When an expert is not an expert

I used to read articles at Vice until they published an article about cannabis that was ignorant and wrong. Let’s see what Vice is getting wrong today, shall we?

This article is full of incorrect statistics and biased conclusions that are endemic in the media. And guess who Vice chose as their addiction “expert”?

http://www.news.vice.com/story/opioids-chronic-pain

The CDC insists it isn’t trying to create barriers to legitimate treatment. The new guidelines, the agency says, are the result of extensive input from “experts” and a thorough review of the available “evidence.” They don’t explicitly rule out opioids for chronic pain, but they do send a clear message that opioids should not be considered a first-line treatment…

I’m sure everyone’s experience is different, but my experience has been that doctors don’t consider opioids as a first-line treatment for anything except acute pain, if then. This makes it sound like chronic pain patients just want an easy fix, the pills. That’s very wrong (as my bank account can attest). In other words, the CDC didn’t need to create regulations because of this issue. I’d say that about 95% of doctors already practiced that way. But wait, we need to punish that 5% of doctors who aren’t following the rules, just like we’re punishing pain patients for those who suffer from addiction. Because drug war.

Alternatives do exist. For instance, the CDC says exercise therapy has been shown to improve physical function in some patients. Non-opioid medications, such as acetaminophen or ibuprofen, can be useful for conditions like arthritis and lower back pain, and some antidepressants and anticonvulsants are also effective.

Tell me, how are people in pain supposed to exercise without any pain relief? Sure, exercise will improve my physical function, but why would I want to increase my pain levels without anything to relieve the increased pain? That would make me stupid. Or a masochist. And speaking of masochists…

Hey Kolodny, are you going to treat the conditions that arise from taking acetaminophen or ibuprofen on a long-term basis? Even the CDC advises against that. How about when an antidepressant causes suicidal ideation? Do your addiction centers treat that, too?

In 1996, the American Pain Society launched its influential “fifth vital sign” campaign, giving pain equal billing with blood pressure, pulse, temperature, and rate of breathing… Just as the “fifth vital sign” campaign encouraged physicians to prescribe opioids indiscriminately…

The media and the medical industry love to place blame on the fifth vital sign. Tell me, what does monitoring pain levels (along with blood pressure, etc.) have to do with drug addiction? No, no, no, the fifth vital sign campaign did not encourage doctors to prescribe opioids indiscriminately. That’s doctors talking, blaming overdoses and addiction on pain patients.

That same year, Purdue Pharma released OxyContin, a powerful painkiller sold as a slow-release pill, which the company aggressively marketed as a godsend for pain patients, often to doctors with little knowledge of abuse-disorder warning signs. OxyContin was a blockbuster, reaching sales of over $1 billion by the end of the decade. But it turned out the drug was also pretty easy to crush, snort, and inject for a high — and Purdue downplayed the risk of patients becoming addicted. In 2007, the company and its executives agreed to pay fines of $635 million for misleading the public.

Sure, blame Purdue. Don’t blame doctors, who use ignorance of treating pain and addiction as the reason for Oxy’s popularity. Bullshit. Doctors have always known that Oxy is addictive. All painkillers can be addicting in a small percentage of patients and doctors know that.

One study the CDC looked at showed that dependence among patients on opioid therapy was as high as 26 percent…

Actually, there are studies that show the addiction rate for pain patients at about 3% to 10%, but the CDC wasn’t interested in any information that was contrary to what their “experts” wanted. Why would the CDC base the treatment of pain on this one study? And why is the CDC making regulations according to 26% of the population? What about the other 74%? I can’t be sure, but I believe that constitutes a majority.

But if the evidence doesn’t support opioid treatment for long-term pain, why are so many chronic pain patients convinced they need the drugs to function? Andrew Kolodny, an influential substance-abuse expert and one of the country’s most vocal critics of opioid overprescribing, thinks he has a pretty good answer. Those patients, he says, are probably dependent on the drugs and may be addicted.

