On Sunday night, CBS 60 Minutes aired a segment that has raised the ire of many chronic pain advocates.
It asked “Did the FDA Ignite the Opioid Epidemic” and asserted a label change in 2001 by the FDA expanded the use of opioids without what 60 Minutes said was “any evidence”.
Cindy Steinberg, Policy Advocate for the U.S. Pain Foundation, tweeted:
Scanning Dead Salmon in fMRI Machine Highlights Risk of Red Herrings – Wired.com – by Lexis Madrigal – Sep 2009
Here’s a humorous, but also dead serious (pardon the pun), study pointing out the HUGE problems with fMRI brain scans that supposedly tell us something about what we’re thinking or feeling.
Neuroscientist Craig Bennett purchased a whole Atlantic salmon, took it to a lab at Dartmouth, and put it into an fMRI machine used to study the brain. The beautiful fish was to be the lab’s test object as they worked out some new methods.
So, as the fish sat in the scanner, they showed it “a series of photographs depicting human individuals in social situations.” To maintain the rigor of the protocol (and perhaps because it was hilarious), the salmon, just like a human test subject, “was asked to determine what emotion the individual in the photo must have been experiencing.” Continue reading
Many have critically examined the methodology of meta-analysis, and others have set standards for their execution. Despite such guidance, meta-analyses continue to proliferate, but we should ask: do they really contribute?
Esteemed organizations regard the conclusions of a well-executed meta-analysis as a higher level of evidence than a single well-done clinical trial.
This commentary explains why this cannot possibly be true. Continue reading
It looks like I’m not the only one upset by the severely biased report from the Brookings Institute:
An article published December 7 by the Brookings Institution, a prominent Washington, DC think tank, is under fire for promoting the idea that harm reduction approaches—like syringe exchange and naloxone—may encourage “riskier opioid use” and increase rates of opioid-related deaths.
The focus of the criticism is the choice of which articles to cite—and which not to cite—by the authors of the Institution’s “research roundup.” Continue reading
Today’s Drug Abusers Did Not Derive From Yesterday’s Patients – By Jeffrey A. Singer – December 4, 2018
We learned last week that the 2017 drug overdose numbers reported by the US Centers for Disease Control and Prevention clearly show most opioid-related deaths are due to illicit fentanyl and heroin, while deaths due to prescription opioids have stabilized, continuing a steady trend for the past several years.
But the media and policymakers remain unshakably committed to the idea that the overdose crisis is the product of greedy pharmaceutical companies manipulating gullible and poorly-trained doctors into over-prescribing opioids for patients in pain and ensnaring them in the nightmare of addiction. Continue reading
This is a review of three books written about the so-called “opioid epidemic”.
The term opioid is now used to include opiates, which are derivatives of the opium poppy, and opioids, which originally referred only to synthesized drugs that act in the same way as opiates do.
Opium, the sap from the poppy, has been used throughout the world for thousands of years to treat pain and shortness of breath, suppress cough and diarrhea, and, maybe most often, simply for its tranquilizing effect. 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
Detecting BS in Healthcare – Lawton R. Burns, PhD & Mark V. Pauly, PhD – Department of Health Care Management, The Wharton School, University of Pennsylvania – Nov 2018
In the past several months, we have observed several notable signs of deceptive, misleading, unsubstantiated, and foolish statements—what we will call “BS” — in the health care industry.
These new signs include fraudulently marketed products from Theranos and IBM Watson,and a recent statement by the CEO of One Medical that his firm aims to take out 10 percent of U.S. health care spending — something no one has ever done (not even the Federal Government). These follow closely on the heels of other likely BS, including claims that the proposed CVS- Aetna merger will turn your local pharmacy into a neighborhood “health care hub.”
Why does this kind of behavior occur? Continue reading
Do Opioid Scripts For Tooth Extraction Really Cause Abuse – Or Just Useless Numbers? – By Josh Bloom — December 6, 2018
This article is a take-down of the absurdedly muddled and manipulated study looking for opioid abuse in adolescents (likeliest group to develop problems) that got opioids after the very specific procedure of “third molar extraction” in 2015.
That strange selection of subjects is already a glaring indication that this is another one of those anti-opioid studies that cherry-picks the subjects, massages the data, and then misrepresents the results. I hope our tax dollars aren’t paying for the endlessly repeating studies designed explicitly to show negatives about opioids; there must be hundreds.
A new online article in JAMA Internal Medicine entitled “Association of Opioid Prescriptions From Dental Clinicians for US Adolescents and Young Adults With Subsequent Opioid Use and Abuse” claims that there is a clear association between opioid prescriptions and subsequent abuse for adolescents and young adults who had wisdom teeth removed. Continue reading
Here’s another review showing that anticonvulsants (anti-epileptics like Lyrica and gabapentin) are not effective for pain, even though they are increasingly prescribed for it.
For no other purpose than to avoid using opioids, pain patients are being prescribed all kinds of drugs off-label because they may be effective for some kinds of pain is some people some of the time.
Pain management doctors are forced to practice medicine based on hope, not evidence, when the most effective drugs for this condition are prohibited due to their potential damage to patients who may potentially abuse them and potentially develop an addiction. Continue reading