A Review of Opioid Prescribing in Tasmania: A Blueprint for the Future

https://ndarc.med.unsw.edu.au/resource/review-opioid-prescribing-tasmania-blueprint-future

Clinicians, backed by research evidence, emphasised the need for early analgesic interventions to reduce the incidence of chronic pain after surgery. The Acute Postoperative Pain (APOP) Project identified a number of key messages…

Pain was associated with increased likelihood for misuse of analgesics, suggesting that ongoing pain contributes to more severe drug-seeking behaviour. This highlights the need for such patients to have their pain treated. Patients with pain did not differ from patients without pain in use of heroin, alcohol, cocaine or in injecting practices…

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Voices of pain patients

http://nationalpainreport.com/a-new-approach-to-prescribing-narcotics-8825780.html

Mickie Brown says:  All I know is that for nearly 5 years, I’ve been tortured by denial of pain relief. Since being diagnosed with Rheumatoid Arthritis, Fibromyalgia, Gout, and Sjogren’s Syndrome, I have not received a single prescription for pain, except for once at the Emergency Room. I started out at a low-income clinic, who, when I inquired what would be done to control my pain, was told contemptuously, “We don’t dispense narcotics here.” Well, I’m a little ignorant of the treatments–I didn’t know narcotics were the only pain relief available. I felt very demeaned to the point of tears. Since then, I have asked my Primary Care Physician, and my Rheumatatologist what is the plan for controlling my pain? I don’t even ask anymore, because it’s so humiliating to be sent home in Level 10 pain time and again. I’m a 60 year old woman with no history of narcotic abuse. I just don’t understand why this torture is happening. I’ve told my doctors I can’t go on like this. I am polite & understated about it, but a fact is a fact…I can’t take this much longer. Like they say about suicides, I feel hopeless and helpless. No one can live like this for long. What is going to be done about it? I’m glad Dr. Ibsen brings the issue to the public forum.

John Sandherr says: My 2nd post; Returning Veterans that once were over prescribed pain meds are now given no real hope for chronic pain Anti Depressants are the new pain reliever along with relaxation and other modalities. Yes some of these can work in conjunction with the proper meds but its not realistic to rely just on their new guidelines that do not include narcotic pain medicine. The VA has given our Vets the – Take it or leave it – non option.

My own son a US Marine Vet with 80% disability rating has been made worse after getting forced to take NSAIDS after he told the Dr. about his ulcer. All the VA has offered is ”good luck” after my son begged for pain relief. After pleading for a referral for a private hospital he was told by his PCD that he can’t do that even after my son showed him the new law put into place to help Vets get help quicker. I say and listened to the Dr. lie about my sons condition and he said that NSAIDS will not hurt his stomach .

The humanity is gone from our new healthcare system and only god knows how many will be dead as a result.

John Sandherr says: Please let me know what I can do to help with the formal complaint.

Anything that can be done will be more effective when its done in larger numbers. If you can send me an email or reply to me in a post that would be great.

I just came from a meeting st the Pittsburgh VA Hospital with my son a discharged US Marine with an 80% disability rating mostly due to pinched nerves in his back. I got involved because I couldn’t believe the stories he was telling me. Well, they are true and its sad that doctors are ok with being untruthful with patients. The VA will not offer narcotic pain medication because chances are it will not help and they claim that there is a good chance my son would be dead even if he took the meds as prescribed. Opiates kill and we will not use them – that’s what the VA doctors told me. Even a single small dose could lead to death so it’s better to use NSAIDS for all pain. That is the VA’s stance on pain meds or opiates.

Thank you, jjs

Paita says: I find it very curious that for all the true strong comments about how the D.E.A..has now turned into our Doctors,,that only 3 strong women here have choosen to do something about it by jumping on the bandwagon to file a formal complaint against the D.E.A. with the United Nations human rights council,,,why is that???why are others willing write truthful comments about the suffering the D.E.A..has created by their ignorance,,but only a few are willing to actually do anything about it??I seriously would like to know why???paita

Kristine says: I am sick and tired of people judging me about how I deal with chronic neck and shoulder spasms, following a 4 level cervical fusion. (it fell apart once and nobody BELIEVED ME!) A drunk driver drove me to disability, and she “walked” after the burning crash. I am now qualified for a medical mj card, and I am substituting Kadian and oxycontin for Setiva oil in a vape cartridge and Indica for pm, so I can sleep.

Using something that does not “bind my intestine” anymore, has allowed me to lose 20 lbs, and I am no longer “nodding out”, from side effects. KADIAN was something that I did get good benefit from, and I had no side effects. My primary care doctor is the one that is so nervous about prescribing.

Once you are on MEDICARE, they refuse to pay for the “drug testing” that comes with being in a “pain clinic”. They have contracts and rules, and the testing is very pricey.

I still have to take oxycodone BID, but I reduced it gradually from 40mgs TID, to 20 mgs BID.
Live with 8 screws and a titanium plate in your neck, and then get back to me, on how that feels.
Doctors that are kicking their patients to the curb, because they are not “comfortable” making their pain relieved, should find a new profession.

sueb says:  kerry, good for you if it works, but there are some conditions that don’t respond to, as the last quack/pain specialist told me “you are just a drug addict, and you will have your life back once you are weaned off narcotics, and put on a diet of green leafy vegetables.”

