Don’t be fooled

http://www.bloomberg.com/news/articles/2016-08-17/this-drug-could-end-america-s-painkiller-epidemic

The new molecule targets the brain-mediated emotional component of pain. This allows it to kill pain just as well as morphine does, without the side effects of respiratory suppression and dopamine-driven addiction in the brain. (Regular painkillers target both the brain-mediated and reflexive response aspects of pain.) The new drug also causes less constipation and doesn’t affect spinal cord reflexive responses as traditional narcotics do, according to the study. The potential difference in addiction was shown in experiments involving mice…

Manglik estimates that it will take multiple years for the compound to be tested in humans, noting the importance of such trials to learn more about PZM21’s addictive properties and safety. “The real experiment for a lot of these things is going to have to happen in humans,” he said, adding that addiction is “really a human disease.” …

This drug kills pain as well as morphine does? Don’t be fooled…

“brain-mediated emotional component of pain”

I may not be a neurologist, but I can read between the lines. Researchers are trying to go around the main areas of the brain that deal with pain to target the area that deals with the “emotional component” of pain. It’s my understanding that this is how antidepressants can alleviate pain, along with other drugs prescribed off-label for pain, like anticonvulsants and antipsychotics. It’s also similar to drugs used to treat addiction.

On the Wikipedia page for this new drug (PZM21) under “See Also,” I found this (which looks like the same drug):

https://en.wikipedia.org/wiki/Cebranopadol

Notably, it has also been found to be more potent in models of chronic neuropathic pain than acute nociceptive pain…

As an agonist of the κ-opioid receptor, cebranopadol may have the capacity to produce psychotomimetic effects and other adverse reactions at sufficiently high doses, a property which could potentially limit its practical clinical dosage range…

Google definition: A drug with psychotomimetic actions mimics the symptoms of psychosis, including delusions and/or delirium, as opposed to just hallucinations…

And on the Wikipedia page for cebranopadol, I found a link to norbuprenorphine.

I wish the research community was on the right path in the study of pain, but as far as I’m concerned, they’re following paths dictated by the funding they receive, which is anti-opioid. (In other words, we’re fucked.)

https://www.ncbi.nlm.nih.gov/books/NBK57254/

(2010) Translational Pain Research: From Mouse to Man.

Chapter 15, Human Brain Imaging Studies of Chronic Pain

The advent of non-invasive human brain imaging technologies provided the opportunity for direct examination of the human brain. This occurred about 15 years ago with the related expectation that we were at the threshold of a revolution in our understanding of chronic pain. This expectation remains largely unfulfilled, although much has been published in the topic. Here we concentrate mainly on our own work in the topic, arguing in general that the subject of brain mechanisms of chronic pain remains in its infancy mainly because of a heavy emphasis in the field on studying nociception rather than chronicity of pain…

Are Opioids the Next Antidepressant?

http://www.nytimes.com/2016/06/05/opinion/sunday/are-opioids-the-next-antidepressant.html

Essentially, all the anti-depressants now in use affect a single group of neurotransmitters called monoamines and are likely to treat only specific subtypes of depression. Clinicians and scientists alike are in agreement that other pathways in the brain that control mood need to be explored. The opioids are one such pathway…

Opioids may also hold out hope for a devastating illness formally known as borderline personality disorder. Characterized by severe emotional dysregulation, patients with this disorder have feelings of loneliness, rejection, anger and sadness that can quickly overwhelm them. They struggle to maintain relationships and are terrified of abandonment. They are often substance abusers and — in fact — opioids are frequently their drugs of choice. In one study, 44 percent of patients seeking buprenorphine treatment for their opioid addiction were found to have borderline personality disorder. There are no Food and Drug Administration-approved medications for this illness…

Research looking at opioid receptors in patients with borderline personality disorder in comparison to control subjects has documented abnormalities in these patients’ opioids system. It is a finding that would help explain why many opioid abusers describe the sensation they get from using drugs not as “getting high” but as “getting right,” or as “feeling normal.”

It may seem counterintuitive and even dangerous to be considering the medicinal use of substances that are currently a scourge to our society. Yet opioids have a long history of being used to treat melancholia and other psychological disorders — right up until the 1950s, when the current group of antidepressants were discovered…

Dr. Hypocrisy

Here we have another one-sided article from the New York Times, this one about the abuse of drugs used to treat addiction.

http://www.edsinfo.wordpress.com/2016/06/28/addicted-to-a-treatment-for-addiction/

http://www.nytimes.com/2016/05/29/opinion/sunday/addicted-to-a-treatment-for-addiction.html?_r=0

“Let’s be clear,” said Dr. Andrew Kolodny, a longtime Suboxone prescriber in New York and executive director of Physicians for Responsible Opioid Prescribing. “The real crisis is the severe epidemic of opioid addiction and overdose deaths that’s devastating families across the country.”

And here we have Mr. Kolodny, still trying to convince everyone that drugs like Suboxone aren’t part of the opioid family. As if there aren’t any families that have been devastated by deaths related to the use of bupe, methadone, and Suboxone.

It says a lot about how lazy the media is that it uses “experts” like Kolodny. And they never include important facts about Kolodny, like the criminal investigations into some of his Phoenix Houses. Like how Kolodny started his work with addiction in the New York prison system, specifically with bupe.

And before Kolodny began his work in the prison system, in 1996, France approved bupe (Suboxone) for the treatment of addiction. The current situation in France is that, along with methadone, buprenorphine is the opioid that’s causing the most damage:

https://painkills2.wordpress.com/2014/12/02/whats-the-drugopioid-epidemic-look-like-in-france/

Dr. Kolodny ranks anti-Suboxone judges like Judge Moore in a category with climate-change deniers and people who believe vaccines cause autism. “When there’s really dangerous heroin on the streets, I’d rather see Suboxone out there, even if it is being prescribed irresponsibly or is being sold by drug dealers,” he said…

And here we have Mr. Kolodny advocating for the underground Suboxone market, which really makes him look like a drug dealer. I wonder if he gets a percentage of all Suboxone sales… Or maybe he’s been promised a better job with the government or Big Pharma.

Hey, Kolodny, don’t you understand that doctors are drug dealers, too? Do you think the drugs that doctors prescribe never do any damage, never kill anyone? Perhaps you should change your name to Dr. Hypocrisy.

Under comments:

Steven A. King, M.D., Philadelphia, May 29, 2016

The issues of using buprenorphine for opioid use disorders are not as clear cut as the author appears to be making them.

Some of what Judge Moore believes is true and some of what Drs. Volkow and Kolodny say is misleading.

As a physician who specializes in pain management, I know that there are a not insignificant number patients prescribed opioids for legitimate pain complaints who end up abusing and becoming addicted to these, and although it is often reported that we’ve only become recently aware of this in fact there is research going back 25 years demonstrating this.

However, there are no studies showing that either buprenorphine or methadone are appropriate treatments for these patients. As these both provide analgesia equal to the other opioids, if these were the proper treatment for these patients then it would make sense to make them the first line opioids for pain as we would be prescribing the appropriate treatment for the problem at the same time we were prescribing the cause of the problem.

Sorry, bupe and methadone do NOT provide analgesia equal to other opioids. Yes, they help some pain patients, but their strength is more in line with, say, codeine, if that.

