My Take on the Biopsychosocial Model of Patient-Centered Care | Pain Medicine | Oxford Academic – Jianguo Cheng, MD, PhD, FIPP – September 2018
I am privileged to participate in the US Department of Health and Human Services (HHS) Pain Management Inter-Agency Task Force (PMTF) and in the National Academy of Medicine (NAM) Action Collaborative on Countering the US Opioid Epidemic.
Promoting patient-centered care is what I believe to be the most important mission of our profession.
And patient-centered care should be the guiding principle of policy-making by federal and state agencies, health care payers, and professional organizations and societies. Continue reading
The civil war over prescription opioids – by Lynn Webster, MD – Dec 2018
The war is between science and fact versus PROPaganda and media hype.
Over the past 10 to 15 years, attitudes towards opioid use for pain have shifted dramatically. In the 1990s and early 2000s, pain relief was front and center on the newsstands and in medical literature.
During that time, compassion for people in pain increased and permeated our culture and opioids became standard therapy for chronic pain, because few affordable and effective treatment alternatives existed. Continue reading
National Spotlight: Congressional Briefing, and Advocacy for Patient-Centered Research and Pain Care – Beth Darnall, PhD – Oct 2018
This is significant because Dr. Darnall was the main proponent of the “catastrophizing is causing your pain” movement. This idea is exactly what the anti-opioid zealots needed to blame patients for their own pain.
This idea became so widespread that most of the public, and even far too many doctors, believed that changing patients’ “bad attitude” was the only treatment necessary for pain management.
Though I think it took far longer than it should have, Dr. Darnall now seems to have realized that her studies were grossly misinterpreted (and outright weaponized) to prove the preposterous idea that opioids are not necessary to treat chronic pain.
To her great credit, she is now fighting against the very misconceptions that her previous work encouraged. Continue reading
The Tribune was wrong. Medicine often involves a risk to the patient. – By Lynn Webster, M.D. – Dec 2018
The Salt Lake Tribune published an editorial on Sunday Nov 12, 2017, “Medical professionals need to play a role in opioid crisis.” The first line reads, “First do no harm.”
According to the editorial, physicians who prescribe opioids to treat pain patients may be violating the Hippocratic Oath, because “a doctor’s first concern is to not do anything to make things worse.”
However, the editorial got it wrong.
In all of life, it often happens that bad situations are made worse in the short run in order to improve them in the long run, for example, like painfully resetting a broken bone or going through labor to birth a child. Continue reading
Pain Experts Speak Out Against Forced Opioid Tapering – Pain Medicine News – Dec 2018
The tone of this article is very pain-patient-centric and finally shows sympathy for our plight.
Appearing in a mainstream medical newsletter will give our cause far more visibility than what we publish on sites devoted to our cause, so I feel this is a positive sign that the media narrative is starting to shift.
I believe we’ll be seeing less of the outdated and outright wrong “innocent people getting hooked on prescription opioids” stories to more stories about Rx opioids denied to pain patients while others overdose on injected illicit opioids freely available on the black market. Continue reading
While we’ve been thrown under the bus by most doctors, a few brave souls have been protesting since the unscientific and anti-opioid biased CDC Opioid Prescribing Guidelines were issued.
Each year, more doctors are speaking up and our medical professional advocates are publishing more and more studies poking holes in the guideline’s methodology and assumptions.
Below, I’ve listed these papers and articles in reverse chronological order so you can see the groundswell of opposition from medical experts (not self-appointed gurus) growing louder each year: Continue reading
Stanford Letter to Oregon Chronic Pain Task Force – protesting forced opioid tapers and showing these proposals go against guidelines and evidence
We, the undersigned, write to respond to the above-mentioned document released by the Chronic Pain Task Force regarding opioid medication coverage for Oregon Medicaid patients.
In our view, the Task Force embraces a state-mandated treatment change that contravenes the three major national and international guidelines on prescribing opioids for chronic pain.
These guidelines include:
- The Centers for Disease Control and Prevention Guideline for Opioid Prescribing,
- the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain, and
- the VA/DOD Clinical Practice Guidelines for Opioid Therapy for Chronic Pain V. 3.0 – 2017 Continue reading
International Stakeholder Community of Pain Experts and Leaders Call for an Urgent Action on Forced Opioid Tapering | Pain Medicine | Oxford Academic – 29 November 2018
We, the undersigned, stand as a unified community of stakeholders and key opinion leaders deeply concerned about forced opioid tapering in patients receiving long-term prescription opioid therapy for chronic pain.
This is a large-scale humanitarian issue.
As happy as I am to see this declaration, even long after the opioid prescribing guidelines were weaponized to force opioid tapers, I’m appalled that it took 2.5 years of entirely foreseeable consequences for all these doctors to finally speak up.
There’s an impressively long list of signatories to this document, including several that have been vocally pushing for the very restrictions they now call a “large-scale humanitarian issue”. I’m stunned at the hypocrisy. Continue reading
A tweet from one of our champions for pain patient access to opioids, Dr. Stefan Kertesz (@StefanKertesz) identifies major problems in a study supposedly showing that prescription deaths decreased in states where PDMP was instituted:
Suicide Accounts for Higher Percentage Of Opioid Deaths Than Previously Believed – Pain Medicine News – Sept 2018
In 2016, 42,000 Americans died of an opioid overdose, according to the CDC. In the past, just a tiny fraction of those deaths would have been counted as suicides.
But now, , writing in The New England Journal of Medicine, Maria A. Oquendo, MD, PhD, the chair of the Psychiatry Department in the Perelman School of Medicine and Nora D. Volkow, MD, the director of the National Institute on Drug Abuse estimated that 20% to 30% of these deaths (8,400-12,600) were likely by suicide. Dr. Oquendo told Pain Medicine News that the rate could be as high as 40% (16,800).
Pain Medicine News editorial advisory board member Lynn R. Webster, MD, believes death by suicide may be even more prevalent among opioid overdoses than Drs. Oquendo and Volkow suggest. [see Suicide Due to Chronic Pain]