OPIOID FACTS: Are we getting the whole picture?

OPIOID FACTS: Are we getting the whole picture? “A Physician’s Perspective” – by medium.com/@ThomasKlineMD/ Jun 2019

This is an article in quasi-interview format by Dr. Kline, who is also tracking the damage done by the “unintended consequences” of the CDC guideline with a list of SUICIDES associated with forced tapering of opiate pain treatments

Q: Is there an epidemic of opioid overdose deaths?

Not really.

The actual increase from 2014 to 2015 was in line with years past, a 0.001% increase. These are street overdose deaths in addiction communities, not in the general public. No particular year was statistically higher than another.  

Q: Is addiction rare?

Yes, the rate for the last 100 years has been steady at 0.5% (today CDC reports 1 million heroin addicted/320 million US population = 0.5%).

Q: Why are addiction rates staying the same with so many prescriptions we hear about?

Opiate addiction (not addiction to marijuana, cocaine or amphetamines) needs two things to trigger it: an opioid and the genes for addiction. No genes, no addiction.

Q: Does the CDC recommend tapering?

No, but they suggest it.

The word “taper” appears 42 times, unusual for a document purported to be a medication guideline.

That’s a good point: a guideline for pain medication shouldn’t be so exclusively focused on tapers.

As a result of not saying it was bad, nearly 70% of 10 million long-term pain patients have been tapered, against their will.

Since 90% actually needed long-term treatment to hold their lives together, the carnage is without belief.

If it is working, the medicine should not be tapered, says the CDC, finally, after three years of the worst medical disaster in U.S. history.

Q: Are there really two million with Opioid Use Disorder (OUD)?

A National Survey was done, people were paid $30 and asked if they “ever used their prescription in any way other than what the doctor put on the bottle.”

If they said yes, they were diagnosed with Opioid Use Disorder (OUD). OUD is not a valid medical diagnosis in this way.

This is insane. It’s like asking a person if they ever had chest pain and then diagnosing them with heart trouble.

Q: Why aren’t there more addicts?

The percentage of type 2 addicts has remained the same since the 1920’s. If you have the genes for type 2 addiction, you will experience unusually intense positive reaction to all opiates, about 0.5% or 1 in 250 people.

On the other hand, 99.5% of the population that does not have the gene will not get “high” with a positive reaction and instead will feel drowsy, this is considered to be type 1 “addiction”.

This vast majority of the population will never experience opiate addiction

Q: Are doctor prescriptions for pain medicine drugs causing more overdose deaths?

No.

In the CDC reports of 40,000 deaths, only 500 deaths are occurring across the United States in physician-managed opiate prescription patients.

The other 39,500 reported by CDC, terrifying the nation into thinking these are occurring in their neighborhoods, are actually those without medical care, without access to pharmacies, the nation’s heroin addicts, not everyday people under a doctor’s care.

This is dishonest data abuse disorder by the CDC.

This is an excellent description of what the CDC has done: it has deliberately manipulated data to make it seem that prescribed opioids for patients are causing the problem when the data actually shows no such thing.

Q: Doctors prescribe too much opiate medicine per patient? Shouldn’t the number of prescriptions be limited?

No.

Opiates nor insulin have no upper limit mg dosages due to the safety of the drug with respect to direct toxicity. The FDA has not established upper limits for either drug.

Both can be safely taken, slowly increased to the endpoint: for relief of pain with opiates, or blood sugar in the case of insulin.

IF we do not believe the patients’ reports of pain, then we have a serious problem in the practice of medicine.

I could not agree more. When a symptom cannot be measured, the doctor has no choice but to rely on the patient’s report. If they don’t believe what their patient is telling them, how can they treat them?

We believe people when they say they have chest pain and sweating; why not believe them when they say “my pain from my interstitial cystitis is worse.” The concern is, higher doses cause more “overdose deaths” and “addiction”. The FDA has already ruled that this is not true (FDA 2012-P-0818).

Q: Doesn’t cutting back on the availability of opioid pain medicine reduce the chance of addiction?

No,addicted people will find a source.

When the government cuts back on supply, as they are doing now (2017–2018), addicted people go to the streets. If you had no prescription pain medicines in the country, you would still have heroin-addicted people finding it somewhere. You cannot beat the black market by reducing legal supply, as this is what creates black markets in the first place.

Q: Opiates given longer than 90 days don’t work and can cause more pain, addiction and overdose.

Not true.

