Pain was once viewed only as a symptom, the consequence of another condition. It was often ignored as doctors focused on treating its underlying medical cause.
But for almost everyone, pain is what matters. “It’s pain that brings people into the doctor’s office,” says Penney Cowan, executive director of the American Chronic Pain Association. “It’s pain that they want treated.”
“The costs are incalculable,” says Christopher L. Edwards, PhD, assistant professor of psychiatry at Duke University School of Medicine. “How do you estimate the value of lost self-worth? How do you estimate the loss of family, friends, and a sense of accomplishment?” Continue reading
How Did We Come to Abandon America’s Pain Patients? – Filter Magazine – by Alison Knopf – July 2019
This is an excellent article pointing out exactly how pain patients have been neglected and dismissed by the medical system. Kudos to Alison Knopf for her exemplary work.
- Pain patients are untreated and suffering.
- Pharmaceutical companies are being sued and settling.
- Law enforcement is cracking down on providers.
The Ethical Responsibility to Manage Pain and the Suffering It Causes – Position Statement of the American Nurses Association, Apr 2018 – Repost
I’m reposting this from last year because it’s such a good (and rare) example of a reasonable attitude toward opioids. The Nurses Association gets credit for standing up for patients a year earlier than others.
The purpose of this position statement is to provide ethical guidance and support to nurses as they fulfill their responsibility to provide optimal care to persons experiencing pain.
The national debate on the appropriate use of opioids highlights the complexities of providing optimal management of pain and the suffering it causes.
In these first sentences, the difference between nurses and doctors shine through:
Nurses are much more concerned with suffering, while doctors nit-pick about what is painful and what isn’t, who is “really” hurting and who is “catastrophizing”. Continue reading
Here’s a recent study from the NIH showing that sudden tapers are a disaster for patients. If you showed them this study (link in title), with documented harm to patients, any doctor who still honestly cares for their patients would not force sudden tapers like this.
Between 2012 and 2017, the United States dramatically reduced opioid prescribing rates.
While this may be an appropriate given the opioid epidemic, there has been little research to guide the clinical practice of discontinuing patients from opioid medications and opioid death rates have continued to increase. Continue reading
No Shortcuts to Safer Opioid Prescribing | NEJM – Deborah Dowell, M.D., M.P.H., Tamara Haegerich, Ph.D., and Roger Chou, M.D. [!!!] – Apr 2019
This article is astonishing because Dr. Roger Chou has been one of the most influential anti-opioid crusaders. I’m thrilled that he’s finally understanding (or at least noticing) the problems (torture) caused by the CDC Guideline that he helped write.
Since the Centers for Disease Control and Prevention (CDC) released its Guideline for Prescribing Opioids for Chronic Pain in 2016, the medical and health policy communities have largely embraced its recommendations.
Although outpatient opioid prescribing had been declining since 2012, accelerated decreases — including in high-risk prescribing — followed the guideline’s release.
“Accelerated decreases” is a deliberately innocuous term when referring to the brutal, suicide-inducing, drastic forced opioid tapers pain patients have had to endure. Continue reading
I don’t know if it’s because I have EDS, but it can take my opioid pain medication over an hour to have any effect, which has led to far too many literally agonizing waits.
Can Pain Be Used to Treat Pain? — Pain News Network – By Jeanne McArdle – Apr 2019
“Can you cure pain with more pain?” was the provocative question posed last month by National Public Radio’s Invisibilia podcast, “The Fifth Vital Sign.”
The show features the story of Devyn, a 16-year old former gymnast living with chronic pain.
Devyn broke the end of her thighbone and required surgery, but the injury never fully healed and her pain was spreading. Continue reading
I’m angry that the CDC issued this clarification for only three discreet conditions
- cancer patients,
- cancer survivors, and
- individuals with sickle cell disease.
Because it so carefully carves out these three very specific conditions for special notice, it seems to imply that any other conditions not listed are currently being understood and implemented as intended, and I’m afraid it could become even harder for chronic pain patients to get opioid relief. Continue reading
Draft Report on Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations – PPM Editorial – Authors of this commentary are: Richard A Lawhern, PhD and Stephen E Nadeau, MD – Feb 2019
Here is a great example of an excellent commentary on the Draft Report from the HHS. We can all use this as a template for how to organize our own comments.
The following review comments were submitted in response to the draft report, Pain Management Best Practices: Updates, Gaps, Inconsistencies, and Recommendations, published by the HHS Pain Management Best Practices Inter-Agency Task Force.
To Be Praised
I urge everyone to start with the positive to make our later criticism more palatable. We have to remember the person reading our comments and try to be what they would regard as “reasonable”. Otherwise, I fear our commentary will be left unread and disregarded. Continue reading
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