“I take the Hippocratic oath seriously that my job is to relieve pain and suffering,” says Dr. Forest Tennant, a California pain specialist. (See DEA Raids Dr. Forest Tennant’s Pain Clinic)
This YouTube presentation is embedded in a Mad in America blog appeal to readers to participate in a class action suit against CDC. The blog appeal doesn’t appear to be getting any traction. However, apart from the appeal, the video itself is very compelling and well produced.
The opioid crisis makes the therapeutic relationship adversarial – KevinMD – by KRISTIN PUHL | Feb 2018
This article gives an example of how a doctor’s appointment for pain can look so different depending on which side you’re on (not to mention that pitting doctors against patients can never lead to good results).
A patient with chronic pain and a physician walk into an exam room. This could be the set-up for a punchline, but in our current medical climate, it’s more often the first step in an elaborate dance that leaves both parties feeling frustrated, belittled, and ignored.
Often, this is a first-time appointment rather than an established therapeutic relationship. Continue reading
Dr. Lown identifies first and foremost as a healer. In 1996, he published “The Lost Art of Healing,” an appeal to restore the “3,000-year tradition, which bonded doctor and patient in a special affinity of trust.”
The biomedical sciences had begun to dominate our conception of health care, and he warned that
- “healing is replaced with treating,
- caring is supplanted by managing, and
- the art of listening is taken over by technological procedures.”
Flying under the radar of the big opioid crisis is another opioid crisis | Toronto Star – Feb. 6, 2018 – By Jeff Ennis
Though this article is from Canada and refers to the new Canadian “opioid prescribing guideline”, which seems derived from the U.S. guidelines, the similarities are striking:
In response, the government closely monitors physicians who prescribe opioids and a new set of opioid guidelines have been produced to help physicians prescribe this medication more safely.
However, flying under the radar of the big opioid crisis is another opioid crisis. Continue reading
The other opioid epidemic: chronic pain patients in need of care – Philly – February 12, 2018 – by Ira Cantor, For the Inquirer
We have two epidemics related to misuse of opioids in America.
- people with addiction and premature death from abuse of opioids.
- also devastating but getting far less attention, people suffering for years from chronic unrelenting pain losing access to needed medicine.
They are in more pain and experiencing terrible deterioration of their quality of life – unnecessarily. Continue reading
This “Perspective” from the prestigious New England Journal of Medicine laments the industrialization of medicine, the application of standardization and manufacturing efficiencies to the practice of healing.
Frederick Taylor, a son of Philadelphia aristocrats who lived at the turn of the last century, became known as the “father of scientific management” — the original “efficiency expert.”
He believed that the components of every job could and should be scientifically studied, measured, timed, and standardized to maximize efficiency and profit. Continue reading
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
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
“In the beginner’s mind there are many possibilities,
but in the expert’s view, there are few.”
Shunryu Suzuki was writing about Zen beginners and masters, but this concept applies to the practice of medicine as well. Experienced physicians are slow to accept a new paradigm, while medical students and new physicians are more open.
Sometimes, what we “know” to be true is not. Continue reading
Patients with chronic pain forced into opioid tapers by their prescribers – January 15, 2018 – By Alison Knopf
Patients with opioid use disorders (OUDs) are getting better treatment with methadone or buprenorphine than many chronic pain patients.
Prescribers are cutting chronic pain patients off from their opioids.
Providers who treat OUDs know better than to withdraw opioids cold-turkey, and not to taper them carelessly or for no good clinical reason. This does not appear to be the case with physicians treating pain, ADAW has learned. Continue reading