatory policy of the Department of Veterans Affairs and the Centers for Medicare and Medicaid Services.
As a result, patients who undergo major surgeries will not receive opioid pain medication post- surgically for more than three to seven days in most states. Previously stable patients are being taken off of their opioid medications or denied care altogether by fearful or frustrated physicians. The consequences of limiting legitimate medical treatment can be dire, resulting, as a preliminary report from VA recently found, in increased suicide mortality. Opioid limits have also proved ineffective: Overdose deaths involving prescription opioids have scarcely fallen in the past five years despite a substantial decrease in opioid prescribing, which is at a 10-year low.
Nearly 50 million Americans suffer from severe or persistent pain, which is 25 times more than those who misuse opioids. Increasing their suffering and incentivizing people to turn to the black market will not solve the opioid crisis. Human Rights Watch is asking reasonable questions. Let’s not bias its inquiry.
Kate Nicholson, Boulder, Colo.
The writer, a civil rights lawyer, gave the recent TED talk “What We Lose When We Undertreat Pain.”
Diane Hoffmann, Baltimore
The writer directs the Law & Health Care Program at the University of Maryland School of Law.