There’s nothing wrong or sinful about feeling good

I believe we should have access to any and all treatments for pain, including cannabis. But I don’t want pain patients to think that if they switch to cannabis, it will be the only drug or treatment they’ll need to manage their pain. (Any drug is just one part of an overall pain management program.)

I’ve been very lucky to have access to a quality strain of cannabis in the last couple of months — one of those strains that are very hard to find. I’ve wondered if daily use of a good strain would be enough to manage my high pain levels (averaging about a 7 out of 10), but I think that’s about false hope. Cannabis is great, but it’s not a wonder drug. Of course, everyone’s experience will be different, but I think I’ve had enough experience throughout the past 3+ years to reach some conclusions.

If I had a choice (which I do not), I would probably choose a combination of cannabis and a painkiller to treat my pain. The addition of a painkiller would allow me to smoke less cannabis, and the cannabis would allow me to keep my painkiller usage to a minimum. I might even add a muscle relaxer at night, because the muscles in my face deserve more rest than I’m able to provide.

If I was able to add a painkiller to my pain management program, I might be able to take a walk every other day, instead of once or twice a week. I might be able to lose some weight. With a little extra pain relief, I might not think about death so much. I might think that I have some kind of survivable future. There’s even a possibility that I’d be able to regularly clean my toilet. (Okay, maybe not.)

When I was taking a bucket full of prescription medications, I relied on them to manage my pain. Maybe I relied on them too much, but that’s only because, out of all the treatments I’ve tried, prescription medications worked the best. I think that’s true for most people. I think it’s true that a lot of acute and chronic pain is best controlled with painkillers. (Patients aren’t given high doses of antidepressants before surgery.) Maybe the opioid war advocates would agree with me on that, but would disagree about how long we should be allowed to use opioids to manage pain. After all, according to the other side, anyone who swallows a pain pill has a high risk of becoming a drug addict. (And what’s worse than being a drug addict? Maybe a murderer?)

I read an article recently about how cannabis affects the part of the brain that deals with your sense of time. I’ve been thinking about that…

I know that being in constant pain makes time go by very slowly. Twenty-four hours feels like a week, not one day. And then I thought about the occasions that I’ve felt “high” from a drug. You know, the shameful high that almost all pain patients deny they experience with painkillers. The high that drug addicts chase on a daily basis. The high that makes you feel good artificially because it’s from a drug. The feel-good high that is really what the drug war is all about.

Within that high — a possible side effect of some drugs — is a distortion of time. That relief allows time to float, almost fly by, as if you lost 10 pounds and your feet had wings. As if a heavy burden had been lifted just a little, allowing a tiny taste of freedom inside your prison of pain. (Everyone’s prison of pain is different, caused by mental and/or physical pain.)

Does it feel good to get high? You betchya. However, it’s not like that good feeling lasts very long. But it can last long enough to, say, take a walk (or scrub your toilet). Or the high can work as an incentive — a reward for doing the painful thing that you really don’t want to do.

I suppose it’s all about what you do with the high. Those who suffer from addiction will always be chasing the high, and because of the drug war, will always be shamed and criminalized. Looked down on for suffering from a medical condition that most people think is a choice.

Those who suffer from constant pain will always be chasing after relief, and because of the drug war, we are now treated like those who suffer from addiction.

I’d just like to point out that the high I’ve been talking about gives relief to both pain patients and drug addicts. Look down on that high if you will, but it serves a purpose. The pleasure centers in our brains are there for a reason. They’re activated not only by drugs (including caffeine and chocolate), but also by things like friendship, caring, sex, love, risk, and winning.

Good feelings are part of being human. Unfortunately, so is pain. But just like humans are not meant to feel constant pleasure, we’re also not meant to be in constant pain. We’re not meant to feel depressed every single day, and if we do, that means our brains are out of balance. We’re not meant to feel constant fear and anxiety, and if we do, that means our brains need help.