I’m not exactly sure what this pain doctor is trying to say, but I think pain patients will increasingly be offered bupe and methadone, whether they’ve been red-flagged for addiction or not.

Chili Peppers Could Free Us From Opioids

Sometimes the media cracks me up, like with this headline. Do you know how long the medical industry has been promising a breakthrough for the treatment of pain with chili peppers? I can’t be sure, but I think it’s decades.

http://www.bloomberg.com/news/articles/2016-06-27/chili-peppers-could-free-us-from-opioids

“When we talk about chronic pain, like chronic low-back pain, physicians feel like they only have one bullet in their toolbox that works for many, many patients,” says Michael Oshinsky, program director for pain and migraine at the National Institutes of Health, about opioids.

Do you think doctors feel that way because it’s true? Like, duh.

The pharma industry has struggled to come up with alternatives. No fewer than 33 experimental medicines for chronic pain went into clinical trials from 2009 to 2015, and all failed, Oshinsky says…

You can’t search for an alternative treatment for pain by trying to circumvent another problem, addiction. (Some people even believe that the quickest way between two points is a straight line.)

It appears that Big Pharma (working with the medical industry) is looking in the wrong direction. Don’t ask me what the right direction is, because I don’t know. But I do know that looking for ways to beat addiction during the treatment of pain is not a direct route to finding new ways to manage pain. Because 90% of people who suffer from pain do not need treatment for addiction.

A brain on chronic pain is not the same as a brain that suffers from addiction and some level of pain. Those who suffer from addiction have different wires crossed. Their brains react differently to opioids. Treating pain with drugs that focus on addiction will only help a very small percentage of pain patients. I think methadone and bupe have been around long enough to prove that fact.

The problem with narcotics is that in treating pain they affect an area of the brain that registers intense pleasure…

What’s the opposite of pleasure? Pain. And just like there are two sides of a coin, the areas of the brain that deal with pleasure and pain are the same ones — the same coin. These areas of the brain do the same work. They work so closely together that some people feel pain just like it’s pleasure, and vice versa. Even the very few people who are unable to feel pain don’t live a life of pleasure.

Centrexion’s drugs are designed to target pain directly, without triggering the brain’s reward system…

So, yeah, try to target pain without going through the pleasure/reward system of the brain… I’m no expert, but I don’t think it’s possible. Well, perhaps it would be more accurate to say that we already have these drugs, like aspirin and NSAIDs, which come with their own risks and lack of effectiveness.

You should eat chili peppers. Not only do they taste good, but they’re good for you. Because they work as an anti-inflammatory, they can relieve pain. Just like aspirin. And by the way, just like decongestants and antihistamines. But these drugs do not target pain directly — they’re not really painkillers.

Progress?

What would progress in the opioid war look like? For the government, progress is a decrease in the supply of opioids, along with the number of doctors prescribing (treating pain). And of course it means a decrease in the number of drug overdoses and deaths. In this Bloomberg article, New Mexico is highlighted as a state that’s making progress, but that’s not the reality.

Unfortunately, any “progress” in the opioid war is bad news for patients.

http://www.bloomberg.com/news/articles/2016-06-23/opioid-crisis-draws-failed-response-from-most-states-group-says

Kentucky, New Mexico, Vermont among states making progress

States were evaluated on six criteria, including the availability of treatment; mandatory education for doctors who prescribe opioids; and access to naloxone, which can reverse the effect of opioids. Michigan, Missouri and Nebraska didn’t meet a single one of the standards, according to a report from the council. Twenty-four other states were labeled as “failing” because they meet just one or two of the six objectives. While Kentucky, New Mexico, Tennessee and Vermont passed at least five, no state had a perfect score…

Does this look like progress to you?

https://nmhealth.org/publication/view/marketing/2117/

In 2014, there were 540 deaths to drug overdose in New Mexico.

New Mexico has the 2nd highest drug overdose death rate in the U.S.

https://nmhealth.org/publication/view/help/1832/

In 2014, 450 New Mexicans died by suicide (21.1 deaths per 100,000 residents)

The New Mexico suicide rate is more than 50% higher than the United States rate

http://www.practicalpainmanagement.com/resources/ethics/new-mexico-approach-improving-pain-addiction-management

However, New Mexico decided not to establish a “trigger” dosage threshold because of concern that such a policy would interfere with the patient-provider relationship. Instead, the state requires a mandatory continuing medical education course covering both prescription drug abuse prevention and the treatment of pain…

Opioid prescribers are mandated to sign up with the New Mexico Board of Pharmacy prescription monitoring program (PMP) and obtain a patient PMP report for the preceding 12 months when initially prescribing chronic opioid therapy (ie, ≥10 days) and every 6 months thereafter…

https://painkills2.wordpress.com/2015/09/06/unm-project-echo-bites-the-dust/

New Mexico is one of 16 states that successfully competed for the four-year grant from the U.S. Centers for Disease Control and Prevention. The grant is from a new program called Prescription Drug Overdose: Prevention for States that helps states address the ongoing prescription drug overdose epidemic.

It appears that a bucket load of education and the PDMP were not enough to make a real difference in the number of overdoses in New Mexico. In fact, after a few years of seeing a small decrease in overdoses, the latest statistics show an increase.

Which leaves me to wonder what is being taught in these continuing education classes and seminars on chronic pain and addiction. Since this education is being funded by the government — and disseminated with the help of the medical industry — I assume everyone is learning to comply with the new CDC rules. And treating pain according to the CDC rules is not going to work for very many patients.

http://amarillo.com/news/2016-02-04/new-mexico-lawmakers-look-curb-opioid-addiction

More New Mexicans died in 2014 of drug overdoses than in any other year on record…

Neurologist Joanna Katzman, president of the American Academy of Pain Management and head of the University of New Mexico’s Pain Consultation and Treatment Center, said continued education for medical professionals who prescribe opioids as well as better access to care for patients dealing with chronic pain must still be part of the equation.

“Chronic pain overlaps with addiction. Chronic pain overlaps with mental health,” she said, pointing to higher incidences of depression, anxiety and even suicide. “We need to really think about increasing treatment for chronic pain, increasing access to treatment.”

Dr. Katzman can talk a good game, making it seem like she could be on the side of pain patients. But I can’t imagine that too many pain patients would agree with her view of what constitutes treatment:

https://painkills2.wordpress.com/2016/03/18/addiction-clinics-masquerading-as-pain-clinics/

Council leading joint process to develop common language for the 7 licensing boards to use in developing their chronic pain management rules by 1/1/17

If you’re a pain patient in New Mexico, you should keep a watch out for these new rules. I assume they will mostly be in line with the new CDC rules, but I also assume that they will include a lot more restrictions on what doctors can prescribe.

I’m sorry, but I think things are about to get a lot worse, not only for patients in New Mexico, but in every state.

Facebook comments that disappear

I use Facebook to make comments, but I’m not that familiar with how the software works. When I made a comment on this Consumer Affairs article through my Facebook account, I expected it to show up in my activity log. But my comment was deleted by Consumer Affairs, so it doesn’t appear in my Facebook account. (I guess everybody hates — and prefers to silence — a critic.)