3/5/2015, Quadrupled Death Rates of Heroin Overdoses

http://blog.palmpartners.com/tag/heroin-overdose-death/

Between 2010 and 2013 the bulk of that outbreak took root, with the death rate of spiking from 6% in the previous decade to 37% in just that 3 year period alone. 2013 itself saw more than 40,000 people in the United States die from heroin overdoses. That year with that number heroin overdose became the leading cause of injury-rated death in America!

Not all of these cases were the same either. Out of all the drug-poisoning deaths in 2013:

81% were unintentional
12% were suicides
6% were of undetermined intent
Less than 1% were homicides

Tell me, who decides when to document a death as unintentional or a suicide?  It’s certainly not the deceased, who is really the only one who actually knows.  Sometimes, it’s not even the coroner.  And sometimes, religion and/or denial and grief decide whether a death is a suicide or not.

The theory is that as we combat prescription painkillers, we are giving that power to another evil…

Evil?  Drugs are not evil.  And neither are the people who take or abuse them.

Uptick in overdoses has coroner concerned

http://wlfi.com/2015/03/06/up-tick-in-overdoses-has-coroner-concerned/

TIPPECANOE COUNTY, Ind. (WLFI) — Tippecanoe County Coroner Donna Avolt is warning the public about what could be a bad batch of heroin.  Avolt said there have been seven heroin overdoses in the past seven to 10 days in Tippecanoe County. Five were fatal…

It’s not surprising that most of the people who commented on this article are as clueless about the disease of addiction as a large portion of the doctors who are treating it.

https://painkills2.wordpress.com/2015/01/31/3112014-secret-at-the-drugstore-indiana/

12/26/2014, Help still sought for closed pain center’s patients

Using addiction as a reason not to treat pain

http://www.lexisnexis.com/legalnewsroom/workers-compensation/b/recent-cases-news-trends-developments/archive/2015/03/06/strong-correlation-between-nonopoid-substance-abuse-disorders-and-therapeutic-opioid-addiction.aspx

3/6/2015, Strong Correlation Between Nonopoid Substance Abuse Disorders and Therapeutic Opioid Addiction

Health care providers face an uneasy dilemma, note the researchers. They must weigh the potential benefits of long-term opioid therapy with the risk of misuse or addiction and yet, according to the researchers, there is “a dearth of reliable information on the prevalence of misuse in those who receive it.”

Gee, I wonder why there is more “reliable” information on drug abuse and addiction than on the benefits of opioid therapy.  I wonder if it’s because the NIDA only funds research on the harms of drug use.  Or maybe it’s because no one wants to fund a long-term study on opioid therapy, especially during the war against pain patients.

Age and sex appeared to be an important factor, with young males being particularly susceptible to developing TOA. Marital status did not appear to be related to TOA development…

If you are a “young male” in chronic pain, you’re probably being discriminated against.  You’re being profiled.  The high suicide rate in this age group suggests that their pain is being under-treated.

They also noted that their study did not address the question of whether higher doses of opioids lead to addiction or rather that addiction leads to higher doses…

Patients who do not achieve substantive benefit from opioid prescriptions should be transitioned to other treatment…

What kind of benefit would be acceptable?  Who decides if the patient is obtaining substantive benefits — the doctor, insurance company, or the DEA?  What if the patient is achieving moderate rather than substantive benefits?  Do doctors and insurance companies believe that opioid therapy for chronic pain patients is some kind of cure?

This study underscores the need for the proposed screening tools in the treatment of workers’ compensation patients. There can be little question that the appropriate use of opioid drugs to treat chronic injuries in the Workers’ Compensation System continues to be a serious problem.

The screening tools are used to support the denial of prescription medications.

In 2014, the California Division of Workers’ Compensation posted proposed treatment guidelines for the use of opioid medications in the treatment of workers’ compensation patients. Those proposed guidelines specifically recommended the use of screening tools to identify a predicted increased risk for substance misuse/abuse. In those cases, the guidelines indicated that chronic opioid treatment should only be initiated if other alternatives are not viable.

So, if you live in a state that doesn’t have a medical cannabis program, you get to choose opioid treatment?

The following are real life examples of workers’ compensation patients who had a prior substance abuse problem and what happened when they were prescribed opioids to treat pain for their injuries…

The judge in the case stated that the employee was “drug-seeking before his injuries and is drug-seeking now.” The judge found that the employee had not met his burden of proving that the work injury caused aggravation of his mental condition or his drug abuse propensities…

Oh, it’s a judge who decides if a pain patient is drug-seeking or just treating his pain.

The judge credited this psychiatrist’s explanation of the decedent’s death and concluded there was no persuasive evidence to establish that the decedent’s work-related knee injury aggravated or accelerated his mood disorder or otherwise caused the overdose. The judge therefore denied the claims for death benefits.

Judges are now doctors.  Insurance companies and the DEA are now judges and doctors.  I guess anybody can play doctor these days.

Holy Water

http://the420times.com/2015/03/strain-review-california-honey-extracts-girl-scout-cookie-shatter-live-resin-extract-shatter/

Everyone loves a concentrate that tastes like the original flowers that it was made with. The latest and greatest thing to happen for some discerning patients is known as “live resin” extracts or also coined as “holy water.”

Typically an extract has around 4-5% total terpenoid content, however live resin or holy water extracts are often tested to be 20% total or greater…