FDA reviewed these arguments and found all three false in 2013 (FDA 2012-P-0818). These scary assumptions are made up by lunatic fringe groups ***, such as the “Physicians for Responsible (reduction) of Opioid Prescriptions,” commonly known as “PROP,” a group with the goal to stop the use of opiate pain medicines as both ineffective and dangerous, are not true.
***in the words of an ex-FDA senior official.

Q: Pain medicine prescriptions for broken legs and car wrecks should only be given for three days, the CDC says.

Not correct.

There is no support for a three-day prescription, just opinions of CDC and PROP consultants, who have been accused of severe anti-pain and anti-pain medicine biases. Since opiate addiction occurs on the first one or two tablets, such a limitation would not work.

Second, this is an attempt by an agency not tasked with making opiate recommendations to interfere with the practice of medicine (illegal under 42 USC 1395 for all those covered by CMS).

Physicians practicing in the real world know that all patients are different. CDC assumes all patients are the same; no study has proven this. This manifesto of pain nihilism causes immense harm and suffering by limiting the dose and by removing the physician or healer from the equation

Q:Is it true opiate pain medication does not work for long-term painful disease?

Not true.

This is a rumor spread by anti-opioid activists that even worked its way into the CDC Guidelines, which, by restating already disproven (FDA) opiophobic tenets, did not improve the idea’s lack of validity. There is no proof, and I have looked exhaustively.

Q: The CDC recommends limiting the pain medicine dosage.

This was set at 90 mg MED (morphine equivalent dose) to ostensibly prevent addictions and overdose deaths, but is completely arbitrary.

Problems can occur at lower doses as well, according to FDA scientists (FDA 2012-P-0818). Only the FDA can change the rules about prescription drugs, not the communicable disease experts at the CDC.

The references in the CDC “Guideline” are, by self-confession, of “low” scientific quality and framed by “contextual evidence review,” a newly created medical word for “opinion.” The key is, whose opinion?

Q:Does it really matter if patients take fewer opioids? Isn’t that better for them?

No, not if you are in pain from surgery, in pain from a broken leg in the ER, or in pain from 30 or so incurable diseases, with pain as a significant component.

There are no harms from taking pain medicines.

You will not become addicted, unless you already are, andyou will not die (only heroin users die from “overdose deaths”).

Many of your friends might be taking opiates without noticeable effect, working, safely driving, being caregivers, and being parents and spouses. Mother nature could have not provided a more useful nontoxic solution for pain. Opiates are safer than ibuprofen or Tylenol.

Q:But won’t people on high dose pain medicine get “high” and become addicted?

No.

There has never been a case of a person addicting while on long-term or high-dose pain medicine regimens.

No reports of getting high after being on a stable dose have been recorded in any study found.

This is due to the lack of brain receptor changes in genetic addition type 2 disease. Only with the genetic mu receptor disease will you get high from opiates — 1%.

Type 2 Addiction people have an unusual and extreme positive reaction to opiates, but no one else. This is an important misunderstanding of the two types of addiction.

In type 1 addiction, the use of marijuana, cocaine or amphetamines will produce “highs” in most all people, but not in 99% taking opiates.

Q:Do Physicians agree with the CDC guidelines?

No study has been done.

Doctors are more driven to follow the CDC guidelines out of fear of reprisal by federal police taking their practices away from them than out of a sense of ethical responsibilities to treat pain and suffering.

The word “guidelines” for doctors means something quite different. It means “law,” do it or pay the consequences. Presumably the guideline writers at the CDC were aware of this subtle, but important, connotation.

I’m sure they were. See Were Consequences of CDC Guideline Unintended?

Q:Prescription opioid deaths are increasing at an alarming rate.

False.

They have been the same for six years.

Heroin deaths have been increasing, an important difference that’s conveniently “forgotten” in many reports. Google {NIH overdose deaths September 2017}, and see the graphs for yourself.

Prescription opiate deaths are not increasing, just more FOA thinking and actions.

Q: Overdose deaths” are the highest they have ever been .

Yes. They have been going up every year since 1970, not 1999, as frequently reported, so, naturally, they are the highest ever.

Q: There are 55,000 to 60,000 overdose deaths last year.

True but false. The key adjective missing is heroin overdose deaths, as only 500 of the 60,000 die each year from opiates prescribed and monitored by doctors in the general population, and those may well be deaths from other conditions.

The misleading CDC numbers are for ALL overdoses, including antifreeze, cough syrup, speed, cocaine, antidepressants, etc.

