Tag Archives: suffering

Complications of Uncontrolled, Persistent Pain

Complications of Uncontrolled, Persistent Pain – By Forest Tennant, MD, DrPH – Jan 2018

To the unfortunate patient who is afflicted and the practitioner who treats it, incurable, persistent pain is truly its own disease regardless of its underlying cause.

Persistent pain, which is also often characterized as chronic or intractable, has all the ramifications of a disease in that it may have pre-clinical and overt phases.

I like that he calls it “persistent pain” instead of “chronic pain”, a term which has become synonymous in the public’s eye as a whining, complaining, catastrophizing, gonna-be addict.    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

Solutions for Consequences of Opioid Rules

Fox Part 3 | Health experts offer solutions for unintended consequences of opioid crackdown – By Elizabeth Llorente | Fox News – December 12

Treating America’s Pain: Unintended Victims of the Opioid Crackdown, Part 3The Solutions

Solutions are obvious (rewrite CDC Opioid Guideline), but there’s just no political will to reverse course.

It looks like this Titanic will have to sink before anyone dares make corrections. Pain patients (like passengers on the Titanic) will just be sacrificed before we eventually see progress.   Continue reading

Opioid Nation: inequality and “deaths of despair”

Opioid Nation by Marcia Angell – December 6, 2018 Issue

This is a review of three books written about the so-called “opioid epidemic”.

The term opioid is now used to include opiates, which are derivatives of the opium poppy, and opioids, which originally referred only to synthesized drugs that act in the same way as opiates do.

Opium, the sap from the poppy, has been used throughout the world for thousands of years to treat pain and shortness of breath, suppress cough and diarrhea, and, maybe most often, simply for its tranquilizing effect.   Continue reading

Pain management, Rx opioid mortality, and the CDC

Pain management, prescription opioid mortality, and the CDC: is the devil in the data? by Michael E Schatman & Stephen J Ziegler – Journal of Pain Research – Oct 2017

Though a year old, this article explains the flaws in the CDC opioid prescribing guideline.

Transparency, freedom from bias, and accountability are, in principle, hallmarks of taxpayer-funded institutions. Unfortunately, it seems that at least one institution, the Centers for Disease Control and Prevention (CDC), continues to struggle with all three.

What began with a prescribing guideline created in secrecy has now evolved to the use of statistical data and public statements that fail to capture not only the complexity of the problem but also the distinction between licit and illicit opioids and their relationship to the alarming increase in unintentional overdose.  Continue reading

Opioids Prescribed after Injury or Surgery

If You’re Prescribed Opioids after Injury or Surgery, Will You Become Dependent? – National Pain Report – Oct 2016

We’ve all seen the massive media attention on the opioid epidemic and as the dust settles and changes are made to how opioids are viewed, we are left with a few takeaways.  One of them is that if someone is injured or has had surgery, prescribing opioids is a bad thing because many will become dependent.

A new study presented at the American College of Surgeons refutes this notion, reporting that up to one year after discharge from the hospital, only about 1 percent of trauma patients were reportedly still taking prescription opiates, or opioids, such as hydrocodone, oxycodone, morphine, and fentanyl.

This new study is one of the largest investigations of prescription opiate use among patients who sustained trauma and may have the longest continued follow-up one year after hospital discharge.  Continue reading

Mandated Queries of the Florida PDMP

Mandated Queries of the Florida Prescription Drug Monitoring Program: Early Experiences from a Cancer Center-based Outpatient Palliative Medicine Clinic – September 14, 2018 – by Chad Kollas (@ChadDKollas) via pallimed.org

Background and Introduction

On July 1, 2018, Florida implemented a new law requiring all licensed physicians to query the state’s prescription drug monitoring program (PDMP), known as the Electronic Florida Online Reporting of Controlled Substances Evaluation (E-FORSCE), before prescribing controlled medications, including opioid analgesics

In light of this anxiety about the potential impact of the new law on both patients and physicians, we initiated a quality improvement (QI) project to characterize its effects and identify opportunities to improve palliative care in the setting of implementation of the new law.  Continue reading

Stanford Letter to Oregon Chronic Pain Task Force

Stanford Letter to Oregon Chronic Pain Task Force – protesting forced opioid tapers and showing these proposals go against guidelines and evidence

We, the undersigned, write to respond to the above-mentioned document released by the Chronic Pain Task Force regarding opioid medication coverage for Oregon Medicaid patients.

In our view, the Task Force embraces a state-mandated treatment change that contravenes the three major national and international guidelines on prescribing opioids for chronic pain.

These guidelines include:

  • The Centers for Disease Control and Prevention Guideline for Opioid Prescribing,
  • the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain, and
  • the VA/DOD Clinical Practice Guidelines for Opioid Therapy for Chronic Pain V. 3.0 – 2017  Continue reading

In excruciating pain, sickle cell patients shunted aside

‘Every time it’s a battle’: In excruciating pain, sickle cell patients are shunted aside – By Sharon Begley @sxbegle – Sept 2017

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

Suffering and abandoned: Chronic pain patients cut off

Suffering and abandoned: Chronic pain patients cut off in the opioid era | cleveland.com – Apr 23, 2018 – By Brie Zeltner, The Plain Dealer

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