12/4/2014, Don’t worry, be happy: Just go to bed earlier

http://medicalxpress.com/news/2014-12-dont-happy-bed-earlier.html

Such thoughts are often typical of people suffering from generalized anxiety disorder, major depressive disorder, post-traumatic stress disorder, obsessive compulsive disorder, and social anxiety disorder [and chronic pain disorder]. These individuals also tend to have sleep problems.

Stress may increase desire for reward but not pleasure, research finds

http://medicalxpress.com/news/2014-12-stress-desire-reward-pleasure.html

Stress prompted chocolate lovers in an experiment to exert three times as much effort to smell chocolate than unstressed chocolate lovers, but both groups reported about the same level of enjoyment when they got a whiff of the pleasing aroma, according to the study, published in APA’s Journal of Experimental Psychology: Animal Learning and Cognition.

12/19/2014, Early exposure to antidepressants affects adult anxiety and serotonin transmission

http://medicalxpress.com/news/2014-12-early-exposure-antidepressants-affects-adult.html

About 15 percent of women in the United States suffer from anxiety disorders and depression during their pregnancies, and many are prescribed antidepressants. However little is known about how early exposure to these medications might affect their offspring as they mature into adults.

The answer to that question is vital, as 5 percent of all babies born in the U.S. – more than 200,000 a year – are exposed to antidepressants during gestation via transmission from their mothers…

Current antidepressant therapies are ineffective in treating anxiety and depression in large numbers of patients, and advances in predicting individual responses are hindered by difficulties associated with characterizing complex influences of genetic and environmental factors on serotonergic transmission in humans,” the study states.

(2007) The nonmedical use of prescription ADHD medications

http://www.substanceabusepolicy.com/content/2/1/32

Among persons who had never been prescribed medication to treat ADHD, friends or family members were the most common source. Productivity was the most frequently endorsed reason for NMU [non-medical use]. Alcohol was the substance most commonly used in combination with ADHD drugs…

See, if you just say that the drug use was “non-medical,” then it automatically means addiction.

Because most prescription ADHD medications currently are highly regulated, policy options for supply-side reduction of nonmedical use may include identifying those medications with lower abuse liability for inclusion on insurance formularies.

Even Wikipedia says dependence is addiction…

https://en.wikipedia.org/wiki/Opioid_dependence

Opioid dependence is a medical diagnosis of an opioid addiction, and is characterized by an individual’s compulsive use of opioids (e.g., morphine, heroin, codeine, oxycodone, hydrocodone, etc.) in spite of consequences of continued drug use.

Consequences, like pain relief?

As of 2010 opioid use disorder resulted in about 43,000 deaths globally up from 8,900 in 1990. Among adults, the rate of inpatient hospital stays in the United States related to opioid overuse increased by an average of 5% annually from 1993–2012. The percentage of inpatient stays due to opioid overuse that were admitted from the emergency department increased from 43% in 1993 to 64% in 2005, but have remained relatively constant since.

The problem with statistics is that they are frequently outdated, so policy decisions are made while looking in the rear view mirror.  The NIDA has never been ahead of America’s drug problem — it is rarely up-to-date on what drugs kids are currently using.  And everyone in the federal government gets their drug-war information from the DEA and the NIDA.

So, who cooked up “Opioid Use Disorder”?  The medical industry or the drug war?

“Opioid Use Disorder” created by NIDA/SAMHSA/ONDCP

It all started with a survey:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3745028/

…the 2002-2004 National Survey on Drug Use and Health (NSDUH), a survey conducted by RTI International, sponsored by the Substance Abuse and Mental Health Services Administration, and formatted for public use by the Inter-University Consortium for Political and Social Research. The NSDUH is an annual survey of the civilian, non-institutionalized population aged 12 years and older designed to collect information on the prevalence of substance use and psychiatric comorbidity (Substance Abuse and Mental Health Services Admininstration and Office of Applied Studies, 2003).

And now we have a continuing education course sponsored by the NIDA (6/25/03) — which, by the way, uses the fear of HIV/AIDS (drug needles) and opioid addiction against pain patients. Well, certain kinds of opioid therapy…

file:///C:/Users/computer1/Downloads/See_Last_Page.pdf

(6/25/03) Overview: Opioid abuse is a major problem in the United States. At the end of the 1990s, there were an estimated 898,000 hard-core heroin addicts and 253,000 occasional heroin users (ONDCP, 2001). In addition, it is estimated that two million or more people abuse prescription pain relievers every year (SAMHSA, 2002).

