CDC Condones Torture

http://www.nejm.org/doi/full/10.1056/NEJMp1515917

(4/21/2016) Reducing the Risks of Relief — The CDC Opioid-Prescribing Guideline

By Thomas R. Frieden, M.D., M.P.H., and Debra Houry, M.D., M.P.H.

My comment:

Where are the studies that show there’s a difference between cancer pain and other chronic pain? Why does a cancer patient deserve adequate and affordable treatment, while chronic pain patients are forced to suffer? Because a small percentage (of rich, white patients) may become addicted? Does the CDC contend that dependence and addiction are the same thing?

Mr. Frieden, what the CDC has done (along with the DEA) is legalized torture, the definition of which is to “inflict severe pain on.” (Do you think chronic pain can’t ever be characterized as severe or acute?) Torture is also “the action or practice of inflicting severe pain on someone as a punishment or to force them to do or say something…” (That’s a great definition of the drug war.)

You’re not only punishing chronic pain patients, you are torturing them. Admit it. Admit the blatant discrimination in these “guidelines.” Admit that being an alcoholic does not give you any experience with the treatment of chronic pain.

I am a 30-year intractable pain survivor. The only treatment option I have left is the right to die. Thanks, CDC. (Also posted at painkills2 on WordPress.)

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Comments open through April 27, 2016

Update (4/21/2016):

My comment was approved for posting on the CDC’s website, but they removed this language:

“Admit it. Admit the blatant discrimination in these ‘guidelines.’ Admit that being an alcoholic does not give you any experience with the treatment of chronic pain.”

Drugs are a treatment, not a cure

Current Survey on MedPageToday.com:

A group of medical organizations has written to the Joint Commission, urging it to drop pain as a 5th vital sign in the wake of the opioid abuse epidemic. Is it time to get rid of pain as a 5th vital sign?

Under comments:

numa turner
Apr 16, 2016
The problem as I saw it was it was totally subjective. We don’t ask people what their blood pressure is. Granted that there is no objective way to measure pain, treating it as a vital sign can cause confusion for doctors and patients. I worked for the VA and our performance was often based on this “fifth vital sign ” and how we responded. I often saw patients on large doses of opioids who still claimed 8 out of 10 on the pain scale. What do you do with that?

This is all about money, not patients. Medicare is trying out different programs to reduce healthcare costs, and performance-based pay is one of them. How to determine if a doctor is doing his job? Ask the doctor or the patients? But PFROP is using the media- and government-hyped opioid “epidemic” to cozy up to all the doctors who hate patient reviews, especially if it’s costing them money. It’s a lesson on how to gain power and influence by increasing the number of people who support anything close to your agenda.

It’s like doctors think the only reason for a patient to give them a low score is because the doctor wouldn’t prescribe painkillers. Of course, the 400,000 patients who die every year due to the mistakes of doctors don’t get a chance to fill out a performance review. I’m guessing that many more doctors will be getting low scores because they will refuse to adequately treat both acute and chronic pain. And don’t you think they know that? This isn’t about patients, this is about money. And ideology.

Just think, if every tooth in your mouth constantly ached and throbbed, what would your pain levels be? My current pain levels average about a 7 on the 1-10 scale, but that hasn’t always been the case. I’m talking about the progression of an intractable pain condition over a 30-year period. How do you track that on a 1-10 scale? Even when I was on opioid therapy, my pain levels progressed, albeit more slowly than during the times when the pain was (and is) under-treated or untreated.

I also estimated that I received, on average, a 25% reduction in pain with opioid therapy. Did that change my average pain levels? Did my pain levels go from a 7 to a 5.25? No, that’s not what happened. The prescription drugs mostly kept me stable at a 7 (and away from a 10 and thoughts of suicide). After all, drugs are a treatment for pain, not a cure.

Let’s also acknowledge that rating pain on a scale of 1-10 is a very basic and inadequate measure of pain. Many things can affect how you rate your pain, like fear, anxiety, depression, insomnia, and anger. And also things like age, gender, and DNA.

“I often saw patients on large doses of opioids who still claimed 8 out of 10 on the pain scale. What do you do with that?”

As a doctor, you should try to understand all of these nuances, and that the pain scale is not an x-ray or blood test (none of which are 100% accurate). And as a doctor, stop putting so much pressure on pain patients to improve — why are you expecting miracles from drugs? Do you think drugs can stop the aging and degenerative processes? Do you expect all of your patients to improve from one treatment option? What kind of improvements are you demanding from your patients?

Patients are afraid to report any improvement in their pain levels. How are doctors going to change that dynamic? I’m guessing that doctors are now understanding how dentists feel, since most patients hate and fear going to the dentist. And do you know why? Because it’s freaking painful, that’s why.

Notice of Appearance in Court scam

Sun, Apr 17, 2016 4:46 pm
Re: Notice of appearance in Court #000957561
From: (District Court) brandon.cohen@seebuy.co.il

Notice to Appear,

You have to appear in the Court on the April 23.
Please, do not forget to bring all the documents related to the case.
Note: The case may be heard by the judge in your absence if you do not come.

