Request a Meeting on Drugs from FDA

I just found this interesting government web page, indicating that you can simply request a meeting with the FDA’s “Center of Medical Products and Tobacco” (an odd pairing) by filling out a short form online.

Meetings between stakeholders and the FDA’s Center for Drug Evaluation and Research (CDER) promote effective two-way communication to improve drug development and safety.

To submit your request for a meeting on drug-related topics, please click the Request a Meeting on Drugs button below and download the meeting request form to your desktop.   Continue reading

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Patient Abandonment in the Name of Opioid Safety

Patient Abandonment in the Name of Opioid Safety | Pain Medicine | Oxford Academic – March 2013 – Stephen J. Ziegler, PhD, J.D.

This article speaks so directly to our current concerns that It’s hard to believe it’s almost 5 years old. Despite these years of increasing restrictions that have dramatically decreased opioid prescribing, opioid overdoses just keep going up.

In the political arena, when two branches of government are headed in one direction, the other branch is often dragged along in the process.

This also appears to be the case with prescription opioid policy, but instead of political branches, well-meaning researchers and politicians are dragging prescribers in a direction that could result in patient abandonment.   Continue reading

Crash Course for Submitting Comments to CMS

#HPM Crash Course in Submitting Comments to CMS | Matthew Cortland on Patreon – Feb 2018 – by Matthew Cortland

Mr. Cortland gives excellent advice for the best way to write your comments on opioid policy. Though his words are aimed at Hospice & Palliative Medicine (HPM) clinicians, I believe many of us chronic pain patients have just as much knowledge and experience with this subject.

CMS has published their proposed changes to Medicare for 2019.

Here are the changes that, in my view, may be the most concerning to Hospice & Palliative Medicine (HPM) clinicians:  

  1. Starting to crack down on opioid ‘potentiator’ drugs – like gabapentin and pregabalin.
  2. Limiting opioids to 90 MME per day.
  3. Making it more difficult for patients to fill two or more long-acting opioids.    Continue reading

Mindfulness Rx Allows Doctors to Ignore Pain

Prescribing Mindfulness Allows Doctors to Ignore Legitimate Female Pain – Feb 2018 – by Sarah Yahm

A few years ago, after a series of cascading injuries and illnesses that rendered me unable to type, drive, or sleep, I briefly became a professional patient.

Like all of my professions, I took it seriously. I went to appointments armed with lists of well-researched questions written down neatly on my yellow legal pad, brought in the occasional medical journal article, and compiled detailed descriptions of my array of increasingly bizarre symptoms.

My goal was to get my doctors to take me seriously so they would dive into the complexities of my case.   Continue reading

The mysterious rise in knee osteoarthritis

The mysterious rise in knee osteoarthritis – Harvard Health Blog – Harvard Health Publishing

Osteoarthritis is the form of joint disease that’s often called “wear-and-tear” or “age-related,” although it’s more complicated than that.

While it tends to affect older adults, it is not a matter of “wearing out” your joints the way tires on your car wear out over time. Your genes, your weight, and other factors contribute to the development of osteoarthritis.

Since genes don’t change quickly across populations, the rise in prevalence of osteoarthritis in recent generations suggests an environmental factor, such as activity, diet, or weight.   Continue reading

Survey on Complimentary Therapy for EDS

Study Title: Use of Complementary Therapies for Pain Management in Patients with Ehlers-Danlos and Hypermobility Spectrum Disorders – Principal Investigator: Jessica Demes

The purpose of our study is to learn more about how adult patients manage their pain when affected by Ehlers Danlos or a Hypermobility Spectrum Disorder. We are hoping that you could provide your opinions and perspectives in this survey.

To join the study, we will ask you to complete a survey with questions about hypermobility and how you experience and manage any pain you have. These questions may take approximately 30-45 minutes to complete.

Anti-Inflammatories for Depression?

The Depression Puzzle: Are Anti-inflammatories Better Than Anti-depressants? An ME/CFS and FM Perspective – Health Rising

Both depression and inflammation may be present in both chronic fatigue syndrome (ME/CFS) and fibromyalgia (FM).

Antidepressants can help some but not others.

Evidence that inflammation may cause depression in as many as 40% of depressed patients suggests that anti-inflammatories might be better at mood elevation for some ME/CFS/FM patients than antidepressants.  Continue reading

Doctors resisting opioid restrictions in Florida

Doctors concerned Florida opioids bills would go too far | The Seattle Times – February 4, 2018 – By  JOE REEDY

It’s wonderful to hear of more doctors pushing back against these ridiculous restrictions on medical care.

Legislation aimed at fighting opioid abuse in Florida has raised concerns among doctors over provisions to impose limits as short as three days for prescriptions of the potentially addictive painkillers.

Physicians have mounted strong opposition to provisions being considered by House and Senate committees to limit prescriptions for Schedule II painkillers like Oxycontin and Fentanyl to three days — or seven days in some cases if a physician documents it as medically necessary.   Continue reading

Forced opioid reductions “by the numbers”

What’s Wrong With Just Counting the Patients on High Dose Opioids and Calling that Bad Care? – by Stefan Kertesz – Feb 2018

Dr. Kertesz exposes the unscientific basis and hazardous effect of forced opioid reductions.

In early 2018, the Center for Medicare and Medicaid Services requested public comments on a draft quality measure of physician performance, called “Potential Opioid Overuse”. It’s alluringly simple.

Payers and regulators will count the number of patients who receive a total opioid dose equivalent to 90 milligrams morphine or more.

The higher the number, the worse the physician is rated.      Continue reading

The Orphaned Patient with Chronic Pain

The Orphaned Patient: Treating Chronic Pain with Opioids | Harvard Medical School | Lean Forward By Peter Grinspoon, M.D. – February 1, 2018

The commonly cited proverb, “The road to hell is paved with good intentions,” was coined in the twelfth century by a French abbot named Bernard of Clairvaux. In no case is this adage more apt than as applies to chronic pain patients, who have been cut off from their longstanding and stable supplies of opiates by

physicians who have been convinced, cajoled, intimidated, mandated, and cowed into no longer prescribing high-dose opiates for chronic pain patients in response to the current opiate epidemic.   Continue reading