The opioid “epidemic” was based on an “estimation” from two different surveys… from way back in 2001/2002.  When was the last time you took a survey from the federal government?

More physicians will be called upon to treat opioid-dependent patients as opioid treatments move into primary care with the emergence of office-based buprenorphine treatment.

Oh, not because of the opioid “epidemic”?

Website funded by the NIDA:  http://www.buppractice.com/node/5377

Opioid-dependent individuals are at an increased risk for mental illness.

And here we have the psychiatric community weighing in:

http://www.uptodate.com/contents/opioid-use-disorder-epidemiology-pharmacology-clinical-manifestations-course-screening-assessment-and-diagnosis

(2014) Opioid use disorder: Epidemiology, pharmacology, clinical manifestations, course, screening, assessment, and diagnosis

The psychiatric diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) opioid abuse and opioid dependence were replaced by one diagnosis, opioid use disorder, in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Although the crosswalk between DSM-IV and DSM-5 disorders is imprecise, opioid dependence is approximately comparable to opioid use disorder, moderate to severe subtype, while opioid abuse is similar to the mild subtype.

Did you get that?  So, which “subtype” are you?

http://www.sciencedirect.com/science/article/pii/S0306460304000632

(2011) Prevalence of Prescription Opioid-Use Disorder Among Chronic Pain Patients: Comparison of the DSM-5 vs. DSM-4 Diagnostic Criteria

http://www.tandfonline.com/doi/abs/10.1080/10550887.2011.581961#.VJ4qs14ANA

(12/9/2008) Clinical Characteristics of Treatment-Seeking Prescription Opioid versus Heroin using Adolescents with Opioid Use Disorder

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746065/

Now it’s the NIDA’s turn:

Click to access reading_12a.pdf

Major increases in opioid analgesic abuse in the United States: Concerns and strategies

Wilson M. Compton, Nora D. Volkow, National Institute of Drug Abuse

(2005) Substance use and posttraumatic stress disorders: Symptom interplay and effects on outcome

Prescription Opioid Use Disorder (POUD)

Prescription opioid use disorder: A complex clinical challenge (2012)

http://www.currentpsychiatry.com/home/article/prescription-opioid-use-disorder-a-complex-clinical-challenge/07df2ac90009340bf541bb4fdcdc15f9.html

The incidence of POUD during opioid therapy for pain is unknown. Some researchers have suggested it may be as low as 0.2%,7 while others estimate that rates of POUD in patients with chronic pain may be similar to those in the general population: 3% to 16%. When applying the proposed DSM-5 criteria to patients receiving long-term opioid therapy for noncancer pain, the lifetime prevalence of POUD may be as high as 35%.

If you are a pain patient who follows all the rules, you’re probably thinking this “disorder” doesn’t apply to you.  But let me assure you that this is how the medical industry views every single chronic pain patient — so whether you suffer from this “disorder” or not, you will be heavily monitored and treated for it.

Face it, if you’re still lucky enough to be on opioid therapy, you are now a Drug Addict.  How do you like that label?  From what I’ve learned about labels (like “stoner” for marijuana users), I’d say it’s better to claim the negative labels rather than try to fight them… Really, it’s easy to make any label negative — just think how the term “gay” has evolved from meaning “really happy” to being a put down (in some circles).

12/1/2014, Opioid Abuse Clinical Presentation

http://emedicine.medscape.com/article/287790-clinical

The Diagnostic and Statistical Manual for Mental Disorders, 5th Edition (DSM-5) defines opioid use disorder as a problematic pattern of opioid use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period…

Opioid tolerance usually does not develop in patients with cancer who are being treated for pain; the need for increasing doses in those patients typically is due to an increasing level of pain.

Really? So, when a patient has cancer, their pain is real… as opposed to every other pain patient?  And what happens when a cancer patient complains of increasing pain even when they’re in remission?  Are they still believed?  Will a cancer patient who’s in remission but still suffering from chronic pain — say from the after effects of treatment or surgery — also be denied pain medications?  Or if you have cancer, does that give you access to prescription pain medication for life?

