Opioid Misuse In Chronic Pain Patients Is Around 25%, New Study Shows

http://www.forbes.com/sites/cjarlotta/2015/04/01/opioid-misuse-in-chronic-pain-patients-is-around-25-new-study-shows/#comment-29

A new report — which was published in the April issue of PAIN, the official journal of the International Association for the Study of Pain (IASP) — found that 20-30% of opioids prescribed for chronic pain are being misused. It also concluded that the rate of addiction is approximately 10%. The journal is published by Wolters Kluwer.

Ten percent is an estimate, but since 9% of any population suffers from drug addiction, it’s not that bad.  Say, did ya’ll look at the reason why pain patients misuse their medications?  Or is that not even important anymore?

Wikipedia:  The IASP was founded in 1973 under the leadership of John Bonica. Its secretariat, formerly based in Seattle, Washington is now located in Washington, DC.

Well, well, based in Washington, DC, huh? That says a lot about this group.  More political than patient-focused.  And Mr. Bonica was an anesthesiologist, so that says a lot too:

The years of gladiatorial competition left Dr. Bonica a chronic pain sufferer himself, and thus empathizer with his patients. He would be awarded the Professional Wrestling Hall of Fame New York State Award in 2004.

Perhaps after his death in 1994, this group changed its focus?

Wikipedia:  In 2004, supported by various IASP chapters and federations holding their own local events and activities worldwide, IASP initiated its first “Global Year Against Pain” with the motto “The Relief of Pain Should be a Human Right.” Every year, the focus is on another aspect of pain.

Looks like this association has done a 180 since 2004.  Could it be that it gets funding from the federal government?  That the federal government dictates this group’s goals and the types of research it does?  Could it be that this group works closely with the DEA?

“We find that although opioid misuse (the usage of opioids contrary to medical instructions) and addiction occur in a minority of opiate users, prescribers should closely monitor their patients for signs of these aberrant behaviors,” said study co-author David N. van der Goes, assistant professor in the Department of Economics at the University of New Mexico. “Prescribers can also compare their outcomes to the baseline presented in the paper.”

So, now an assistant professor in the economics department (and in my home state, at that) has decided that pain patients need to face even MORE scrutiny.  I really don’t see how that’s possible.  And really, Mr. van der Goes, I’d like to monitor you for signs of “aberrant” behaviors. Let’s see how normal you are.

Did the University of New Mexico disclose any conflicts of interest with this study?  Like Project ECHO?

https://painkills2.wordpress.com/2014/12/31/nm-behavioral-health-subcommittee-1172014/

 And what about this report from UNM in October 2013?

https://painkills2.wordpress.com/2015/01/06/the-epidemic-of-chronic-pain/

24 studies with 2,057 patients with rate of 3.27% for abuse/addiction.
Rate of abuse/addiction in patients with no past or current SUD was 0.19%

Gee, this current study didn’t break it down like this, I wonder why?

Also, these aberrant behaviors have been defined by the addiction and psychiatric industries. Now, I wonder why these doctors want more patients to be diagnosed with addiction?  And if pain patients do become addicted (not just dependent) on their medications, could it be because the pain management industry has failed so horribly in treating pain?

Tell me, if we’re talking about a minority of pain patients, why do so many call this an epidemic?

“Some people who become addicted develop the disease from misuse, but people can just as easily become addicted taking pills exactly prescribed,” said Dr. Andrew Kolodny, who is the chief medical officer at Phoenix House, a drug treatment provider, in an interview. “Once addicted, misuse (i.e. taking more pills than prescribed or crushing and snorting pills) becomes more common, but again, keep in mind that patients can still be addicted without misuse.”

Why, hello again, Mr. Kolodny.  Are you enjoying Washington and the millions of dollars in funding from the federal government?  And how is the addiction industry these days?  Still making a lot of money off the backs of desperately ill patients?  I know, I know, once you’ve treated all the drug addicts, who’s left?  Why, there are millions and millions of chronic pain patients that need to be treated for addiction, right?

Tell me, Mr. Kolodny, what’s the difference between addiction and dependence?  Do you even know?

Dr. Jane C. Ballantyne, a retired professor of Anesthesiology and Pain Medicine at the University of Washington, questioned the results of the PAIN study in her own response to the report, noting that it’s fairly difficult to define what addiction is when it arises during chronic pain treatment with opioids. “But, could rates of addiction have been underestimated because there cannot be clear distinctions between misuse and addiction, despite the apparent clarify of the definitions?” she asked…

Dr. Ballantyne, you’re not helping matters.  Could it be that the rate of misuse is directly connected to the amount of under-treated or mistreated pain?  Have you heard about that epidemic?

Researchers reviewed 38 articles on the topic of problematic opioid use in chronic pain patients. According to the report’s authors, 76% of the articles contributed information on opioid misuse and 32% of them provided additional insight on opioid addiction. Only one of the studies used for the research reported on opioid abuse.

The study did not look at opioid tolerance — which can be considered to be the “greatest obstacle to the development of effective opioid treatment for intractable pain” — in chronic pain patients. ”Opioid tolerance, while a real issue for both providers and patients, was outside of the scope of this study,” said Dr. John Ney, co-author of the report…

Not much of a study, then, huh?  Did ya’ll look at suicide rates in the pain patient population? How about looking at the percentage of pain patients who have been harmed by the non-narcotic treatment options, like injections and surgery?  Medical errors?  How many chronic pain patients have been created by the medical industry?

Under comments:

Martha Petersen 1 day ago

…Kolodny, until you have changed from a dignified human being to one crawling on the floor, moaning, hopeless, unable to process anything but a universe of suffering, begging for anyone to help—as I have—you ought to shut your damned mouth.

Dear CJ Arlotta (the “reporter” for this article):  WTF?  Do you work for Forbes or the DEA?

5 thoughts on “Opioid Misuse In Chronic Pain Patients Is Around 25%, New Study Shows

  1. “Well, well, based in Washington, DC, huh? That says a lot about this group. More political than patient-focused.”

    “Could it be that it gets funding from the federal government? That the federal government dictates this group’s goals and the types of research it does? Could it be that this group works closely with the DEA?”

    Next time you try to debunk a research report do a bit of research yourself. IASP gets no money at all from the U.S. or any other government. Zip, zero, zilch. It has no lobbying function whatsoever. It is, after all –international– with fewer than one-third of its members from the United States. So it cares not one whit about U.S. policy or funding.

    Its members are researchers and clinicians focused on the study of pain (hence the name of the organization), and the journal PAIN is peer-reviewed and tops in the field.

    It’s fair to question research results, but when you get some basic facts wrong it compromises your argument, not to mention your integrity.

    Like

    • Are you trying to tell me that international groups don’t care about U.S. policy or funding? About the DEA and the drug war? Or that funding isn’t siphoned through different agencies to finally arrive at groups like this?

      And isn’t it funny how you didn’t address the remarkable difference in what was found previously about the percentage of pain patients who become addicted, compared to what this group found? Why do “experts” claim there isn’t enough research to support the use of opioids for chronic pain, but there’s plenty of research to prove misuse and addiction? Is it because that’s all these studies focus on?

      All I was doing is offering questions — not facts. As a 30-year intractable pain patient, if doctors want to question my integrity, they’re welcome to try.

      Like

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