MedPage Today is written and read by doctors, which is why I think it’s important for patients to have a voice in that forum. Unfortunately, the website wouldn’t allow me to post a comment to this article, so I’ve got to post it here.
“Nelson noted that most chronic pain does not respond optimally to opioids, and many patients can use better alternatives for chronic pain. ‘We have learned this the hard way over the past 20 years,’ he said.”
It appears that pain patients and doctors have learned completely different things over the past 20 years. With the experience of suffering from intractable pain for the last 30 years, I certainly don’t agree with this doctor’s opinion. (How many other pain patients would also disagree? And whose opinion is more important?)
In fact, I’d like to know which treatment options this doctor believes are “better” alternatives for the treatment of chronic pain. Better in what way? Better for each individual patient, insurance companies, the alternative medicine and addiction industries, or the DEA? (Breaking news: Walgreens and CVS employ addiction “counselors” at every pharmacy. Just $20 for an initial visit. Bupe prescriptions available. Thanks, President Obama!)
What does successful treatment for pain look like? If a pain patient doesn’t develop addiction, doctors consider that a success. Are doctors trying to treat pain or the mental illness of addiction? And how many pain patients really suffer from both?
Maybe I missed the research that proves any of these alternative treatments actually help a significant percentage of pain patients (like opioids do). But I haven’t missed the complaints by patients that show the amount of harm caused by the non-opioid treatments which are being forced upon them.
Which is more harmful, treatments like steroid injections and antidepressants or opioids? What about the pain patient who’s been spending an enormous amount of money on painful chiropractic adjustments for the last 5 years and hasn’t seen any improvement? There are many different levels of harm caused by non-opioid treatments (including financial), and yet doctors still use them because of the opioid war. When there are about 400,000 patients who die every year from medical mistakes, why should doctors (and law enforcement) decide which treatment options should be available to patients? Who are the experts here?
What pain patients have learned during the past few decades — while the drug war invaded their health care — is that trusting doctors and medical science is a big mistake. Research by survey is now considered evidence and used to shame and discriminate against patients. Long-term evidence doesn’t exist for most drugs, not just opioids, because no one wants to pay for it. Anecdotal evidence is the only thing left that doesn’t always include conflicts of interest.
“Study authors and the editorialists reported no relevant financial interests.”
Everyone knows that financial interests — whether deemed relevant or not — are not the only conflicts of interest that exist within these industries.
“‘There is virtually no data for safety or efficacy in chronic non-end-of-life pain, but patients are convinced that they need [opiate medications],’ Nelson added.”
Funny thing about medications that work — patients learn to ask for them. (And because of the drug war, drugs that work are worth more money in the underground market, so diversion will always happen.)
No one can deny that opioids work, and just like all other legal and illegal drugs, that means opioids come with side effects. Let’s see, which is more harmful in the long-term, chemotherapy or opioid therapy? Surgery or opioid therapy? Dulling chronic pain with alcohol or opioid therapy? Medical cannabis or opioid therapy? Instead of discriminating against one drug or another, why not utilize a combination so as to reduce the harm of a single one? C’mon, this isn’t rocket science.
With doctors like Lewis Nelson (practicing in New York, just like Kolodny from PFROP), who needs enemies? And when did patients become more knowledgeable than doctors? Within the last 20 years? I admit, I enjoy seeing doctors make fools of themselves because of the drug war. It allows me to imagine a day when doctors become obsolete, just like cars you have to drive yourself.