Tag Archives: rules

Paraplegic Drug User Victim of Involuntary Commitment

How a Paraplegic Drug User Became a Victim of Involuntary Commitment by Christopher Moraff – Feb 2019

New laws make it easy for anyone accused of having an addiction problem to be committed if they don’t agree to whatever treatment is recommended for them.

Involuntary commitment for people accused of having an addiction and not actively participating in treatment for it is becoming more common as more laws are being passed to make this legal.

Barely a day passes on my beat without my meeting someone with a harrowing story about the impact of zero-tolerance drug policies on their lives. But few of these stories have impacted me personally as much as that of a young man I’ll call “Jay.”

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Opioid Crisis: No Easy Fix to Social and Economic Causes

Opioid Crisis: No Easy Fix to Its Social and Economic Determinants – Feb 2018

The accepted wisdom about the US overdose crisis singles out prescribing as the causative vector.

I don’t see how this wrong idea can be called “accepted wisdom” when it is much more akin to “accepted nonsense” and “urban legend”.

Although drug supply is a key factor, we posit that the crisis is fundamentally fueled by economic and social upheaval, its etiology closely linked to the role of opioids as a refuge from physical and psychological trauma, concentrated disadvantage, isolation, and hopelessness.   Continue reading

Opiophobia: The Irrational Fear of Opioids

Opiophobia: The Irrational Fear of Opioids – by Dr. Jeffrey Grolig – National Pain Report – Feb 2019

The irrational fear of opioids, opiophobia, has plagued our country before. Prior to 2000, especially in the 1980s and 1990s, opiophobia ruled the medical community.

The fear was that opioids used for more than a short time would cause overdose, death and addiction. The War on Drugs from the Nixon era caused non-opiophobic doctors to be targeted, arrested and disciplined.

But then Dr. Russell Portenoy conducted research showing that chronic pain patients actually did well on these opioids, achieving an excellent quality of life with vanishingly few developing problems.   Continue reading

CA Links Past Opioid Rx by Doctors to Deaths

California Doctors Alarmed As State Links Their Opioid Prescriptions to Deaths – Heard on All Things Considered – Jan 2019

Of all the hare-brained ideas states have implemented to clamp down on legal and medically appropriate opioids, California has come up with the worst:

Comb through the state’s PDMP for the last three years to find a link from someone who recently died from an overdose of illegal drugs to a doctor who prescribed them opioids up to three years ago, and threaten them with prosecution if the CA medical board doesn’t agree with some aspect of this long-ago prescription.

About a year ago, Dr. Ako Jacintho of San Francisco returned home from traveling to find a letter from the state medical board waiting for him.   Continue reading

Should SSDI change how they consider pain?

Should Social Security Disability Insurance change how they consider pain? – U.S. Pain Foundation

Social Security Administration (SSA), which administers SSDI, recognizes these challenges. The SSA recently announced it is accepting feedback in how it considers pain for disability benefit claims via a public comment period that ends Feb. 18.

Social Security Disability Insurance (SSDI) can be a lifeline for individuals who are disabled by chronic pain. If approved, it can provide monthly insurance benefits to those whose disabilities are so severe that they cannot work a substantial amount.

However, the application and approval process can be rigorous, and because assessing pain can be extremely challenging — given that it is invisible, subjective, and stigmatized — this may mean that some individuals with pain are incorrectly denied benefits.   Continue reading

DEA says prescription records not private

The DEA Thinks You Have “No Constitutionally Protected Privacy Interest” in Your Confidential Prescription Records – By Nathan Freed Wessler, Staff Attorney, ACLU Speech, Privacy, and Technology Project – Sept 2013 

The Drug Enforcement Administration (DEA) thinks people have “no constitutionally protected privacy interest” in their confidential prescription records, according to a brief filed last month in federal court.

That disconcerting statement comes in response to an ACLU lawsuit challenging the DEA’s practice of obtaining private medical information without a warrant.

The ACLU has just filed its response brief, explaining to the court why the DEA’s position is both startling and wrong.   Continue reading

Medical Assn. President Shares Pain Horror Story

Calif. Medical Assn. President Shares Medical Horror Story – by Cheryl Clark, Contributing Writer, MedPage Today – Jan 2019

The new president of the California Medical Association was expecting to spend New Year’s at a wedding in Las Vegas.

Instead, David Aizuss, MD, posted on Facebook about his “eye opening” first-hand view of “American medicine at its worst.”

While I’m sorry for what he endured, I can’t help but be pleased that such a high-ranking doctor suffered exactly the same brutal treatment pain patients struggle with: the routine refusal to relieve pain (if not outright disbelief and accusations of drug-seeking).   Continue reading

Use of Big Data to Investigate Doctors

Authorities’ Use of Big Data May Harm—or Help—Your Chances of Investigation – By Efrem M. Grail – September 12, 2018

A former prosecutor and current defense lawyer shares strategies to help protect your practice.

This is what it has come to: lawyers are advising doctors how to practice medicine without ending up in jail.

As pain practitioners well know, two recent developments – one federal, one state – have combined to increase the risk of providers being investigated for prescribing opioids for their patients.   Continue reading

Review of HHS Report on Pain Mgmt Best Practices

This major report is long and detailed, so I covered most of it in three long posts:

  1. HHS Report on Pain Mgmt Best Practices – part 1
  2. HHS Report on Pain Mgmt Best Practices – part 2
  3. HHS Report on Pain Mgmt Best Practices – part 3

 

If you’re interested in a particular section of the report, below is the full article outline with links to each section:   Continue reading

HHS Report on Pain Mgmt Best Practices – part 3

Draft Report on Pain Management Best Practices | HHS.gov – Dec 2018

This document is so long and so detailed that I spent hours working it over to add my own voluminous commentary.

I posted the second, most significant part yesterday, HHS Report on Pain Mgmt Best Practices – part 2, and the first part the day before: HHS Report on Pain Mgmt Best Practices – part 1.  

This is the third and final part of my series, and covers the middle of the document, starting where I left off in the second part detailing interventional procedures. Continue reading