About 35,000 heroin addicts die each year from not knowing the dosages of the illegal drug they obtained. Only a rare person in the general population dies, but with newspaper coverage it would appear common.

Ninety five percent of overdose deaths are “street” overdose deaths, a fact not made clear by PROP/CDC.

Q: Is the PDMP or Prescription Drug Monitoring Program stopping addiction and overdose deaths?

No.

The Appriss company that sells profiling and surveillance software to states for one million dollars is not catching very many “doctor shoppers,” the new criminals for the FOA (Fear of Addiction) phobia sweeping the country.

Sadly, 60% of “doctor shoppers” are pain patients not being given enough to control their painful diseases, not hustlers.

Pharmacists and doctors and practitioners have been involuntarily deputized by the federal drug police as “front line” resources in the “fight” against drugs.

This is law enforcement falling outside the scope of the practice of medicine.

To complete the picture of the situation, you can read the full article on medium.com: OPIOID FACTS: Are we getting the whole picture? “A Physician’s Perspective”

Author: Thomas F. Kline MD, for JATH Educational Consortium, LLC, Raleigh NC.
42 years varied primary care • former Chief, Hospital in Home Service @harvardmed • formerly: @UofMaryland, @StanfordDeptMed, @uoregon • thomasklinemd.com
Edited by Leslie Bythewood and Kyle Lorentzen

2 thoughts on “OPIOID FACTS: Are we getting the whole picture?

  1. Kathy C

    The media keeps stoking fear and lying to the public. I noticed there is no publicly available information about outcomes. I also noticed that some of the largest benefactors of the false narrative about opiates, combined “education” with advertising. The largest chain pharmacies, benefited from the diversion of opioids to the black market, and continue to make massive profits from the “alternatives.” The fact that these “alternates” are ineffective or led to more deaths, were repackaged old drugs, sold at a massive mark up, is not explained.

    This so called opiate epidemic has been really profitable. Lots of people launched careers as social media influencers, or were go to people for media, due to their high profile stances. At the same time no information is publicly available for treatment outcomes, of the various addiction treatment businesses or pain clinics. Any alternative practitioner can open a “pain clinic” and make any kind of false claim in the media, as long as they proclaim that opiates are dangerous, and repeat popular lies and false narratives.

    We have to remember that our federal agencies, have been undermined by industry interests, they no longer operate to benefit the public. The FTC and other agencies that were supposed to regulate health marketing are no longer functional. The CDC is no longer required to make fact based decisions or evaluate any of their unintended consequences. The opioid debacle showed us that these pharma companies were able to undermine the laws and regulations easily, and avoid any prosecution. 22 years out they are still targeting patients and sick people, it is no surprise that the industry chose this false narrative, and the media amplifies it.

    Take a look at what they are peddling here, https://soundcloud.com/painweek/values-based-interdisciplinary-pain-management?linkId=71477619

    Patients who seek pain relief are to blame for their pain. Not one of these researcher, ever evaluated patient interactions with their physicians. Perhaps when a physician Gas Lights a patient about pain, it could lead to more distress and disability. Once again there is no information on outcomes after 6 weeks. “Values Based” sounds really nice. Of course they start with patients who have good insurance and “low back pain.” They then take the LBP findings and project it on all pain conditions. A program based on deception and pseudo science. They never researched how this kind of program could have a negative impact, especially for people with underlying conditions and limited insurance and no access to a real diagnosis.

    People who look for facts at these sites, instead get alternative facts. Again it is the patients bad habits that lead to chronic pain. Pain does not contribute to sleeplessness, it is opposite world. They probably have to carefully re frame every reference to pain.

    “Sleep is a key contributor to chronic pain. Impaired sleep worsens pain, which in turn prevents patients from getting restful sleep. When pursuing treatment for chronic pain, it is important to not overlook simple, non-drug strategies that can markedly improve sleep.”

    View at Medium.com

    They are clearly brainwashing people, and peddling this alternative reality, where pain is inconsequential and can be wished away. People with chronic pain now this is not true, but they are marketing to the new cases, or people with mild discomfort. There is a lot more money in expanding the definition to the moderately uncomfortable.

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      Yes, people who haven’t a clue about chronic pain are the ones deciding how it should be treated. Because they don’t know otherwise from experience (not their own and not their patients’ because they don’t believe what we say) they absorb all the disinformation being spread by other interests, especially the addiction-recovery industry which directly profits from diagnosing pain patients who need opioids as addicts.

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