Category Archives: Opioid Debate

Paraplegic Drug User Victim of Involuntary Commitment

How a Paraplegic Drug User Became a Victim of Involuntary Commitment by Christopher Moraff – Feb 2019

New laws make it easy for anyone accused of having an addiction problem to be committed if they don’t agree to whatever treatment is recommended for them.

Involuntary commitment for people accused of having an addiction and not actively participating in treatment for it is becoming more common as more laws are being passed to make this legal.

Barely a day passes on my beat without my meeting someone with a harrowing story about the impact of zero-tolerance drug policies on their lives. But few of these stories have impacted me personally as much as that of a young man I’ll call “Jay.”

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A patient’s opposition to the anti-opioid movement

A patient’s opposition to the anti-opioid movement – KevinMD.com – Mar 2019

I wrote this essay for the doctors’ blog, KevinMD.com. My original title was “California’s Death of Sanity Project” as I criticize what’s called the “California Death Certificate Project”.

It’s bad enough that they are prosecuting doctors for prescription they are writing now, but this project goes up to three years into the past, looking for any opioid prescription to a person who overdoses, even years after they received the prescription, even if the overdose was from fentanyl or a combination of multiple illicit drugs.

As I end my essay:

Trying to stem illicit opioid overdose deaths by mandating restrictions on opioids for patients in pain is only a cruel experiment fueled by ignorance and fear.

— Read on www.kevinmd.com/blog/2019/03/a-patients-opposition-to-the-anti-opioid-movement.html

The Real “Death Panels”: Oregon Medicaid

The Real “Death Panels”: Oregon Medicaid planned to cut off opioids to chronic pain patients | Tarbell – By Art Levine – Mar 2019

At the height of the Tea Party and Republican campaign against the Affordable Care Act, the GOP raised a false alarm about “death panels” that would purportedly kill the disabled based on a subjective judgment and “pull the plug on Grandma.”

But to real grandmothers like 60-year-old Wendy Morgan, who has suffered excruciating back and neck pain in the wake of two botched surgeries, degenerative disc disease and severe pain from MS for decades, there’s now a genuine death panel:  the Oregon Health Authority’s pain and evidence committees.

They were slated on March 14 in Salem to finalize mandated opioid cut-offs to zero for Medicaid patients with chronic back and neck pain conditions, plus fibromyalgia.   Continue reading

Defining Your Story As a Patient Advocate

Defining Your Story As a Patient AdvocateBy Barby Ingle, PNN Columnist – Jan 2019

When honing your message, start with deciding what you want to talk about.

Sometimes it is important to go wide and broad when talking about chronic pain, but other times it’s important to discuss your most pressing experiences with a specific disease or challenge.

Defining the issue that’s important to you is key.

You must be able to explain your point of view and back it up with data and science that is relevant and recent.

Even though this is important, the anti-opioid zealots never present data or proof for their viewpoints, yet they are being listened to much more than pain patients. Continue reading

Raising Alarm on Oregon Force-Tapering Opioids

Pain and Addiction Leaders Raise Alarm on Oregon Force Tapering Opioid Proposal – by Sean Mackey, MD, PhDMar 2019

On Mar 14th, the Oregon HERC Task Force was going to vote to make a rule for Medicaid requiring all opioids to be tapered to zero except in a few very narrowly defined cases.

At the last minute on the morning of the vote, HERC said they were postponing the vote due to a conflict of interest they had “just learned about”. That’s a pretty flimsy excuse because the membership and the whole process of this group have been driven by conflicts of interest (of the alternative medicine community) and a vast ignorance of medicine, pharmacology, and reality.

The extreme nature of this proposal has reached a level of such preposterous cruelty that protest by medical professionals is now required to preserve some limits on the government’s practice of medicine.

…it became clear that there are times when people of good conscience cannot blindly allow bad policies to move forward unchallenged.    –Sean Mackey, MD, PhD

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Illegal drug users rewarded as pain patients suffer

Oregon’s illegal drug users rewarded as chronic pain patients suffer – by Dr. Darryl George – Jan 2019

This article points out that the supposed targets of the “war on drugs” are actually rewarded while pain patients are punished.

As a general practitioner, I have seen the “good,” the “bad,” and the “ugly” of the “opioid epidemic.”

The “good” happens when patients are stabilized on their analgesics and able to return to work or volunteer and regain a better quality of life.    Continue reading

Pain Patients Testify to Congress

Pain Patients to Congress: CDC’s Opioid Guideline Is Hurting Us – by Shannon Firth – Med Page Today – Feb 2019

Now we just have to hope Congress really listened and “heard” what pain patients are trying to make clear.

Patients with chronic pain are suffering from ham-handed efforts to curb opioid overdoses, a series of witnesses told the Senate Health, Education, Labor and Pensions (HELP) Committee on Tuesday.

In particular, the CDC’s 2016 guidelines for opioid prescribing came under heavy fire, as even a self-described supporter of its recommendations admitted the evidence base was weak.

About 50 million Americans suffer from chronic pain and almost 20 million have high-impact chronic pain.   Continue reading

The Problem with Surrogate Endpoints

The Problem with Surrogate Endpoints – Alex Gertner – Twitter stream from @setmoreoff – Feb 2019

Mr. Gertner shows why you cannot measure drug use by counting various “surrogate outcomes” like those listed below and expect to get a realistic number.  Measurements can be dramatically skewed and lead to wildly inaccurate results when invalid surrogate endpoints are chosen.

1/ If you’d like to research the effect of a policy or program on drug use rates then you need to measure drug use.

  • ED overdose visits,
  • drug related arrests, and
  • overdose deaths

are not good measures of drug use rates. Thoughts from >10 years working in drug policy & research   Continue reading

Since when does the government write prescriptions?

Opioid crisis — Since when does the government write prescriptions?By Dr. Henry I. Miller, Josh Bloom | Fox NewsMar 2019

federal and state agencies are focusing on the wrong target – legitimate prescribing of opioids – and have insinuated themselves into the doctor-patient relationship as never before.

Our governments are taking prescription pads out of the hands of physicians and dictating which, and how much, prescription pain medication may be prescribed for patients. This is chilling and unprecedented.

And nationwide, millions of pain patients, even those who were functioning well with long-term opioid therapy, are being forcibly tapered or having their medicines stopped outright, regardless of their wishes or those of their physicians.   Continue reading

Opioid Use, Misuse, and Suicidal Behaviors

Opioid Use, Misuse, and Suicidal Behaviors in a Nationally Representative Sample of U.S. Adults. – PubMed – NCBI – just the abstract available – Mar 2019

This study proves that simply using opioids to treat a medical condition does not lead to increases in suicidal thoughts and behaviors.

Prior research has shown associations between opioid misuse and suicidal behaviors, but the relationship between medical opioid use and suicidal behaviors is not known.

We assessed associations between opioid use and misuse to suicidal ideation, suicide plans, and suicide attempts among adults 18-64 years old (n=86,186) using nationally representative cross-sectional data from the 2015-2016 National Survey on Drug Use and Health.   Continue reading