I wonder how many of the other 100 million chronic pain patients would agree that only cancer pain is real?

I tell you what, cancer is your ticket to having your pain levels believed.  Since the medical industry developed and created tests for cancer, this medical condition can be “proven.”  Since there are no tests for many chronic pain conditions, or even for mental conditions like PTSD, then too bad, so sad — doctors don’t believe you.

Guess what?  Patients don’t believe doctors anymore, either.  So there.

4/9/2014, Confronting the Stigma of Opioid Use Disorder—and Its Treatment

http://jama.jamanetwork.com/article.aspx?articleid=1838170

First, the understanding of opioid use disorder as a medical illness is still overshadowed by its misconception as a moral weakness or a willful choice.6 This misconception has historically separated this illness and its treatment from the rest of health care. Within the substance use treatment community, many still believe that recovery depends solely on willpower to abstain from all opioids, including methadone and buprenorphine. As a result, many who provide residential services force patients receiving methadone or buprenorphine to taper off of medication as a condition of initial or continued treatment, and many counselors consider taking medication a character weakness…

Methadone and buprenorphine effectively treat opioid use disorder, but not cocaine, sedative, cannabis, nicotine, or alcohol use disorder, and not depression, diabetes, hypertension, asthma, schizophrenia, bipolar disorder, or HIV infection…

Third, language mirrors and perpetuates the stigma related to treatment of opioid use disorder with medications. The health care system, and therefore the public, does not routinely talk about opioid use disorder and its treatment as medical care, but rather often may assign judgmental, pejorative terms. Urine test results are called “clean” or “dirty” rather than “positive,” “expected,” “negative,” or “unexpected.” Medically indicated situations in which patients receiving methadone or buprenorphine are tapering or decreasing their doses are described as “detoxification,” as though the medications are toxins poisonous to the body. Patients with opioid use disorder are referred to as “clean” when they are in recovery or managing symptoms and are referred to as “dirty” if they are still demonstrating symptoms of their illness. Within the substance use treatment sector, therapy that does not involve a medication is known as “drug-free” with the implication that by taking a medication such as methadone or buprenorphine, a person cannot be in recovery. Health care practitioners, and many lay people, refer to people with opioid use disorder as “junkies.” While the term “junkie” originated because of the heroin individuals were using, it now is broadly associated particularly with the people who use illicit opioids. Who would use similar terms about a patient with diabetes and an elevated hemoglobin A1C level?

Polite censorship on WordPress

This is the second time that Ms. Nee closed comments on her blog before I was able to respond to one of her comments.  And it’s funny, but I don’t think she does this very often… if at all, before now.  But see, I have a WordPress site of my very own now…

Sure, everyone has a right to censor their own blog, especially from mean or nasty comments. But that’s not the case here…

Don’t worry, Ms. Nee, I won’t be making any more comments on your blog.  I sincerely appreciate all the information you’ve posted about Unum. And I assume that your blog is also a marketing tool for your business, helping you obtain clients.  But as I told you via email, I can’t afford your rates, so you already know I’m not a prospective client… I assume you would prefer that claimants use your services instead of going it alone or hiring an attorney.  Sure, I guess I can understand why you closed down the comment sections where I made posts…

But just because I can’t afford to live in your world, Ms. Nee, doesn’t mean I don’t have opinions worth sharing — which I don’t have to do on your blog, granted.  I can respond to your blog posts right here…

http://lindanee.wordpress.com/2014/12/10/discretionary-authority-the-hand-in-the-cookie-jar/

Comments from December 24, 2014:

Painkills2 said:  And if we’re not fixable, why must we be forced to pay for treatment? Oh, that’s right, there’s a “contract.”

Lindanee said:  Were it not for the contract you wouldn’t have had coverage or benefits at all.

And now, my uncensored response:

At first, I was going to say, “Touche, Ms. Nee, and a happy holidays to you, as well.”  But that sounded kinda snarky, so here we go:

“Only free men can negotiate. A prisoner cannot enter into contracts.” Nelson Mandela

Definition of “prisoner”:  a person who is or feels confined or trapped by a situation or set of circumstances.