Touching opioids extremely unlikely to cause symptoms

Research: Illness from accidental opioid exposure ‘extremely unlikely’ – By Laura French – Mar 2020

A recent scientific review and editorial published in a medical journal found no credible cases of first responders experiencing opioid poisoning from accidental exposure and warned of the negative consequences of misinformation in the media.

This is what I’ve been saying and posting all along – see Fear, Loathing and Fentanyl Exposure.

The researchers found that none of the reports provided credible evidence of opioid intoxication, such as a plausible route of exposure, symptoms consistent with opioid exposure or laboratory results showing that opioids caused the first responder’s symptoms.

Numbers and Statistics still Bedevil Medicine

Go figure: In era of Big Data, numbers and statistics still bedevil medicine | Patrick Malone & Associates P.C. | DC Injury Lawyers – JDSupra – Sep 2019 

Big data and numbers may seem to drive the world these days, but human factors can play a dizzying role when it comes to statistics and medical treatments.

For those fascinated by numeracy in health care, writer Hannah Fry, in a readable New Yorker essay, details how medicine and patients alike have been bedeviled by attempts to quantify life-and-death decision making.

Fry shows how errors in evaluating statistics could confuse authorities investigating if Harold Shipman, a British doctor who cared for the elderly, was merely unlucky or a stone-cold killer.  

Addicts and Pain Patients are NOT the Same

Defining Addicts and Pain Patients as One and the Same, A Moral and Ethical Failure in Policy • CERGM – By R Carter – Mar 2019

Morals and ethics are often used interchangeably, but there are small differences.

• Ethics refers to rules provided by an external source, e.g., codes of conduct in workplaces or principles in religions.
• Morals refer to an individual’s own principles regarding right and wrong

There are two great arbitrators of morality devised by mankind, the State and Religion. Each has a power they use to enforce ethical standards.   

Difference Between Drug Addiction and Dependence

Is There Really a Difference Between Drug Addiction and Drug Dependence? – Scientific American Blog Network – By Jonathan N. Stea – Nov 2019

In my experience as a clinical psychologist and, dare I facetiously say, a Twitter addict, the most important and commonly confused distinction is between “addiction” and “dependence.”

And it is no wonder.

This deadly (to pain patients) confusion is due to the psychiatric “bible” which either unintentionally or intentionally erased the difference between the two.

The latest version, the DSM-5, now hides “addiction” as a category of “dependence”, even though these are two very distinct issues. 

Evidence? We don’t need no stinkin’ evidence.

The Opioid Crisis Requires Evidence-Based Solutions, Part I: How the President’s Commission on Combating Drug Addiction Misinterpreted Scientific Studies | Bill of Health | law.harvard.edu – By Mason Marks – Dec 2017

Despite the Opioid Commission’s justifiable recommendations, it drew many conclusions that lack empirical support or are contradicted by scientific evidence.

the Opioid Commission was convinced that pain-related questions are driving inappropriate prescriptions.

PROP has really outsmarted all of us patients and doctors who rely on opioids to ease pain. Early on, they framed the discussion as a simplistic opioid addiction issue and ever since, we’ve been stuck trying to defend ourselves against this ignorant tide of drug-war-based policies. 

Let’s Face It–Some Patients Need to Be on Opioids

Let’s Face It–Some Patients Need to Be on Opioids – medscape.com – Kenneth W. Lin, MD, MPH – Feb 2019

According to a National Institutes of Health–sponsored workshop, an estimated 25 million Americans experience moderate to severe chronic pain, and 5-8 million of them use opioids for long-term pain management.

Although it is now widely recognized that excessive opioid prescribing has contributed to an epidemic of opioid use disorder and overdoses, the adoption of inflexible dosing limits or “no opioid” policies by many physicians and pharmacy benefit managers has also caused substantial harm.

Last November, the American Medical Association’s House of Delegates adopted several resolutions that advocated against misapplication of the 2016 CDC guideline on opioids for chronic pain.

So far, there have been no changes, despite the FDA’s and the CDC’s warnings about minterpretation of the guidelines. 

Opinion | Fear, Loathing and Fentanyl Exposure

Opinion | Fear, Loathing and Fentanyl Exposure – https://www.nytimes.com/ By The Editorial Board – April 4, 2019

The New York Times has published many articles about the “opioid crisis” that follow the usual unchecked assumptions around opioids, so I’m glad this opinion piece by the “top guns” of the Times finally explains the problems posed by fentanyl: it’s super potent, but not by accidental skin exposure or “breathing fumes”.

As baseless public health scares go, the one about police officers and nurses purportedly overdosing from passive fentanyl exposure should have been easy to dispel.

Emergency workers across the country have reported dozens of such incidents in recent years, but their symptoms are often inconsistent with opioid poisoning.   

Blunting pain’s emotional component

Blunting pain’s emotional component | Newswise: News for Journalists – Mar 2019

Chronic pain involves more than just hurting. People suffering from pain often experience sadness, depression, and lethargy.

These days, I’m almost surprised they’re not claiming that people are causing their own pain when they experience “sadness, depression, and lethargy”.

That’s one reason opioids can be so addictive — they not only dampen the pain but also make people feel euphoric. [not!]

Wrong. Those of us using opioids for serious pain do not experience this euphoria; see Opioids + Pain != Euphoria for an explanation why this doesn’t happen.   

Escalating Opioid Doses in Chronic Pain

Escalating Opioid Doses in Chronic Pain – by Judy George, Senior Staff Writer, MedPage Today – Apr 2019

This study, like 99% of the research being done, assumes opioid doses are completely independent of pain levels, making it utter nonsense to anyone who understands pain.

Increases in prescription opioid doses were unrelated to most clinical outcomes among chronic pain patients, according to a 2-year prospective cohort study.

Moreover, patients who had been prescribed a stable dose of long-term opioid therapy demonstrated few clinically significant changes in pain-related outcomes over time.   

Anti-intellectualism and its impact on physicians

American anti-intellectualism and its impact on physicians – KevinMD | Karen S. Sibert, MD | Physician | Nov 2018

Our country is increasingly controlled by corporations throwing their massive financial weight behind any new opportunity for profit, especially in the high-tech and medical spheres where so much money is to be made.

Issues that used to be considered in terms of social or moral values, like crime and healthcare, are now redefined on corporate financial statements, where they are evaluated on the basis of profit or loss, while moral concerns have evaporated under the hot sizzle of high finance.

The “practice of medicine”, once a proud, independent, and highly intellectual profession, has been eviscerated by increasing standardization. Diagnosis is a computed decision tree and treatment is ordered by universal guidelines, in an effort to create “mix and match” or “plug and play” interchangeable “units of healthcare”.