Blatant discrimination and faulty science

Data suggest use of heroin rose in Maine as access to pills waned

Dr. Christopher Pezzullo, Maine’s chief health officer, said the dosage maximum is important because the science does not support such high doses. The dosage cap of 100 morphine milligram equivalents proposed in the bill closely coincides with U.S. Centers for Disease Control and Prevention guidelines on prescribing opioids that were released last week…

Pezzullo pointed to recent research that shows over-the-counter pain medications are more effective than opioids at controlling pain…

As far as I can tell, this doctor is referring to a paper by this man at the National Safety Council, an alleged “nonprofit, nongovernmental public service organization.”

Donald Teater is responsible for advising National Safety Council advocacy initiatives to reduce deaths and injuries associated with prescription drug overdoses. Teater is a patient advocate who specializes in psychiatric services and opioid dependence treatment. Prior to joining NSC, Teater held positions at Blue Ridge Family Practice as a physician, and at the Mountaintop Healthcare and Good Samaritan Clinic of Haywood County as a physician and medical director. At present, along with his role at NSC, Teater treats opioid dependence at Meridian Behavioral Health Services and Mountain Area Recovery Center, along with volunteer work in the field.

Looks like Kolodny from PFROP has been cloned. From the National Safety Council Wikipedia page:  “The Board of Delegates develops the mission agenda, creates public policies, and tracks safety, health and environmental trends.” It seems everybody’s on board for the opioid war.

Click to access Evidence-Efficacy-Pain-Medications.pdf

For example, when testing pain medications, the intervention is the dose of pain medication and the effect is usually 50 percent pain relief. Fifty percent relief of pain is considered effective treatment, allowing people increased functional abilities and an improved quality of life (Cochrane. org, 2014). So the question becomes, how many people must be treated with a certain dose of a medication for one person to receive 50 percent pain relief (effective relief)?

The whole white paper is based on this notion that pain medication can be 50% effective, and that it’s only effective if the patient experiences 50% relief. How many patients experience 50% relief with drugs? It can’t be that big of a percentage, because 50% relief seems almost miraculous to me. Most chronic pain patients, including me, estimate relief derived from drugs at 25% to 30%.

Dental pain:  A recent review article in the Journal of the American Dental Association addressing the treatment of dental pain following wisdom tooth extraction concluded that 325 mg of acetaminophen (APAP) taken with 200 mg of ibuprofen provides better pain relief than oral opioids. Moore et al. concluded, “The results of the quantitative systematic reviews indicated that the ibuprofen-APAP combination may be a more effective analgesic, with fewer untoward effects, than are many of the currently available opioid-containing formulations.” (Moore, 2013, p. 898)

For one thing, there’s usually an end to dental pain, especially wisdom tooth extraction (although some patients experience phantom tooth and nerve pain afterwards). And the key words here are “with fewer untoward effects, than are many of the currently available opioid-containing formulations.”

Sure, for acute pain, the effects of taking over-the-counter drugs is mostly positive. That is, if they work. If a dentist told me to take Tylenol after a wisdom tooth extraction, I’d tell him to fuck off. No, before the procedure, I’d find out what the pain management program was going to be, and if I didn’t agree, the wisdom teeth would stay in.

The problem is the long-term effects of taking these drugs (along with their efficacy), although doctors don’t seem to care about that. Or else, they care more about the “epidemic” of addiction than the damaging results of long-term use of OTC drugs.

http://www.nsc.org/learn/about/Pages/Over-the-counter-pain-medications.aspx

(10/6/2014) National Safety Council: Over-the-counter pain medications are more effective for acute pain than prescribed painkillers

In certain circumstances, opioid painkillers are an appropriate treatment option. NSC Medical Advisor Dr. Donald Teater points to research showing short-term opioid painkiller use can be helpful when treating patients recovering from surgery. These medications also can be effective in treating chronic pain associated with terminal cancer because opioids have positive psychotherapeutic effects that help offset depression and anxiety.

So, cancer and terminal patients deserve these psychotherapeutic effects, but chronic pain patients don’t? This is what you call discrimination against the disabled.

The new standards would allow for exceptions for end-of-life care, palliative care, cancer pain and potentially other diagnoses. Also, those currently on higher doses – the 16,000 taking more than 100 morphine milligram equivalents per days – would be given until July 2017 to taper to lower doses.

This reminds me of medical cannabis programs, all of which have a list of qualifying conditions. Is there a list of qualifying conditions for other drugs? Yes, now for opioids, thanks so much to all who have contributed to this blatant discrimination.