Tennessee Pain Clinics to Stop Using Opioids

Tennessee Pain Clinics to Stop Using Opioids — Pain News Network – April 27, 2016 – By Pat Anson, Editor

One of the largest healthcare systems in Tennessee will no longer prescribe long term opioid pain medication to patients at two of its pain management clinics.

Although the CDC guidelines are voluntary and meant only for primary care physicians, many doctors around the country are adopting them and either weaning their patients off opioids or cutting them off entirely.

“This change was considered for several months in response to changing regulations and increasing national opiate addiction rates, and we began notifying physicians and patients of this decision in early April,” Jerry Askew, Tennova Healthcare’s vice president of external relations said in a statement.  

Tennova Healthcare is managed by the Sisters of Mercy, an organization of Roman Catholic nuns.

Correction: I’ve been notified that

The Sisters of Mercy have never run Tennova, it was once owned by Catholic Health Partners but is now owned by a huge for-profit corporation out of Nashville. There are only a few nuns left at the facility where the pain clinic was located and I occasionally see them at the grocery store (there is a convent on site). They are sweet, caring women who would never want to see any of their patients in pain”

See http://www.local8now.com/home/headlines/Tennova-parent-company-sold-to-Franklin-Tenn-firm-217574481.html

Tennova operates a chain of 17 hospitals in Tennessee, but its new opioid policy only applies to patients at two pain clinics affiliated with Tennova hospitals in Knoxville and Turkey Creek

“After 30 days of your receipt of this letter, we no longer plan to provide long-term opiate pain medication to our patients,” Tennova said in a letter to patients.

30 days is not enough time to be tapered down from high opioid doses, so they are essentially throwing all their patients with the most pain into withdrawal.

Forcing patients into withdrawal should be considered malpractice. It’s easily avoidable, but it takes weeks or months of tapering slowly to prevent withdrawal.

“While pain medication therapy is widely used, non-opiate alternatives can be equally effective and can be generally safer for the patients who use them.

I keep hearing this statement, but it’s absolutely false. Non-opioid alternatives are by no means “equally effective” for pain, but rather best used as an adjunct therapy to reduce, not eliminate, the doses of opioids.

The Center in Knoxville will continue to provide effective and compassionate treatment with non-opiate options including

  • non-opioid pain medications,
  • interventional procedures such as injections and radiofrequency ablations;
  • referral to neurology and spine specialists;
  • physical and aquatic therapy;
  • weight loss strategies;
  • acupuncture;
  • massage therapy; and
  • lifestyle counseling programs.”

None of these treatments are nearly as effective as opioids, and forcing every patient to use these helpful therapies instead of effective medication is far from compassionate.

But many of those alternative treatments do not work and are not covered by insurance, according to a recent survey of over 2,000 patients by Pain News Network and the International Pain Foundation.

Essentially, access to all the suddenly miraculously effective alternative treatments is controlled by money. If you’re not wealthy enough, this means you will not get any pain treatment at all.

Three out of four patients said over-the-counter pain relievers did not help them at all and

over half said non-opioid prescription drugs like Lyrica and Cymbalta are also ineffective.   

Douglas Varney, commissioner of the Department of Mental Health and Substance Abuse Services. “We are succeeding in reducing the number of prescriptions being written.

The goal seems to be reducing prescriptions above all else, without counting people are left with crippling pain . This is a ridiculous metric to use for pain treatment.

We have helped more people into treatment and recovery and rallied a new generation of Tennesseans to live a life free of addiction.”

Treatment. in this case, refers to addiction treatment, not pain treatment. This is happening in pain clinics around the country.

Instead of treating pain, they treat all patients taking opioids as addicts. They measure their success by sending people away without prescriptions.

But patient advocates say the crackdown on painkillers is unfairly focused on pain sufferers, not on the addicts who abuse opioid medication.

“I am seeing literally hundreds of reports from people who are being denied renewal of opioid meds which work well for them and are frequently the only medical treatments that give them any quality of life.

Doctors are giving up their pain management practices for fear of prosecution by the DEA,” said Richard Lawhern, PhD, who became an advocate after his wife developed trigeminal neuralgia, a chronic facial pain disorder.

“I am convinced that the CDC guidelines are creating what we will later recognize to be a wave of patient suicides due to resurgent pain and hopelessness, as well as a surge in patients seeking out street drugs because they cannot function without pain relief and are being forced by their doctors to do so.”

