In the report it published yesterday (Nov 1, 2017), the President’s Commission on Combating Drug Addiction and the Opioid Crisis, chaired by New Jersey Gov. Chris Christie, endorses what has become the standard explanation for the rise in opioid-related deaths during the last decade and a half.
“A widely held and supportable view is that the modern opioid crisis originated within the healthcare system,” the report says. The problem began, it explains, with “a growing compulsion to detect and treat pain.”
Cancer Patients Face Difficulties in Getting Opioids – Alicia Ault – June 26, 2018
Cancer patients have found it more difficult to receive opioids since the opioid epidemic has been in the news and since new policies to stem abuse have been introduced.
During the past year and a half (from late 2016 to May 2018), cancer patients and survivors have experienced increasing barriers to getting opioid prescriptions, a new survey has found.
Letting patients be eaten alive by cancer without providing effective pain relief qualifies as torture. Continue reading
Yes, Restrictions on Opioids Are a Threat to Human Rights – May 12, 2018 by Lynn Webster, M.D.
In a recent Washington Post story, “Are restrictions on opioids a threat to human rights?,” Charles Lane states that the wave of prescription opioid overdoses has crested thanks to public policy changes including the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain.
Actually, opioid prescribing and overdoses essentially peaked four years before the CDC guidelines were introduced.
I owe my life to evidence‐based medicine (EBM), but that is not the story I want to tell in this article. Here, I want to tell a more critical story—of how the assiduous application of “good” evidence‐based guidelines can sometimes result in a “bad” patient experience
Evidence‐based medicine saves lives, but it is not perfect.
Valkenburg et al distinguish between limits to EBM that might someday be overcome by more research and more philosophical limits that are inherent to EBM’s recommended approach. Continue reading
How did it happen that palliative care lost the dignity debate? Palliative care is a discipline dedicated to improving quality of life by preventing and alleviating suffering. There can be few higher callings in medicine.
Yet those who advocate “dignity in dying” have successfully claimed that the idea of dignity lies not in palliative care but in assisted dying for the terminally ill. A large majority of the public seems to agree. Continue reading
The Center for Disease Control (CDC) published guidelines on opioid prescribing in 2016, but some doctors think it is time to re-examine the guidelines because they say they might have been influenced by inaccurate data.
“It was obvious from the get-go that they were inflating the numbers,” said Dr. Dan Laird, pain management physician and medical malpractice attorney in Las Vegas.
Even I was doubting that so much of the “opioid crisis” was with prescription drugs. There aren’t enough pills in granny’s medicine cabinet to have fueled the surge in “opioid use” when millions of pills flooded the black market. Continue reading
Mr. P. is a 34-year-old man who sees his primary care physician regularly for chronic spine pain. Several years ago, he had a motorcycle accident that left him with a ruptured spleen, a shattered pelvis, and multiple thoracic vertebral fractures.
His daily pain regimen consisted of 3600 mg of gabapentin, 60 mg of baclofen, 120 mg of oxycodone IR (a 180-mg morphine-equivalent dose), and nonsteroidal antiinflammatory drugs as needed.
Mr. P.’s condition had been stable on this regimen for 2 years. His prescription-drug monitoring reports and urine toxicology screens were pristine. Continue reading
Should Doctors Try to Alleviate Pain? | Cato @ Liberty – Nov, 2017 – By DAVID BOAZ
In the rush to find a solution to the problem of opioids, I hope we don’t forget the problem that opioids were intended to cure: chronic severe pain. Living with that kind of pain is awful, and it’s wonderful that science has found ways to help people in pain.
But that’s not the way President Trump’s surgeon general sees it. Continue reading
Opioid Crisis Continues to Pressure Physicians, But Patients Bear the Pain – Pain Medicine News – NOVEMBER 7, 2017 – by David C. Holzman
The efforts to crack down on opioids are coming to a head. As a result, patients are hurting—literally.
Payors and legislators are limiting physicians’ ability to prescribe, said Joseph Ranieri, DO, an addiction medicine and pain specialist who is medical director of Seabrook House, in Newell, N.J.
Moreover, even where rules are absent, the specter of monitoring has many physicians caught between protecting their practices and protecting their patient. Continue reading
Editor’s Memo October 2017: United Nations Says Untreated Pain Is “Inhumane and Cruel” – Oct 2017 – Forrest Tenant
The national debate on the proper use of opioids continues to build as the high prevalence of addiction and overdoses fuel the continuing attention to this “public health crisis.”
Much of the anti-opioid rhetoric regarding the “opioid epidemic” implies that pain is a nuisance that really doesn’t require treatment.
Instead of making the focus one of achieving good pain relief, far too much attention has been directed solely at the risks of opioid prescribing and how we must provide naloxone on every street corner where an opioid might be sold. Continue reading