When an expert is not an expert

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Modern day torture

http://www.painnewsnetwork.org/stories/2016/9/12/half-of-patients-have-trouble-getting-pain-meds

Under comments:

David B. 13 hours ago

My doctor is pain management specialist/anesthesiologist, impeccable record, highly skilled & has controlled my pain more than a decade. My dosage has never increased, nor have I asked for it to be. I’ve never failed a random urine test. My doctor has shown genuine care through some rough patches over the years, more like a friend or brother. I was in excruciating constant pain from spina bifida and frozen shoulder from botched post-op care. My life has been full & productive once I found this doctor. Before that I had 2 concrete plans for suicide w/ everything I needed to carry one or the other out–& every intention to do so once my affairs were in order.

Last week, with no warning, my doctor refused to prescribe more than half of the amount I’ve been on almost 11 yrs. I’m in complete shock. I’m trying to stretch the meds out but I’m getting sicker and sicker from withdrawal. I was too shaken to hear all he said but now knowing what the Feds have done, I believe next month he will send me home with nothing. I’m a widower w/ no living children. My late wife and I had two babies– both were born with spina bifida (years before my own “occult” condition was discovered). Our son died at 17 months, our baby girl at just 20 days. We never allowed ourselves another pregnancy.

A chiropractor suspected my occult spina bifida ten years after my year in Vietnam (drafted) and after our babies were born and died. A neurologist diagnosed it. I worked with pain–took a lot of OTC meds that got me thru, until the shoulder surgery mistake landed me in chronic pain that was unbearable. I never imagined my fantastic doctor would betray me, that the country I fought for would do this to me, to so many of us and most likely more to come. As a veteran, in my opinion, this is torture pure & simple.

Never thought I’d say this but I’m GLAD my dad, a WWII vet who spent 3 years fighting the Nazis in Europe, isn’t alive to see what this country is doing to us. And I’m glad my wife, who was my childhood sweetheart, my first and only love, isn’t here to see me like this. If I can’t find another doctor, tho even if I do, how long before he cuts me off too? I can’t live in agony. I won’t. Why should I when in the blink of an eye I can be 100% whole again and with my wife and my little son and daughter? I will pray for all of you.

God help us all.

Doctors suck

http://www.nationalpainreport.com/my-fight-with-the-va-updated-8831025.html

Then last month I was given a new Primary Care Physician (PCP) at the Palm Desert, VA who told me in a phone conversation that the VA, Loma Linda had sent all the PCP’s a “memo” giving them the right to refuse pain medication to any Veteran who uses Medical Marijuana, if they so choose. So she refused to give me the pain medication I need as long as I use Medical Marijuana and has refused to care for me, a 100%, SC Disabled Veteran…

“I can find no scientific evidence to support this statement.”

I’m tired of refuting all the lies published by the New York Times. And I have to say that the once-revered profession of journalism has certainly fallen on very hard times.

http://www.nytimes.com/2016/06/07/health/opioid-limits-older-patients-pain.html

Under comments:

John, Burlington, VT, June 8, 2016
“Older adults don’t metabolize drugs as well as a 30- or 50-year old, so the medication stays in a person’s system longer,” Dr. Reid said.

I can find no scientific evidence to support this statement.

David X, new haven, ct, June 6, 2016
As an older person who was totally healthy until a cardiologist pushed a statin drug on me, this article is doubly infuriating. At age 69, I carried 30 opioid pills to Nepal, trekking in the mountains, just in case of injury. I returned with all 30 pills.

At age 70, after 7 months on low-dose statin, I was in constant pain and couldn’t walk around the block. Now I do need pain relief. Ironic? Maybe, but not uncommon.

1/4 of Americans over 40 are on statins. 1/4 of this number (about 8 million Americans) complain of muscle pain.

No one knows about causality, since there would be no profit from knowing, but the growth in statin use exactly parallels the growth in opioid use. No one seems to know or want to know if those on statins take more opioids than the general population.

There are lots of medications that American doctors need to prescribe less, statins at the top of the list. Statinvictims.com

catrunning, pasadena, ca, June 7, 2016
Wow – this is real sadism, intentional or not, on the part of the government and medical providers masquerading as “preventative medicine”. Do those bright minds who are denying elderly pain patients a modicum of relief really believe that they are stopping all those recreational drug users in their tracks? Are they refusing to acknowledge that the recreational people have already transitioned to heroin, which is actually considerably cheaper and much easier to acquire than pills anyway.

If I sound bitter, it is because I just lost a good friend to suicide due to untreated pain. She could no longer stand the agony from a rare auto immune, degenerative disease that has no cure nor remission. After she was cut off opiates by her pain clinic because they had no CDC or whatever agency published guidelines for prescribing them in connection with her very rare disease, her life was reduced to just enduring endless agony. I even offered to get her heroin to try, but she wouldn’t let me take the risk. In retrospect, I wished I had forced the issue.

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.

CNN sucks

Tue, Jun 7, 2016 9:18 pm
To: Carrie.Stevenson@turner.com, Desiree.Adib@turner.com
Re: I don’t watch CNN because…

Dear Ms. Stevenson and Ms. Adib:

The CNN broadcast of an Anderson Cooper interview on the prescription opioid/heroin “epidemic” is just one example of why I don’t watch CNN. Tell me, how are your viewership statistics? Let’s ask the internet, shall we?

http://www.journalism.org/2015/04/29/cable-news-fact-sheet/

Do ya’ll think that CNN will be remembered for championing the drug war? For being on the wrong side of history?

