Category Archives: Opioid Debate

R.I. bill excludes chronic pain from Rx guidelines

Rep. Amore bill that excludes chronic intractable pain from medication prescribing guidelines passed by House – Press release – June 2019

Finally, a state government (which does have the authority to regulate medical practice, unlike the federal government) is proposing a bill to allow chronic intractable pain patients to continue taking opioids if they are the only effective treatment.

This legislation is remarkably reasonable, realistic, and would be a huge relief to pain patients.

Rep. Gregg Amore’s (D-Dist. 65, East Providence) legislation (2019-H 5434A) that would exclude chronic intractable pain from the definition of “acute pain management” for the purposes of prescribing opioid medication was passed by the House of Representatives.   Continue reading

Our Surgeon General Tweeting Nonsense

Need General Surgery? Ignore The Surgeon General | American Council on Science and Health – By Josh Bloom — July 8, 2019

Over the 4th of July Weekend, our U.S. Surgeon General,  Jerome M. Adams, MD, MPHTweeted: 

U.S. Surgeon General – Jul 3
Putting in some work in the ORs. Got to help with some interesting cases and saw several people get Tylenol and other meds to help provide anesthesia and post-op pain relief with my minimal opioids. They all woke up comfy and happy!

U.S. Surgeon General – Jul 4
And here’s a study where 1000 mg IV Tylenol was found equivalent to IV morphine (based on body weight, but in some cases greater than 6 mg) Note, rib fractures are extremely painful!

This sure makes it sound like Tylenol works better than morphine. Josh Bloom from the ACSH evaluated the study and the Surgeon General’s conclusions.  
Continue reading

Abandoning America’s Pain Patients

How Did We Come to Abandon America’s Pain Patients?Filter Magazineby Alison Knopf – July 2019

This is an excellent article pointing out exactly how pain patients have been neglected and dismissed by the medical system. Kudos to Alison Knopf for her exemplary work.

Overdoses—not those involving prescription opioids, but of heroin and illicit fentanyl, often combined with benzodiazepines—continue to go up. But opioid prescribing continues to go down.

Continue reading

A Mea Culpa on CDC Opioid Guideline

A Mea Culpa on CDC Opioid Guideline – Pain Medicine News – by Nikki Kean – Jul 2019

This article focuses on the flaws with how the guideline has been interpreted and applied. I’m starting to see more articles that are critical of the current overriding fear of opioids appearing in medical publications.

Almost from the day it was released in 2016, the “CDC Guideline for Prescribing Opioids for Chronic Pain” has triggered criticism from many patients and providers.

Nearly three years later, the agency finally seems to be listening, with two publications in April that take a hard look at the guideline and how it is being applied in clinical practice.   Continue reading

Most heroin addicts didn’t start with Rx pain pills

The White House drug czar is wrong: Most heroin addicts didn’t start with prescribed pain pills by Phillip Smith / Independent Media Institute July 3, 2019

As part of its campaign to stem opioid addiction and overdoses, the White House Office of National Drug Control Policy (ONDCP — the drug czar’s office) has launched an education campaign called The Truth About Opioids, but some of the material it is presenting has more than a whiff of spin to it — and could imperil the ability of pain patients to get the relief they need.

The website declares in big, bold letters that “80% of heroin users started with a prescription painkillerThe graphic suggests that heroin users were prescribed opioids, developed a habit, and then went on to junk, with the further implication that a way to reduce heroin addiction is to tighten and reduce the prescribing of opioids.

Now even the “Drug Czar” is promoting the erroneous media story about the “innocent victims” and doubling down on the hype spread by anti-opioid activists.  Continue reading

Threatening letters being sent to our doctors

The following anonymous comment was entered in the responses to Richard Lawhern’s recent editorial on STAT News: Stop persecuting docs for legitimately prescribing opioids for chronic pain.

He’d like to hear from anyone who has had a similar experience with their pharmacy or doctor.

ATTENTION: All Medicare Recipients who are Non-Cancer Chronic Pain Patients. If You have Medicare Part D Rx Drug Insurance through “United Healthcare Medicare AARP”  Continue reading

Overdoses Increasing – With or Without Opioids

Nonopioid Overdose Death Rates Rose Almost As Fast As Those Involving Opioids, 1999-2016 – July 2019

A very recent PubMed study counting all the non-opioid overdose deaths shows the “crisis” is about overdoses from all kinds of illicit drugs, not only opioids (heroin, fentanyl) and certainly not from prescribed medication.

The number of Americans dying from drug overdoses has risen rapidly, but the contribution of nonopioid drugs to this growth is not well understood. Using vital statistics data from the universe of deaths among US residents in the period 1999-2016, I calculated levels of and increases in overall nonopioid fatal overdose rates and those for subgroups stratified by manner of death, sex, race/ethnicity, and age.

From 1999 to 2016 the number of nonopioid drug deaths rose 274 percent, and deaths per 100,000 population rose by 223 percent. Over the same period, opioid-involved fatality counts and rates grew by 371 percent and 307 percent, respectively.

Fatal overdose rates involving stimulants increased more than tenfold, with slower growth but higher rates for deaths involving sedatives and cocaine.

Doctor reprimanded for treatment of pain patient

Portsmouth doctor reprimanded for treatment of chronic pain patient – by Shawne K. Wickham New Hampshire Sunday News – Jul 6, 2019 

This is incredibly good news: finally, a doctor is punished for forcing a significant dose reduction of opioid pain relief, which left his patient in agony and close to suicide.

A Portsmouth doctor has been reprimanded and fined by the New Hampshire Board of Medicine after he cut back a chronic pain patient’s prescription opioid painkillers — and then dropped him as a patient altogether after the man threatened suicide.

Joshua Greenspan, who is board certified in pain management and anesthesiology, signed a settlement agreement in May to resolve allegations of professional misconduct.   Continue reading

No Shortcuts to Safer Opioid Prescribing

No Shortcuts to Safer Opioid Prescribing – Deborah Dowell, M.D., M.P.H., Tamara Haegerich, Ph.D., and Roger Chou, M.D.

Since the Centers for Disease Control and Prevention (CDC) released its Guideline for Prescribing Opioids for Chronic Pain in 2016,1 the medical and health policy communities have largely embraced its recommendations.

Although outpatient opioid prescribing had been declining since 2012, accelerated decreases — including in high-risk prescribing — followed the guideline’s release

Indeed, guideline uptake has been rapid…

…as the survivors of loved ones who fell victim to pain induced suicides after their effective pain relievers were taken away can attest.    Continue reading

CDC Guideline Needs to be Withdrawn

Stop persecuting doctors for legitimately prescribing opioids for chronic pain – By Richard A. “Red” Lawhern – June 28, 2019

Doctors should have gotten the message by now that deserting patients is a violation of medical practice standards, not to mention human rights. But they haven’t.

To the contrary, they’ve been hearing about other doctors who got raided by Drug Enforcement Agency swat teams, their patients terrorized, medical records seized, and practices ruined by announcements in local news media.   Continue reading