How Did We Come to Abandon America’s Pain Patients? – Filter Magazine – by Alison Knopf – July 2019
This is an excellent article pointing out exactly how pain patients have been neglected and dismissed by the medical system. Kudos to Alison Knopf for her exemplary work.
Overdoses—not those involving prescription opioids, but of heroin and illicit fentanyl, often combined with benzodiazepines—continue to go up. But opioid prescribing continues to go down.
Lawmakers contend WHO pain treatment guidelines are really Purdue ‘marketing materials’ – By ED SILVERMAN @Pharmalot MAY 22, 2019 – (article at “https://www.statnews.com/pharmalot/2019/05/22/purdue-opioids-world-health-guidelines/” accessible only through subscription to StatPlus)
Just the two first paragraphs of visible preview are astonishing and so infuriating that I’ll just leave you with these two:
Two lawmakers are urging the World Health Organization to rescind guidelines issued nearly a decade ago for treating pain because they contain “dangerously misleading” and sometimes “outright false claims” about the safety and effectiveness that were orchestrated by Purdue Pharma.
In a new report, the lawmakers contend that the WHO guidelines, which were released in 2011 and 2012, are “serving as marketing materials for Purdue.” And they pointed to efforts by the company to create and fund front groups that participated in research that shaped WHO decision making – and dovetailed with corporate goals to boost use of opioids, such as its own OxyContin pill.
CDC Director Says Agency Will ‘Clarify’ Opioid Guideline – April 11, 2019 – By Pat Anson – Apr 2019
CDC Director Robert Redfield, MD, has for the first time suggested that his agency may be preparing to make changes to its controversial opioid prescribing guideline.
“The Guideline does not endorse mandated or abrupt dose reduction or discontinuation, as these actions can result in patient harm,” Redfield said in his letter, which was released a day after the FDA warning. “The Guideline includes recommendations for clinicians to work with patients to taper or reduce dosage only when patient harm outweighs patient benefit of opioid therapy.”
I cannot understand why the CDC remained silent so long (almost exactly 3 years). They knew about the harm and suicides of patients yanked off their opioid therapy, they knew it was being used to make laws, they knew many doctors were quitting pain management… yet they said not one word until now. Continue reading
Patient Care and Population Health: Goals, Roles and Costs – free full-text /PMC4207028/ – Aug 2014
We should welcome efforts that encourage clinicians to avoid tests and treatments that do not improve health and thereby waste valuable resources
But we should critically evaluate proposals that assign clinicians the direct double responsibility of
- meeting the medical needs of patients while
- simultaneously meeting the economic needs of populations.
Why should we be sceptical? For two reasons. Continue reading
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
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
Our Broken Healthcare System: How Scared Should We Be? | Medpage Today – by
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
International Stakeholder Community of Pain Experts and Leaders Call for an Urgent Action on Forced Opioid Tapering | Pain Medicine | Oxford Academic – 29 November 2018
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
How do health insurance companies harm patients? – by Linda Girgis MD – Nov 2018
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