In recent weeks, at least 14 people died and dozens were hospitalized in California after ingesting counterfeit pain medication made with illicit fentanyl, a powerful and deadly analgesic. Some of the victims were pain patients.

This is just another casualty of our wrongheaded approach to addiction. These deaths, however, will be counted as just more overdose deaths deliberately conflating desperate acts of pain patients with the recreational activities of drug abusers.

Fake pain pills are being sold by dealers in the Sacramento and San Francisco Bay areas, and have also been intercepted at the California-Mexico border.   

 

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24 thoughts on “Tennessee Pain Clinics to Stop Using Opioids

  1. Doc Anonymous

    NONE of the treatments that the Tennessee clinics are going to offer have been shown to treat chronic pain effectively. I also note that they are going to continue to do interventional procedures, meaning that they will do epidural steroid injections…..even though the FDA states that the most commonly used medication, DepoMedrol or its generic equivalent (methyprednisolone), ARE NOT to be used for epidural injections. Indeed, epidurals can cause significant side effects but the FDA does not count the many people who have developed arachnoiditis from ESI. Arachnoiditis in its chronic form has scar tissue distorting the nerves in the spinal canal. While there is no evidence, I have always wondered if people with EDS are more prone to developing complications.

    But lets look at the overall process. It seems there are many agencies (federal and state), administrators and doctors and others, who are participating in a population based Factitious Disorder Imposed on Another. The clinical entities that are espoused by the Tennessee clinics are FACTITIOUS because they are NOT the TRUE clinical entities that occur in people with severe disabling chronic pain. Here the PERPETRATORS (CDC, FDA, DEA, various administrators, Medical Societies, and State Medical Boards) are the perpetrators because they are using FACTITIOUS symptoms and imposing them on the entire class of people who have disabling chronic incurable pain and they do not even discuss the clinical entities that are affected most by these tirades against pain medication. The victims in this disease are the people with chronic pain.

    This is a very real psychiatric illness that is defined in the most recent Diagnostic and Statistical Manual, 5th Edition. This manual is the official listing of psychiatric disorders in the United States. The problem with this disease is that someone other than the sick one bears the brunt of the harm. It was previously known as Munchausen’s Syndrome by Proxy.

    So lets all join in in informing all of these uncaring bureaucrats of their underlying psychiatric disorder. The alternative is untold torture, suffering and even death by suicide for too many people suffering from chronic pain.

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      Yes, I’ve noticed that although the evidence for these “alternative therapies” is even more lacking then it is for long-term opioids, there’s no reluctance to foist these voodoo treatments (that were widely disparaged decades ago) on pain patients.

      The problem seems to be that the docs want to decide how much pain we’re in because they don’t agree with what we’re telling them. A typical line is “you only think the treatment isn’t working, even though it actually is”. How does one reply to a nonsensical statement like that?

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  2. Lis

    I’m actually not surprised it’s run by the Sisters of Mercy. In Ireland, they’re the center of an abuse scandal where young were institutionalized for ridiculous things and forced to work in awful conditions. This went on for years and they refuse to acknowledge the abuse or makes amends for the suffering caused. I doubt they’re much better in the US.

    Liked by 1 person

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    1. Ann

      The Sisters of Mercy have never run Tennova, it was once owned by Catholic Health Partners but is now owned by a huge for profit corporation out of Nashville. There are only a few nuns left at the facility where the pain clinic was located and I occasionally see them at the grocery store (there is a convent on site). They are sweet, caring women who would never want to see any of their patients in pain.

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  3. Mary D Bryan

    I received this very letter today after being prescribed opiates from Tennova for over 8 years. My records will show that I NEVER took more than prescribed or missed an appointment. With the opiates I have very limited function but I CAN have a life. Without them I will essentially be home bound, possibly bed-ridden for large parts of a long 24-hr day. I was given this letter without compassion, without apology. I was told that “someone might get hold of my pills and die” from the same person who has been prescribing them to me for years.

    As far as the effective and compassionate treatment with non-opiate options that they claim they will continue–except for non-opioid pain medications, injections and radiofrequency ablations–THEY NEVER EXISTED. I was NEVER offered physical or aquatic therapy; acupuncture; massage therapy; or a lifestyle counseling program.

