AMA Finally Speaks Out Against Opioid Restrictions

AMA Delegates Back Physician Freedom in Opioid Prescribing – by Joyce Frieden, News Editor, MedPage Today November 13, 2018

Finally!

In the fall of 2015 the anti-opioid advocacy group, PROP, prodded the CDC to formulate the notorious Opioid Prescribing Guideline using PROP’s literature as a blueprint. Already provoking a great deal of alarmed protest, the guideline was officially released in the spring of 2016.

Since then, insurers, hospitals, pharmacies, and even doctors themselves have chosen to interpret the guideline as a “rule of law”, applicable to all patients taking opioids for any reason at any time. The result has been three excruciating years of pain patient suffering and suicide as pain relief is withheld.

Only now is the AMA finally speaking out against these crude and inappropriate restrictions.   Continue reading

Rebuttal to “Opioids are Biggest Healthcare Problem”

Teater: Opioid problem biggest healthcare issue facing America [???]-  Nov 2018 – utter nonsense!

On the Inspire.com Opioid Information Thread, the member Seshet posted a brilliant rebuttal to the terribly mistaken article above:

The Cleveland Daily Banner has an article with Don Teater, MD, explaining how opioids should never be used for anything other than severe trauma or end-of-life care.

There are glaring errors in every paragraph.

Examples:   Continue reading

Pain Patients and Doctors Have Civil Rights Too

Pain Patients and Doctors Have Civil Rights Too — Pain News Network – By Richard Dobson, MD – November 2018

Dr. Dobson makes the point that pain patients’ civil rights about being violated because we and our doctors are being criminally punished for crimes committed by others.

In a recent column, I described the diversion of blame for the opioid crisis as an example of “Factitious Disorder Imposed on Another,” [See previous post Diversion of Blame and the Opioid Crisis] a psychiatric condition in which a person imposes an illness on someone who is not really sick.

Recently, the U.S. Department of Justice announced a plea deal in which a former police chief in Florida pleaded guilty to violating the civil rights of innocent people by making false arrests “under color of law.” I think there are some striking parallels between the way these innocent victims were treated and the way that chronic pain patients and their doctors are treated today.  Continue reading

Personalized Pain Medicine

Personalized Pain Medicine – By Lynn Webster, M.D. – October, 2018

Here Dr. Webster explains how our genes control both pain sensitivity and drug sensitivity. Many of us with EDS find ourselves with the most unfortunate combination of high pain sensitivity and low drug sensitivity (due to metabolic issues).

Below is an edited excerpt from a chapter titled, Pharmacogenetics and Personalized Medicine in Pain Management, that Inna Belfer, MD PhD and I published in Clinics in Laboratory Medicine, Volume 36, Issue 3, September 2016.

Pharmacogenetic therapy in people with pain requires consideration of 2 different genetic substrates to determine the outcome of pharmacotherapy.

  1. The first is the genetic contribution to a variety of different pain types, and
  2. the second is the genetic influence on drug effectiveness and safety. Continue reading

Opioid analgesic tolerance without hyperalgesia

Analgesic tolerance without demonstrable opioid-induced hyperalgesia: a double-blinded, randomized, placebo-controlled trial of sustained-release m… – PubMed – NCBI – Aug 2012

Although often successful in acute settings, long-term use of opioid pain medications may be accompanied by waning levels of analgesic response not readily attributable to advancing underlying disease, necessitating dose escalation to attain pain relief.

How can a doctor determine whether a patient’s increasing pain is attributable to “advancing underlying disease” or tolerance to opioids?

It’s impossible for anyone except the patient to determine this. Even for myself, it’s difficult to distinguish between increasing pain versus increasing tolerance to the medication.   Continue reading

Drug overdose deaths decline for sixth straight month

Drug overdose deaths decline for sixth straight month – Opioid Watch – Nonprofit News from The Opioid Research Institute

Drug overdose deaths in the United States have now fallen for six straight months, according to the CDC’s most recent data, dropping 2.8 percent from their peak.

Similarly, the subset of those deaths attributable to opioid drugs has steadily declined over the same period, falling 2.3 percent.

These modest, but steady, declines are reflected in “provisional” data published by the Centers for Disease Control and Prevention, which are subject to adjustment as additional data come in.  Continue reading

Veiled threats by Pharmacy to Doctors

From J. Julian Grove, MD @JulianGroveMD – Nov 2018

Chronic Pain Patients: An insight to the veiled threats Health Care Providers receive treating pain. From Walgreens on this example to my Physician’s Assistant.

I am a double board certified Anesthesiologist and Pain Specialist, treating complex pain and cancer pain always w/comprehensive approach. Insulting.

Continue reading

Suicide Due to Chronic Pain

Here are excerpts from 4 more articles showing that many suicides classified as “overdose” deaths are likely due to chronic pain.

The first article I include below started the “official awareness” that many opioid-overdose deaths may have been due to unbearable pain. Patients are committing suicide when their pain medications are taken away by the over-zealous promotion of anti-opioid policies.

With a powerful and well-known author like the head of NIDA, Dr. Nora Volkow, we can hope that other professionals will take note.  Continue reading

Wealthy, motivated by greed, more likely to cheat

I’m furious and disgusted about how the corporate pursuit of short-term profit, unrestrained by ethics or social needs or long-term consequences, is controlling our healthcare.

The dark underside of corporate wealth is the condition of the workers who create the corporation’s success. Working in the jobs the rich create, there are multitudes who work just as long and hard and don’t get rich. They labor in dangerous and dirty jobs for endless hours, under far worse conditions. Often they barely get paid while some C-suite guy running the corporation committing these abuses gets millions in bonuses.

And all those rich people with all their advantages aren’t even nice:

Instead of looking up to rich people as “self-made” heroes, I know they are actually just lucky when all their skills and preparation meet an opportunity they can take advantage of. Without that luck, they’d just be “commoners” like the rest of us.

In excruciating pain, sickle cell patients shunted aside

‘Every time it’s a battle’: In excruciating pain, sickle cell patients are shunted aside – By Sharon Begley @sxbegle – Sept 2017

The U.S. health care system is killing adults with sickle cell disease. Racism is a factor — most of the 100,000 U.S. patients with the genetic disorder are African-American — and so is inadequate training of doctors and nurses.

And the care is getting worse, sickle cell patients and their doctors said, because the opioid addiction crisis has made ER doctors extremely reluctant to prescribe pain pills.

STAT interviewed 12 sickle cell patients who described the care they received and didn’t receive. They were old and young, men and women, scattered from coast to coast, some with jobs or attending school and some too sick to do either.   Continue reading