Being human means we have to suffer, but when pain reaches a level where death is preferable to life, then our brains need help. Not help for a couple of weeks or months, but constant help. The pain is constant. The help has to be constant, too.

Sometimes the help we need will include the high from drugs. Let’s stop looking down on the high. There’s nothing wrong or sinful about feeling good.

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To cut costs, Medicare adopts CDC’s regulations

I think you’d be surprised at how many federal and state government agencies are a part of the opioid war. As predicted, the CDC’s opioid guidelines are being treated more like regulations than simple guidelines. With the backing of the CDC’s false theories, these agencies are deciding which treatments for pain will be available to patients — and which will label you a criminal. If you’re a pain patient with Medicare, this information will affect you.

http://www.painnewsnetwork.org/stories/2017/1/12/medicare-takes-big-brother-approach-to-opioid-abuse

A new strategy being developed by Medicare to combat the abuse of opioid pain medication will encourage pharmacists to report physicians who may be prescribing opioids inappropriately. Patients that a pharmacist believes are abusing opioids could also be referred for investigation.

The strategy, which has yet to be finalized, was outlined by the Centers for Medicare & Medicaid Services (CMS) last week in a 30-page report on the agency’s “Opioid Misuse Strategy.” It has not been widely publicized by CMS or reported in the news media…

I read a story the other day about a pain patient who was reported to his doctor by the pharmacist for buying alcohol with his prescription drugs. But I don’t think it’s news that doctors and pharmacists have also become an extension of the DEA in the opioid war, just like other government agencies.

Here are some excerpts from CMS’s “Opioid Misuse Strategy” report:

http://www.cms.gov/Outreach-and-Education/Outreach/Partnerships/Downloads/CMS-Opioid-Misuse-Strategy-2016.pdf

Increase the use of evidence-based practices for acute and chronic pain management. Evidence-based practice is an integral part of all of CMS’s priority areas, but expanding the evidence base of effective and alternative treatments for acute and chronic pain is especially vital. CMS stated this priority area specifically to emphasize the need to address the limitations of research that is currently available.

By January 1, 2019, CMS will enforce requirements that the vast majority of prescribers who write prescriptions for Medicare Part D beneficiaries must be enrolled in Medicare or be validly opted out in order for the beneficiaries’ drugs to be covered. This enrollment requirement will allow Medicare to have better oversight of prescriber behaviors and revoke enrollment of providers proven to demonstrate inappropriate behaviors.

The Medicare Part D Opioid Prescriber Summary File, which will build on this Medicare prescriber enrollment requirement, presents information on the individual opioid prescribing rates (for new prescriptions as well as refills) of prescribers of Part D drugs. This public data set will provide information on the number and percentage of prescription claims for opioid drugs, as well as each provider’s name, specialty, state, and zip code. The file can be used to explore the impact of prescribing practices of controlled substances on vulnerable populations.

Finally, through CMS’s Overutilization Monitoring System (OMS), Part D sponsors are provided quarterly reports on high risk beneficiaries and provide CMS with the outcome of their review of each case. Since 2011, the OMS helped sponsors reduce the number of potential opioid overutilizers by 47 percent among Medicare Part D beneficiaries.

Additionally, CMS is addressing the issue of drug diversion by identifying consistent thresholds across programs to flag providers as “high prescribers” and patients as “high utilizers” who may require additional scrutiny.

CMS is in the exploratory phase of identifying metrics to quantify and track progress in each priority area. For priority area 1, metrics are currently under consideration in the following areas:

For prescribers enrolled in Medicare who prescribe Part D drugs:

Percentage of opioid prescriptions:
o Exceeding CDC guideline of 90 morphine milligram equivalents (MME) per day
o Exceeding 7 days of treatment
o Written for extended release/long-acting opioids

Percentage with beneficiaries receiving an opioid prescription without other supportive therapies/treatments

Research would also increase the focus on identifying methods for migrating the significant number of chronic pain patients with long standing opioid use to other medications along with alternative modalities. Without initiating other medications at the same time as alternative therapies, these patients may vigorously resist reducing or giving up the opioids that for many years have allowed them to manage their pain at tolerable levels and lead functional lives. The benefit of tolerable pain levels and functional lives may outweigh the risk of opioid use for these patients.

