Hyperalgesia: No Reason to Stop or Reduce Opioids – May 30, 2017 – by Forest Tennant M.D., Dr. P.H.
One of the excuses that some health practitioners are using to stop opioids is to claim a patient has hyperalgesia (HA).
This is a most dishonest, devious, and dangerous ploy.
First, the definition of hyperalgesia is simply that a stimulus such as hitting your thumb with a hammer is more painful than usual.
Second, there is no way to measure or quantify the presence of HA in a chronic pain patient who takes opioids. Continue reading
Addict brokers profit as desperate patients are ‘treated like paychecks’ – By DAVID ARMSTRONG and EVAN ALLEN — BOSTON GLOBE – MAY 28, 2017
Days after he relapsed on heroin last summer, Patrick Graney received an offer that was too good to turn down.
How would he like to get treatment in a beach town with a hipster vibe in South Florida — with all expenses paid, including airfare from his Massachusetts home?
Graney didn’t have to think long. He was on a flight south the next day. Two months later he was dead. Continue reading
Patient Suicide Blamed on Montana Pain Clinic — Pain News Network – May 26, 2017 – By Pat Anson
A 54-year old Montana man who apparently committed suicide earlier this month was a patient at a Great Falls pain clinic accused of mistreating patients and poorly managing their chronic pain. Bryan Spece was found dead in his Lewistown home on May 3.
“From what we know, about two weeks before his death, they had cut his pain pills back significantly. We’re not sure the exact amount. We’re trying to get ahold of his medical records,” said a family member. Continue reading
Medicine with a side of mysticism: Top hospitals promote unproven therapies – By CASEY ROSS @byCaseyRoss, MAX BLAU @maxblau, and KATE SHERIDAN @sheridan_kate – Mar 2017
I know that various unusual therapies work for some people some of the time (myself included), but they are truly a hit and miss proposition.
They’re among the nation’s premier medical centers, at the leading edge of scientific research.
Yet hospitals affiliated with Yale, Duke, Johns Hopkins, and other top medical research centers also aggressively promote alternative therapies with little or no scientific backing.
They offer “energy healing” to help treat multiple sclerosis, acupuncture for infertility, and homeopathic bee venom for fibromyalgia. A public forum hosted by the University of Florida’s hospital even promises to explain how herbal therapy can reverse Alzheimer’s. (It can’t.) Continue reading
Prescription Drug Diversion an Issue at VA Hospitals – Mar 2017 – Jennifer Barrett, Assistant Editor
I’ve long believed that the quantities of illicit Rx opioids available on the black market cannot be accounted for by pills stolen from “grandma’s medicine cabinet”. I think opioids are/were being diverted at a much higher level and involve huge quantities. By now, however, pills have become much too expensive in comparison to cheap heroin and illicitly manufactured fentanyl additives.
Employees involved in manufacturing, distribution, and pharmacy stocking aren’t as carefully monitored as individual pain patients, and diversion of mass quantities is so profitable that some of the staff involved in the supply chain are undoubtedly corruptible. Continue reading
Pain and Suicide: The Other Side of the Opioid Story | Pain Medicine | Oxford Academic – March 2014 – Lynn R. Webster, MD
Here is a very sad story about a pain patient’s suicide that will resonate with many of us. It illustrates how arbitrary opioid restrictions put doctors in an impossible situation and leave patients without hope.
A former patient whom I’ll call Jack came to me for help after three back operations. He was on disability because of his pain. I treated him for about four years, struggling all the while to get his insurance to cover his therapies. I tried to get him to see a psychologist, but his insurance would not pay for the service. He was on what most physicians today would term a high dose of opioids and other medications.
He was mostly inactive and reported little improvement in pain or function while on his medication. Continue reading
Regain your quality of life … SUE THEIR ASS! PHARMACIST STEVE – January 17, 2017 by Pharmaciststeve
I have talked to… exchanged emails with… read chronic pain pts statements that they have contacted law firms to sue some healthcare provider for cutting their opiates, discharging them for no – or trumped up – reasons.
And without exception, the law firms have replied NOT INTERESTED !!!!
The truth of the matter is that in our legal system… the “value” of the life of a handicapped/disabled, elderly, unemployable person is NEAR ZERO… because these people are considered “takers” as opposed to “makers” within our society. Continue reading
An Opioid Quality Metric Based on Dose Alone? 80 Professionals Respond to NCQA by Dr. Stefan Kertesz
Efforts to reduce prescribing while optimizing care for patients with pain, and expanding access to addiction treatment, are of cardinal importance.
How we advance these objectives depends partly on changing our shared understandings of what it means to deliver good care. It also depends on policies, resources and formal methods to assess if we are doing a good job.
Dr. Kertesz points out that all these new restrictions aren’t based on any studies at all. Nor are any studies planned to investigate the effect of these new policies. Continue reading
Docs warn that Medicare crackdown will hurt pain patients – POLITICO – By Arthur Allen – March 2017
A group of prominent pain and addiction specialists are pushing back against the federal opioid crackdown by asking CMS to withdraw a notice that would make it extremely difficult for Medicare patients to get painkiller prescriptions above a certain strength.
More than 80 physicians, including four who helped create the 2016 CDC guidelines on opioid prescribing, wrote to acting Medicare director Cynthia Tudor about the notice, which would require pharmacists to refuse prescriptions over 90 milligrams of morphine or its equivalent unless the patient first went through a complex, time-consuming review.
While the CDC guidelines caution that high doses create an overdose risk, they also state that physicians should have ultimate discretion on prescribing, and warn that it is not advisable for patients to be tapered off high doses of opioids involuntarily. Continue reading
Though not particularly long, this comment took me several days to compose and edit (and edit again). I have only one chance to influence all these various agencies trying to restrict our opioid use, so I want to make my comment compelling enough to make someone think twice.
I intend to point out various issues the reader may have overlooked, the unfairness of the restrictions, the personal harm I will suffer, and end it with a strong question or statement that might resonate with the reader.
==== COMMENT ====
I’m writing to urge you to not let the government set standard medication dosages for individual patients, which will happen if this agency adopts policies based on the scientifically flawed CDC Opioid Prescribing Guidelines. Continue reading