The U.S. health care system is killing adults with sickle cell disease. Racism is a factor — most of the 100,000 U.S. patients with the genetic disorder are African-American — and so is inadequate training of doctors and nurses.
And the care is getting worse, sickle cell patients and their doctors said, because the opioid addiction crisis has made ER doctors extremely reluctant to prescribe pain pills.
STAT interviewed 12 sickle cell patients who described the care they received and didn’t receive. They were old and young, men and women, scattered from coast to coast, some with jobs or attending school and some too sick to do either. Continue reading
The 63-year-old retired Mentor schools bus driver remembers the date because, she says, she was shell-shocked by what her doctor told her that day: she would no longer treat Karchefsky’s chronic pain.
Karchefsky’s Chardon-based primary care physician had been managing the Willoughby woman’s well-documented and longstanding pain, resulting from disk and bone degeneration in her neck and spine, with opioid medications for 14 years. No more.
While these patients acknowledge the seriousness of the overdose epidemic, they say their legal prescriptions, for legitimate disease, are not the source of the problem. Continue reading
I wonder how the public will feel when the anti-opioid rules they so enthusiastically support are applied even to cancer patients like their mothers, fathers, kids, or even themselves? Until now, the effective treatment of cancer pain with opioids was always a politically untouchable “sacred cow”… as long as cancer was terminal.
In an article published online last week in JAMA Oncology, writers from the University of Pennsylvania School of Nursing and the Perelman School of Medicine warn that clinical guidelines developed in the face of the opioid abuse and misuse crisis are likely confounding efforts to treat chronic cancer related pain.
Lead author Salimah H. Meghani, PhD, MBE, RN, FAAN, and coauthor, Neha Vapiwala, MD, Associate Professor of Radiation Oncology, urge that guideline-producing agencies, including the CDC and others work to resolve inconsistencies between their recommendations and those of the National Comprehensive Care Network (NCCN). Continue reading
New opioids’ guidelines stifling pain management| BY PATTY MILLER | THE EDMOND SUN | Sep 21, 2018
Although no laws have been passed that negatively impact chronically ill patients in Oklahoma, guidelines are being created and treated as laws by the healthcare profession because of the doctors’ fear of running afoul of law enforcement.
“Guidelines are set by the CDC (Center for Disease Control and Prevention),” said local pain management doctor and Edmond resident, James Lynch, M.D., and if a pharmacist believes a doctor is prescribing too much medication then the pharmacist reports the doctor to the DEA (Drug Enforcement Administration).
How can a pharmacist decide how much medication is appropriate, when they do not have access to the patient’s healthcare history or diagnosis? Continue reading
The recent article on Vox called “Solving America’s painkiller paradox“ is getting a lot of attention.
This is unfortunate, because the Vox article has a number of major errors and misconceptions that are causing more harm than is generally realized. So I’m going to go through it in detail.
“This year, researchers uncovered a simple method for getting doctors to reduce profligate prescriptions of drugs like OxyContin and Percocet that have contributed to America’s opioid epidemic: informing doctors that one of their patients had died.” Continue reading
Unintended targets: How pain patients suffer in the opioid crisis – By Mary Huber, American-Statesman Staff – Sept 2018
You can read about what I think of these supposed “unintended” consequences: CDC Opioid Prescribing Guideline: Unintentional Consequences?
Sonya Gibson said she doesn’t schedule anything before noon. She usually gets in a few good hours folding laundry and cleaning the house before she has to lie back down again at about 5 p.m.
She said she can’t sing or perform the way she used to, before the two car crashes that wrecked her pelvis and spine and permanently altered her life. Continue reading
Coincidentally, the month of September is both “Pain Awareness Month” and “Suicide Prevention Month”.
Judging from all the articles I’ve found discussing the link between pain and suicide, the juxtaposition of these two awareness campaigns is a fortuitous coincidence, a chance to raise awareness of the potentially deadly consequences of poor pain control.
Perhaps it can start some necessary conversations about how the withdrawal of opioid pain management could exacerbate suicidal impulses. Continue reading
This is a Twitter discussion thread from one of our favorite advocates: Dr. Stefan Kertesz from Sept 7, 2018. He makes an excellent argument, with links to his previous articles, about the wrong-headedness of restricting prescription opioids.
1/New study shows US #opioid prescribing is down 35.5% overall and 48% for high dose in particular (2012-2017, per capita figures) http://annals.org/aim/fullarticle/2698111/opioid-prescribing-united-states-before-after-centers-disease-control-prevention Continue reading
Opioid crisis not helped by panic – Jeffery A. Singer – Sept. 2, 2018
The opioid crisis that gets the most attention is the growing rate of opioid-related overdose deaths in non-medical users.
How refreshing to see the “opioid overdoses” qualified like this, making it clear that these are from *non-medical* users.
According to the National Survey on Drug Use and Health, less than 25 percent of non-medical users of prescription opioids ever get them from a doctor — they get them from a friend, relative, or drug dealer. Continue reading
These two high profile defenders of pain patients’ access to opioids both responded to Oregon’s proposal to force the taper all pain patients off opioids.
I’ve captured their reasonable objections in a series of comments from their Twitter accounts:
Stefan Kertesz – @StefanKertesz – 29 August
1/An unknowing defense: Oregon Medicaid Director responds to our critique of his plan to force-taper all #opioid receiving patients in WSJ, and reveals to all that he is unaware of what’s unique about the plan he’s defending https://www.wsj.com/articles/oregon-opioid-abuse-policy-is-the-right-one-1535469847 https://twitter.com/StefanKertesz/status/1034849416195190784/photo/1 Continue reading