FDA Zeros In on Abuse-Deterrent Opioids


[I tried to post this comment at the National Pain Report website on its article for CR845 — twice. But my comment was censored and not posted. Since that’s the first time I’ve been censored on the National Pain Report website, I have to conclude that my comment touched a nerve. After all, who’s afraid of the truth? I’ve also concluded that the website is not really for pain patients — it appears to be a front for the investors involved with CR845. Therefore, I’ve unsubscribed to that website and will no longer be posting there. And I just thought pain patients should be aware of the truth behind the websites they are supporting.]

November 11, 2014 at 8:39 pm

At first I thought CR845 was another Celebrex. Then, with a little more digging, I figured out we’re talking about another Suboxone.

From Wikipedia page for “κ-opioid receptor”: “However, KOR agonists also produce side effects such as dysphoria and hallucinations, which limits their clinical usefulness.”

I’m confused. Have these drugs been successful for anything other than the treatment of addiction (if that)? Because most of what I’ve read about this drug’s effectiveness to treat pain is not good (I’m talking about from actual patients, not studies). In fact, I am very interested in hearing from any patients who’ve taken these new biopharmaceutical concoctions.

Additionally, I’ve read that these kinds of drugs are also part of the opioid abuse “epidemic.” I think the worst thing I’ve read about Naloxone was at Wikipedia: “Studies show that to give this to a person in severe pain would be unethical and inhumane.” (Yikes.)

“We really need to find something that doesn’t have rewarding properties that doesn’t lead to addiction,” said Lynn Webster, MD, past president of the American Academy of Pain Medicine, who was the lead investigator in initial studies of the drug.

For 95% of chronic pain patients, we already have drugs that don’t lead to addiction. And it is within that “reward” effect where most pain relief is found. Regardless, most chronic pain patients don’t get “high,” so that’s not the reason that a very small percentage of us become addicted.

What we’ve got here is a treatment for addiction, not pain. It just so happens that addiction causes pain — but most chronic pain patients are not suffering from that kind of pain.

As for the percentage of the population who suffer from addiction at any given time, they will use whatever drugs are available and affordable — regardless of the sorcery of the biopharmaceutical industry. What, you think doctors and scientists know more about drugs than addicts?

Ya’ll should be studying and researching endocannabinoids — that’s the future. If you’re against the psychoactive effect, then just look at CBDs other than THC — I think there are over 70 of them (so far).

TMZ and censorship

During a bout with insomnia last night, I visited TMZ’s website for an article and picture of how Chaz Bono lost some weight. And while I wasn’t the only one on the thread of over 1,000 comments standing up for the LGBTQ community, there weren’t very many of us. Mostly it was just a bunch of haters and people who believed in Satan.

I don’t know why TMZ decided to remove all my posts, but it’s not like this is the first time I’ve been censored. I just didn’t think I would get flagged for posts like this:

painkills2 a day ago Removed
Good for Chaz. More Americans should get in shape too. I guess that makes him a role model. 🙂

painkills2 devinjustno(ツ)1999 a day ago Removed
Definition of abomination: “a feeling of hatred”
Oh, now I see where you’re coming from…

painkills2 18 hours ago Removed
There’s nothing wrong with loving who you are, she said, cause I made you perfect, babe. So hold your head up and you’ll go far, listen to me when I say:

I’m beautiful in my way cause God makes no mistakes, I’m on the right track, baby, I was born this way, yeah…

Lady Gaga

painkills2 smoothoperator 20 hours ago Removed
Reduced to name calling… sad.

painkills2 smoothoperator 21 hours ago Removed
You should stop snooping in people’s bedroom windows.

painkills2 xman 21 hours ago Removed
My goodness, you are grumpy. Have you had your chocolate today?

painkills2 smoothoperator a day ago Removed
Life is short. Have some chocolate.

painkills2 smoothoperator a day ago Removed
National Suicide Prevention Lifeline 1-800-273-8255

That was my first and last visit to TMZ — a very sad bunch of people over there commenting, and it’s depressing.

1/6/2015, How should U.S. regulate powerful painkillers?


I remember back in the 1980s, when anti-depressants were about the only long-term treatment available to chronic pain patients. Lots and lots of anti-depressants, which were later proven to only be as effective as a placebo. And while pain was being mistreated and under-treated, acute pain was allowed to morph into chronic pain; chronic pain was allowed to explode into intractable pain; and intractable pain rose to suicidal levels.

I’ve lived the history of the treatment of chronic pain, and Dr. Kolodny is a newcomer to this fight. Being the intensely curious person that I am, I did some digging. I mean, it’s not like the media includes the background of these groups when they allow their spokespeople to pretend to be experts. If you’re interested, I’ve posted the information on PFROP and Phoenix House at painkills2 on WordPress.

Dr. Kolodny has no background or expertise in the treatment of pain. The billion-dollar addiction medicine and rehabilitation industry is one not even recognized by the America Board of Medical Specialties. And it is no surprise that Dr. Kolodny is part of the failed drug war, as he is mostly funded by the federal government.

And just like when the media gives air time to Dick Cheney, when Dr. Kolodny speaks, I get nauseated and think “war criminal.”


I tried 3 different times to make this post, deleting the WordPress mention, and then “war criminal.”  All the posts were denied, and then they shut me down… If anyone reads this, and you’re on Disqus, maybe you can go give Kolodny a hard time for me?

