Need General Surgery? Ignore The Surgeon General | American Council on Science and Health – By Josh Bloom — July 8, 2019
Over the 4th of July Weekend, our U.S. Surgeon General, Jerome M. Adams, MD, MPH, Tweeted:
U.S. Surgeon General – Jul 3
Putting in some work in the ORs. Got to help with some interesting cases and saw several people get Tylenol and other meds to help provide anesthesia and post-op pain relief with my minimal opioids. They all woke up comfy and happy!
U.S. Surgeon General – Jul 4
And here’s a study where 1000 mg IV Tylenol was found equivalent to IV morphine (based on body weight, but in some cases greater than 6 mg) Note, rib fractures are extremely painful!
This sure makes it sound like Tylenol works better than morphine. Josh Bloom from the ACSH evaluated the study and the Surgeon General’s conclusions.
The White House drug czar is wrong: Most heroin addicts didn’t start with prescribed pain pills – by Phillip Smith / Independent Media Institute July 3, 2019
As part of its campaign to stem opioid addiction and overdoses, the White House Office of National Drug Control Policy (ONDCP — the drug czar’s office) has launched an education campaign called The Truth About Opioids, but some of the material it is presenting has more than a whiff of spin to it — and could imperil the ability of pain patients to get the relief they need.
The website declares in big, bold letters that “80% of heroin users started with a prescription painkiller”. The graphic suggests that heroin users were prescribed opioids, developed a habit, and then went on to junk, with the further implication that a way to reduce heroin addiction is to tighten and reduce the prescribing of opioids.
Now even the “Drug Czar” is promoting the erroneous media story about the “innocent victims” and doubling down on the hype spread by anti-opioid activists. Continue reading
Nonopioid Overdose Death Rates Rose Almost As Fast As Those Involving Opioids, 1999-2016 – July 2019
A very recent PubMed study counting all the non-opioid overdose deaths shows the “crisis” is about overdoses from all kinds of illicit drugs, not only opioids (heroin, fentanyl) and certainly not from prescribed medication.
The number of Americans dying from drug overdoses has risen rapidly, but the contribution of nonopioid drugs to this growth is not well understood. Using vital statistics data from the universe of deaths among US residents in the period 1999-2016, I calculated levels of and increases in overall nonopioid fatal overdose rates and those for subgroups stratified by manner of death, sex, race/ethnicity, and age.
From 1999 to 2016 the number of nonopioid drug deaths rose 274 percent, and deaths per 100,000 population rose by 223 percent. Over the same period, opioid-involved fatality counts and rates grew by 371 percent and 307 percent, respectively.
Fatal overdose rates involving stimulants increased more than tenfold, with slower growth but higher rates for deaths involving sedatives and cocaine.
Aim your baloney detector at the BS in health care – STAT – by Lawton R. Burns and Mark V. Pauly – May 2019
BS, what Princeton philosopher Harry Frankfurt once called a “lack of connection to a concern with truth — this indifference to how things really are,” has probably been around since the beginning of language.
We’ve noticed an influx of BS in health care. You don’t have to look far to spot it. Just think of Theranos and IBM Watson.
We are wondering if several new corporate “turduckens”…
I thought this was a made-up word, but no, it’s real and it’s not for the squeamish: Continue reading
Escalating Opioid Doses in Chronic Pain – by 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. Continue reading
Seeking to Clarify Its Opioid Prescribing Guidelines, CDC Joins FDA in Decrying ‘Mandated or Abrupt Dose Reduction’– by Jacob Sullum – Apr 2019
Acknowledging the suffering caused by “misinterpretation” of the opioid prescribing guidelines it published in 2016, the U.S. Centers for Disease Control and Prevention (CDC) yesterday sought to clarify that it never recommended imposing involuntary dose reductions on chronic pain patients.
In a letter to physicians who had objected to that widespread practice, CDC Director Robert Redfield emphasized that his agency “does not endorse mandated or abrupt dose reduction or discontinuation, as these actions can result in patient harm.”
The CDC may not “endorse” them, but they deliberately looked the other way for 3 years while this was happening. Continue reading
Invasive Surgery: Effective in Relieving Chronic Pain? – By Sunali Wadehra, MD – Feb 2019
Invasive surgery may not be any more effective than sham procedures in reducing chronic pain, according to a meta analysis published by Wayne B. Jonas, MD, in Pain Medicine last September.
Dr. Jonas and his team performed a systematic review of 25 randomized controlled trials published between 1959 and 2013, involving 2,000 patients undergoing surgery for chronic pain.
This article explains a concept I haven’t seen elsewhere: chronic pain versus protracted pain. Especially in the case of EDS, this means we can hurt every day, but still not have true “chronic pain”. Continue reading
According to CDC – Addiction Rate From Opiates is 0.62% • CERGM – By R. Carter – Mar 2019
(The 0.62% quoted in the post title is based on verbal statements made by CDC leadership.)
We’ve all heard the headlines, the sound bites. Opiate overdose deaths now exceed deaths from auto accidents. Opiates now the 3rd leading cause of unintentional deaths in the U.S.
Sounds dramatic doesn’t it. I’m critical of these statements because the data doesn’t fit the message.
Such statements are another way of weaponizing the data. Continue reading
Agreement between definitions of pharmaceutical opioid use disorders and dependence in people taking opioids for chronic non-cancer pain (POINT): a cohort study – The Lancet Psychiatry – free full-text – Mar 2015
Classification of patients with pharmaceutical opioid use disorder and dependence varies depending on which definition is used.
I find it outrageous that OUD can be diagnosed on a whim just by using the fitting definition in one of the several classification systems.
The DSM-5 is the worst, thanks to its “spectrum” of Opioid Use Disorder (OUD), which always places us pain patients, with our regularly prescribed opioids, into the low end of this spectrum. Continue reading
Blaming Prescription Pain Pills For The Opioid Epidemic Is Fake News –
How negligent media have helped inflate a deadly moral panic over prescription opioids and ignored the real sources of addiction while hurting people who live with devastating chronic pain. – By Peter Pischke – March 26, 2019
Although opioid-related deaths are driven mainly by heroin and black-market fentanyl, you would not know that from most of the press coverage, which emphasizes pain medication prescribed to patients who become addicted, overdose, and die.
This narrative is “fake news.”
This is the fairytale the media has been pushing for years and years. Just by its incessant repetition, it has ingrained itself in our culture and remains stubbornly immune to facts. Continue reading