Recognizing its critical role in promoting and reinforcing appropriate treatment approaches, Medicare, Medicaid, and Marketplace plans would cover therapies that are consistent with CMS’s evidentiary standards.

CMS has a number of initiatives underway to increase the use of recommended evidence-based practices for pain management. CMS provides outreach regarding best practices and technical assistance through the Transforming Clinical Practice Initiative’s Practice Transformation Networks. CMS has distributed publications on evidence-based prescribing practices to providers, often in coordination with other HHS agencies, including the Office of the Surgeon General.

CMS is also playing a part in expanding the evidence base to identify and support effective nonpharmacologic therapies and additional non-opioid pharmaceuticals. The agency’s key role is to identify services that need more evidence to support coverage by Medicare and other health plans. CMS then collaborates with research-focused HHS agencies, such as NIH, who can concentrate research on these need areas.

The focus of CMS’s immediate efforts under this priority area is twofold. First, identify non-covered treatments that already have sufficient evidence in order to quickly expand coverage of those therapies; for example, for certain common pain conditions, such as chronic lower back pain, CMS is exploring ways to streamline coverage of evidence-supported alternative therapies.

Secondly, educate providers and beneficiaries in order to improve provider utilization of evidence-based treatments and adjust patient expectations appropriately.

CMS’s long term priorities focus on broadening coverage and increasing utilization of therapies that are [might be] proven to be effective. This approach will accelerate identification and implementation of effective alternative treatments for pain.

What happens when access to the only adequate treatments for pain are reduced and removed before other “effective” therapies are found? Like, what happens when Republicans repeal Obamacare before having something comparable to replace it with? I think the term “chaos” fits.

http://www.blog.cms.gov/2017/01/05/addressing-the-opioid-epidemic/

“The opioid epidemic is one of the most pressing public health issues in the United States today.” – Health and Human Services (HHS) Secretary Sylvia Mathews Burwell

Really? If more people suffer from untreated chronic pain than suffer from addiction, which is the epidemic? If more people die from suicide than from drug overdoses, which is the epidemic?

Many Medicare and Medicaid beneficiaries and their families have been affected by the consequences of opioid misuse and opioid use disorder, commonly referred to as addiction. Given the growing body of evidence on the risks of misuse, highlighted by the Centers for Disease Control’s (CDC) new guidelines for prescribing opioids that was released earlier this year, and the Administration’s commitment to combatting the opioid epidemic, CMS is outlining our agency’s strategy and the array of actions underway to address the national opioid misuse epidemic. The actions outlined here do not include CMS’s vision for the treatment of cancer and hospice patients.

See, those who suffer from cancer, or are under hospice care, deserve to have their pain treated, while everyone else can just suffer. Thanks, CDC.

Comments are closed.

Of course comments are closed. They don’t want anyone to invade their bubble. But Medicare is on Facebook, along with the agency that oversees it, HHS:

http://www.facebook.com/HHS/

http://www.facebook.com/medicare/

My comment posted today on Medicare’s Facebook page:

The CDC’s opioid regulations, and Medicare’s adoption of them, are forcing tens of millions of Americans to find alternative treatments for pain, like marijuana and kratom. How much savings does that amount to for Medicare?

What happens when you reduce and remove access to the only successfully proven treatment for pain before equally successful alternative treatments are available? How smart is it to repeal before you replace?

Many pain patients are unable to find safe and adequate replacements for opioids. Some will be forced into the underground drug market. Some will choose suicide. Most will survive, but their lives won’t be worth living. Many will just hunker down, suffer quietly, and wait to die — shamed by the opioid war into believing they deserve to suffer.