That doesn’t seem right, but I guess it’s just another reason to dislike Facebook. After all, why would I want to use the same blogging platform as Mark Zuckerberg?

https://www.consumeraffairs.com/news/study-most-patients-getting-opioids-have-leftover-pills-061516.html

My censored comment:

Most deaths related to an opioid overdose are due to a combination of drugs, not just the opioid. If Consumer Affairs would like to see responsible reporting on the drug war, here’s one (lonely) example:

http://www.theguardian.com/us-news/commentisfree/2016/jun/08/opioid-epidemic-drug-mix-overdose-death

“Opioid use on its own is not dangerous, and it’s time we stop demonizing it.”

New York (with Bloomberg at the helm) is the poster state for how not to fight the drug war. That state (with help from Kolodny and PFROP) has been at the forefront of restricting access to prescription pain medications and increasing the amount of addiction clinics (along with the use of drugs like methadone, bupe, and Narcan).

http://www.huffingtonpost.com/2013/01/11/new-victims-in-the-war-on_n_2455917.html

And look where New York is at now — they’ve gone from bad to worse.

This study is a day late and a dollar short. The problems with diversion aren’t being caused by patients anymore, and it was only a small percentage of patients who were responsible for diversion anyway. If Consumer Affairs is going to “report” on the drug war, it should include other stories about diversion, like from DEA agents, pharmacies, hospitals, and nurses. The longer the medical industry blames patients, the more guilty it looks.

Finally, a sane voice in the opioid war

http://www.theguardian.com/us-news/commentisfree/2016/jun/08/opioid-epidemic-drug-mix-overdose-death

Our current obsession with opioids is just the latest trend in a long history of scapegoating single drugs: alcohol in 1830s and 40s, opium in 1870s, marijuana in the 1950s and 60s, crack cocaine in the 1980s and 90s, methamphetamine in the 1990s and early 2000s and now, opioids like heroin, Oxycontin and Fentanyl. The problem of multiple-substance use has remained absent from much of this conversation – and from the education of users and health practitioners – despite the fact that drug mixing is both dangerous and pervasive…

By fixating on fearing opioids, we are missing the more culpable factors that lead some people to keep using drugs despite negative consequences. Opioid use on its own is not dangerous, and it’s time we stop demonizing it. Instead, we must implement a national overdose education strategy targeting the immediate factors of opioid-related overdose: drug mixing and tolerance changes.

Under comments:

cowboy335 2d ago
The thing politicians and others don’t understand. We have a pain epidemic not a drug epidemic. People are in mental and physical pain from life and the controllers of medicene say no. What do you do . Heroin, methadone, vicodan. I am a 64yr old combat Vietnam Vet. I take what I need for pain. I do believe I am old enough and don’t need others to decide for me. That happened when I went to serve in Vietnam. Freedom even if they don’t decide to free me. I have freed myself.

panamadave 2d ago
I am 70 years old and in pain. I really don’t give a damn what some politician wants me to do

Samson151 2d ago
I think the author may have misinterpreted what happens in an OD situation. The user combines an opioid with other CNS depressants in order to overcome his or her greatly elevated tolerance and once again get high. It’s the same motivation that drives addicts to seek out new varieties of heroin laced with fentanyl. It’d be wrong to assume that if we could just convince them to stick to opioids only they’d be fine — they’re not going to do that. From the addict perspective, the opioid is no longer enough…

There are many reasons that pain patients take more than just painkillers, including drugs like muscle relaxers, anti-anxiety meds, antidepressants, anticonvulsants, and blood pressure meds. Suffering from chronic pain is not just about the pain and many patients have comorbid conditions. And all of these additional meds can work in conjunction with painkillers, increasing their effectiveness. Because, let’s face it, opioids can only do so much. And remember, even though opioids work for most people, there are still millions of people who can’t take them.

One of the shortcomings of an opioid is that it treats pain and that’s it. And when there’s pain, there’s usually more to treat than just the pain. But then, most drugs are focused on treating only one condition, just like opioids. Then some people end up taking a bucket full of different drugs to treat each symptom, on the advice of doctors. And this can result in overdose and death, even if it’s only in a very small portion of most patient populations (with the exception of those who suffer from addiction).

When the drug war ends, the overdose and death rate will decrease significantly, but it will never be zero. We’re humans, not robots, and mistakes will be made, both by patients and doctors. But keep in mind that more mistakes are made by doctors — the so-called professionals — than by patients themselves.

This would be a good time to point out one of the benefits of cannabis, in that it treats more than one symptom, no matter what your medical condition. For some patients, it will be able to replace that bucket full of pills, but not for all.

They’re coming for your Oxy

This was an interesting article about the history of Oxy, but I’m not sure it told me anything I don’t already know.

http://static.latimes.com/oxycontin-part1/#nt=oft12aH-1gp2

But OxyContin’s stunning success masked a fundamental problem: The drug wears off hours early in many people, a Los Angeles Times investigation found. OxyContin is a chemical cousin of heroin, and when it doesn’t last, patients can experience excruciating symptoms of withdrawal, including an intense craving for the drug.

The problem offers new insight into why so many people have become addicted to OxyContin, one of the most abused pharmaceuticals in U.S. history…

“What was happening was that they were taking more than they were prescribed because the pain medication wasn’t working,” Hughes recalled in an interview…

The doctor kept raising the dose, eventually putting Bodie on 400 milligrams a day…

Holy cow, that’s a high dose. And it’s probably very rare.

Anyone who has taken Oxy knows that it doesn’t last for 12 hours, even though our doctors have tried to convince us otherwise.

https://painkills2.wordpress.com/2016/01/24/the-effectiveness-of-pills/

I understand that some patients experienced the symptoms of withdrawal as described in this article, but that didn’t happen to me. I had to convince my pain doctor to lower my dosage of Oxy, as the main side effect I experienced was nausea. Yuck. And the nausea wasn’t worth the very small amount of pain relief I obtained from Oxy.

I don’t have proof that my doctor accepted bribes from Big Pharma, but he didn’t pay for all those international vacations on his own. So, I had to keep taking the Oxy, because the medical industry decided that short-acting pain medication could only be used for breakthrough pain. As the article details, breakthrough pain only happens because the stupid pills don’t last as long as they’re supposed to. (Doctors suck.)

Did Prince take his own life?

All of Prince’s friends and representatives were trying to convince him to agree to addiction treatment. It appears they couldn’t convince him to go for inpatient treatment, so they were trying to offer him an outpatient program. I’m sure Prince was worried about security, but I’m also sure that security wasn’t the only thing he was worried about.

And so an intervention was set up. Prince knew about it, but I’m not sure he agreed to it. Yet Prince also knew that there would be painful consequences to his overdose just a short time before the date of his death.

Can you feel his desperation?

Even though Prince knew he had a drug problem, I’m not sure he was ready to quit. He had just performed in Atlanta to rave reviews. I’m sure it was easy to convince himself that now was not the right time to go into treatment.

The addiction clinic chosen for Prince says it treats chronic pain and addiction, as if they were the same thing. But, being treated for addiction is not the same as being treated for chronic pain, regardless of what the government and medical industry say. They were going to offer him buprenorphine, but I doubt Prince believed it would help his pain.

Prince knew that the treatment of his chronic pain would soon be over. Perhaps he even knew that his pain could not be treated, not really. Maybe after all these years, Prince was finally coming to the understanding that he would be suffering and in pain for the rest of his life, drugs or no drugs.

