My comment on proposed FDA pain mgmt training

FDA Blueprint for Prescriber Education for Extended-Release and Long-Acting Opioids

The period for commenting ends Monday, July 10, so please take a moment to visit the site and express your objections.

Below is the comment I wrote:  

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I am appalled by these heartless and cruel instructions by my government to discredit and deny my only means of relief from my painful genetic connective tissue disorder.

This proposed curriculum is a transparent attempt by the addiction-recovery industry to insert their dogma into the FDA’s instructions to doctors, classifying any and all chronic or high-dose opioid use for intractable pain as a “substance use disorder” instead of “pain management”.

They seek to incriminate chronic pain patients as addicts, restrict prescribing of effective opioid pain relievers, and condemn us to their “12-step addiction recovery” programs, which are unregulated, rarely successful (~10%), and highly profitable.

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Pain is the most forceful and unpleasant sensation we humans can experience because it is intended to motivate us to extraordinary feats of survival. When this powerful bodily alarm sensation becomes chronic, pain overshadows and disrupts every moment of existence and life is no longer worth surviving.

I have tried all the non-opioid, psychological, and alternative (unscientific) medicine therapies suggested by the CDC and found true pain relief only from opioids. I’ve been taking them for over 20 years now and suffer only mild constipation as a side effect.

Opioid medication extended my career by 10 years when my increasing pain would have forced me to quit working much sooner. Without my high-dose opioid medication, I would be bed or couch-bound, existing, but not really living.  

The suggested opioid dose ranges of the CDC opioid prescribing guideline are being grossly distorted and misused, despite their stated purpose only as suggestions for non-specialists. I watch in dismay as they are being codified into inflexible rules and I fear for my life.

Without opioid pain relief, my life would become incessant torture with death as the only escape. Because I am only 60, I must prepare to end my life if I’m left defenseless against pain’s merciless rampage through my broken body.

The statement that “Opioids are rarely needed for chronic pain” is stunningly ignorant, callous, and dismissive of this most powerful of human sensations. Opioids have been used effectively against pain for thousands of years, and are addictive for only a small subset of humanity (~2%).

We cannot prevent these people from becoming addicted by forcing so many other people (~25 million) to live with incapacitating pain.

If these medications were dangerously addictive for almost every person after just a few doses, as PROP and Kolodny claim, everyone who has ever taken opioids after surgery would be addicted. This is clearly not the case.

The “opioid epidemic” is one of addiction, not a specific drug, and new data from the CDC show that it is fed by illicitly manufactured and imported opioid analogs far more potent than prescription medication tablets.

For an unproven and questionable benefit to potential addicts, people with permanently painful conditions are sacrificed to the incapacitating pain that opioids had made bearable.

There is absolutely NO connection between my and my mother’s prescribed opioid pain medications and a young person overdosing on an illicit, uncontrolled heroin/fentanyl/carfentanil mix. Denying us relief from our painful genetic disorder (Ehlers-Danlos Syndrome) does nothing to help the people suffering from addiction – the ones in danger of overdosing.

These misguided efforts to stop people from overdosing on street drugs are cruel and disabling to people like me who must live with constant pain.

When our pain relieving medication is drastically decreased (and in some cases stopped without notice or aftercare), we can no longer function in our jobs or family roles, we become dependent and burdensome to our loved ones, and our lives become a progression of daily suffering.  

We cannot prevent illicit heroin/fentanyl/carfentanil overdoses by limiting prescriptions for intractable pain.

To effectively address the growing crisis of addiction and overdose in our society, we must invest far more in the effective treatment of its root cause, addiction, not merely limit the treatment of chronic pain.

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America’s War on Drugs has been a consistent failure in its 100-year-long attempt to control population behavior by limiting the supply of various illicit drugs. Can we finally accept this reality?

Even the World Health Organization has now spoken out against the harms of this ill-advised policy and urges that illicit drug use be considered a public health issue, not a criminal case.

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3 thoughts on “My comment on proposed FDA pain mgmt training

  1. scott michaels

    i am besridden because i cant get the medicatio that gave me a quality if life. i ahould not be collateral damage.i alwways rook as dirwcted and never ran out.
    now if the csc does not know the difference between a drug addict and a person dependent on pain relievers, they should close the doors.
    I actually believe this is a paid for by insurance companies and hmos made up lie. the billions they are saving by ignoeing pain patients is criminal. the basically blackmail the doctors with threat of jail and since when in this countey arw a fww tgousand drug addicts more important the millions and millions of legitimate chronic pain suffers. ARE WE TO BE THAT NAIVE. WERE NOT STUPID JUST IN A LOT OF PAIN

    Liked by 2 people

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