Day: 01/01/2015

12/29/2014, Groups unite against curbing painkillers

http://www.bostonglobe.com/news/nation/2014/12/29/opiate-prescribing-crackdown-massachusetts-opposed-industry-backed-patient-group/aAjGBp2NTHkfPfTSZrhF9N/story.html

Locally, [Cindy] Steinberg has teamed with another powerful organization that also opposes some of the strictest narcotic prescribing proposals: the Massachusetts Medical Society, which represents the state’s physicians. This sort of organized resistance from the patient and medical community frustrates elected leaders and public health officials who are trying to devise measures to curb a wave of narcotic painkiller abuse and overdoses…

“There’s an imbalance, an unevenness in the view of the benefits of these products versus the dangers,” said Representative Bill Keating, the Bourne Democrat who has introduced a bill in Congress to require that opiate pills be manufactured in a way that makes them difficult to crush and then snort or inject.

Democrat, my ass…

Mr. Keating, weighing the benefits and risks of treatment is what patients are supposed to do, isn’t it?  Not politicians.  (You know, unless you suffer from chronic pain or addiction, then you don’t get to make your own medical choices.)

And Dr. Keating — oh, you’re not a doctor?  Then, Mr. Keating, I would ask that you do more research on this issue before deciding that politicians have a right to determine how drugs are made. Like looking up the information on these drugs you’re so in love with to see how they haven’t worked — either to help the drug abuse problem or as prescribed for addiction.

“What about the pain of someone’s spouse or loved one or daughter, and they are dead? That is a pain that doesn’t go away,” Keating said.

Hmmmm… What do chronic pain patients know about pain that never goes away?  Gee, Mr. Keating, I wonder who you’ve been talking to…

Law enforcement leaders say prescription opiates serve as a gateway to heroin, which has been responsible for a shocking surge in deaths in New England recently. Massachusetts alone experienced 58 heroin overdose deaths in the first half of December, State Police said.

Ah, the oft-used and easily debunked “gateway theory” — why do intelligent people still use that excuse? Oh, it’s law enforcement who believes in the gateway theory? Well then, that explains it — everyone knows you have to be a doctor before you’re allowed to work in law enforcement.

And can the author of this article guess why heroin has become a problem? Because I’m getting really tired of spelling it out…

She [Steinberg] also is a leader of the US Pain Foundation, a Connecticut-based nonprofit that received 87 percent of its $250,000 budget from prescription drug companies in 2012. Steinberg was paid $6,480 by the US Pain Foundation in 2012 for her role, according to tax records. She received the same amount from the group in 2013.

Oh my god, Ms. Steinberg made almost $7,000 in 2012 from the foundation… is she driving around in a Rolls?  Dining on caviar?

And why not mention that almost every anti-drug agency is funded by the federal government? That the amount of money and time spent fighting the failed drug war can never be compared to any efforts that oppose it?

Steinberg said the payments she receives from the US Pain Foundation do not influence the positions she takes as a volunteer advocate speaking to lawmakers and public officials: “Am I motivated because a pharmaceutical company told me to say anything? No.”

Like Big Pharma could influence any pain patient… Jesus.  And what, pray tell, are the motivations of the federal government?  Criminalization, incarceration, and what else?

Dr. Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing, a nonprofit group, would not name specific organizations but said the debate has been heavily influenced by “front groups” that “exist to take money from industry and [that] service industry needs.” The industry and its representatives, Kolodny added, “will support everything but reductions in prescribing.”

Kolodny and his conspiracy theories — this guy must be a Republican…

If Big Pharma wants to help pain patients fight back, what is it to you, Kolodny?  You’ve got the federal government backing you, so even with the multi-billion-dollar pharmaceutical industry behind pain patients, it will never equal the power of having the federal government backing you (pulling your strings).

“As widely documented, these lawsuits are designed to enrich trial attorneys, not improve public health,” Purdue Pharma said in a statement. “Purdue actively discourages the misprescribing and overprescribing of our medications,” it added. In addition to partnering with patient advocacy groups, it said, it also has joined law enforcement officials and addiction experts to combat abuse.

Oh, Purdue, get your head out of your ass.  Of course your industry messed up with pain medications, just like it has with anti-depressants and a host of other drugs.

And see, Kolodny? Not only do you have the power and resources of the federal government backing your side, you’ve got Big Pharma funding a lot of these anti-drug “advocacy groups.”

What makes you so “clean,” Kolodny?  Your agenda and motivations so deserving? What, you think the drugs you push, like buprenorphine, aren’t made by Big Pharma?  That the industry you belong to — the addiction medicine and rehabilitation industry — has some kind of… status?

