CHRONIC PAIN SUFFERERS UNITE!​​​​

OPIOID CALCULATION WEBSITES INTO MME/MED


THERE ARE DIFFERENT WAYS TO CALCULATE MORPHINE MILLIGRAM EQUIVALENT (MME)/MORPHINE EQUIVALENT DOSEAGE (MED) DEPENDING ON WHAT CONVERSION CHART THE DOCTOR USES!! (SEE WEBSITES BELOW)

THE MME/MED IS A CONVERSION CHART TO CONVERT ALL OTHER OPIOIDS TO MORPHINE EQUIVALENT TO SEE IF THE PATIENT IS AT OR BELOW THE 90 MME/50 MME
The correct question is: How much of another opioid is equal to MME/MED


The Answer is Morphine 100mg Equivalent – Morphine Jeopardy

http://paindr.com/the-answer-is-morphine-100mg-equivalent-morphine-jeopardy/

Opioid Conversion Guidelines Vary Substantially


 http://www.medscape.com/viewarticle/803955

CONVERSION CHART Morphine Milligram Equivalent/Morphine Equivalent Dose (MME/MED)


https://www.bing.com/search?q=Morphine+Milligram+Equivalent+Definition&FORM=QSRE6


https://www.bing.com/search?q=morphine+milliequivalents+calculator&form=EDGHPC&qs=AS&cvid=b7d4ec2d72ac4208baef2db1ca2709bc&pq=morphine%20mi


ORAL OPIOD DOSING EQUIVALENTS AND CONVERSIONS:

http://www.med.umich.edu/1info/FHP/practiceguides/pain/dosing.pdf

http://emedicine.medscape.com/article/2138678-overview

http://www.medcalc.com/narcotics.html


 

FDA Restricts Long-term Opioid Use to Combat Abuse


​Extended-release and long -acting ER/LA opioid analgesics stated that they were indicated for "moderate to severe pain in patients requiring continuous, around-the-clock opioid treatment for an extended period of time". The labels now will state that the drugs are indicated "for the management of pain severe enough to require daily, around-the-clock opioid treatment and for which alternative treatments are inadequate." The new labeling emphasizes first considering potentially less addictive measures.


​The new wording is designed to make a clinician go beyond a pain-intensity scale to consider what an individual patient needs to "live and function better," said Douglas Throckmorton, MD, deputy director of regulatory programs in the FDA's Center for Drug Evaluation and Research, in a press conference today.

2016 Guidelines

​CDC issues guidelines against opioid prescriptions to treat chronic pain

CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016 (CDC website)

http://www.cdc.gov/media/modules/dpk/2016/dpk-pod/rr6501e1er-ebook.pdf


Excretes from the CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016 

Dr. Deborah Dowell says the considerations of pain advocates were addressed in the most recent draft and that the agency softened the final version to allow for recommendations of up to no more than ​90 MME (Morphine Milligram Equivalent).


​They also advise that doctors should reassess decisions to prescribe more than 50 MME a day and avoid or carefully consider prescribing more than 90 MME. They recommend going over risks and goals for pain treatment with patients, and checking patients' history of prescription opioid use in state databases.


After the guidelines were issued in draft form and left open for comment, they sparked outcry months before they were officially released. In November, the non-profit group Washington Legal Foundation - which receives grants from Purdue Pharma according to a spokesperson - accused ​the CDC of violating federal law by initially refusing to disclose the "Core Expert Group" who drafted the initial guidelines.


But the most notable resistance came from within the federal government, the Interagency Pain Research Coordinating Committee (IPRCC), which complained in a statement that there were not enough pain providers represented in the group, and questioned the science behind the CDC's studies that opioids were not effective in treating long-term pain.


The IPRCC ultimately prompted the CDC to delay the release of the opioid guidelines and ask for more public input.


In return, the IPRCC panelists came under fire. The Associated Press reported that nearly a third of the panelists receive ​funding from pharmaceutical companies who make opioids. Oregon senator Ron Wyden of the committee on finance  has begun an inquiry into the IPRCC and the involvement of pharmaceutical companies on government panels.


This is not the first time financial ties to pharmaceutical companies have caused problems for pain advocates. In 2012, the US Senate finance committee launched an investigation into the American Pain Foundation that found the leading pain advocacy group was receiving 90% of it's funding ​from pharmaceutical companies. It disbanded before the Senate finance committee could release a report on their findings.


The scandal at the foundation came after executives at Purdue Pharma, the company that makes OxyContin, got in trouble for their direct influence in the medical community. The company pleaded guilty and agreed to pay a $600m penalty to the US Justice Department in 2007 over charges of "misbranding" the product to doctors and patients as non-addictive due to it's time-release sealant, which could be easily removed. The pharmaceutical company settled a similar lawsuit with the state of Kentucky for $24m last December.