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
Congress is about to screw up the drug overdose crisis – Daniel Horowitz · April 10, 2018
Though a bit dated, this article points out how the current legislation is destructive and cruel, yet pours money into businesses seeking profit.
The politicians are still blind to nature of the illicit drug/chemical warfare crisis in this country that they misleadingly refer to as a prescription opioid crisis
As such, their solutions are making the problem worse, as they focus exclusively on government practicing medicine, Continue reading
I see so many current problems in so many aspects of our society arising from the supreme focus on profits when capitalism is allowed to run amok without any social constraints.
Our healthcare industry values patients only as consumers and manipulates us to “need” moneymaking services like surgeries, or lucrative products like the latest medications.
In An American Sickness: How Healthcare Became Big Business and How You Can Take It Back, author Elisabeth Rosenthal, MD, argues that our health care system focuses less on health and more on profitability — and supports the premise with compelling anecdotal illustrations of what is wrong. Continue reading
We, the undersigned, stand as a unified community of stakeholders and key opinion leaders deeply concerned about forced opioid tapering in patients receiving long-term prescription opioid therapy for chronic pain.
This is a large-scale humanitarian issue.
As happy as I am to see this declaration, even long after the opioid prescribing guidelines were weaponized to force opioid tapers, I’m appalled that it took 2.5 years of entirely foreseeable consequences for all these doctors to finally speak up.
There’s an impressively long list of signatories to this document, including several that have been vocally pushing for the very restrictions they now call a “large-scale humanitarian issue”. I’m stunned at the hypocrisy. Continue reading
Health care policy has been a hotly debated political topic for many years now. In recent years, new laws passed the halls of Congress while others failed to gain any traction. Despite the rules that have rolled out, health insurance companies have been in the driver’s seat for decades.
While spokespersons for the health insurance industry will tell you that they do not make medical decisions.
As a doctor, I can tell you that they make medical decisions on my patients every day. Continue reading
Chronic pain requires access to medication – By Lauren Deluca – September 22, 2018
New York is confronting a serious illicit fentanyl epidemic [thank you, Lauren, for calling it what it is!] better known as the opioid crisis, and lawmakers, nonprofits and the health care community are desperately seeking a solution.
…to the point that they are pursuing solutions to problems that don’t exist, like the supposed “prescription” opioid crisis.
However, a new law recently signed by Gov. Andrew Cuomo will do nothing to alleviate the suffering of addiction. But it could add immeasurably to the suffering of patients with serious health conditions. Continue reading
Time for Pain Practitioners to Take Back Pain Prescribing – By Jodi Godfrey, MS, RD – at PAINWeek, Sept 2017
Presentations by Stephen J. Ziegler, PhD, JD, Kevin L. Zacharoff, MD, and Michael Schatman, PhD
“with what may be viewed as opioid McCarthyism—our fears are being exploited in the media and by the government with some individuals being blacklisted, just as occurred 70 years ago.
“We have government investigations of prescribers and a marginalization of pain,” Dr. Ziegler said, “to the point that the trend toward undertreating post-surgical pain is now manifesting as chronic pain.”
Pain practitioners are essentially operating under a fear of sanction. Continue reading
The House is touting passage of dozens of bills that could help combat the national opioid crisis — but a small handful of companies that have spent millions lobbying Congress could reap a windfall if any of the bills become law.
In a two-week legislative blitz, the House cleared several narrowly tailored measures that would spur sales for companies that have ramped up their influence game in Washington, according to a review of the more than five dozen bills up for votes.
Those poised to benefit include: Continue reading
Politics, Confirmation Bias, and Opioids – by Jeffrey Singer – Aug 2018
Much has been written about how politics and ideology
- influence research funding,
- suppress research in certain areas, and
- lead to the cherry-picking and misrepresentation of evidence in support of a narrative or agenda.
Science journalist John Tierney explored “The Real War on Science” in an excellent essay in City Journal in 2016.
blatant politicized science is becoming the norm in the environmental arena, and probably has infiltrated most every other discipline, too. Continue reading
Though the author is writing about the witch hunt and punishment of doctors suspected of drug abuse, this article is equally pertinent to pain patients who are always suspected (if not downright accused) of drug abuse.
Sociologist Stanley Cohen used the term ”moral panic” to characterize the amplification of deviance by the media, the public, and agents of social control.
Labeled as being outside the central core values of consensual society, the deviants in the designated group are perceived as posing a threat to both the values of society and society itself. Belief in the seriousness of the situation justifies intolerance and unfair treatment of the accused. The evidentiary standard is lowered. Continue reading