Dear Patient,

In August 2016, the US Surgeon General sent an historic letter to every physician in the country addressing the opioid epidemic in America. He asked that we all join him in addressing the growing opioid problem and he urged that we adhere to the CDC Opioid Prescribing Guidelines, which have been published and are now available on the CDC website. Governor Scott Walker signed a bill in 2016 endorsing guidelines for the State of Wisconsin which are based on standards from the Federal Centers for Disease Control. In August 2017, President Trump declared the opioid crisis a national emergency.

While the CDC and the US Surgeon General are in agreement that acute pain can and should be treated safely and effectively, these authorities have determined that there are no conclusive studies on the efficacy of long-term opioid analgesic use for chronic pain. The research has furthermore revealed that the risk of accidental overdose increases with higher doses of opioid (narcotic) medications.

Our pain management providers have been carefully reviewing the data and recommendations provided by the CDC over the past few months. We have come to the conclusion that we cannot continue to prescribe long-term opioid medications for chronic, nonmalignant pain. While there may be a role for these medications over the short term for new injuries and for postoperative pain, we interpret the recommendations of the CDC as no longer supporting the long term use of opioid medications. Thus, we will gradually and safely transition our patients off of these medications as soon as possible.

We recognize the concerns this may raise for some patients. However, our experience has been that most patients tolerate a gradual reduction and discontinuation of their opioid medications without unusual side effects or withdrawal symptoms. This tapering can be accomplished without worsening of their underlying pain complaints; in fact, some report an improvement in symptoms after discontinuing the medications. In rare circumstances, there may be an indication for a referral to an addiction specialist for further evaluation and treatment.

If you are taking opioid medication, your provider will be outlining a plan for your medications over your upcoming appointments. We recognize, of course, that you have the right to seek a second opinion from another provider should you disagree with these recommendations. However, we urge that you carefully weigh the risks as outlined by the CDC and join us in our efforts to respond to the opioid crisis as requested by the Federal and State Governments, the Wisconsin State Medical Board, and the medical authorities. Please do not hesitate to contact our office if you have any additional questions or concerns.

In Health,

The Neuroscience Group Physicians