All Things Considered: Except Patients

All Things Considered: Except Patients — Pain News Network

All Things Considered aired a two-part series this week on the opioid prescribing guidelines being developed by the Centers for Disease Control and Prevention (CDC), many expected an in-depth and balanced report on America’s love-hate relationship with opioids – how a medicine that gives pain relief to millions is also responsible for the deaths of thousands who abuse it.

Host Robert Siegel said the nation was at a “turning point” in its complicated relationship with opioids. The broadcast interviewed pain specialists, a family physician, and various experts who said the CDC guidelines either go too far or are long overdue.

“We have a moral responsibility to address pain and suffering. And we do have a responsibility not to do harm, but you can do harm in either direction,” said Richard Payne, MD, of Duke University.  

Completely missing from the report was the voice of pain patients. Many noticed the omission and left comments on NPR’s website.   

“Please consider interviewing real chronic pain patients. Everyone seems to be making decisions about our treatment but no one asks us how these medications work for us,” wrote one pain sufferer.

“The recent public discussion on opiates, which paints all opiate users as addicts or drug-seeking, is not only unhelpful, it is exceedingly harmful to patients like myself who take their medications as prescribed,” said a woman who suffers from chronic back pain.

the broadcast included a lengthy interview with Ballantyne, a retired pain specialist who has recently emerged as a controversial figure in the debate over opioids. As Pain News Network has reported, Ballantyne is one of five PROP board members who are advising the CDC and her inclusion in a secret panel of experts is one of the reasons the agency delayed implementing the guidelines and reopened a public comment period.

Critics have said Ballantyne is biased, has a financial conflict of interest, and should be fired from her academic position at the University of Washington School of Medicine for advocating that pain intensity not be treated.

None of that was reported by All Things Considered, which gave Ballantyne a prominent role in the broadcast. Ballantyne told the program that during her lengthy career in pain management she and other doctors were sometimes abused and insulted by “awful” pain patients when they tried to wean them off opiates.

Ballantyne said patients on high doses of opiates “were absolutely miserable, were not doing well, were medically ill and always had severe pain.” It was then that she and her colleagues began to think “the opiate wasn’t helping, and maybe it was harming.”You can listen to Ballantyne in the first part of NPR’s story, by clicking here.  

Well, it’s very strange to have a stranger tell me how much pain I’m feeling and how well I’m doing. How does she know what I’m feeling? How dare she make such definitive statements about the quality of my life when she doesn’t even know me? …or the other hundreds of thousands of people she’s talking about?

What she says about patients with pain severe enough to take opioids is absolutely true:

“were absolutely miserable, were not doing well, were medically ill and always had severe pain.”

But these are the very reason opioids are prescribed for me: 

1. I’m “not doing well” because I live with chronic pain that keeps me from earning a living, accomplishing much, or doing so many things that used to give me such pleasure.
2. Without opioids, I’m “absolutely miserable”, confined to remaining horizontal most of the time.
3. I take opioids is because I am “medically ill”, as are people with fibromyalgia, cancer, and genetic syndromes, like EDS, or those that suffer from medically induced harm, like Arachnoiditis.
4. Another reason I take opioids is because I “always had severe pain”. Isn’t that what these medications are for?