    The letter also says they will “work with you to develop a clinically-appropriate tapering regimen to transition you to the appropriate alternatives.” This consisted of handing me a prescription for one more month of medication and telling me to gradually wean off on my own. The letter continues with “If despite our best efforts, you experience withdrawal symptoms, please seek treatment at the nearest emergency department.” If other words, once I walked out the door today my only recourse if I experience severe withdrawal will be to go to an ER which will then transfer me to a rehab center and my pain will not be considered. I know this as fact. I have been there before.

    Luckily I had some inkling that this was coming down the pike and made an appointment with a reputable pain clinic a couple of months ago. I can only pray that they will continue to prescribe opiates I have lived in pain for over 10 years now. Some days are overwhelmingly bad as it is. I really don’t know how I will be able to handle having no hope of pain relief when I begin another day. I too predict a wave of suicides as a result of the CDC guidelines.

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      This is truly heartbreaking. It’s malpractice because one month is not long enough to taper for many of us, but I doubt you could find a lawyer to help you when there are opioids involved. Still, how can this be considered appropriate medical care?

      You’ve written your story well – perhaps you could send it to a local newspaper? I know it doesn’t change the hell you’re facing now, but if we keep making noise and protesting until our dying breaths, maybe the cumulative effect would get noticed. No single story will turn the tide, but your eloquent tale of this gross injustice should be posted in more places.

      Please consider sending it to the National Pain Report (Our goal is to increase public awareness and promote a digital conversation about chronic pain. We encourage story ideas from all. Contact us by email: editor@nationalpainreport.com) or the Pain News Network (If you have a story idea, question or comment, feel free to send us an email at editor@PainNewsNetwork.org)

      Liked by 1 person

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      1. Mary D Bryan

        Thank you Zyp Czyk. I would be happy to share my story as you have suggested. I had already begun a letter to my newspaper and would be glad to send it to the National Pain Report.

        Liked by 1 person

        Reply
        1. Zyp Czyk Post author

          That’s wonderful! You can give a first hand account of the cruel absurdity of the new rules. This is still fresh news about those clinics, so your timing is great.

          I hope that writing about and broadcasting this outrage makes you feel a little better. Part of my coping method for my pain is keeping this blog updated and writing essays.

          Unfortunately, I can’t even do that when my pain gets too intense and starts interrupting me constantly. I’m dependent on my opioid meds to keep me writing – and that worries me.

          We may be powerless, but we don’t have to disappear into silent suffering – we can still make a heck of a lot of noise. Please send me a link when you get published!

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          1. countinggirl

            A dear friend sent me this link. I can’t tell you how cathartic it has been to be able to vent my anger. Keep up your great work. I too have pain with writing so I understand what a gift you are giving to others.

            Liked by 1 person

            Reply
            1. Zyp Czyk Post author

              Thanks for the kudos! This is not a very popular blog, but my readers are so appreciative that it keeps me going.

              It does feel good to find and point out how outrageously pain patients are being treated. It made a huge difference when I found others like myself and realized I wasn’t imagining my pain and the disbelieving, suspicious attitude of some doctors.

              I thought I was the crazy one when I still believed it was “just me”, but now I know we’re all considered “crazy” even though our pain is devastatingly real.

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            2. Mary D Bryan

              With great trepidation I posted the letter about Tennova and my use of opiates on my Facebook page today knowing full well that many will think that if I had never used opiates that I would not be having a problem now. What they don’t know is that when I have detoxed and stopped using opiates that the pain is simply unbearable. I “outed” myself in the hope that others will be led to this blog and find the support that people with chronic pain so disparately need. Again, thank you for your work.

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            3. Zyp Czyk Post author

              Congratulations!

              I’ve been “out” about my opioid use for so long I forget how difficult the decision is. I, too, was very hesitant to talk about my opioid use online and I remember feeling a little sick to my stomach after the first time I did it. But there was also a much stronger and deeper sense of pride that I was standing up not just for myself, but a whole group of invisible stigmatized people. I hope you are feeling that too.

              But I am using an alias and you are using your real name, which is much braver. I’ve had some writing published in online publications and there again I was faced with the decision whether to admit it was I, Angelika, who was using opioids. My writing is too important to me now to hide behind an alias, so I “came out” again.

              Anyone can find out who Zyp Czyk is if they look around a little, but it does leave my identity somewhat obfuscated. I can tell you, however, that I have not received even one nasty comment. I have received nothing but understanding, kindness, and support, of such sincerity and volume that by now, a nasty comment wouldn’t even bother me (I think).

              I’m so happy to think I may have helped influence someone silent to speak up. I think you’ll have the same experience I did and that you’ll get stronger and even more outspoken as you step into the public arena to fight for our rights.