Chronic pain is a very difficult reality to come to terms with — there is a grieving process that Prince may not have had the chance to experience, especially as coddled as he was.

Prince knew that the intervention was going to start soon — the doctor was on his way, flying in from another state. Pretty soon, his pain would not be treated, only his addiction.

I know how he felt. When my pain doctor abandoned me, I knew I had lost my access to pain medications. There was fear, anger, confusion, and an acute sense of desperation. A life-and-death type of desperation. And of course there was pain and more pain. Did I want to survive if it meant living with no relief from this pain? At this point, what were my options?

What other options did Prince have to treat his constant pain? Did he believe that he’d run out of options?

Can you smell his desperation?

It could have gone one of two ways:

Prince decides to take one more handful of pills for his pain, knowing he wouldn’t have access while being treated for addiction. His overdose is an accident, perhaps precipitated by the Narcan he had received just days ago. (He keeps increasing his drug dosages because they’re amazingly ineffective.)

Prince decides he doesn’t want treatment for his drug addiction. What he really wants is adequate treatment for his pain, but he doesn’t see any other options. He finally understands that the pain is never going to go away. A ton of grief descends upon his head and body. He decides to take his own life before the intervention begins.

There’s also the possibility that Prince was given some bad pills, but since he was Prince and all, I kinda doubt anyone would do that. Maybe it’s more likely that Prince didn’t understand the combination of drugs he was taking (or the side effects of Narcan), especially for a man of his age.

All this is conjecture, of course. And even an autopsy cannot determine if Prince’s death was accidental or not. But there are some things that transcend being strangers, and one of those things is suffering from chronic pain. And I’m sad to say that Prince and I had a few too many things in common.

When pain patients attack each other (and the CDC)

You’ll have to be patient with me, as it appears I’m not quite done ranting against the CDC…

http://www.buzzfeed.com/danvergano/cdc-opioids-guidelines

“We know of no other drug prescribed so frequently that kills so many patients,” said CDC Director Thomas Frieden, at a briefing for reporters.

Statements like this are so generic that they could be true, but that would depend on a lot of things, including the CDC’s definition of “drug” — which doesn’t appear to include alcohol or cigarettes, as these drugs are not prescribed by doctors. (Alcohol and cigarettes are drugs that are mainly used by poor people to self-medicate, although the recreational market for these two drugs is obviously very large.)

And to put it into context, MRSA infections kill about as many people as opioid-related deaths. Is the CDC panicking and holding press conferences about MRSA? (Freaking hypocrites.)

While hardly any of the media adds the “related” part to “opioid-related” when talking about overdoses, that is the correct term. And because the CDC includes both legal and illegal opioids in their statistics, it inflates the problem even more — yet the numbers still don’t rise to the description of an “epidemic.” And if they do, then the CDC needs to post a list of epidemics in this country, and let’s see where opioid-related deaths are listed in the overall picture.

https://painkills2.wordpress.com/2015/06/30/which-is-an-epidemic/

I think that opioids, by themselves, probably kill more people who are actually committing suicide than unintentionally overdosing, but no one can know for sure. However, since more people die from suicide than from opioid-related causes, why hasn’t the CDC declared suicide as an epidemic? (Freaking hypocrites, that’s why.)

Considering the media blitz on the opioid war, the CDC has had plenty of opportunities to talk about suicides, especially in connection with opioids and chronic pain.

Dawn Anewday · Magnolia High
What is the suicide rate in chronic pain patients now?

Hey, CDC, why don’t you answer this commenter’s question? (Because even if you did, you would be wrong. No one knows the answer to this very important question.)

“Almost all opioids on the market are just as addictive as heroin,” the CDC director said.

I guess the director is excluding opioids like methadone and bupe, as they’re used to treat addiction. (Hypocrite, hypocrite, hypocrite.)

This is just a bald-faced lie. If you’re talking about the population of the U.S. — at 318 million — then for over 90% of us, this is not true. Because about 90% of us will never suffer from an opioid addiction, so these drugs are perfectly safe to use. (Unless you have an allergy or suffer from intolerable side effects.)

If that was true, then many patients who’ve been given opioids in the hospital would have later turned to heroin. How many women are given opioids during labor and delivery? How come the majority of mothers don’t turn into heroin addicts?

There are only 47 comments on this article right now, which partially illustrates how the CDC (and FDA) have been able to join the opioid war — there are more people fighting on the drug-war side, and they have much more money and influence. The voices of pain patients are too little and very easily overlooked. And it looks like a lot of pain patients are just giving up, not even bothering to comment anymore.

Sure, the media pretends that patients have a voice through advocacy groups, but there are only a handful that do good work — and they all have their own agenda. Currently, there is no lobby for pain patients. Now, compare that to the anti-drug lobby that includes the federal government (and now Big Pharma). Seriously, we never had a chance.

Pain patients who commented on this article are very angry (and you can use swear words on BuzzFeed). I get that. But it’s no excuse to attack other pain patients:

Susan Carnes · Western Illinois University
Hydrocodone for BOWLING TOURNAMENTS? Are you kidding me? Your doctor is one of the reasons legit chronic pain patients have to fight for their medicine. I don’t think I could even pick up a bowling ball.

No, the doctor is not to blame for the opioid war. You’re obviously believing what certain media sites are telling you (which are just regurgitating the government’s view). And there’s no reason to compare each other’s pain levels — as if we should be judging who deserves adequate treatment. (In other words, stop being a dickhead.)

Maggie Karabel Christy · Indiana University Northwest
Why are you taking opiods for migraines?

Why are you asking this question? Let’s learn more about Ms. Christy, shall we?

Maggie Karabel Christy · Indiana University Northwest
I understand people are mad about this. I have chronic migraines and neck and shoulder pain because of a genetic fluke in my skeletal system. I was addicted to painkillers for 7 years. Having come out of the other side, I understand this.
Painkillers cause rebound pain. You go to the doctor and ask why they aren’t working. He or she ups the dose. It still doesn’t work. You switch medications. The new pill works for a while and then the same thing happens. I almost died of an accidental overdose so I had a medical withdrawal and went to rehab. It’s a shock to find out how much the pills that you think help you get through the day are ruining your life.
I get the Harvard Botox Migraine Treatment once a year now (you start doing it once every three months) and aside from maybe a month of slightly droopy brows each time I get it, I have no complaints. It’s funny, they use roughly the same amount of Botox recommended for each smile line, but there are 32 places on the head and neck where you get tiny amounts. Creepy to think about how much of that a woman can legally get injected with.
I had two surgeries and although half of my shoulder pain remains, physical therapy and massage help me deal.
These pills are SO DANGEROUS. I’m 8 years sober and still recovering from Seratonin Syndrome. Synthetic opiods can make your brain lazy and stop it from knowing how to make seratonin. It’s hell and I’m still on medication to help. That’s just one example of what they do to you.
GO TO A PAIN SPECIALIST. A doctor (legally) has to give you pain medication (not kidding) when you complain of pain. Pain specialists want you to try everything under the sun along with small monitored doses of painkillers.
There is always something else to try. Try it.

