In Search of Sane Pain Policies: An Interview With Richard Lawhern, Ph.D. | American Council on Science and Health – By Josh Bloom — November 10, 2016
Richard A. “Red” Lawhern, Ph.D. is a long-time advocate, webmaster, and online research analyst for chronic pain patients, their families and their doctors. He has kindly agreed to be interviewed.
Josh Blum: Pain management is a very complex issue, for example, balancing the legitimate needs of people who suffer from pain with the prevention of others from becoming addicted.
In your opinion, what is the most important facet of this enormous problem?
Richard Lawhern: The most important thing to know about the so-called ” epidemic of prescription opioid overdose deaths” is that it is has been seriously mis-characterized.
By trying to solve the wrong problems, I believe it is inevitable that government policy on the issue is presently misdirected.
Lost in the current hype and hysteria concerning opioids is the reality that the great majority of chronic pain patients
- do not get a euphoric high from the use of opioids, and
- do not experience the drug cravings and psycho-social behavior distortions that addicts without chronic pain do.
Physical dependence and withdrawal symptoms can and do occur, but can be medically managed.
JB: Do you have statistics to back up your claim?
RL: In recent State-wide studies, a quarter or fewer of overdose victims have a current medical prescription for pain relievers.
Likewise, many of these deaths also involve alcohol or other drugs.
In the limited number of published studies of addiction in chronic pain patients, risk of opioid abuse disorder varies between 10% and 2%, depending on the study you believe.
Risk of death by overdose is less than one-tenth of one percent — a number exceeded by an order of magnitude in the 440,000 deaths per year due to medical errors in hospital settings, often involving non-opioid prescription drugs.
JB: You seem to hold the CDC in particularly low regard for the current situation. Why is this?
RL: There is ample evidence that the CDC “Guidelines” on prescription of opioids in adult non-cancer chronic pain are deeply flawed by weak or no scientific support, professional bias, errors of methodology and process.
The consultants working group that wrote the guidelines didnt’ include a single Board Certified pain management specialist.
These folks literally had no first-hand practical knowledge of what they were writing about.
The Guidelines are being enshrined in State laws and regulations which doctors correctly see as a threat to their licenses if they treat patients as individuals.
The only ethically sound response to this collection of atrocities is immediate withdrawal of the Guidelines for a re-write by a group which includes both more stakeholders and more expertise.
JB: What is next? How do you see this playing out over the next few years?
RL: …Lobbying of Congress and State legislatures is needed to demand withdrawal of restrictions on opioids for those who need them, and implementation of more effective policies to interrupt the diversion of opioids into addicts’ hands.
A lot of this advocacy is likely to fall to folks like me, who are not suffering from crushing financial hardship or disabled by pain itself.
That is certainly true, especially when we are left exhausted by our struggle with pain because we can no longer get effective pain relief.
These are only a few questions I selected from a longer list in the original article: http://acsh.org/news/2016/11/10/search-sane-pain-policies-interview-richard-lawhern-phd-10430