Has Medicare/CMS identified metrics to quantify and track the destruction being caused by it and the CDC? Like the increase in addiction rates, poisonings, and suicides. The increase in the use of alcohol, cigarettes, acetaminophen and NSAIDs, sugar, and other legal, over-the-counter drugs and supplements. The increase in domestic violence, family break-ups, obesity, kidney and liver disease, disability claims, and homelessness. The increase in anxiety, depression, and PTSD.

Once the government cures addiction (with money and good intentions), what is it going to do about the epidemic of intractable pain? The epidemic of suicides and gun violence? The epidemic of Americans being unable to trust even one government agency in this country?

Thinking of you, Zondra Nash

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http://www.fox6now.com/2017/01/05/family-says-woman-found-dead-near-23rd-hadley-had-no-heat-in-her-home-you-have-to-check-on-them/

MILWAUKEE — The Milwaukee County Medical Examiner’s Office is investigating a possible cold weather related death. A family found their 48-year-old relative frozen in her home on Thursday afternoon, January 5th. They’re now encouraging others to check on their loved ones…

The woman’s sister Zeldra Strong found her sister’s frozen body in her home… “Everything was off. The water was frozen in cups and bowls,” Timothy Nash said.

What was certain Thursday — in her last moments, Zondra Nash was not living comfortably. The heat was turned off. Nash’s family said she suffered from depression and refused to open her door — even for them…

http://www.cbs58.com/story/34203153/woman-died-from-the-cold-was-an-army-veteran

According to the medical examiner’s report, the woman had not paid her rent in three months and her sister had not been in contact for three months. The woman was found on January 5. She had served in the army for six years…

Zondra Nash’s heat had been turned off in August. The last phone call she made was on November 27. She had purchased cold and cough medicine from Walgreens. The family told the medical examiner she had lost her job two years ago when the business closed.

How do you feel about spanking?

http://www.today.com/parents/france-just-made-spanking-your-kid-illegal-t106715

Studies have shown that spanking basically doesn’t work: It can not only impair a child’s IQ and their overall ability to learn, but it can also lead to low self esteem, aggressive behaviors and substance abuse and addiction problems in later years.

According to a June 2016 study that appeared in the Journal of Family Psychology, more than five decades of research revealed that children who were spanked were more likely to encounter mental health and cognitive difficulties and obstacles, become anti-social and introverted, and were more likely to defy their parents.

Reports have revealed that, since 1986, the practice of spanking children has decreased among women. However, parents across the U.S. say they still approve of spanking as a form of discipline…

I’m very thankful that spanking was not a part of my upbringing. If you hit a stranger, it’s considered criminal battery. Why not the same for your own child? What can a child learn when violence is used as a reinforcement? Spanking is about bullying, not about teaching. It’s about who has the most power in a parent/child relationship.

Don’t hit your kids. Don’t hit your pets. Spanking is not an educational tool. It creates anger and resentment, and just makes the victim want to hit you back. And if they can’t hit you back, they’ll take it out on someone else.

The Collapse of the Health Care Insurance Industry

WASHINGTON, DC (Rueters) — In December, 2016, the Kaiser Family Foundation reported that more than 11 million people had purchased private health insurance plans through the Affordable Care Act exchanges. Now, three plus years after President Trump took office, Kaiser is reporting that 30 million people have lost their insurance. What happened?

One of the first moves of the Republican Congress was to get rid of the ACA requirement that insurers provide certain benefits such as mental-health services and maternity care, saying those requirements drove up premiums.

Since the crash of the health care insurance industry, premiums are no longer a problem.

Studies have shown that since the ACA was gutted by a male president and mostly-male congress, women have suffered the most from its loss. There’s been a sharp increase in abortions, and the U.S. — already one of the international leaders in infant mortality — is now number one on that list.