For one thing, obviously a doctor is not legally bound to give you pain medication when you complain of pain. (Not kidding.) In fact, this article is all about how the CDC is giving doctors support (and a legal defense) so that they can refuse to prescribe pain medication. (Duh.) (As if fear of the DEA was not enough.)

Along with hyperalgesia, serotonin syndrome is used as part of the rhetoric in the opioid war to scare the public. But doctors often put a label on medical conditions before they understand them, which I think is the case with these two conditions. Caused by over-use of opioids? Could be, at least in some patients. Perhaps in those who build up a sensitivity to opioids, or perhaps it has to do with changing hormone levels or a mental illness.

Ms. Christy is also putting forth the argument that opioids can “make your brain lazy and stop it from knowing how to make serotonin.” Actually, I think chronic pain patients have a lack of serotonin — the constant pain either sucks it all up, stops it from being created, or both. And opioids also treat that part of chronic pain, affecting serotonin levels. But just like antidepressants have negative effects for many patients, opioids can also have negative effects on some patients.

And really, is injecting a poison like Botox better than opioids? Perhaps, at least if it works for you. (And you can afford it.)

Maggie Karabel Christy · Indiana University Northwest
How often do you go to physical therapy?
Chronic pain sufferer and former prescription drug addict here. Long term use of painkillers causes rebound pain. Your back probably wouldn’t hurt as much if you STOPPED the drugs. You’d still be in pain for sure. But you’d be motivated to try other methods that aren’t causing brain damage and stopping you from producing seratonin naturally.
You have options. Hopefully you won’t almost die of an accidental overdose like I did before you figure it out.
I have been in your shoes. Life seems impossible without the pills and I feel your anger. I remember it. I hope it stops.
Please don’t take this as condescension, if you feel I was rude I apologize.

Some pain patients advocate to stop all drugs, claiming that pain levels will decrease after doing so. I’m sure this happens, but it’s rare. And then there are the patients who stop taking prescription medications, preferring to suffer rather than jump through hoops and be treated like a drug addict again. Some will switch to alcohol or bud (if they can find and afford it), some will choose stoicism, and some will distract themselves from the pain with gambling, sex, and/or food. Other patients will give up on life and just stop eating, and some will engage in risky behavior to hasten death, including suicide.

Pushing patients into a desperate state so that they’ll “try other methods” is one way to treat pain (which the CDC has chosen). I don’t know if these patients didn’t try other options first (before opioids), because they obviously don’t understand that most pain patients have already tried all the other options, paying for them out of their own pockets. Health insurance doesn’t cover much for the treatment of pain, and the CDC has now been instrumental in the removal of one of the most successful treatment options.

I believe that affordable access to all options is the solution, and even the CDC agrees that pain is best treated with a combination of therapies. But when you take away the pain relief that allows patients to participate in a lot of these other treatment options (if they can afford it), you’ve basically taken away just about everything.

After the CDC guidelines…

http://www.huffingtonpost.com/tom-frieden-md-mph/do-no-harm-cdc-guideline_b_9471168.html

Jett Ward · Troy, Ohio
I had three wisdom teeth pulled and the dentist would not give me anything. Told me to take some Tylenol…

People already avoid the dentist, mostly because of cost, but what do you think will happen when more people realize that dentists are refusing to treat the pain from dental work? Surgeons refusing to treat pain after a certain number of days after surgery? All the healthcare insurance coverage in the world will not provide better outcomes for a large population who refuses to even seek treatment.

Whatever good Obamacare has brought is now destroyed by the CDC (and FDA).

Carole Dunn · SUNY Empire State
I have to look at this from the perspective of people who are in horrific pain. For two years I had nothing but bone on bone in my left hip. I was prescribed opioids that barely took the edge off the pain. I had days where I couldn’t walk at all, but I was never able to get the amount of medicine I actually needed. I had thoughts of suicide a lot. I was finally able to get my hip replaced after doctors repeatedly told me the pain was coming from my back. After the operation the pain meds were so inadequate I couldn’t do the physical therapy. The physical therapists realized I was not adequately medicated and they convinced the pain management specialist to give me adequate meds so I could do the necessary exercises. They said it was a common problem with patients who were in terrible pain and were so inadequately medicated they couldn’t participate.

They talk about people overdosing, but no one talks about the suicides of people who are denied the help they need because of the drug laws and doctors using a one size fits all approach. One of my neighbors killed himself by using his electric drill on his head…

When pain patients attack each other

I suppose it’s not easy to talk “to” people instead of “at” them, especially if you’re on opposite sides of an issue. I realize that my blog allows me to articulate my opinions in ways that I might not be able to if face-to-face with my opponents. However, I put more thought and effort into my writing than I do for verbal communication. In other words, I stand by all of the words and opinions expressed by me on this blog.

I’ve seen the drug war force many changes on the pain patient population in the past 30 years, but I don’t think I’ve ever felt such desperation in my fellow sufferers. Unfortunately, desperation has caused some patients to draw lines, like how many pain patients blame drug addicts for the opioid war. Like how the DEA and grieving family members of overdose victims blame the drugs.

My blog is mostly about my own opinions of living with chronic pain, although I also include the thoughts, feelings, and comments from other pain patients. Which brings me here…

https://painkills2.wordpress.com/2016/02/23/future-visit-to-serenity-mesa-addiction-clinic/

Sun, Mar 6, 2016 1:10 pm
Re: Blog posts about Jennifer Weiss-Burke
From: Jennifer Weiss-Burke (jenweiss24@msn.com)

Dear Johnna,

You are right I am not an expert in chronic pain and I’ve never claimed to be. My husband suffers from chronic pain and, like yourself, was dependent on painkillers for a number of years. They almost killed him and destroyed his life so he now seeks effective alternatives and non-opioid medications. So while I do not have direct experience with being a chronic pain patient, I know what my husband went through and continues to go through each and every day.

When you decide to visit Serenity Mesa, I will be happy to have someone other than myself guide you on a tour. You can call 877-3644 which is our main number. Anyone who answers can help schedule something.

I am a supporter of MAT and do not deny any of our residents access to these medicines that are proven to be effective for opiate addiction. In addition my son was on MAT so no I do not deny people access to effective and evidence based solutions, including medication.

We submitted our Medicaid application back in August and are waiting for it to be approved. We have contacted the state Medicaid office numerous times and have been told that all Medicaid applications are on hold because they are changing the application process. If you have any contacts in this area who can help me push the process through I would greatly appreciate it.

No, these are not paid positions. I am a community member of the prescription drug misuse and overdose prevention committee and there are two other community members who are chronic pain patients so your concerns are represented on this committee. The meetings are open to anyone so you are welcome to attend.

You have made a number of assumptions about me that are not true, posted quotes on your blog that I have not said and continue to try and devalue my advocacy efforts. But, the truth remains that young people are becoming addicted to pain killers at alarming rates throughout this country. Kids are dying. Kids are becoming heroin addicts when their supply of pills runs out. Those are the facts. I wish that was my opinion or my over exaggerated perception but sadly it’s not.

I feel for your pain and pray for your strength and perseverance to get through each and every day. I am sorry you are going through what you are going through and hope you somehow find peace. My heart goes out to you.

