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
The Other Opiate Problem By Ted Noel, MD – March 2019
Dr. Noel shows us again that overprescribing isn’t the problem – it’s an “overdose crisis” from street drugs, often contaminated with deadly illicit fentanyl.
On February 24, 60 Minutes did a segment … calling out drug companies for “corrupt,” “immoral,” and “depraved” actions in marketing opioids.
David Kessler, former Commissioner of the FDA said, “There are no studies on the safety or efficacy of opioids for long-term use.”
Case closed! We need to restrict opioids to two or three days at most. Anything longer than that is bad medicine and gets people killed. But… Continue reading
Over-Prescribing Did Not Cause America’s Opioid Crisis – By Richard A. Lawhern, Ph.D. – Mar 2019
A central assertion in many articles is that the crisis began with physicians over-prescribing to their patients in the 1990s and early 2000s, in an era of “Pain as the Fifth Vital Sign.”
Almost the entirety of present U.S. public policy on opioid pain relievers at Federal and State levels is founded upon this false claim.
Governments are engaged in a vast exercise in regulatory over-reach, seeking to “solve” our opioid crisis by restricting dose levels and duration of treatment for both acute and chronic pain. Continue reading
60 Minutes Segment on Opioids Draws Ire of Chronic Pain Community – National Pain Report – by Ed Coghlan – Feb 2019
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:
“Shame on @60minutes for its 1-sided coverage: https://cbsn.ws/2IvwL7B that somehow forgot about the 20 million Americans living with hi-impact #chronicpain” Continue reading
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