There’s been an increase in deaths from certain types of cancer that mostly affect women, like breast and uterine cancer. By the time women seek treatment, it’s already too late. Planned Parenthood has been made to close an alarmingly large amount of clinics, both before and after Trump took office. The corresponding explosion of sexually-transmitted diseases, including AIDS, is unsurprising and was expected by most experts.

Mental health clinics, already poorly funded, have also been closing left and right since Trump’s inauguration. The suicide rate has mostly increased every year, but since 2017, it has skyrocketed, finally forcing the CDC to consider suicide as a threat to public health. Rates for depression, addiction, and crime have also increased. After 8 years of an unemployment rate that only went down, it started creeping back up again in the early part of 2018, and is still increasing.

Another idea supported by the Republican Congress was health savings accounts, but it didn’t take long for HSAs to fall out of favor after China Bank & Trust was found guilty of bankrupting around a million of these accounts held by Americans. The Russian Gold Bank was found to have only bankrupted about 1,000 American health savings accounts. The Consumer Financial Protection Bureau discovered these criminal actions before Republicans closed it down, the information only coming to light this year through anonymous internet sources.

Almost everyone (with the exception of state insurance commissioners) thought that selling health care insurance across state lines would be beneficial to consumers, but a recent study by Harvard University showed that the majority of consumers were actually harmed by the proliferation of fly-by-night insurance companies created by this new market. Customers often bought insurance from companies that only existed on the internet, and many people were dumped as soon as they filed a claim.

The health care insurance industry was able to withstand these changes, only falling apart in 2018 after Republicans cut the taxes which funded the ACA. Doctors began to only accept insurance from well-known companies, leaving millions of people unable to find a doctor, even with insurance. Then the largest corporations stopped selling health care insurance altogether.

After the collapse of the health care insurance industry in early 2019, medical costs have started to decline. When it’s too expensive to go to the doctor, you just don’t go. Doctors are now advertising on Craig’s List and Tinder, many offering free introductory visits. After a slew of busy years for hospitals and mergers, three years after Trump became President, there are now 40% fewer hospitals in the U.S.

After President Trump ended the drug war last month, experts have predicted a similar collapse of the medical industry. Only time will tell.

Are you lonely?

Sure, I get lonely. Doesn’t everybody? But it’s not something that bothers me too much. It appears that my intractable pain eclipses many things that might otherwise bother me.

It’s normal and natural to get lonely. Human beings are social animals. Why do you think Facebook has 1.79 billion monthly active users?

http://www.zephoria.com/top-15-valuable-facebook-statistics/

Talk about a crowd. How do users hear anything in all that noise? Anyway, if you’re feeling lonely, here are some links:

http://www.pickthebrain.com/blog/10-ways-cure-loneliness/

http://www.livestrong.com/article/66458-cure-loneliness/

http://www.psychologytoday.com/blog/the-science-success/201010/the-cure-loneliness

Even better, here are some things to laugh at:

You gotta love American humor. 🙂

Inspiration Never Dies

Quotes by Carrie Fisher:

“You know the bad thing about being a survivor? You keep having to get into difficult situations in order to show off your gift.”

“At times, bipolar can be an all-consuming challenge, requiring a lot of stamina and even more courage, so if you’re living with this illness and functioning at all, it’s something to be proud of, not ashamed of.”

“Shame is not something I aspire to.”

“Youth and beauty are not accomplishments.”

“I heard someone say once that many of us only seem able to find heaven by backing away from hell. And while the place that I’ve arrived at in my life may not precisely be everyone’s idea of heavenly, I could swear sometimes — I hear angels sing.”

http://www.indy100.com/article/debbie-reynolds-quotes-carrie-fisher-7500101

“Singin’ in the Rain and childbirth were the two hardest things I ever had to do in my life.”

http://www.azquotes.com/author/34544-Debbie_Reynolds

“The only way you learn is by failure.”