What’s Wrong With Just Counting the Patients on High Dose Opioids and Calling that Bad Care? – by Stefan Kertesz – Feb 2018
Dr. Kertesz exposes the unscientific basis and hazardous effect of forced opioid reductions.
In early 2018, the Center for Medicare and Medicaid Services requested public comments on a draft quality measure of physician performance, called “Potential Opioid Overuse”. It’s alluringly simple.
Payers and regulators will count the number of patients who receive a total opioid dose equivalent to 90 milligrams morphine or more.
The higher the number, the worse the physician is rated. Continue reading
Jeff Sessions’ Advice to Pain Patients: ‘Take Some Aspirin’ and ‘Tough It Out’ – Hit & Run : Reason.com – by Jacob Sullum|Feb 2018
The attorney general thinks people should suffer needlessly, just like John Kelly.
USDOJAttorney General Jeff Sessions is a well-known admirer of Nancy Reagan’s recommendation that kids “just say no” to drugs. It turns out he applies that advice not only to curious teenagers but also to people suffering from severe pain.
“I am operating on the assumption that this country prescribes too many opioids,” Sessions said during a speech at the U.S. Attorney’s Office in Tampa yesterday. Continue reading
Opiate prescribing in Cumberland County – Jan 2018 – Joshua Vaughn The Sentinel
As the Midstate remains in the midst of a growing overdose epidemic, some focus has shifted to reducing the number of opiates prescribed to patients.
Reducing opioid prescriptions to pain patients seems to be the ONLY response to the overdose crisis that is killing so many, even while it is completely ineffective and even worsens the problem. Continue reading
Patients with chronic pain forced into opioid tapers by their prescribers – January 15, 2018 – By Alison Knopf
Patients with opioid use disorders (OUDs) are getting better treatment with methadone or buprenorphine than many chronic pain patients.
Prescribers are cutting chronic pain patients off from their opioids.
Providers who treat OUDs know better than to withdraw opioids cold-turkey, and not to taper them carelessly or for no good clinical reason. This does not appear to be the case with physicians treating pain, ADAW has learned. Continue reading
Medicare Expands Opioid Monitoring After GAO Report — Pain News Network – January 27, 2018/ By Pat Anson, Editor
The General Accounting Office (GAO) – now known as the Government Accountability Office – was established by Congress in 1921 to act as an independent, nonpartisan watchdog of the federal government.
“We provide Congress with timely information that is objective, fact-based, nonpartisan, nonideological, fair, and balanced. Our core values of accountability, integrity, and reliability are reflected in all of the work we do,” the GAO says in its mission statement.
Fair and balanced? Not always – at least not when it comes pain patients and their medication. Continue reading
VA reps to discuss impact of opioid reduction on suicides during summit – By Nate Morabito Published: January 16, 2018
I’m thrilled to see this finally being brought to light and publicly discussed.
According to the summit’s agenda, those VA employees will discuss, among other things, Department of Veterans Affairs’ data that shows, “In two sets of fiscal years — 2010-2011 and 2013-2014 — opioid discontinuation was not associated with overdose mortality but was associated with increased suicide mortality.”
Someone finally made this an official issue, officially stated and officially documented. This is a small but significant first step. Continue reading
Report in Lancet Calls for Needed Pain Relief | Human Rights Watch
Poor people around the world live and die with little or no pain relief or palliative care, a report published today in the medical journal, Lancet, said, calling the fact a “medical, public health, and moral failing and a travesty of justice.”
And they are trying to make this happen in the US too. Continue reading
Persistent Pain Tied to Memory Decline And Dementia in Elders – Pain Medicine News – Nov 27, 2017
Persistent pain is associated with accelerated memory decline and development of dementia in the elderly.
According to researchers, elderly patients who reported having persistent pain experienced an accelerated decline in functional independence.
Taking away our opioid pain relief to end the “opioid crisis” will then lead to a “dementia crisis” as our pain levels rise – that is, if we can even continue to live with our pain untreated. Continue reading
Polymorphic Cytochrome P450 Enzymes (CYPs) and Their Role in Personalized Therapy – December 10, 2013 – free full-text article
The cytochrome P450 (CYP) enzymes are major players in drug metabolism. More than 2,000 mutations have been described, and certain single nucleotide polymorphisms (SNPs) have been shown to have a large impact on CYP activity.
Therefore, CYPs play an important role in inter-individual drug response and their genetic variability should be factored into personalized medicine.
We have personalized medicine for everything but pain, in which case rigid standards are set by politicians and enforced by the DEA. Continue reading
Liquid Gold: Pain Doctors Soak Up Profits By Screening Urine For Drugs | Kaiser Health News – Nov 2017 – By Fred Schulte and Elizabeth Lucas
The cups of urine travel by express mail to the Comprehensive Pain Specialists lab in an industrial park in Brentwood, Tenn., not far from Nashville.
Most days bring more than 700 of the little sealed cups from clinics across 10 states, wrapped in red-tagged waste bags. The network treats about 48,000 people each month, and many will be tested for drugs.
Gloved lab techs keep busy inside the cavernous facility, piping smaller urine samples into tubes. Continue reading