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 – Oct 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
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 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, 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 Actually Feel Euphoric When They Take Opioids, Study Finds | Live Science – By Nicoletta Lanese – Staff Writer – Oct 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
Nonopioid Overdose Death Rates Rose Almost As Fast As Those Involving Opioids, 1999-2016. – PubMed – NCBI – Jul 2019
Even 6 months ago, it was becoming clear that overdoses aren’t “caused by opioids”, but rather all kinds of drugs, of which illicit opioids like fentanyl undoubtedly play a huge part.
But they are still trying to link all the overdoses to opioids using the most inside-out reasoning (if it can even be called that) that’s clearly influenced by PROPaganda.
The number of Americans dying from drug overdoses has risen rapidly, but the contribution of nonopioid drugs to this growth is not well understood.
And it won’t be understood until they clear their heads of the nonsense they’ve been flooded with. Continue reading
The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain. – PubMed – NCBI – Sep 2014
I originally found this in a government-sponsored Research Review, from the Effective Health Care Program (Helping You Make Better Treatment Choices) under the Agency for Healthcare Research and Quality (AHRQ).
But now in 2019, I can’t find it there anymore. I can only find the abstract of what used to be a 219-page report, which had reached the same non-conclusion as all other studies of the last couple of decades: “more research is needed”, used when the study doesn’t find the results they wanted.
I think this increasingly common “conclusion” to studies of opioids is a pathetic evasion of the full truth. Continue reading
Breakthrough research reveals parachutes don’t prevent death when jumping from a plane | Association of Health Care Journalists – by Tara Haelle – Feb 2019
The goal of evidence-based medicine (EBM) is to base medical care only on the best evidence: rigorous randomized controlled trials (RCTs). In general, this seems to make sense, but as an overarching objective applied to all cases, it can become absurd.
It’s been 15 years since BMJ published the most rigorous type of study there is — a systematic review of randomized controlled trials — to assess the evidence for using a parachute to prevent death and major injury when jumping from a plane.
They had to conclude, “As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomized controlled trials.” Continue reading
Most People Don’t Actually Feel Euphoric When They Take Opioids, Study Finds | Live Science – By Nicoletta Lanese – Oct 2019
Opioids are known to spark feelings of euphoria in users, but does everyone really share the same experience?
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. In fact, people who are not addicted to opioids may feel subjectively worse after taking the drug, according to cognitive neuroscientist Siri Leknes. Continue reading