Sincerely,

Jennifer Weiss-Burke
Executive Director Healing Addiction in Our Community (HAC) & Serenity Mesa Youth Recovery Center
jenweissburke@serenitymesa.com
(505) 363-9684
http://www.serenitymesa.org
http://www.healingaddictionnm.org

Along with this reply from Mrs. Weiss-Burke, her significant other, David Burke (Dbkono@gmail.com), posted a comment to the above link (twice), which I have copied below in its entirety:

As a fellow chronic pain patient I completely agree that prescription pain medications should not be taken away from us! The last thing those suffering from chronic pain need is to suffer daily without remediation. I have been fighting since 2006 with an intense intestinal disease in which I have lost sections of my small intestine and suffer daily from villitrocious sections of my intestines that will never heal. Currently I am still on a variety of other medicines to take care of my condition but I have to live in constant pain everyday.

I, like you, was addicted to painkillers and they almost destroyed my life. I lost everything before I was finally able to detox off the opiates and am proud to say that I have been clean for over 5 years now. I have learned to live and deal with the pain and now advocate. along with my wife, for laws, funding, facilities and whatever else it takes to help stop this epidemic that results in needless opiate overdose deaths.

I have been reading your blog (more like uneducated personal attacks) and have come to one conclusion. You like me are nothing more than an addict. If you weren’t you wouldn’t be so crazed about losing your “drug” and would be more active in doing something about ensuring the laws being put into place protected your rights in being able to use them safely and ensuring that big pharma wasn’t continuing to get rich off of your addiction. If you were actually educated in the facts instead of spewing lies and mis quoting people you would also know that for the last five years we have been working hard with the department of health and many Senators and Representatives ensuring laws like SB 263 and SB 277 among many others protected the rights of chronic pain patients. If you don’t believe me, Call Senator Richard Martinez from Rio Arriba or Sen. Brandt from Sandavol County who is himself a chronic pain sufferer and advocate. Or how about Senator Cervantes. I can go on and on with all the support we have received from both sides of the aisle to show you that one of the biggest concerns from all involved was to ensure the protection of chronic pain patients. Believe me when I say this that your rights as a chronic pain patient are protected.

Unfortunately, your rights as an addict are much harder to protect. In NM there isn’t enough treatment beds for adults, teens, Men or women. When it’s time for you to get help what are you going to do? Where are you going to go? Who are you going to call? Sadly most people have no where to go or call. For the last five years we have been fighting to change that. HAC has been fighting for the youth of this state. Doing everything we can to ensure our young people have a place to go to get help. Wether they are rich, poor, middle class, coming out of jail, homeless or affluent homes. White, black, Hispanic, Native American, purple, or green. After all drugs or addiction don’t really discriminate do they? Have you ever seen anyone die from an overdose? Have you ever looked into the eyes of a 16 year old who is so gripped by opiates that his whole life is consumed by the drug? Have you ever looked into the eyes of a family that has had their lives turned upside down because they lost their son or daughter because of these drugs? Do you not care? Do you not have a heart? I don’t think you do. I think right now you are like every other addict I have ever met. All you care about at this point in your addiction is making sure you are able to get your next dose or “fix”. You are so blinded by your addiction that your lashing out at people who are actually trying to help you keep your precious drugs while trying to make sure others are protected from those same drugs.

My wife may not be an expert in chronic pain but she has never claimed to be. I, however am an expert in chronic pain. My wife has never claimed to be an expert in addiction but an advocate and one who constantly educates herself on addiction. I am an addict and I do the same. We do both however live it everyday. We live it through the eyes of the boys we care for. Through the death of her son. Through the everyday struggle of addiction in my own disease. Through the pain we see in the hundreds of phone calls and emails we receive from parents, grandparents, brothers, sisters and friends of people who have died or are struggling with this horrible addiction!

Do you even know the statistics? Do you even care about where our state falls nationally? Do you even care how many people die every year because of prescription pain pills?

I know if you truly wanted to you could advocate for your cause. It doesn’t take any thing more than picking up a phone or as you are always on your computer or outside taking pictures of planted trash outside your apartment. Just pick up your computer and write a letter to you legislator stating your concerns! Did you know they are required to respond to you? Did you know your elected officials in reality actually do care? All you have to do is try!

You constantly assume things and you know what they say about people who assume things right? There is absolutely nothing and I mean nothing truthful about one thing in ANY of your blogs about my wife or our facility.. We continue to lobby UNPAID for more funding to complete the entire facility. We travel around the state speaking to everyone possible. Anyone who will listen about this epidemic. We will speak to judges, DRs, lawyers, dentists, students, teachers. ANYONE. Especially addicts like you because I don’t want to see you die of an accidental overdose. As a matter of fact I think you should get a prescription of Nalaxone and keep it on hand for anyone around you to know how to use just In case you overdose. Doctors in NM are now starting to co-prescribe Naloxone with an opiate script because the danger of death is so high. There are lots of good NA meetings located around NM. Remember the first step is admitting you have a problem😀 You may have chronic pain but being an addict and a chronic liar can be a far worse disease than the other disability😢

So there is no chance of you misrepresenting this post or me I will be posting my wife’s letter yours and mine on my Facebook page, Yahoo page and have saved a copy of it in my notes in case you decide to alter it in any way. You know being that your so honest and all.

Dear Mr. Burke:

Sometimes my honesty comes across in a negative way…

Well, if I’m being honest (about my obsession with honesty), perhaps I should say that it’s often seen in a negative light. I suppose that’s because the truth often hurts. But since my pain levels are always higher than the pain from honesty, I find the truth to be quite refreshing.

Obviously, this obsession doesn’t win me any popularity contests. But I think the lies we tell ourselves cause us more pain — like anxiety, depression, and digestive problems — than the truth.

So, I think the very last line of your comment pretty much sums up how much you know about me. Funny, if you really wanted to learn more about me, all you had to do was take the time to read some of my blog posts — not just the very small handful that are about your wife.

There’s an awful lot of information on my blog (over 6,500 posts), so I don’t expect you to be familiar with all the details of my chronic pain survivor story. I find it terribly ironic that you accuse me of making assumptions, when it’s you who has made a great number of assumptions about me. But that’s okay, because I don’t mind correcting you.

I think it’s very, very sad when pain patients attack each other. And one of the poison darts often thrown is to accuse another patient of being a drug addict — as if suffering from this additional medical condition is something to be ashamed of. Anyone who follows and reads my blog knows about the enormous amount of empathy I have for those who suffer from any kind of addiction, as well as the in-depth self-analyzing I’ve done on my own addictions.

Tell me, Mr. Burke, do you recognize your addictions?

https://painkills2.wordpress.com/2015/02/17/do-you-recognize-your-addictions/

For those pain patients who choose stoicism over drugs, I salute you. I can only warn you that untreated pain can very easily turn into chronic and intractable pain, increasing your daily pain levels, sometimes to the point of being unmanageable (even with drugs).

For those who choose to treat their pain with other drugs besides opioids, I wish you luck. But please don’t play the hypocrite, with the belief that some drugs are good, while others are bad. All drugs have side effects, and you can become addicted to antidepressants, anti-anxiety drugs, and stimulants, just like opioids. In fact, some patients have more trouble detoxing from antidepressants than opioids, with longer-lasting effects. Have you read about brain zaps?

https://painkills2.wordpress.com/2015/08/12/lilly-chalks-up-a-win-for-cymbalta-in-first-u-s-trial-over-withdrawal-symptom-claims/

Mr. Burke, you claim to have been “clean” for five years. I suppose that means you haven’t taken any painkillers, as if these are the only drugs that can make one feel dirty while taking, and become clean when they cease taking them. (Heck, some people feel that way about gluten.) If your chosen treatments for pain are working for you, that’s great.

