Tag Archives: diversion

The Swinging Pendulum of Opiate Prescribing

The Swinging Pendulum of Opiate Prescribing – June, 2016 – Cmdr John Burke

In the several decades I have been in the business of following the diversion of pharmaceuticals, I have noticed a pendulum effect regarding this issue.

In almost everything important in life, balance is usually paramount; extremes are rarely the answer

However, finding balance is difficult and requires work. Balance requires careful thought, weighing the pros and cons, and taking an action that can be accepted by most individuals because getting everyone to agree is virtually impossible.   Continue reading

Negative outcomes of unbalanced opioid policy

Negative outcomes of unbalanced opioid policy supported by clinicians, politicians, and the media – Journal of Pain & Palliative Care Pharmacotherapy – 18 Feb 2016

This article contains good facts to use in arguments against overly restrictive opioid limits.

Harmful and nonmedical use of prescription opioids has increased precipitously in the United States…  Addressing this problem requires attention to scientific data and to objective and balanced consideration of factors driving the problems

Unfortunately, the situation has been blurred by some politicians, health professionals, and the media by their using inadequate concepts, misrepresenting and exaggerating facts, and demonizing pain patients.
Continue reading

The Continuing Problem of Opioids and Pain

Friday Feedback: The Continuing Problem of Opioids and Pain | Medpage Today

This article shows to what ridiculous extremes opioiphobes are willing to go to demonize these drugs that are helpful for so many of us.

We contacted pain management experts via email to ask:

  • Do you agree that opioids are overprescribed (i.e., given for excessive durations and/or for inappropriate indications)? Who is responsible for this overprescribing?
  • Is it currently too hard or too easy to prescribe opioids and for patients who need them to get them?
  • Many patients with chronic noncancer pain insist that opioids help them, even though systematic reviews have consistently found no solid evidence to support a benefit — how can that be?
  • Are genuinely abuse-deterrent opioid products the solution?

Continue reading

Physician’s Guide to DEA Inspections

Physician’s Guide to DEA Administrative Inspections – Pain Medicine News

This article was written for doctors and helps explain why so many of them are reluctant to prescribe opioids.

If you had to face this kind of government-mandated harassment, which could result in losing your ability to practice your profession, would you risk it?

The Drug Enforcement Administration (DEA) employs hundreds of Diversion Investigators to monitor compliance with the Controlled Substances Act (CSA).1 Principal methods for maintaining compliance and determining noncompliance are “inspections” or “audits,” which the DEA has the authority to conduct without a criminal warrant, as established by federal law outlined in the Code of Federal Regulations (CFR)   Continue reading

Pain patients shouldn’t suffer from opioid crackdown

Maine Voices: Legitimate pain patients shouldn’t suffer from crackdown on opiates – The Portland Press Herald / Maine Sunday Telegram By Douglas J. Jorgensen

A state bill that aims to control pain medications is based on empty rhetoric and fear mongering.

I’m writing to express concerns about the 350,000 Mainers with chronic nonmalignant pain and L.D. 1646 [the state bill], meant to better control dispensing pain medicine in Maine.

As a federal expert witness and litigation consultant for the U.S. Drug Enforcement Administration, the FBI and the Office of the Inspector General, I’ve helped imprison and remove from practice physicians around the country who have killed patients by overprescribing controlled substances.   Continue reading

Opioid abuse and chronic pain: Twin epidemics

Opioid abuse and chronic pain: Twin epidemics | TheHill | April 2016

It’s encouraging to see this article published in The Hill’s Congress Blog, a Forum for Lawmakers and Policy Professionals. I find it encouraging that the chronic pain crisis is becoming more publicized, especially in such forums.

We are all aware of the serious opioid misuse, abuse, diversion and overdose issue in our country and the devastating effect it is having on communities across the United States

Less familiar to the public and to policymakers are the millions of Americans suffering from debilitating chronic pain; however, the statistics are just as alarming.      Continue reading

Don’t Flinch From Prescribing >90 MME Opioids!

Don’t Flinch From Prescribing Pain Medications!
Editor’s Memo from April 2016  By Forest Tennant, MD, DrPH

Although these guidelines  [CDC “Guidelines for Opioids for Chronic Pain” ] have been, and will continue to be, strongly criticized for the process by which they were created, they are now published. One of the often stated goals of CDC, despite widespread skepticism from many pain specialists, is that they did not want to limit access to pain care. Let’s take them at their word.

A major “bone of contention” regarding the guidelines is the recommendation that a daily dose of opioid should seldom go over 90 mg equivalents of morphine a day.   Continue reading

A Proactive Response to Prescription Opioid Abuse

A Proactive Response to Prescription Opioid Abuse — NEJM  – by Robert M. Califf, M.D, commissioner of the FDA

The increasing and deliberate obfuscation of what the crisis is really about is making me angry. The problem is opioid–including heroin–abuse, not prescriptions for pain. Most opioid abusers use diverted opioids, not their own prescriptions.

Most opioid abusers use diverted opioids, not their own prescriptions. So far, this crackdown on opioids has merely pushed opioid abusers to heroin, while unfortunate pain patients are left without relief.

A proactive response would be to sink money into research for both addiction and pain treatments that are truly effective. We need to be healed, not criminalized.

We at the Food and Drug Administration (FDA) continue to be deeply concerned about the growing epidemic of opioid abuse, addiction, and overdosean epidemic directly related to the increasingly widespread misuse of powerful opioid pain medications.

The misuse is mostly from diverted opioids, not a person’s own prescription, so all these restrictions are targeting the wrong group.   Continue reading

Professional Criticisms of CDC Guidelines

Responses and Criticisms Over New CDC Opioid Prescribing Guidelines | March 18, 2016

In their statements, both the American Academy of Pain Medicine (AAPM) and the American Medical Association (AMA) first cautiously express approval of the CDC’s intentions (obviously intimidated) before diving into the glaring problems with the guidelines.

I feel the worst part is the fixed dosage limit, unscientific to the point of irrationality and most damaging to patients. It’s absurd to legislate a universal fixed limit since individuals’ responses vary so widely. I personally know of a 6x dose difference between a long-term user and someone who uses it after surgery.

Additionally, many of us have developed tolerance over the years and decades of successfully using opioids for our pain. It makes no sense to hold long-term opioid users and opioid-naive patients to the same dosages.   Continue reading

Law Enforcement and Pain Patients

Law Enforcement and Pain Patients — Pain News Network

This is a headline I never imagined I’d see, addressing pain patients in the context of law enforcement. It makes me so angry, I had to say a few words first.

It seems pain patients are assumed to be addicts by the majority of participants involved in the current effort to create an opioid prescription guideline to solve the overdose crisis (closing the barn door after the horse is gone).

What they did not consider is that opioid prescriptions aren’t causing heroin overdoses,

Addiction is what’s killing people, not a particular drug.

This effort to limit prescriptions drugs comes just as addicts are switching to heroin instead because it’s so much cheaper and does the same job.   Continue reading