Pain Mgmt Leader Criticizes Opioid Restrictions

A ‘civil war’ over painkillers rips apart the medical community | By BOB TEDESCHI @bobtedeschiJ  Jan 17, 2017

I see it as a great positive when one of the leading pain physicians in one of the leading pain management programs at one of the leading universities (Stanford).

Two years after the United States saw a record 27,000 deaths involving prescription opioid medications and heroin, doctors and regulators are sharply restricting access to drugs like Oxycontin and Vicodin.

But as the pendulum swings in the other direction, many patients who genuinely need drugs to manage their pain say they are being left behind.

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Strong Pain Tx Recommendations Based on Low-quality Evidence

Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain | Annals of Internal Medicine | American College of Physicians

Recommendation 1:

Given that most patients with acute or subacute low back pain improve over time regardless of treatment, clinicians and patients should select nonpharmacologic treatmentwith

  • superficial heat (moderate-quality evidence),
  • massage,
  • acupuncture, or
  • spinal manipulation (low-quality evidence). Continue reading

From ACP: Another Unscientific & Biased Guideline

New clinical guideline issued for treating low back pain – Medical News Today – 2/14/17

The American College of Physicians (ACP) have published their clinical practice guideline for treating nonradicular low back pain in the journal Annals of Internal Medicine. Nonradicular pain refers to pain that does not irradiate from, and is not caused by, damage to the spinal nerve root.

approximately 31 million U.S. individuals experience low back pain at one point during their lives

The condition accounts for a large proportion of all doctor visits in the U.S., and almost 25 percent of the entire adult population in the U.S. has experienced at least one day of low back pain in the past 3 months.  Continue reading

How to read and understand a scientific paper

Impact of Social Sciences – How to read and understand a scientific paper: a guide for non-scientists

From vaccinations to climate change, getting science wrong has very real consequences.

But journal articles, a primary way science is communicated in academia, are a different format to newspaper articles or blogs and require a level of skill and undoubtedly a greater amount of patience.

Here Jennifer Raff has prepared a helpful guide for non-scientists on how to read a scientific paper.   Continue reading

Opioid Prohibition Risks ‘Inhumane Treatment’ of Patients

Strict limits on opioid prescribing risks ‘inhumane treatment’ of pain patients
By Stephan G. Kertesz and Adam J. Gordon – Feb 24, 2017

Here is another article from Dr. Kertesz, pointing out how the CDC Guidelines are NOT VALD as STANDARDS for pain treatment.  He and Dr. Gordon both practice Addiction Medicine, so this article shows that the problems with the CDC guideline are visible to unbiased addiction specialists.

Amid a rising toll of opioid overdoses, recommendations discouraging their use to treat pain seem to make sense. Yet the devil is in the details: how recommendations play out in real life can harm the very patients they purport to protect.

A new proposal from the Centers for Medicare and Medicaid Services to enforce hard limits on opioid dosing is a dangerous case in point.  
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AAPM defends opioid use against PROP petition

American Academy of Pain Medicine Response to PROP Petition to the FDA That Seeks to Limit Pain Medications for Legitimate Noncancer Pain Sufferers  – | August 15, 2012

This is a letter sent by the AAPM to the FDA in 2012, rebutting a petition to restricts opioids submitted by PROP. It explains why the proposals are scientifically and statistically invalid, based on unrealistic assumptions, and in some cases, are even irrational.

Here is the complete text of the letter (with my emphasis):

Dear FDA Officers:  We write to respond to the petition submitted by Physicians for Responsible Opioid Prescribing requesting label changes from the FDA in connection with certain opioid products.  Continue reading

Access to pain treatment as a human right

“The lack of pain treatment medicine is both perplexing and inexcusable.
Pain causes terrible suffering yet the medications to treat it are cheap, safe, effective and generally straightforward to administer.”

Access to pain treatment as a human right | BMC Med. 2010

Almost five decades ago, governments around the world adopted the 1961 Single Convention on Narcotic Drugs which, in addition to addressing the control of illicit narcotics, obligated countries to work towards universal access to the narcotic drugs necessary to alleviate pain and suffering.   Continue reading

Risks of Compounded Drugs

Potential Risks of Pharmacy CompoundingDrugs R D.2013 Mar – free full-text PMC article

Published reports of independent testing by the FDA, state agencies, and others consistently show that compounded drugs fail to meet specifications at a considerably higher rate than FDA-approved drugs.

Pharmacy compounding involves the preparation of customized medications that are not commercially available for individual patients with specialized medical needs. Traditional pharmacy compounding is appropriate when done on a small scale by pharmacists who prepare the medication based on an individual prescription.

the regulatory oversight of pharmacy compounding is significantly less rigorous than that required for Food and Drug Administration (FDA)-approved drugs; as such, compounded drugs may pose additional risks to patients.   Continue reading

The BMJ Advocating AGAINST Drug-War

The BMJ (British Medical Journal) is advocating AGAINST the drug-war!

I found this so hard believe that I had to double and triple-check that I was really looking at the respected medical journal and not some fake site.

Instead, the Journal is documenting and publicizing the collateral damage of America’s globally-enforced prohibition of any and all mind-altering drugs (except alcohol and nicotine) in the face of mounting evidence of harm.

Such a sensible viewpoint/suggestion would never be published in the mainstream American medical journals – there’s way too much money being made from prohibition (by selling drugs, selling drug-tests, selling prison cells, selling recovery, selling pain patients to recovery by relabeling them as addicts, and selling out both pain patients and people with addiction to make a buck),   Continue reading

Updated: Evidence Against CDC Opioid Guidelines

Here is the latest (as of 2/24/17) collection of posts that explain the many serious flaws in these guidelines:

4 articles with the best evidence
against legitimacy of CDC Guidelines

  1. By far the most comprehensive:
    Opioids, Addiction, and Pain: Briefing for Policy Leaders
  2. CDC Manipulated Data to Deceive
  3. CDC Guidelines Refuted with Scientific Evidence
  4. The Changing Opioid Epidemic: Not from Rx 

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