Tag Archives: rules

The Opioid Crackdown: Have We Gone Too Far? (Part III)

The Opioid Crackdown: Have We Gone Too Far? Part III – November 21, 2017 – by Anne Fletcher 

Part three of this series examines what happens when government guidelines and recommendations such those in as the CDC Guideline for Prescribing Opioids for Chronic Pain are used to make rules and regulations about medications that leave little or no room for physicians’ discretion and individual patient needs.

How does this impact people who depend on these medications to avoid suffering and have a decent quality of life?   Continue reading


BOHICA: New Joint Commission Pain Standards

New Joint Commission Pain Standards a Good Start, but Devil’s in the Details: Experts – Pain Medicine News – Nov 2017 —Ajai Raj 

Bend over, here it comes again…

The Joint Commission described the new standards in its “Requirement, Rationale, Reference” (R3) report, released on Aug. 29, 2017, writing that they are “designed to improve the quality and safety of care provided by Joint Commission–accredited hospitals.”

And, of course, quality in pain treatment is currently defined by how much they can reduce (or deny outright) opioid pain relievers.  Continue reading

DEA Statement Promoting Pain Relief

Promoting Pain Relief and Preventing Abuse of Pain Medications: A Critical Balancing Act – A joint statement from 21 health organizations and the Drug Enforcement Administration (DEA).

In this PDF file from October 2016, I found surprisingly patient-centered statements endorsed by the DEA, like:

“For many patients, opioid analgesics… are the most effective way to treat their pain, and often the only treatment option that provides significant relief.”

…share a responsibility for ensuring that prescription pain medications are available to the patients who need them

However, I don’t see any indication the DEA is following its own “consensus statement”.   Continue reading

Justification of MME Dosage Above 90mg

Justification of Morphine Equivalent Opioid Dosage Above 90 mg – Practical Pain Management – August 16, 2017

It is recognized that some patients with severe chronic pain require opioid dosages over 90 morphine milligram equivalents (MME) a day.

The Centers for Disease Control and Prevention (CDC) has stated in its opioid prescribing guidelines that physicians should evaluate and carefully justify the rationale for prescribing above this level.

In California, where we practice, also has written guidelines that require justification for a daily opioid dosage above 80 MME.   Continue reading

The Dangers of Guidelines & Recommendations

Guidelines are wonderful. Guidelines are dangerous – KevinMD.com – ROBERT CENTOR, MD | July 2017

Over the past decade, I have thought often about the benefits and the problems of clinical guidelines. The first concept that attracted my attention was reading about conflicting guidelines.  

Given the same data, different guideline committees would have significantly different recommendations.  At the least, this problem raises questions about guideline validity.

It makes clear that committee perspective could influence recommendations.  

This is exactly what happened when the CDC opioid prescribing guidelines were ghost written by addiction specialists from PROP.   Continue reading

When Managing Pain Becomes a Criminal Offense

When Managing Pain Becomes a Criminal Offense: Advice for Health Care Professionals – Pain Medicine News – JUNE 7, 2017 – Jack Sharman

When does your patient care turn into your criminal trial?

That’s the question many physicians, nurse practitioners (NPs), certified registered nurse anesthetists (CRNAs) and physician assistants (PAs) are asking in the wake of a tidal wave of prosecutions related to pain medicine.

This has been partly spurred on by the “opioid epidemic.”

There has been a sharp spike in convictions—either by guilty plea or by conviction after a trial—of health care professionals involved in pain medicine.   Continue reading

What your doctor thinks when you talk about pain

INSIDER INFORMATION: Opiate Prescriptions – from drugs-forum.com – Richard_smoker, Mar 21, 2006

Interested in what your psychiatrist &/or pain control doc is thinking when you tell him you’re in pain?

Perhaps you will be shocked when you read what’s going through his mind. If you know what’s best for yourself (pun intended), then you will read the ‘suggestions’ herein very carefully.

Here it is. 2 back-to-back articles copied starting on pg. 1282, JOURNAL OF PALLIATIVE MEDICINE. Volume 8, Number 6, 2005.

Is It Pain or Addiction? – DAVID E. WEISSMAN, M.D.  Continue reading

Tragedy of Unrelieved Pain and Suffering

Back to the Future—the Tragedy of Unrelieved Pain and Suffering – PAINS – Pain Action Alliance to Implement a National Strategy –  PAINS Project | Jun 15, 2017 |by Richard Payne, MD, Medical Director, PAINS Project

As a young doctor I attended a conference at MD Anderson Cancer Center titled “Treating Pain in a Drug Oriented Society.”

One of the conference keynote speakers, Dr. Kathleen Foley, called for the “decriminalization” of cancer pain, noting that (even back then) the American Medical Association,

  • the American Pain Society,
  • the American College of Physicians and
  • the World Health Organization

recognized that opioid pharmacotherapy was the mainstay of treatment for patients with cancer experiencing moderate to severe pain.  Continue reading

Call lawyers Morgan & Morgan and tell your story

» call MORGAN & MORGAN ..tell your story… refer to chronic pain patient class action PHARMACIST STEVE June 19, 2017 by Steve Ariens

 Chronic Pain Patients – Call Now
Morgan & Morgan Lawyers

Ask for the medical malpractice department.
Refer to chronic pain patient class action and tell your story. 
Continue reading