Polite censorship on WordPress

This is the second time that Ms. Nee closed comments on her blog before I was able to respond to one of her comments.  And it’s funny, but I don’t think she does this very often… if at all, before now.  But see, I have a WordPress site of my very own now…

Sure, everyone has a right to censor their own blog, especially from mean or nasty comments. But that’s not the case here…

Don’t worry, Ms. Nee, I won’t be making any more comments on your blog.  I sincerely appreciate all the information you’ve posted about Unum. And I assume that your blog is also a marketing tool for your business, helping you obtain clients.  But as I told you via email, I can’t afford your rates, so you already know I’m not a prospective client… I assume you would prefer that claimants use your services instead of going it alone or hiring an attorney.  Sure, I guess I can understand why you closed down the comment sections where I made posts…

But just because I can’t afford to live in your world, Ms. Nee, doesn’t mean I don’t have opinions worth sharing — which I don’t have to do on your blog, granted.  I can respond to your blog posts right here…


Comments from December 24, 2014:

Painkills2 said:  And if we’re not fixable, why must we be forced to pay for treatment? Oh, that’s right, there’s a “contract.”

Lindanee said:  Were it not for the contract you wouldn’t have had coverage or benefits at all.

And now, my uncensored response:

At first, I was going to say, “Touche, Ms. Nee, and a happy holidays to you, as well.”  But that sounded kinda snarky, so here we go:

“Only free men can negotiate. A prisoner cannot enter into contracts.” Nelson Mandela

Definition of “prisoner”:  a person who is or feels confined or trapped by a situation or set of circumstances.

Additional post on Lindanee’s Blog

By Linda Nee on December 13, 2014 at 10:18 am

Another story is the claim I managed while still employed by Unum of a gentleman who was receiving treatment by a Mexican witch doctor. Each month, he would cross the border for a ceremony that was actually working for his cardiac condition. However, in some respect, although insurance companies cannot compel anyone to seek certain types of treatment most policies do include a provision, “treated by a qualified physician with a speciality suitable to the claimed disability.” With some encouragement (not threats) I was able to convince my claimant that he should seek treatment in the US by a qualified cardiologist. He did so, and his care was medically managed.

Patient notes should not be altered, written on, or changed in any way for disability claim purposes. It doesn’t matter that the changes made were benign, it shouldn’t be done.

There is a proper way to change medical notes by contacting the physician in writing, pointing out the errors, and requesting that the notes be changed or amended. Physicians do not like to “change” medical notes because it’s a time consuming nuisance. And, not everything that happens is a planned conspiracy since doctor’s offices are more chaotic than insurance companies are. If patient notes are consistently wrong, a letter to the physician citing the errors along with a request for more accurate reporting is appropriate.

The proper way to change medical notes doesn’t work.  Besides doctors not wanting to change anything, they have this problem of believing they’re always right.  And incorrect records are much more of a nuisance for the patient than for the doctor, especially since those medical records follow a patient wherever they go — for the rest of their lives.

Unum as a “Covered Entity” under HIPAA

Comments were closed by this blog before I was able to respond, so here’s my last post:


There are many different kinds of car insurance — coverage for liability, flood, collision — but they all involve the use of a car.

There are different kinds of health care providers too, but they all provide a service that involves your health.

So, is a disability insurance company considered a “Covered Entity” under HIPAA? Here’s part of hhs.gov’s definition:

2. A Health Plan

This includes:

Health insurance companies
Company health plans
Government programs that pay for health care, such as Medicare, Medicaid, and the military and veterans health care programs

3. A Health Care Clearinghouse

This includes entities that process nonstandard health information they receive from another entity into a standard (i.e., standard electronic format or data content), or vice versa.

Unum as a health insurance company: It can certainly be argued that disability insurance is a type of health care insurance. Disability insurance is for when your health declines to the point of disability. Do healthy people use disability insurance?

Unum as a company health plan: Unum’s policies are offered as additions to company health plans, including coverage for worker’s comp and short/long term disability.

Unum as a Health Care Clearinghouse: Doesn’t Unum fit this description? Maybe Unum doesn’t communicate with its insureds by electronic means, but I’m sure they use email and other digital technology with all their subsidiaries, vendors, etc. And doesn’t ERISA (which Unum has to follow) include HIPAA rules?

Unum as a government program that pays for health care: Can we consider ERISA as a type of government program? And I know that Unum provides disability insurance to government contractors, but I don’t now if it provides benefits directly to federal and other government employees.

“All matters relating to disability insurance are matters of contract and the contract always rules (including the provisions of discretionary authority).”

Contracts are just words, and words tend to have more than one meaning. It may not be easy to attack the contract itself, but as you say, the contract always rules. But the contract is not God, and neither is it the federal government.

I don’t expect my arguments to convince anyone at Unum — at this point, they are only made to save and protect them for the record.

“No regular medical treatment, no benefit.”

I’m still waiting for someone to define “regular medical treatment.” Especially for a 25-year intractable pain condition. As an expert on pain management, I can tell you that there is no such thing as “regular medical treatment” for a chronic pain patient. Since the medical industry gave up on me as a chronic pain patient, what will I be seeking treatment for?


If you post from Disqus on KevinMD.com, then you should know that first your comment has to be approved — which is no big deal.  But when you get censored for a comment like this:

painkills2 Vallj 4 days ago Removed

On Disqus? Yeah, pretty much.

I don’t like being censored, so I went back and deleted two other comments that were initially approved, like this:

painkills2 GoCougs 4 days ago Removed


painkills2 QQQ 5 days ago Removed

Deleted by me, in protest of censorship for one of my other comments.

My edited comments never showed up, of course, they were just removed also.  Now I have to wonder why my specific comment was deleted, while others — that were actually offensive — were not. A puzzle with no answer… damn.