When the House bill emerged in the summer, requirements that insurance companies pay for treatment remained. The mandate that doctors regularly check their patients’ prescription histories for signs of abuse was gone…

The debate promises to continue. Governor-elect Charlie Baker, in a post-election interview with the Globe last month, said targeting prescription opiate abuse will be a major priority during the first six months of his administration. He said he was shocked that a doctor prescribed narcotic painkillers for his son after he broke his arm playing football. Baker said during his campaign that he supported a mandate that prescribers check prescription histories of their opiate patients annually.

The new governor can expect Cindy Steinberg to chime in. In fact, she already has, responding to Baker’s remarks in the Globe with a detailed post on public radio station WBUR’s website.

“What are people with pain supposed to do?” Steinberg told the Globe in an interview last week. “All they are asking is to be included in the conversation.”

Look, doctors and pain patients joining together to fight the federal government — I think I may cry.  (Happy tears.)

Hey Cindy — You Go Girl!

Russians Are Organizing Against Putin Using FireChat Messaging App

http://www.bloomberg.com/news/2014-12-30/russians-are-organizing-against-putin-using-firechat-messaging-app.html

Downloads in the country began to increase on Dec. 20 after Facebook blocked a page promoting an opposition rally, under pressure from the government’s communications regulator, according to Open Garden.  

FireChat, which lets users create chat rooms and communicate anonymously, has become popular among protesters around the world. Aside from anonymity, the app offers an advantage to those in politically unstable regions because it works even when Internet service is down.

The White House Triumph of the #BanMen Movement

http://www.bloomberg.com/politics/features/2015-01-01/the-white-house-triumph-of-the-banmen-movement

As Obama was leaving, a male reporter shouted out a question about the president’s New Year’s resolutions. He ignored it, and called instead on American Urban Radio’s April Ryan. What lessons the male press corp may draw from this sudden invisibility, who knows. But women have an idea.

Why are we torturing drug addicts?

As a chronic pain survivor, I consider my untreated pain to be like torture…

And just like pain patients who should be allowed to choose their treatment options — including the kinds of drugs they want to use — why shouldn’t people who suffer from addiction get the same choice?

Why are addicts forced to use methadone, buprenorphine, and Suboxone?  If a patient is willing to manage their chronic medical condition — be it addiction or pain — then whatever drugs they choose will not cause the “high” that the government is so worried about.

As for diversion?  I have yet to meet a chronic pain patient who was willing to sell their medication — not that I asked 🙂

And if drug addicts are treated with the drugs that work best, why would they sell them?

Latest email scam, just arrived in my inbox

Dear Victim,

This is to intimate you of a very important information…

“Intimate me”?  Sounds sexual, this could be interesting…

…which will be of a great help to redeem you from all the difficulties you have been experiencing in getting your long over due payment due to excessive demand for money from you by both corrupt Bank officials and Courier Companies after which your fund remain unpaid to you.

Okay, you lost me…

Due to over rampant internet Banking corrupt activities, and also the High rate of scam on internet, compensation payment was stop. On our information we got about you, we found out that you are among those that have lost money to those internet scammers that claim to have your fund with them. The Board of Trustees decided to cancel the award payment with the bank, This meeting was held in London on 29th of Dec, 2014.

Scammers warning me about… scammers?  Hilarious.

I am Ban Ki Moon Director of international affairs in the United Nation (UN).

And I am Vladimir Putin, Ruler of Russia…

It may interest you to know that reports have reached our office by so many correspondences on the uneasy way which people like you are treated by Various Banks and Courier Companies Diplomat(s) across Europe to Africa and Asia London UK, and we have decided to put a STOP to that and that is why I was appointed to handle your transaction here in Malaysia.

After the meeting on 29th of Dec, 2014. an official agreement was reached on  30th of DEC, 2014 been Tuesday, between the Board of Trustees and Glasfrew Security Company which took an immediate effects for the Security Company to issue all the Award Winners a Certified International Master Card worth Ten Million Five Thousands United States Dollars (USD 10,500,000.00).

Holy cow, I’m rich.

All Governmental and Non-Governmental prostates, NGO’s, Finance Companies, Banks, Security Companies and Diplomat(s) which have been in contact with you of late have been instructed to back off from your transaction and you have been advised NOT to respond to them anymore since the United Nation is now directly in charge of your payment. Your fund will be release to you directly from our source with immediate effect and we shall give you further details on how your fund will be released.

You are hereby advice to provide your information as stated below:
Full Name: …Address:. …Telephone:….Occupation:…….Age :………

Here you go:  Vladimir Putin, Russia, call information, Ruler, I’ll never tell

(Dang, I crack myself up…)

Name: Ban Ki Moon

Email: un.service0440@post.com

Sincerely
security code? 1985
un.service0440@post.com
Note: You can also receive your Funds via Bank Draft Check or Bank Wire Transfer depends on your choice.I hope this is clear. STOP any further communication with ANYONE, any action contrary to this instruction is at your own risk.