Actually, the lack of “evidence” to support opioid treatment for chronic pain has more to do with who funds the research. No one wants to fund research for chronic pain, even if they could find volunteers who would agree to treat their pain with a placebo. Those funding research on pain are connected to addiction, like the NIDA. And when others perform research on pain, if it doesn’t comport with the government’s program on addiction, the research is buried or not even published.

Kolodny doesn’t waver when I mention the desperation I’ve heard from sufferers. “You’ve found a group of very vocal patients who are convinced that everyone is trying to take their opiates away from them,” he said. “They believe that the CDC guidelines — that advocacy groups like mine — that what we’re really after is stopping drug abusers, and that they’re being made to pay the price. That’s totally not what’s going on. What’s motivating us is an understanding that opioids are lousy drugs for chronic pain.”

Pain patients are having their medications taken away from them — not just opioids and not just pain patients. Doctors don’t want to treat any kind of pain because they’re scared. No, doctors would rather blame pain patients, stop treating them, and move on. How many pain doctors have switched to treating addiction (see the first link following my rant)?

Kolodny reminds me of people who think that addiction doesn’t exist. I think he believes that chronic pain doesn’t really exist. For Kolodny, only addiction exists.

Anyone who says that opioids are lousy drugs for chronic pain has never suffered from chronic pain — and is an ignorant asshole. This is who the CDC used as an “expert.”

For consensus, Kolodny says to look to the country’s leading pain clinics. The Cleveland Clinic, the Mayo Clinic, and the Washington University School of Medicine are a few of the institutions whose experts now say long-term opioid treatments are ineffective and risky. But there are still pain specialists who disagree…

Why doesn’t the media talk to patients who’ve been treated by these allegedly illustrious clinics? I want to hear from them. Actually, I do hear from patients who’ve been treated at these clinics, in comment sections all over the internet. And it’s nothing good.

“The language that they’ll use to describe how they think opioids are helping them is the exact same language my heroin-using patients use,” Kolodny told me. “I’ve been treating opioid addiction for about 15 years. They use the same exact language: ‘Doc, imagine what it feels like every morning — feeling like you’ve been hit in the chest with a baseball bat until you take your first dose.’”

First of all, Kolodny is neither an addiction expert or an expert on the treatment of pain. He’s a dickhead with a lot of power and money behind him, hoping to move up to bigger and better things, probably in politics.

How much has Kolodny’s income increased since he joined the opioid war? How many patients have died while being treated at one of Kolodny’s addiction clinics? Why isn’t he being held responsible for these deaths, like pain doctors are being prosecuted for their patients’ deaths? Why doesn’t the media include the crimes being committed at these clinics when using Kolodny as an “expert”?

Kolodny says he’s been treating addiction for 15 years. Has he ever suffered from addiction or chronic pain? I’ve suffered from intractable pain for 30 years and I think I know more about addiction than he does.

In Kolodny’s view, these patients are feeling better from opioids not because the medication is treating an underlying pain problem but because it’s treating their withdrawal pain. And his view holds a lot of sway….

Really? Seriously? Well, Mr. Kolodny, I haven’t taken opioids to treat my intractable pain for about 6 years now. Why am I still in a suicidal amount of pain? Because the “pain problem” is not an underlying condition — it is the main condition. And it deserves treatment, just like any other medical condition.

Even Kolodny concedes that some patients have been on opioids so long that they may never be able to function without them. Long-term use can cause physical changes in the brain that are potentially irreversible. “What we don’t want is for primary care doctors to just start firing these patients,” he said. “That would be really bad. It’s a problem that we need good solutions for.

Chronic and intractable pain can also cause physical changes in the brain that are not “potentially” irreversible, but always irreversible.

Thanks to the CDC and the media, Kolodny is the #1 enemy of pain patients. And I think he enjoys being seen this way, as it makes him look like a hero to all of his followers. If he can diagnose me as a drug addict because I suffer from intractable pain, then I’m diagnosing him as a masochist who enjoys seeing people suffer. That’s probably why he got into treating addiction in the first place.

