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June 6, 2016

AS PREDICTED, THE RULES WILL PUNISH THOSE WHO ARE HURTING WHILE DOING LITTLE TO LIMIT ACTUAL ABUSE: New Opioid Limits Challenge the Most Pain-Prone.

If you’ve come to rely on opioids for chronic pain, as a growing proportion of older adults has, you may have noticed that the drugs are becoming more difficult to get.

Something had to be done, surely: More than 165,000 people died from overdoses from 1999 to 2014.

But recent restrictions on access to these painkillers are likely to disproportionately affect the elderly — despite the fact that abuse and misuse of these painkillers have historically been lower among older patients than younger ones.

Older patients are simply more apt to have chronic pain. Some of their doctors are going to get an earful when they suggest different medications or nonpharmacological alternatives, as the Centers for Disease Control and Prevention recommended in new opioid guidelines in March. . . .

For patients who want to get or refill prescriptions, “you have to jump through more hoops,” Dr. McPherson said. At clinics and hospitals, at pharmacies, “everyone’s level of suspicion is higher.”

Along with the C.D.C. guidelines, which urge more careful monitoring, doctors face a wave of state laws restricting access. The Drug Enforcement Administration also reclassified certain opioid formulations in 2014, making them less readily available.

This represents a major swing of the medical pendulum. For years, doctors were warned against paying insufficient attention to pain.

Medicine by fad. This will work out well.