IMHO, Robin Williams was a (sad) genius

http://disruptedphysician.com/2014/08/15/robin-williams-melancholy-suicide-hopelessness-helplessness-and-defeat/

Heightened perceptions of defeat and entrapment are known to be powerful predictors of suicide. According to the “Cry of Pain” model people are particularly prone to suicide when life experiences are interpreted as signaling defeat, defined as a sense of a “failed struggle.” Unable to find some sort of resolution to a defeating situation, a sense of entrapment proliferates and the perception of no way out provides the central impetus for ending one’s life.

As in all suicidal tragedies, the role of addiction and mental illness has been posited as the cause. Although depression and substance abuse are the two biggest risk factors for suicide, neither explains completion of the act–the descent from ideation and planning to finality and oblivion. Saying suicide is caused by depression and drugs is like claiming marijuana is a “gateway drug” to heroin. It may be a a common related pre-conditional occurrence but it is not the cause. It is a non sequitur. And just as most marijuana users never develop an inclination to stick an opiate filled needle into their veins, the majority of depressed individuals and substance abusers do not kill themselves. One does not lead to the other…

Attributing suicide to mental illness and substance abuse deflects culpability. It negates the need for further inquiry. It creates an absence of the need to change…

The link between bullying and suicide is well known, especially when combined with entrapment and the feeling there is no way out…

I’ve been bullied by doctors, the medical industry, and insurance companies for 25 years. And I’ve felt trapped, not only by the constant pain, but by the medical industry’s inability to adequately treat it.

But I agree with Pinsky on one point. His comment that addiction and depression can be a deadly combination is true. And this is especially so when treatment of the addiction is the primary focus and consists of imposed 12-step indoctrination and the depression remains untreated or ineffectively treated. That is a deadly combination indeed–and one that can easily lead a person down the road of hopelessness, helplessness, and despair. And it is time the medical field as a whole shined some light on this, and hold addiction medicine to the same standards of conduct and care as the rest of the profession.

And the “addiction medicine and rehabilitation” arm of the medical industry has the same problem as the pain management industry — the treatments they use don’t work.  Oh, but if they fail, then it’s the patient’s fault…

4/18/2005, Concerns Over Advil, Motrin, Aleve

http://www.cbsnews.com/news/concerns-over-advil-motrin-aleve/

The study was relatively small — 908 people — and involved people prone to heart problems and cancer because they smoked. But specialists said it supports the Food and Drug Administration’s recent decision to warn about long-term use of all such painkillers except aspirin.

The findings add to the suspicion that the heart risk extends beyond the so-called cox-2 drugs — Bextra, Vioxx and Celebrex — to the larger family of medications known as non-steroidal anti-inflammatory drugs, or NSAIDs, which include naproxen, ibuprofen and virtually all other over-the-counter pain relievers except acetaminophen or Tylenol.

2/13/2013, Family awarded $63 million in Motrin case

http://www.bostonglobe.com/business/2013/02/13/plymouth-family-awarded-million-motrin-case/zEdJIbAWaas4zQVVSvIirI/story.html

The family of a Plymouth-area girl who nearly died and was left legally blind after taking one of the country’s most common household medicines, Children’s Motrin, was awarded $63 million Wednesday by a Massachusetts jury that found health care giant Johnson & Johnson failed to warn patients adequately about the painkiller’s potential side effects…

“Drug companies like Johnson & Johnson can no longer hide behind an approval by the overworked FDA as an excuse not to warn consumers about known, devastating drug reactions” such as those Samantha experienced, the Reckis family said in a brief statement after the verdict. “Parents like us have a right to know.”

Sundel said that much is still unknown about the disease and what triggers such severe reactions in some patients. While specialists believe the syndrome can be caused by viral infections, malignancies, or severe allergic reactions to medication, the leading cause appears to be the use of antibiotics and sulfa drugs, he said…

Other drug makers have also been sued by consumers who said they suffered similar severe reactions to their medications. Johnson & Johnson has battled several lawsuits over Children’s Motrin, and was found liable in at least two other cases. A California court awarded a $48 million judgment in Los Angeles in September 2011 and a Philadelphia court awarded a $10 million judgment in July 2011. But another California court found in 2008 that Johnson & Johnson was not responsible for injuries in another case where an 11-year-old was left blind…

4/30/2014, Psychiatric drugs are doing us more harm than good

As with benzodiazepines in the 1980s, the UK is prescribing SSRI antidepressants at a staggering rate – and to no good effect

http://www.theguardian.com/commentisfree/2014/apr/30/psychiatric-drugs-harm-than-good-ssri-antidepressants-benzodiazepines#comments

Figures released by the Council for Evidence-based Psychiatry, which was set up to challenge many of the assumptions commonly made about modern psychiatry, show that more than 53m prescriptions for antidepressants were issued in 2013 in England alone. This is almost the equivalent of one for every man, woman and child and constitutes a 92% increase since 2003.

