Defining Your Story As a Patient Advocate

Defining Your Story As a Patient AdvocateBy Barby Ingle, PNN Columnist – Jan 2019

When honing your message, start with deciding what you want to talk about.

Sometimes it is important to go wide and broad when talking about chronic pain, but other times it’s important to discuss your most pressing experiences with a specific disease or challenge.

Defining the issue that’s important to you is key.

You must be able to explain your point of view and back it up with data and science that is relevant and recent.

Even though this is important, the anti-opioid zealots never present data or proof for their viewpoints, yet they are being listened to much more than pain patients. Continue reading

Treating chronic pain can restore normal brain function

Effective Treatment of Chronic Low Back Pain in Humans Reverses Abnormal Brain Anatomy and Function | Journal of Neuroscience – Free full-text article – May 2011

Though also not new, this study is a follow up on an earlier post: Brain abnormalities are Consequence Not Cause of pain (2009). The article below contains dozens of links to further information.

Abstract:

Chronic pain is associated with reduced brain gray matter and impaired cognitive ability.

In this longitudinal study, we assessed whether neuroanatomical and functional abnormalities were reversible and dependent on treatment outcomes.     Continue reading

Raising Alarm on Oregon Force-Tapering Opioids

Pain and Addiction Leaders Raise Alarm on Oregon Force Tapering Opioid Proposal – by Sean Mackey, MD, PhDMar 2019

On Mar 14th, the Oregon HERC Task Force was going to vote to make a rule for Medicaid requiring all opioids to be tapered to zero except in a few very narrowly defined cases.

At the last minute on the morning of the vote, HERC said they were postponing the vote due to a conflict of interest they had “just learned about”. That’s a pretty flimsy excuse because the membership and the whole process of this group have been driven by conflicts of interest (of the alternative medicine community) and a vast ignorance of medicine, pharmacology, and reality.

The extreme nature of this proposal has reached a level of such preposterous cruelty that protest by medical professionals is now required to preserve some limits on the government’s practice of medicine.

…it became clear that there are times when people of good conscience cannot blindly allow bad policies to move forward unchallenged.    –Sean Mackey, MD, PhD

Continue reading

Industry-Funded Studies and the Skewing of America

I stumbled across this interesting publication that’s dedicated to reporting on the “cheating” that goes on as our country moves to privatize more and more services

Tarbell uncovers how powerful people and companies use their influence to shape a system that works for them, not you. We highlight solutions to pressing problems.

This puts our lives in the hands of corporations whose “moral imperative” is to make money for their shareholders, while all other goals and concerns (like patient outcomes) exist only in service of this “prime directive”.  Continue reading

Illegal drug users rewarded as pain patients suffer

Oregon’s illegal drug users rewarded as chronic pain patients suffer – by Dr. Darryl George – Jan 2019

This article points out that the supposed targets of the “war on drugs” are actually rewarded while pain patients are punished.

As a general practitioner, I have seen the “good,” the “bad,” and the “ugly” of the “opioid epidemic.”

The “good” happens when patients are stabilized on their analgesics and able to return to work or volunteer and regain a better quality of life.    Continue reading

Increased or improved pain after opioid taper?

Does Opioid Tapering in Chronic Pain Patients Result in Improved Pain or Same Pain vs Increased Pain at Taper Completion? A Structured Evidence-Based Systematic Review – December 2018

This review (based on low-quality evidence) came to the unlikely conclusion that their hypothesis is true: pain doesn’t increase (and sometimes even decreases) when opioids are tapered.

Considering that people are committing suicide due to pain when their opioids are tapered, this study’s findings fly in the face of reality. But people (and our doctors) who read such “research” papers then end up believing this heavily biased nonsense.

Objective

To support or refute the hypothesis that opioid tapering in chronic pain patients (CPPs) improves pain or maintains the same pain level by taper completion but does not increase pain.  

Continue reading

Brain abnormalities are Consequence Not Cause of pain

Brain Gray Matter Decrease in Chronic Pain Is the Consequence and Not the Cause of Pain | Journal of Neuroscience Nov 2009

If you can reverse brain “damage” by effectively treating the patient’s chronic pain, it seems pretty clear that the chronic pain was the cause.

This means we don’t have to accept the idea that abnormalities in our brains are what’s causing our pain (which some have hinted at).

Recently, local morphologic alterations of the brain in areas ascribable to the transmission of pain were reported in patients suffering from chronic pain.

Although some authors discussed these findings as damage or loss of brain gray matter, one of the key questions is whether these structural alterations in the cerebral pain-transmitting network precede or succeed the chronicity of pain.   Continue reading

Complex Chronic Pain Disorders

Complex Chronic Pain Disorders By Don L. Goldenberg, MD – Feb 2019

The pathophysiology of and approaches to 3 commonly seen pain conditions: CRPS, EDS, and SFN.

  • Complex regional pain syndrome (CRPS),
  • Ehlers-Danlos syndrome (EDS), and
  • small fiber neuropathy (SFN)

are three important and complex chronic pain disorders.   Continue reading

Alternatives to Opioids in Medication for Pain

Alternatives to Opioids in the Pharmacologic Management of Chronic Pain Syndromes: A Narrative Review of Randomized, Controlled, and Blinded Clinical Trials – free full-text /PMC5785237/ – 2018 Nov

This recent review finds that there is very little evidence beyond a few weeks for the “effectiveness” [see qualification at end of review] of any non-opioid medication that has some beneficial effect on pain.

The goal of this review was to report the current body of evidence-based medicine gained from

  • prospective,
  • randomized-controlled,
  • blinded studies

on the use of non-opioid analgesics for the most common non-cancer chronic pain conditions.    Continue reading

Pain Patients Testify to Congress

Pain Patients to Congress: CDC’s Opioid Guideline Is Hurting Us – by Shannon Firth – Med Page Today – Feb 2019

Now we just have to hope Congress really listened and “heard” what pain patients are trying to make clear.

Patients with chronic pain are suffering from ham-handed efforts to curb opioid overdoses, a series of witnesses told the Senate Health, Education, Labor and Pensions (HELP) Committee on Tuesday.

In particular, the CDC’s 2016 guidelines for opioid prescribing came under heavy fire, as even a self-described supporter of its recommendations admitted the evidence base was weak.

About 50 million Americans suffer from chronic pain and almost 20 million have high-impact chronic pain.   Continue reading