              You really made my day with this!

              PS I hope you’ll keep me posted and send me links to any articles you have published.

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  4. Judith Hughes

    I am Mary Bryan’s sister and I want to thank you for giving her the courage to “out” herself to the online community and to help her think through was threatens to be a disaster if she is forced to come off opiates in the space of 30 days. To say this practice is cruel and wrong-headed doesn’t even begin to delineate the suffering this decision by Tennova will cause. They should be closed down for malpractice. Thank you.

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      You have no idea how good you’re making me feel with your thanks. I’m so happy that I was able to help another pain patient feel a little less trapped by these awful circumstances.

      Of course, we *are* trapped, but we can do our best not to go down quietly. There are millions of us! You can find a great community at the Inspire.com forums. That’s where I finally found my tribe when I read countless stories just like mine.

      I’m so touched you took the time to thank me – you obviously love your sister very much. You may not even realize how incredibly important your support is right now, but if I hadn’t had my hubby at my side during my times of crisis I don’t think I’d have made it. We need someone to witness and believe in our pain when all the doubters can make us start questioning our own sanity.

      We need to stick together and resist as best we can as long as we can.

      Liked by 2 people

      Reply
      1. Mary D Bryan

        What my sister Judy did not mention is that she has chronic pain as well, at least as bad as I do. I believe that this forum and the others it leads to will help us both immensely. Again, many thanks for what you are doing.

        Liked by 2 people

        Reply
      2. Mary D Bryan

        I have to confess that I took down my posting to Facebook. Too many members of my family across the country do not know that I am taking opiates. Although I am not ashamed of doing so, I don’t want them to find out through FB. Kudos to you for “coming out!”

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        1. Zyp Czyk Post author

          Maybe Facebook isn’t the right place to announce things like this. I don’t use it at all. After all, your intent isn’t to announce your opioid use, but rather to make public how you’ve been mistreated.

          Instead, you could send your letter to the medical group itself. These days, patients/customers are always being asked for feedback, which can then affects the clinic’s ratings and possibly insurance reimbursements. So it would be very useful to send your story to Tennova, and then your opioid use won’t be announced to family & friends.

          I checked Tennova’s website and found this (http://www.tennovawest.com/about/phone-directory)

          When you have concerns regarding patient care or safety, that have not been resolved by the hospital, you may contact the Department of Public Health, Division of Health Care quality at 1-800-462-5540 and/or the Joint Commission’s office of Quality Monitoring at 1-800-994-6610 or complaint@jointcommission.org.

          Do you think you could send an email about what’s been done to you to complaint@jointcommission.org? That way, your story would go to where it would have the most impact without coming out to everyone. After all, it’s the clinic administration and the Health Department that need to know about this, not your Facebook friends.

          Remember to explain that this treatment is so horrible because one month isn’t long enough for an opioid taper and you’re being left without any pain management at all. Also, untreated chronic pain has serious medical consequences. (I’ve posted several articles about this at https://edsinfo.wordpress.com/tag/pain-damage/)

          I always prefer using email over the phone because I get so angry and flustered. With an email, I have a record of the communication and can demand an answer. Also, I can organize my thoughts and tone down my emotions to sound much more reasonable than I really am :-)

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  5. Pingback: Pain patients deliberately forced into withdrawals | EDS Info (Ehlers-Danlos Syndrome)

  6. Ann

    Tennova is no longer run by the Sisters of Mercy. I used to work at this facility and the nuns who still remain after the hospital group was bought out by a succession of for profit companies do truly care about their patients. I can’t say the same for the corporation that now owns the hospitals.

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  7. Ann

    Please correct your article –http://www.local8now.com/home/headlines/Tennova-parent-company-sold-to-Franklin-Tenn-firm-217574481.html. The Tennova group of hospitals was given up by Catholic Health Partners several years ago.

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    1. Zyp Czyk Post author

      Thank you so much for sending me this information and its source, so I can fix this mistake.

      I’m sorry I contributed to spreading this false rumor about the Sisters of Mercy.

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      1. Ann

        Thanks so much for correcting your article. I’m actually not a very religious person but do have a lot of respect for what the nuns do at Physicians Regional…probably the only “soul” the place has left after being bought out by Health Management Associates (which was then swallowed up by Community Health Systems, the largest health management company in the United States). I do truly feel for patients who are getting the rug pulled out from under them in this situation.

        Liked by 1 person

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