Sales of antidepressants have skyrocketed everywhere and are now so high in my own country, Denmark, that – if the prescriptions were equally distributed – every citizen could be in treatment for six years of their life. The situation is even worse in the US, where direct advertising of prescription drugs to the public is permitted and where more psychiatrists were “educated” with industry hospitality than any other medical discipline.

I began to realise the scale of the problem when I was persuaded seven years ago to become a tutor for a PhD thesis on whether history was repeating itself, by comparing benzodiazepines (“mother’s little helper”) with SSRIs. This research has established that people get as hooked on SSRIs as they did on benzodiazepines, and 37 of 42 withdrawal symptoms were the same for SSRIs as for benzodiazepines…

The problem is that many of these drugs simply do not work as people suppose. The main effect of antidepressants is not the reduction of depressive symptoms. They are no better than placebo for mild depression, only slightly better for moderate depression, and benefit only one out of 10 with severe depression. In around half of all patients, they cause sexual disturbances. The symptoms include decreased libido, delayed orgasm or ejaculation, no orgasm or ejaculation and erectile dysfunction. Studies in both humans and animals suggest that these effects may persist long after the drug has been discontinued…

What does the future look like for pain patients?

Do chronic pain patients have to threaten suicide before they will be heard?  Because a lot of comments I read from pain patients are doing just that…

But I’m thinking that the government, the medical industry, and law enforcement don’t feel that this threat of suicide from chronic pain patients is worse than the threat of drug abuse and overdose deaths…

So now I’m wondering how effective it is for chronic pain patients to threaten suicide, especially as a way to get attention for their unrelieved and unmanaged pain…

I think the answer to pain patients from the Powers That Be is:  buprenorphine, methadone, and probably anti-depressants.  Buprenorphine and methadone will be as inadequate as codeine for constant pain (along with the added dangers of methadone), and the anti-depressants will only work if you’re one of the lucky ones who achieves the placebo effect.

Maybe some pain patients (especially those with money) won’t be forced to reduce or stop their current pain medications, but eventually, as new pain patients enter the patient population, they will only be given these newly created (and plastic-coated) drugs… and all the drugs that work will eventually be phased out, only prescribed for cancer and end-of-life pain.  How long do you think that will take?  Five or 10 years?

From the BMJ: sex differences in idiotic behaviour

https://edsinfo.wordpress.com/2015/01/01/from-the-bmj-sex-differences-in-idiotic-behaviour/comment-page-1/#comment-2850

In addition, alcohol may play an important part in many of the events leading to a Darwin Award. It is conceivable that the sex difference is attributable to sociobehavioural differences in alcohol use.

While MIT provides a parsimonious explanation of differences in idiotic behaviour and may underlie sex differences in other risk seeking behaviours, it is puzzling that males are willing to take such unnecessary risks—simply as a rite of passage, in pursuit of male social esteem, or solely in exchange for “bragging rights.”

9/28/2014, Portenoy Opioid Talk Sparks Controversy

http://www.medpagetoday.com/PainManagement/PainManagement/47855

Sources within NIH have acknowledged that Portenoy’s presence at the workshop (titled “The Role of Opioids in Treating Chronic Pain”) may be seen as controversial — not least because of a 2012 Wall Street Journal article in which he admitted that he erred in overstating the benefits and diminishing the risks of opioid analgesics…

Andrew Kolodny, MD, a critic of opioids and president of Physicians for Responsible Opioid Prescribing, who will attend the meeting, noted that it was not the decision of the entire work group to invite Portenoy. “It is unfortunate that NIDA and the FDA invited someone with serious conflicts of interest,” Kolodny said…

Mr. Kolodny pointing out conflicts of interest for other people, with no mention of his own… that’s hilarious.

Managing Chronic Pain in Family Medicine: When “Red Flags” Become Brick Walls

The Official Publication of the Kentucky Academy of Family Physicians, Spring 2012

Click to access KAFP-2012-Spring-Journal.pdf

Chronic non-cancer pain management is probably one of the most challenging issues for modern primary care medicine. However there also seems to be a tendency to let “red flags” become “brick walls” that prevent many patients from getting appropriate pain relief or treatment in the absence of data that supports this decision. Red flags are clearly concerning, but in some of these patients, a more healthy approach might be to provide effective and appropriate pain relief, with suitable monitoring, rather than to hope they can find suitable care somewhere else. Prescribing “with caution” in such cases, should not mean “don’t prescribe at all.”