The Court Notice is attached to this email.

Sincerely,
Brandon Cohen,
District Clerk.

The email address is an obvious red flag. And the email was sent on a Sunday, when the courts are closed. Brandon Cohen has a LinkedIn page, indicating that he used to work at the Philadelphia District Attorney’s Office. (Of course, I’ve never lived in Philadelphia.) The email has an attachment, which undoubtedly contains a virus. Still, I imagine this scam catches quite a few people, scared that they’ve missed some important court date.

http://www.snopes.com/crime/fraud/courtnotice.asp

http://www.wafb.com/story/24410179/notice-of-appearance-in-court-email-is-a-scam-do-not-open

Acupuncture for low back pain no longer recommended by NHS

https://edsinfo.wordpress.com/2016/04/12/acupuncture-for-low-back-pain-no-longer-recommended-by-nhs/

The u-turn comes after a review of scientific evidence found that the practice was no better than a placebo in treating those living with low back pain and sciatica.

So why is acupuncture now being recommended by the CDC for all kinds of pain?

Thinking of you, Tonya Martin

http://www.thenation.com/article/state-where-giving-birth-can-be-criminal/

At around midnight on November 13, Tonya Martin slipped out into the yard that separated her trailer from the one in which her grandparents live on a lot in the eastern hills of Tennessee. Just two months earlier, the Monroe County Sheriff’s Department arrested Martin after she gave birth to a son. Her crime: delivering a child at Sweetwater Hospital with drugs—some kind of opioid—in his system.

Martin couldn’t shake her addiction or the depression that plagued her. The 34-year-old mother gave up the newborn for adoption. Not long after, Martin’s boyfriend found her dangling from the clothesline pole in her grandmother’s yard. He tried to resuscitate her, but it was too late…

http://www.motherjones.com/politics/2016/03/tennessee-drug-use-pregnancy-fetal-assault-murder-jail-prison-prosecution

When she went into labor in late 2014, Brittany Hudson couldn’t go to the hospital. The 24-year-old East Tennessee native had been abusing prescription drugs for years and knew that, under a new state law, if her baby was born showing signs of her drug use, Hudson could be sent to jail. That was the reason she’d forgone prenatal care for most of her pregnancy. Hudson was already in labor when she went with a friend to see a midwife, but it was too late. She gave birth to her daughter in the backseat of her friend’s car on the side of the road, where her friend cleaned her up after. Then she turned around and went home….

Hudson didn’t have much time alone with her new daughter. Someone reported her to law enforcement, and just days after giving birth, she was contacted by the police, who asked her to check in at the hospital, where her newborn, Braylee, went into withdrawal. Almost a week later, while Braylee was still in intensive care, Hudson was arrested, charged with assault, and jailed.

Hudson was charged under Tennessee’s new fetal-assault statute, passed in the spring of 2014 as part of a push to combat an opioid addiction epidemic in the state. The newly revised measure, which is the first law of its kind in the nation, allows the state to prosecute women for illegally using narcotics while pregnant, if the child is born “addicted to or harmed by” the drugs…

For example, a pregnant woman in her ninth month was arrested in 2014 for “engaging in conduct which placed her baby in eminent danger or death or serious bodily injury,” according to the warrant. What did she do? Drove without a seatbelt…

By 2010, Tennessee’s opioid overdose rate was almost twice as high as the national average, and in 2012 Tennessee was the second-highest opioid-prescribing state, after Alabama. That year, the state’s lawmakers enacted the Prescription Safety Act, meant to combat opioid abuse. The statute required that physicians use a centralized database to look up their patients’ records before prescribing more pain medication. But it didn’t make a dent in the problem. Opioid abuse continued to rage throughout the state, and in 2014, the number of opioid-related deaths increased from the year before, surpassing the number of people killed by car accidents or gunshots…

theinfluence.org/how-the-myth-of-the-addicted-baby-hurts-newborns-and-moms/

The idea that vast numbers of pregnant women are putting their infants at risk by using drugs like heroin is misguided; nationally, about 5 percent of pregnant women report use of illegal drugs (mostly marijuana) during pregnancy. Nonetheless, media hype has crafted a narrative of disgust around parents of babies with NAS…

http://www.theguardian.com/commentisfree/2016/apr/12/pregnant-women-addiction-healthcare-not-handcuffs

NAS is a highly treatable condition without long-term effects… But even more damning is this: the law hasn’t decreased NAS births statewide. Since its implementation, such births have actually increased…

Ephemerality is Relative

Sadly, we’ve come to the end of Purple Week. And I know what you’re thinking:  Purple Week lasted longer than a week. But when you’re in constant pain, a day can feel like a week, so time is… ephemeral.

From Wikipedia:  Ephemerality… is the concept of things being transitory, existing only briefly… Because different people may value the passage of time differently, “the concept of ephemerality is a relative one”.