For the past 4 years, I haven’t taken any prescription drugs for chronic pain, even though I’ve had more than one opportunity to purchase them in the underground market. And while you think that I’m addicted to drugs — only interested in getting my next “fix” — the truth is that I was really addicted to doctors and the medical industry. Freeing myself from that addiction was both the hardest and best thing I’ve ever done.

So, there’s no way I can overdose, unless it’s on aspirin. But you’re so very kind to worry about me, Mr. Burke. But dude, there’s no way on Earth that you could ever shame me, although I’m sure you tried your best. Tell me, why did you think it was a good idea to assert that I plant trash outside of my apartment? I think that’s the silliest thing I’ve heard all year.

And no matter how many thinly-veiled innuendos you throw at me, you can’t make me feel bad about my blogging and art therapies — at least they’re free. And I’m sure we can agree that blogging and art therapies are not addicting (unlike the prescription drugs you’re currently taking).

The problem I have with you and your wife’s advocacy work is that it’s not helping pain patients. In fact, it’s harming them. (Isn’t New Mexico at the top of the list for drug abuse and overdoses, including alcohol? And if you check your statistics, you’ll find suicide on that list, too.)

I find it odd that you and your wife don’t understand the results of your actions, but then you both have a rather narrow focus on addiction. And until you read every email (posted on this blog) that I’ve written to government employees (and anyone else I thought might help), you have no business telling me to “try.”

Don’t get me wrong, your comments didn’t offend me. But your attitude — especially as a chronic pain patient — is offensive and harmful to millions of other patients. I think you know that. And I hope you also know how foolish you look, trying to judge me, based on your own misconceptions and the lies you tell yourself.

Dude, you’re not an “expert” on chronic pain. You’re only an expert on your version of adequate treatment options. You discriminate against certain drugs, just like your opinions about me discriminate against other pain patients. I’m not trying to change or open up your mind — no, I’m trying to inform millions of other pain patients what they’re up against in the opioid war.

It’s unfortunate that we’re on opposite sides of this war, Mr. Burke, but I prefer to be on the right side of history. The drug war is, and has been, a total failure (just like prohibition). The war against cannabis has been a disaster, too. The opioid war will also be a failure, but it could take decades — decades of increased suffering, depression, disability, alcoholism, homelessness, and suicides. Yes, and overdoses, too. All because of people like you and your wife. (And a shout out to Unum and the CDC.)

If I believed in shame, I would call that shameful. Hopefully, the patients treated at your addiction clinic are not shamed, as you have tried to shame me here.

https://painkills2.wordpress.com/2015/04/14/what-is-the-purpose-of-shame/

Future Visit to Serenity Mesa Addiction Clinic

https://painkills2.wordpress.com/2016/01/22/dear-new-york-times/

Fri, Jan 29, 2016 12:17 am

Johnna,

I have “enjoyed” reading your continual posts about me and my advocacy work and your “opinions” about me give me a good laugh now and then. You question my ability to fact check and to be labeled as an “expert” in addiction but maybe you should do your own fact checking. Numerous entries in your blog are incorrect. Your most recent blog post listed several quotes that you said I made (see below). I never made these quotes and have no idea who did. Maybe there is another Jennifer Weiss in Albuquerque or someone made those comments in my name but I absolutely did NOT make those comments.

You can talk about me, my deceased son, my advocacy work all you want but please do not start posting false information about me and making up things that I did not say. I also do not receive endless amounts of funding from the state as we are up in Santa Fe right now fighting for the little funding we do get. Maybe you should do your own fact checking before you publish inaccurate information with my name attached to it.

And, as it appears that you have an excessive amount of time on your hands, maybe you should come visit Serenity Mesa and I will give you a personalized tour showing you all of the evidence-based therapy we provide our young residents who suffer from heroin and meth addiction. Maybe if you saw the services we provide and the work we are doing you wouldn’t be so quick to judge. It’s obvious you have never been an addict, loved and addict or lost an addict so maybe you should try a little more empathy and a little less judgement for something you know nothing about.

Once again, the comments below were not made by me:

Jennifer Weiss · Top Commenter · Albuquerque, New Mexico

And one more thing. Since it looks like you hate cops, how many times has APD arrested your dumb butt for just being a jackass or slapping around your p*nis because no hooker in their right mind would ever touch you. So how many times have you been locked up?

Jennifer Weiss · Top Commenter · Albuquerque, New Mexico

Loretta Baca obviously you think your s*it doesn’t stink because you think violence begets violence. Wow, you’re more into death and destruction for your own gratification because your life is so boring and lacking of what is truly important. And you know what, I actually feel sorry for you. You are a pitiful excuse for a human.

Jennifer Weiss-Burke
Executive Director
Healing Addiction in Our Community &
Serenity Mesa Youth Recovery Center
jenweiss24@msn.com
(505) 363-9684

—————–

Tue, Feb 23, 2016 4:36 am

Dear Jennifer:

I’m sorry it took me so long to respond to your email, but if you follow my blog, then maybe you can understand the lateness of my reply. (Being disabled, poor, and powerless is no fun, believe me.) And if you’ve read my blog, then no doubt you are prepared for the type of response you would receive. (At least, I hope so.)

You may not believe this, but it was nice to hear from you. And it’s nice to know that I could give you a good laugh, even if it was at my expense. After all, I’ve heard that laughter is the best medicine. 🙂

We’ll have to disagree about the Facebook comments you’re now disclaiming, because I think they were, in fact, made by you. However, there have been plenty of times when I’ve responded in anger and said things I didn’t mean, so let’s just forget about those comments for now.

It’s funny what some people use to claim the title of “expert” these days, especially in the addiction industry. Considering your background, you can’t be surprised that anyone would question your credentials. Maybe that doesn’t happen in the addiction and political industries? Or is this the very first time? Being rich and white is something I’ve never experienced, but I’m guessing the combination has been really helpful for you.

Maybe you can tell me why you think your experience — specifically in pain management — qualifies you for things like this:

https://painkills2.wordpress.com/2014/12/25/prescription-drug-misuse-and-overdose-prevention-advisory-council/

“The council shall meet at least quarterly to review the current status of prescription drug misuse and overdose prevention and current pain management practices in New Mexico and national prescription drug misuse and overdose prevention and pain management standards and educational efforts for both consumers and professionals. The council shall also recommend pain management and clinical guidelines.”

https://painkills2.wordpress.com/2015/02/02/because-grieving-parents-make-great-medical-experts/

“We will have a discussion on how opiates affect the brain, their addictive qualities and how prevention is a far better option than treatment. We will also offer ideas on how the dental community can help be part of the solution to an epidemic affecting so many people in NM.”

I can’t help but wonder if these are paid positions, and if so, which part of your work experience has qualified you for these positions? Maybe all you need is a college degree, like doctors who become addiction “specialists”?