Hey, Kolodny, pain patients are being abandoned left and right, and have been for years. Where the fuck have you been? I know, your only interest is addiction. You care nothing for pain patients, yet you claim to be an expert and the CDC and the media treat you like one. But I know what you are. I know you’re partially responsible for an immeasurable amount of suffering and many deaths. How the fuck do you sleep at night?

http://www.nationalpainreport.com/15-years-with-my-pain-dr-and-my-last-appointment-became-my-final-appointment-8831814.html

http://www.painnewsnetwork.org/stories/2016/10/25/unwilling-to-suffer-in-silence-over-cdc-opioid-guidelines

Jo
I have had reflex sympathetic dystrophy since I was 13 I am now 39. My left leg was amputated due to complications from the RSD. Unfortunately it spread to my right leg about ten yrs ago and again I’m have major complications. I was in fentanyl pops along w Oxy contin and both were helping me make it through the day . The insurance company or drug company changed the label on the fentanyl to cancer patients only and took out chronic pain sufferers. So now my insurance co will no longer cover it bc I do not have cancer. I was on this drug for years , I didn’t abuse I didn’t sell it I used it bc I’m in extreme pain and it helped, but now that was taken away. My legs keep getting worse I have terrible phantom pain in addition to the RSD pain in both legs and my right arm spread to…

Tina
I had my right hip replaced in 2014. DDD, osteoarthritis, and avascular necrosis on top of rheumatoid arthritis disease. During the surgery the muscle tore off the bone creating an avulsion fracture. Discharged home with a prescription. I went 2 weeks not being able to do my physical therapy or anything for that matter all because non of the pharmacies in our area that accepted my insurance would fill the prescription. Talk about torture.

http://www.petition2congress.com/5202/first-do-no-harm-dea-targets-physicians-who-treat-their-patients/comments/page/350

Doris W. from Lyman, SC writes:
My son is a dialysis patient with a severely deteriorated body. He has severe and very painful bone disease, osteomylatia, with bone forming throughout his body. He currently has open wounds on his legs and scrotum that won’t heal. His health is being undermined because he is in so much pain that he can not complete his hemo dialysis treatments, yet we can find anyone who will provide him pain management. All his doctors say they no longer write opiods. They are AFRAID to do so or it’s against their corporate owner’s policy. He is only 37 years old and doesn’t want to give up treatment. This is terrible malpractice and a real shame in a first world country.

Sharon S. from Wilmington, DE writes:
I am a cancer patient; stage 2 lymphoma and the chemo drugs have left me with peripheral neuropathy. Not finished with this devastation yet. The pain from this condition is with me every day now. After several requests to my doctors for pain meds, I was prescribed Gabapentin. Doesn’t work. After reading through the comments here on this site regarding the failures of the American Medical system and the many people who are suffering as a result, I have to say, I am not at all surprised but I am scared.

Malinda S. from Memphis, TN writes:
Yeah I asked my doctor about the First Do No Harm. He told it wasn’t my license on the line. That was when I truly no longer wanted to live. I felt nothing. With no insurance and trying to get my disability, I am no longer per my neurologist allowed the take pain meds over the counter or prescription. So I have to live in pain 24/7. I have to smile when I want to cry but one of my diseases keeps me from psychically crying. I am in constant pain in my bones, joints, muscles, & chronic migraines. I may be in pain everyday and night, the constant is that I keep loosing friends and family. They just don’t want to deal with me anymore.

Mark N. from Brookfield, IL writes:
For the pain I’ve been put through and the way that I’ve been treated since the beginning of this year, I will, as long as I live never trust or respect Doctors again.

As many times as I try to release my anger, it comes back. Reading about the suffering of other pain patients brings back painful memories for me, but I can’t stop. Maybe I’m the masochist.

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