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Oregon Task Force Backs Controversial Opioid Plan

An Oregon proposal to expand alternative treatments for certain chronic pain conditions while limiting the use of opioids has moved forward with minimal changes, despite outcries from chronic pain patients and criticism from pain experts across the country.

Posted: Dec 6, 2018 10:53 AM

BEND, Ore. (AP) — An Oregon proposal to expand alternative treatments for certain chronic pain conditions while limiting the use of opioids has moved forward with minimal changes, despite outcries from chronic pain patients and criticism from pain experts across the country.

The Bulletin reports that the state's Chronic Pain Task Force, an ad hoc committee providing recommendations on treatments for chronic pain under Oregon's Medicaid program, backed a proposal Wednesday to provide coverage for five chronic pain conditions currently not covered by the Oregon Health Plan.

That would allow patients to receive services such as physical therapy, acupuncture and other types of treatment. Opioids would be covered in limited doses for some of the chronic pain conditions, but not for fibromyalgia or centralized pain syndrome, a central pain processing disorder that can heighten the response to painful stimuli.

The task force concluded that opioids are not beneficial and can be harmful for those conditions.

Overprescribing of prescription opioids has been blamed for the ongoing overdose epidemic nationwide.

Patients who are already taking doses above the opioid limits would be required to begin a taper of their medications at rate determined in conjunction with their doctor. Patients with fibromyalgia or centralized pain syndrome would be required to taper off opioids completely.

"This is basically more extreme and draconian than any approach in the country. It goes against all of the guidelines," said Kate Nicholson, a civil rights attorney from Colorado and a chronic pain advocate. "And importantly, it does so without regard for any attempt to measure potential harms or benefits to patients."

The proposal is the second try by the task force to craft the chronic pain coverage guidelines.

A previous proposal would have limited opioid coverage to 90 days and required patients to taper off painkillers within a year. After hearing from patients and providers, Oregon Health Authority staff reworked the proposal to soften the language and provide patients and their doctors more flexibility in the rate of tapering.

"We at OHA believe that health care delivery is really dependent on the trusting relationship between a patient and provider," Dr. Dana Hargunani, chief medical officer at OHA, told the task force. "All of the proposal elements, particularly addressing the opioid tapers . including the timelines, the rates and the ultimate success in getting to zero, are intended to be flexible and to meet individual patient needs based on the patient and doctor relationship."

Oregon Health Authority officials estimated that about 67,400 people would gain coverage to alternative pain treatments under the proposal and that between 600 to 1,200 patients would need to have their opioid treatments re-evaluated by their providers.

Oregon Coronavirus Cases

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Cases: 193732

Reported Deaths: 2572
CountyCasesDeaths
Multnomah38352591
Washington25592233
Marion22026306
Clackamas17440214
Lane13007148
Jackson10862139
Deschutes896274
Umatilla820284
Linn492969
Yamhill446376
Klamath441164
Polk375752
Malheur351863
Josephine334570
Douglas327271
Benton310019
Jefferson219837
Coos206633
Columbia174427
Union144823
Lincoln137921
Wasco137728
Hood River118730
Crook111322
Morrow110716
Clatsop9858
Baker95414
Tillamook6493
Curry6469
Grant5095
Lake4517
Harney3448
Wallowa1845
Gilliam631
Sherman581
Wheeler321
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Cases: 3764405

Reported Deaths: 62573
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Los Angeles123645624067
Riverside2994554594
San Bernardino2967824715
San Diego2785913729
Orange2709835026
Santa Clara1190642096
Kern1091771374
Sacramento1048401686
Fresno1018381688
Alameda879401657
Ventura810011013
San Joaquin732201391
Contra Costa68741805
Stanislaus621421061
Tulare49654839
Monterey43613383
San Mateo42038568
San Francisco36720544
Santa Barbara34337456
Solano32953252
Merced31898460
Sonoma30035320
Imperial28443726
Kings22989246
Placer22679292
San Luis Obispo21308260
Madera16462242
Santa Cruz16264207
Marin14056227
Yolo13910210
Shasta12152226
Butte12026199
El Dorado10168112
Napa987082
Sutter9433112
Yuba626847
San Benito606563
Lassen570624
Tehama557262
Nevada474275
Tuolumne413166
Mendocino410149
Humboldt404641
Amador365847
Lake347643
Glenn239125
Colusa223416
Siskiyou223424
Calaveras212954
Inyo142838
Del Norte13938
Mono12844
Plumas7106
Modoc4994
Mariposa4487
Trinity4005
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Alpine880
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