You say you’re now fighting for more government funding (an endless task, right?), but you didn’t mention the funds you’ve already received:

https://painkills2.wordpress.com/2014/12/25/1172014-healing-addiction-in-our-community/

https://painkills2.wordpress.com/2015/02/02/nonprofit-501c-organizations-albuquerque-nm-87187/

And remember when you advocated to deny the approval of Zohydro?

https://painkills2.wordpress.com/2014/12/31/reconsider-approval-of-dangerous-new-opioid-zohydro/

I also have to wonder, what is your experience with Zohydro? Do you think that treating pain and drug addiction are the same thing? Do you also advocate to deny patients access to opioids like Suboxone, Methadone, and bupe?

And why doesn’t your addiction clinic accept Medicare/Medicaid?

With all your advocacy work on pain management and addiction, you must be aware of the crisis that millions of pain patients are experiencing. You must also be aware that even if your work helps thousands of drug addicts, at the same time, it is also part of terrorizing tens of millions of pain patients. So, with this knowledge, I assume that you also understand why I have felt compelled to publicly point out all the hypocrisy.

We might be fighting on opposite sides of the opioid war, Jennifer, but as a 30-year intractable pain survivor, at least I can say that I’ve tried very hard to understand your side. Can you say the same? Not in my opinion.

For all these reasons, I would be happy to accept your offer for a visit to Serenity Mesa. However, I don’t think it should be a scheduled visit, or include a tour given by the owner of the facility. And because of my current financial difficulties, as well as my disabilities, I don’t know when I’ll be able to plan this visit.

But rest assured, I plan on visiting Serenity Mesa in the future. And just like any stranger off the street who may have questions about your facility (and the treatments offered therein), I hope my visit will help me better understand addiction. After all, I advocate for access to all treatment options for all patients, not just for those suffering from chronic pain.

Now, Jennifer, what are you going to do to learn more about chronic pain?

Johnna Stahl
Executive Director of My Own Blog
The Disabled Community
painkills2@aol.com
No phone

The Effectiveness of Pills

When I was under a doctor’s “care,” I was required to fill out a daily chart, which included monitoring every pill I took and my pain level at that time. It was like homework that lasted for 24 hours, and then was graded by the “school principal” every month (while I forked over hundreds of dollars for the privilege). It caused me to be overly analytical about my pain, almost like having to track, record, and analyze my every breath. (I’m exhausted just thinking about it.)

Of course, since I’ve recovered from my addiction to doctors, I’ve been busy analyzing other things. (Seriously, I don’t think I think too much, I know it.)

One of the things I was thinking about today (in my sleepless stupor) was the fact that pills are not as effective as the labels and recommended dosages suggest. When I was taking pain pills, I blamed myself when they didn’t last for, say, 12 hours. But my allergy pills work the same way, in that the effects don’t last for a full 12 (or 24) hours.

So, you’ll be sitting there, breathing just fine — then, all of a sudden, you lose the effect of the medication and it feels like you haven’t taken anything at all…

Wait, did I take a sugar pill? Is Big Pharma trying to save money by replacing some of my allergy pills with placebos? What other explanation could there be?

Even though I’ve been taking allergy medicine for decades, I don’t believe this is about a rebound effect or a problem with high tolerance. Since I recently spent a couple of weeks without allergy medicine, I’m using that as a comparison. When 12-hour Claritin-D periodically stops working within that 12 hours, I feel just like I did when I was without it. (The 24-hour dosage works in a similar way, at least for me.)

Most pain patients and doctors think that 12-hour formulations work better, giving a consistent dosage of medication over a longer period of time than four-to-six hour pills.

Yes, it’s true that you take fewer pills, but is it really more effective?

Perhaps the 12-hour pills are more effective for some pain patients, but I didn’t think so. When experiencing those periods of ineffectiveness, it was easier for me to hold off taking another pill when I knew I would be able to do so in a shorter period of time — something I don’t have the option of doing with my 12-hour allergy medication. And I thought the four-to-six hour dosages gave me more relief for a longer period of time, at least compared with the 12-hour pills.

How much time throughout the day are you getting relief? If the pills worked as advertised, they would work for a full 12 hours. Patients wouldn’t need to take more than the recommended dosage and there would be a lot less abuse and overdoses. Is it how a pill is digested? The length of time it takes to work? If a better way of getting our vitamins and minerals is through food (not vitamins), what would be the comparison for pain and allergy medications? Something to think about. (Free the Weed.)

This just goes to show you that every patient is different. But I also want pain patients to do their own analyzing — is all that we’ve been taught to believe really accurate?

This is also about the new abuse-deterrent formulations for pain medications, which also have a problem with effectiveness. It appears that patients are having problems digesting these new Big Pharma formulations. (And I have to wonder why the allergy industry hasn’t come up with their own versions of these formulations.)

Trying to outsmart those who don’t use drugs as recommended seems illogical to me — has that ever happen? And I just don’t think that patients deserve all the blame in the drug war, whether we suffer from chronic pain, addiction, or a mental illness. If you take prescribed medication or illegal drugs for any condition, it’s important to know the limitations and risks of those drugs. Don’t leave it up to Big Pharma, the government, or doctors to tell you about your medications — you’re only getting their side of the story.

When privileged politicians, law enforcement, and doctors try to outsmart street smarts, they will always end up looking stupid. Maybe that’s not a nice thing to say, but I think it’s the unvarnished truth. If it wasn’t true, wouldn’t the drug war be a success?

Okay, I’m done thinking now. Thanks for reading. 🙂

How to Fix Drug Courts

http://www.bloombergview.com/articles/2016-01-13/how-to-fix-drug-courts

But to make the courts work in practice, states need to see that they’re adequately funded and properly run. Typically, states offer drug courts as an alternative to prison for addicts who are arrested for nonviolent crimes only: In exchange for pleading guilty, a defendant can spend a year undergoing assessment, treatment and monitoring. Crucially, this opportunity is offered under the threat of sanctions (including jail time) for not following the program…

Many drug courts also need better management. Consider that judges, rather than physicians or other medical professionals, determine people’s treatment…

Indeed, a 2013 study found that two-thirds of drug courts prevented those who had been using illegal opioids from being treated with methadone or similar medication, often on the mistaken belief that such drugs prolong addiction…

My comment:

It seems we’ve gathered a lot of information and statistics for how the drug court system works. Since the opioid war is being blamed on pain patients and their doctors, what I’d like to know is how many of these tragic souls who end up in drug court are classified as suffering from addiction and how many are classified as chronic pain patients? How many of these drug war victims are suffering from depression, bipolar, PTSD, homelessness, or grief?

Let’s say I’m a 25-year-old woman who was abused as a child and have never dealt with it. I’ve been drinking and partying to block my pain, which exposed me to the variety of drugs that I became addicted to. Now, I’ve been arrested, caught selling 10 Vicodin to a friend, and stand in front of a judge in the criminal court system.

This process just increases the shame I feel, not only from my past but from being labeled a criminal for life because of a handful of hydrocodone. Caught in the system, I’m placed in an addiction treatment center, surrounded by other people who know better than anyone else how to find more drugs. Then, I’m given bupe or methadone to treat my addiction, introducing me to new drugs I can use to cover my mental pain.

The reason there is such a high recidivism rate for drug addicts is because the system only tries to treat the addiction, not any of the underlying causes or triggers. In fact, the system appears to create more addicts than it successfully treats.