Tag Archives: outrage

Unintended consequences of addressing the opioid crisis

5 unintended consequences of addressing the opioid crisis – POLITICO – By SARAH KARLIN-SMITH and BRIANNA EHLEY – May 2018

The problem is that we are NOT addressing the opioid crisis – we’re addressing opioid pain treatment, not opioid addiction.

Lawmakers are grappling with how to solve the opioid epidemic — and it’s not simple.

The push for fewer opioid prescriptions at lower doses and for shorter periods has increased suffering for some pain patients including those near the end of life. The emphasis on opioids has also overshadowed other forms of substance abuse that require attention.   Continue reading

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How Will CMS Opioid Changes Play Out for Patients?

Doctors Wait to See How CMS’ Opioid Changes Play Out for Patients in Pain – April 07, 2018 – by Allison Inserro

CMS tweaked an opioid policy aimed at Medicare Part D patients that had drawn criticism when it was first released in draft form.

That’s an understatement; it has drawn condemnation from both patients and doctors and guideline authors (where are the bioethicists when we need them?)

DEA Draws Firestorm of Criticism for New Quotas

Opinion: The DEA Draws a Firestorm of Criticism – April 18, 2018 – by Richard A Lawhern, Ph.D.

DEA has proposed rule changes which will allow them to force reductions on production of opioid pain relievers for any scheduled drug which they believe to be “diverted.”  

They seem utterly uncaring that quotas have already been reduced for the past five years without noticeable positive effect. 

This is typical of the drug-war: when a policy is not showing positive results, instead of trying something different, they double-down on the ineffective policy.  Continue reading

Safety concerns with the CDC opioid calculator

Safety concerns with the Centers for Disease Control opioid calculator – free full-text article /PMC5739114/ – 2017 Dec

Morphine milligram equivalence (MME) and other comparable acronyms have been employed in federal pain guidelines and used by policy makers to limit opioid prescribing

On March 18, 2016, the Centers for Disease Control (CDC) released its Guideline for Prescribing Opioids for Chronic Pain.

The guidelines provided 12 recommendations for “primary care clinicians prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care”.   Continue reading

CMS wants to force patients off effective opioid doses

CMS proposes to force patients off effective opioid doses without their physician’s approval | TheHill – by Lynn R. Webster, MD

Though CMS backed down from a “hard limit”, this 90MME “soft” limit is making its way into all our government and legislative processes. This dose is still considered a valid maximum to “prevent/control addiction”, which makes no sense at all.

Patients taking opioid therapy are not the ones overdosing or even becoming addicted: that comes from illicit drugs use and abuse.

The media has framed the crisis as arising from chronic pain patients just taking their prescribed medication. However, they have never been able to explain how such a person – especially when disabled by pain – would end up overdosing on fentanyl-laced heroin bought on the streets.   Continue reading

Opioid bill includes involuntary commitment

Below is another article about legislators interfering with the practice of medicine for pain patients, but this one has an unusual twist – involuntary commitment:

One controversial part of the bill would allow a doctor or police officer to involuntary transport someone to treatment, where the person could be held for up to 72 hours without a court order.

That rule would be used for all kinds of abuse, forcing pain patients into psych wards because they are taking opioids for pain.   Continue reading

If you think you need opioids for pain…

What to say to your doctor if you think you need opioids for pain – Business Insider – by Travis N. Rieder, The Conversation – Mar. 4, 2018

that a recent article explaining how opioids aren’t always necessary after surgery made a bit of a splash.

Firoozeh Dumas, who wrote the article, underwent a laparoscopic hysterectomy in Germany.  She was told that ibuprofen — the nonprescription medication found in Motrin and Advil — would be sufficient.

And it was. Laparoscopic surgery can be so minimally invasive that they cause very little pain. I wasn’t given opioids after my laparoscopic abdominal surgery 20 years ago either – and I didn’t need them. But for my constant, intractable chronic pain I do. Continue reading

Dr. Forest Tennant Retiring Due to DEA Scrutiny

Dr. Forest Tennant Retiring Due to DEA Scrutiny — Pain News Network – March 26, 2018 – By Pat Anson

A prominent California pain physician and a longtime champion of the pain community has announced his retirement. Dr. Forest Tennant, and his wife and office manager, Miriam, have informed patients that they are closing their pain clinic in the Los Angeles suburb of West Covina, effective April 1.

This is an appalling example of the DEA going after easy and safe targets instead of the dangerous cartels that are importing fentanyl in bulk and poisoning people.

On strong legal and medical advice, as I am 77 and Miriam 76, we are closing the Veract Intractable Pain Medical Clinic and taking retirement. I will write no additional opioid prescriptions after this date,”   Continue reading

Civilian Casualties in the Government’s War on Opioids

Hospitalized Patients Are Civilian Casualties in the Government’s War on Opioids | Cato @ Liberty – March 19, 2018 – By Jeffrey A. Singer

Here is another horror story about the consequences of ill-informed, politically-driven, hasty, and mostly ineffective policy.

A recent story by Pauline Bartolone in the Los Angeles Times draws attention to some under-reported civilian casualties in the government’s war on opioids: hospitalized patients in severe pain, in need of painkillers.

Hospitals across the country are facing shortages of injectable morphine, fentanyl, and Dilaudid (hydromorphone). As a result, trauma patients, post-surgical patients, and hospitalized cancer patients frequently go undertreated for excruciating pain.   Continue reading

No Easy Fix to Opioid Crisis

Opioid Crisis: No Easy Fix to Its Social and Economic Determinants | AJPH | Ahead of Print – Feb 2018 – Nabarun Dasgupta PhD, MPH, Leo Beletsky JD, MPH, and Daniel Ciccarone MD, MPH

In this article, 3 Public Health officials refute the current PROPaganda:

The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector.

Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness.   Continue reading