Tag Archives: research-bias

Truth About the Consequences of Opiophobia

A Dose of Truth about the Consequences of Opiophobia | HCPLive – 2010Joel S. Hochman, MD – Jan 2010

In this old article, the author picks apart a study from 2003 which became the backbone of the claims about hyperalgesia. It’s outrageous that a study from 17 years ago is determining our pain care (or lack thereof) today.

As this decade has progressed, some legal experts assumed that as a consequence of certain tort actions (cf. Bergman v. Chin), physicians would be compelled to treat pain effectively in compliance with the community standard of care.

The “community standard of care” no longer exists for pain control because opiophobia is preventing the use of the most effective medication just because some “street drugs” of the same chemical class, like heroin or illicit fentanyl, are being abused by people who then overdose.  Continue reading

Inaccurate Opioid Information Used by Lawmakers

Damaging State Legislation Regarding Opioids: The Need To Scrutinize Sources Of Inaccurate Information Provided To Lawmakers – free full-text /PMC6857667/Michael E Schatman and Hannah Shapiro2019 Nov

On January 22, 2019, a Massachusetts State Representative introduced House Bill 3656, “An Act requiring practitioners to be held responsible for patient opioid addiction”.

Section 50 of this proposed legislation reads, “A practitioner, who issues a prescription … which contains an opiate, shall be liable to the patientfor the payment of the first 90 days of in-patient hospitalization costs if the patient becomes addicted and is subsequently hospitalized”.

When asked of the source of medical information on which he based his bill, the Representative mentioned the name of a nationally known addiction psychiatrist.

Though unmentioned, this is clearly referring to our nemesis, Mr. Kolodny, who has continued using cherry-picked data from years ago to make his claims that “opioids cause addiction”.  Continue reading

The bias that can cause catastrophe

The bias that can cause catastrophe – BBC WorklifeBy David Robson
– Oct 2019

This article shows how a cognitive error can, and does, cause much misery for those who must suffer the consequences. I think we see a lot of this in our medical care with doctors who see a positive outcome one time expect the same positive outcome in every following case, making it very difficult for any “non-standard” patients to get appropriate care.

Imagine a pilot is taking a familiar flight along a known route, during which the weather takes a turn for the worst. She knows that flying through the storm comes with some serious risks – and according to her training, she should take a detour or return. But she has flown the same route before, in similar weather – and she hadn’t experienced any problems then. Should she continue? Or should she turn back?

If you believe that she is safe to fly on, then you have fallen for a cognitive quirk known as the “outcome bias”.   Continue reading

‘Opioid Epidemic’? Misperceptions Versus Facts

Misperceptions about the ‘Opioid Epidemic:’ Exploring the Facts July 2019Pain Management Nursing

Thank goodness for nurses! In this lengthy document, they meticulously prove that the ‘Opioid Epidemic’ is a complete fabrication, hyped by anti-opioid activists and spread into our society and even our medical system despite reams of evidence to the contrary from science and government data.

This thoroughly referenced article itemizes and thoroughly debunks the anti-opioid misperceptions (if not outright lies) that have swept through the medical profession and corrupted clear, logical thinking about the rising rate of illicit drug overdoses (not from prescribed opioids).

This is the most sensible document I’ve ever read about the so-called “opioid crisis”. Supported by numerous scientific references, it makes all the arguments we pain patient advocates have been making for years.  Continue reading

An Undercover Journey Into the Heart of Madness

An Undercover Journey Into the Heart of Madness – BY CHRISTIE ASCHWANDEN – Dec 2019

The author explains how self-perpetuating falsehoods can trap doctors, researchers, and mental patients, which is exactly what is happening with pain patients and opioids.

When she was 24, Susannah Cahalan developed a sudden psychosis. She grew paranoid — convinced her apartment was infested with bedbugs, that people were spying on her, that her boyfriend was cheating.

She started to believe she could age people with her mind. As she recounted in her 2013 bestseller, “Brain on Fire: My Month of Madness,” she received several misdiagnoses (bipolar disorder, schizoaffective disorder) before an alert doctor discovered the true culprit: autoimmune encephalitis.    Continue reading

Long-term Use of Opioids for Complex Chronic Pain

Long-term Use of Opioids for Complex Chronic PainOct 2014

This chapter focuses on the use of opioids for care of chronic musculoskeletal pain conditions such as back pain, and addresses clinical and public health issues that arise when opioids are used long-term for these conditions.

For our purposes, long-term use is defined by use of opioids for two months or more on a daily or near-daily basis. While the large majority of patients who use opioids for a few days or weeks discontinue use, the likelihood of sustained use is increased among persons who sustain daily or near daily use for more than two months

That’s because “daily use” is due to daily pain! Continue reading

Surgeons’ Estimates of Opioid Needs Highly Variable

Orthopedic Surgeons’ Estimates of Opioid Consumption Following Total Knee Arthroplasty Found Highly Variable – Pain Medicine News – Dec 2019

A survey has uncovered wide variability in how orthopedic surgeons interpret their patients’ postoperative opioid consumption after total knee arthroplasty (TKA).

I find it odd that the leading sentence of this article talks about the “interpretation” (not estimate) of their patients’ postoperative opioid “consumption” (not need).

the researchers surveyed 36 orthopedic surgery residents, fellows and attendings at the institution. Respondents were asked to estimate the percentage of patients using opioids in the month before undergoing their TKA, as well as one to three months postoperatively. Continue reading

Prescription Opioid Use and Satisfaction With Care

Prescription Opioid Use and Satisfaction With Care Among Adults With Musculoskeletal Conditions – free full-text /PMC5758314/Jan/Feb 2018

PURPOSE: In the current payment paradigm, reimbursement is partially based on patient satisfaction scores. We sought to understand the relationship between prescription opioid use and satisfaction with care among adults who have musculoskeletal conditions.

METHODS: We performed a cross-sectional study using nationally representative data from the 2008–2014 Medical Expenditure Panel Survey.

This is the kind of nonsense that passes as scientific opioid research these days. It’s no wonder that there’s so much confusion when such context-free studies look only at the dose of a medication without any regard for its medicinal purpose.  Continue reading

How do we measure pain in lab rats?

How do we measure pain, anyway? – You can’t exactly ask a rat to point to where it hurts – by Jeremy Delahanty – Neuroscience – UC Davis – July 22, 2019

Where does it hurt? How do you feel? The enormous number of questions a provider can ask reflects the many variables that are important for treating pain. It also makes clear that communication about pain is difficult for both patients and providers.

Pain is subjective and no two experiences are alike.

Everybody can agree on this, yet those who don’t have much pain themselves believe they can know our pain better than we can ourselves.  Continue reading

Most People Don’t Feel Euphoric From Opioids

Most People Don’t Actually Feel Euphoric When They Take Opioids, Study Finds | Live Science – By Nicoletta Lanese – Staff WriterOct 2019

Finally, someone is willing to state the truth, one that goes against all the rabidly anti-opioid media hype:

Opioids jump-start the brain’s reward system, provoking a burst of pleasurable feelings along with a dizzying drug-induced high. At least that’s what scientists used to think.

But mounting research suggests that the average person doesn’t actually reach this euphoric state on opioids, particularly not the first time they try it.  

Yet, this is exactly the kind of research that is not getting funded these days.   Continue reading