How Helpful—Or Harmful—Are Prescription Drug Monitoring Programs? – FilterMag.org – by Jackie Rocheleau – April 9, 2019
Before admitting new patients to his practice, Dr. Miguel Diaz checks their prescription history. Diaz, a family medicine physician with Community Care Physicians, PC in Clifton Park, New York, logs onto the state’s prescription drug monitoring program, or PDMP.
There, he sees everything the patient has been prescribed during the past year and who prescribed it.
PDMPs are now being used for all “scheduled” medications, not just opioids, and are made available for perusal by law enforcement and their minions. Continue reading
Hospital Stays Are Becoming Hell on Earth – by Heather Wargo – Feb 2019
This story is worth reading in its entirety (link above) and warns us about trusting even hospitals to treat our health emergencies if they involve pain. Mentioning pain instantly makes us suspect and we are assumed to be “drug-seeking”.
America’s Hospitals are Refusing to Properly Treat Pain, Leaving Patients In Agony
When I had an endoscopic ERCP procedure* performed in May 2018, it was supposed to be an in and out procedure. Continue reading
Death By 1,000 Clicks: Where Electronic Health Records Went Wrong
The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief.
Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, had never been tested for or diagnosed until she turned up in the emergency room days before her death.
Monachelli’s husband sued Stowe, the federally qualified health center the physician worked for. Owen Foster, a newly hired assistant U.S. attorney with the District of Vermont, was assigned to defend the government. Continue reading
CDC Issues Key Clarification on Guideline for Prescribing Opioids for Chronic Pain | ASCO – April 9, 2019
I’m angry that the CDC issued this clarification for only three discreet conditions
- cancer patients,
- cancer survivors, and
- individuals with sickle cell disease.
Because it so carefully carves out these three very specific conditions for special notice, it seems to imply that any other conditions not listed are currently being understood and implemented as intended, and I’m afraid it could become even harder for chronic pain patients to get opioid relief. Continue reading
Oregon at impasse over opioids for chronic pain: Voluntary vs Involuntary – by Markian Hawryluk @markianhawryluk – Mar 2019
Oregon’s efforts to prevent opioid overdoses have reached a difficult impasse: what to do with the chronic pain patients who are on high doses of opioids now considered unsafe.
No one ever showed that high doses of opioids are unsafe; opioids are as safe as many other prescription drugs.
The popular storyline that “opioids are unsafe”, gets accepted as fact by the people that are making decisions about our access to them. Such “common knowledge” is repeated ad nauseum and rarely questioned when it fits the cultural mood, just like the myth that patients would be better off without opioids.
Fewer Opioids, More Pay: New Tack on How Doctors Prescribe Them – by Jacquie Lee – Nov 2018
To put it simply, doctors are being bribed by insurance carriers not to prescribe opioids.
Some doctors in Michigan are prescribing as few as four opioid pills for pain relief after a common gall bladder surgery.
And, in return, they are paid 35 percent more for doing the surgery in tandem with patient education.
The plan is an effort by Blue Cross Blue Shield of Michigan to reduce the number of opioids prescribed. Continue reading
How a Paraplegic Drug User Became a Victim of Involuntary Commitment – by Christopher Moraff – Feb 2019
New laws make it easy for anyone accused of having an addiction problem to be committed if they don’t agree to whatever treatment is recommended for them.
Involuntary commitment for people accused of having an addiction and not actively participating in treatment for it is becoming more common as more laws are being passed to make this legal.
Barely a day passes on my beat without my meeting someone with a harrowing story about the impact of zero-tolerance drug policies on their lives. But few of these stories have impacted me personally as much as that of a young man I’ll call “Jay.”
Pain and Addiction Leaders Raise Alarm on Oregon Force Tapering Opioid Proposal – by Sean Mackey, MD, PhD – Mar 2019
On Mar 14th, the Oregon HERC Task Force was going to vote to make a rule for Medicaid requiring all opioids to be tapered to zero except in a few very narrowly defined cases.
At the last minute on the morning of the vote, HERC said they were postponing the vote due to a conflict of interest they had “just learned about”. That’s a pretty flimsy excuse because the membership and the whole process of this group have been driven by conflicts of interest (of the alternative medicine community) and a vast ignorance of medicine, pharmacology, and reality.
The extreme nature of this proposal has reached a level of such preposterous cruelty that protest by medical professionals is now required to preserve some limits on the government’s practice of medicine.
…it became clear that there are times when people of good conscience cannot blindly allow bad policies to move forward unchallenged. –Sean Mackey, MD, PhD
Misuse of Hyperalgesia to Limit Care | Practical Pain Mgmt | By Donald C. Harper, MD, BSc – March 2011
John (not his real name) is a 51-year-old chronic pain patient that I have been seeing since 2003. I had begun carefully titrating him on oxycodone, Oxycontin® and Dilaudid®, which had been started by another doctor and, ultimately, settled on a dose of Oxycontin 640mg B.I.D., 32mg hydromorphone q 4 hrs prn breakthrough pain and Xanax® 1 to 1.5mg q.i.d. prn muscle spasms and anxiety. On these medicines, he was content and functional and denied any deficits or side-effects due to his medicine.
His insurance company was concerned about the expenses of his medicine and asked me to arrange for a second opinion. Given the complicating factor of his end-stage lung cancer, I arranged for an evaluation by the pain clinic of a major cancer center. Continue reading
Chronic-pain patients suffer as agencies try to regulate addiction – by Wendy Sinclair – Jan 2019
I’m encouraged to see our side of the opioid story published in the mainstream media like this. We must expose more of the public to the nightmare experienced by pain patients, one they are only one accident or misfortune away from landing in themselves.
Opioid. For many, the word elicits images of addiction, but that’s only one side of the story.
This is our side, the one that’s no longer socially acceptable, that shatters bias and stigma. It’s the side of the story that I live — that of the chronic pain patient (CPP), not the addict. Continue reading