Category Archives: Opioid Debate

Benefits and harms of drugs for “neuropathic” pain

Benefits and harms of drugs for “neuropathic” pain | Therapeutics Initiative – January 19, 2016

Chronic pain (at times presumed to be “neuropathic” in origin) is a common problem in clinical practice. It is now well recognized that the results of drug treatment are more often disappointing than no

Despite this, from 2005-2014 the number of British Columbians prescribed

  • gabapentin increased 1.8 fold,
  • pregabalin 17 fold, and
  • duloxetine 3.6 fold (from 2008).
  • Use of venlafaxine (mostly for depression/anxiety) has remained relatively stable.

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The Link Between Opioids and Unemployment

The Link Between Opioids and Unemployment –  OLGA KHAZAN – Apr 18, 2017

Since 1990, drug overdose deaths have increased by 500 percent.

A new study suggests unemployment might be one of the factors behind that dramatic rise. The paper, published by NBER last week, finds that:

As the unemployment rate increases by one percentage point in a given county,

  • the opioid-death-rate rises by 3.6 percent, and 
  • emergency room visits rise by 7 percent.  

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3 Things You Need to Know About Opioid Pain Meds

3 Things You Need to Know About Opioid Pain Meds — Pain News Network 3/6/17 – By Janice Reynolds, RN, Guest Columnist

All medications have the potential to be dangerous, yet opioids are the only class of medication being treated as if they are the gateway to Armageddon.  Due to “fake news” and “alternative facts,” many see opioids as bad for acute pain, as well as persistent pain.

This hysteria has even affected the use of opioids to treat non-pain medical conditions — one being as a first line therapy for potential heart attack or heart failure. Opioids cause blood vessels to dilate and lower blood pressure; getting more oxygen to the heart, decreasing anxiety, and reducing the risk of a heart attack.   Continue reading

CDC Observations on Opioid Guideline

Observations presented to the National Center for Injury Prevention and Control’s Board of Scientific Counselors on behalf of the Opioid Guideline Workgroup – May 2016

This presentation covers many of the problems pain patients and pain doctors have been trying to point out.

Update @11am 4/22/2017: I had thought that our concerns may be reaching the awareness of the CDC, but Richard Lawhern pointed out that this document is from May 2016, just 2 months after the final version of the CDC opioid guideline was released.

It seems to list our concerns merely as issues to be overcome by the “implementation” of the guidelines, which shows they knew all along that the guidelines would be “implemented” as rules for pain patients.

Below, I have extracted the text from the slides of the presentation:  Continue reading

Let’s not kill pain patients to “save” patients with addiction

Let’s not kill pain patients to “save” patients with addiction.
– @StefanKertesz on Twitter

As a physician, I urge caution as we cut back opioids | TheHill | By Dr. Stefan G Kertesz – Mar 28, 2017

“If all we talk about is a pill, for or against,
we are having the wrong conversation
We don’t take care of prescription pads.
We take care of people.” 
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Where is the patient in the discussion of the opioid epidemic?

Where is the patient in the discussion of the opioid epidemic? – KevinMD | Blake Kelly, MD | April 13, 2017

This pain management doctor knows us; he understands exactly why pain patients need opioids. He points out that opioids are used as the last (and only) resort for pain patients that have tried absolutely everything else.

The opioid epidemic has been declared loud and clear in the media over the past several years.  

Doctors have been demonized, and patients have been stereotyped.  The statistics are alarming.  

However, I have yet to see anything published that focuses on the patient who lives with chronic pain.  There is very little understanding for these individuals.
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Opioid Guidelines By Patients For Patients

How Would Opioid Prescription Guidelines Read if Pain Patients Wrote Them? – National Pain Report – April 10, 2017 – By Richard A. Lawhern, Ph.D.

A CDC Guideline for prescribing opioids in chronic pain was published in March 2016.  It has become clear that this Guideline is generating horrendously negative results for both chronic pain patients and their doctors.  

Many doctors are choosing to leave pain management rather than face possible prosecution by State or Drug Enforcement Agency authorities for over-prescription of pain relieving opioids.  Tens (if not hundreds) of thousands of patients are being summarily discharged without referral and sometimes without management of opioid withdrawal.  

There are increasing reports of patient suicides.  Continue reading

Opioid Crackdown Threatens Innocent Bystanders

Chronic pain sufferers feel stigma amid opioid crackdown –  March 26, 2017 | by Jessica Bliss

I’m heartened to see that this reporter clearly understands the misery of chronic pain.

Bridgette Rewick has experienced pain — sometimes agonizing — for all of her adult life.

At 56 years old, the mom from Brentwood in Middle Tennessee is on disability. She doesn’t work. She can’t kneel, wear high-heeled shoes because of her constant discomfort. Pain swells through her body, moving from her fingers and wrists to her shoulders, hips and ever-swollen ankles.   Continue reading

Rx painkillers aren’t driving opioid overdoses anymore

Opioid overdoses are climbing. But prescription painkillers aren’t driving them anymore. – Vox – by Apr 1, 2017,

The crackdown on opioid prescriptions to rein in the raging epidemic of opioid abuse and overdoses is picking up steam.

Ten states have passed legislation that limits new opioid prescriptions to 10 days or less (in line with 2016 Centers for Diseases Control and Prevention guidelines), and more states are likely to follow suit. 

But as prescriptions for oxycodone and morphine get more restrictive, opioids sold on the black market are eclipsing them as a bigger threat, at least when it comes to overdoses.   Continue reading