As a 30-year intractable pain survivor, if I thought CNN really wanted to hear and report on the side of pain patients, I would include a link to my blog. But just like your corporation couldn’t be bothered to find the truth, I can’t be bothered to watch lies.

Johnna Stahl
Albuquerque, New Mexico

Censoring the comments of pain patients

http://www.salem-news.com/articles/may172016/stigma-opioid-epidemic-ms.php

By:  Marianne Skolek-Perez, Salem-News.com “Investigative Reporter”

(MYRTLE BEACH, S.C.) – This past week CNN broadcast an Anderson Cooper interview on the prescription opioid/heroin epidemic at a Town Hall Meeting.

CNN has been accused by the U.S. Pain Foundation, a lobbying group for pharma in catering to the needs of chronic pain patients in their use of long term opioids, at stigmatizing the pain patients…

Mr. Gileno charged that a woman in the audience named Kay Sanford was the only person with pain — and on prescription opioids for “25 years” given the opportunity to speak. He was appalled that Ms. Sanford was interrupted by both Anderson Cooper and Dr. Drew Pinsky during the broadcast and were dismissive of her pain journey.

Gileno further stated that those on the CNN panel “had the audacity to say her story was the minority.” I recall that Ms. Sanford proudly stated that she walked a mile and a half three times a week and swims even while taking prescription opioids for her chronic pain condition — for 25 years.

Strange though that people in attendance at the broadcast watched as Ms. Sanford was assisted to be seated and subsequently assisted from her seat after the broadcast.

Yet she is a walker of 1-1/2 miles and swims? …

Do you know what matters Mr. Gileno?

It is that we are losing a generation of young people to the prescription opioid epidemic now leading to soaring heroin usage. Stigma of the chronic pain patients? Give me a break…

This country has an over abundance of opioids prescribed to pain patients — many long term who are addicted — hook, line and sinker. The stigma is that your foundation is funded by the pharmaceutical industry and pharma controls the FDA. Thereby, the approval of so many dangerous and addictive opioids being prescribed not only to your “pain patients”, but to young people, Addiction is the culprit.

Notice I don’t use the word “dependent” and I won’t. As long as the U.S. Pain Foundation “advocates” for pain patients and their long-term use of opioids, the addiction and death toll will rage out of control…

CNN and other news media need to keep this epidemic in the forefront. Lives depend upon it.

Email addresses for the CNN producers are: Carrie.Stevenson@turner.com & Desiree.Adib@turner.com

On February 17, 2015 I wrote an article asking why an advocate/official of the U.S. Pain Foundation was allowed to perform antics during hearings on the Senate floor, lying on a yoga mat, while giving testimony about chronic pain.

Why the yoga mat though? Well it seems the senators conducting the hearings allowed her to lay on the Senate floor on her yoga mat and testify using a hand held microphone because in the 1990’s, she sustained an injury.

Bizarre? No it is shame on the senators during these legislative hearings in allowing this disrespect for the tens of thousands of families who suffer pain in the loss of loved ones — and they do not use theatrics in total disrespect for this health crisis…

All comments and messages are approved by people and self promotional links or unacceptable comments are denied.

My comments, all of which have been censored on this website:

Comment #1:

As a 30-year intractable pain survivor, I can’t add anything to this comment section that hasn’t already been said. Instead, I’ll share some poems that I’ve written, words that I think about every single day.

Please kill me
Just kill me now
I’ve suffered enough
and how

Suffering
shuddering
pain roaring
thundering
overpowering
head hammering
eyes watering
thoughts scattering
body lumbering
no glimmering
time shuttering
heart hardening
life guttering
bad thoughts whispering
pain is poisoning

I can easily
picture myself
on my deathbed
denied pain relief
denied dignity
Frightening

https://painkills2.wordpress.com/2015/12/27/uncontrolled-pain/

Comment #2:

How long does it take for you to approve comments?

Comment #3:

I absolutely abhor censorship, especially when it’s done out of selfishness.

Last comment:

When fear causes you to censor my words, you steal my voice. When you steal my voice, you silence me. That’s what you think will happen, but it’s not true. Because when you have your own blog, with terms searchable through Google, your voice can reach whoever’s listening.

Please support pain patients

http://www.rawstory.com/2016/06/the-new-reefer-madness-hysteria-against-opioids-wont-help-patients-who-suffer-from-chronic-pain/comments/#disqus

This is a great article supporting pain patients, with numerous stories of what we’re going through in the comments. Please support those who suffer with chronic pain by supporting this website and the author of this article. Gracias.

Trying to save just one life

When I check my WordPress stats, I’m re-introduced to some of my old posts that people visit, including this one:

https://painkills2.wordpress.com/2015/04/23/email-to-huffpost-on-behalf-of-pain-patients/

“So I’m writing because I hope the Huffington Post, as a major news organization, will do something to help us. Don’t worry, I don’t expect a response — if I can’t get one from government agencies like the Medical Board and Department of Health in my state, I surely don’t expect to receive one from the Huffington Post. But I had to try, because maybe, just maybe, the right media coverage will save the life of one chronic pain patient. Maybe if pain patients see this coverage, they will begin to have hope. If our stories can be told, then maybe it will stop a pain patient from giving up and committing suicide.”

Of course, I never received a response from the Huffington Post. And since this organization’s coverage hasn’t changed one iota in the year since I sent this email, it appears my voice — and the voices of all pain patients — mean absolutely nothing to the media. I have to wonder why that’s the case, but it’s not like I have the answer. Our stories are not being told, but with my blog, at least our stories will remain forever on the internet.

“Like the story of a veteran in New Mexico who was denied renewal in the Medical Cannabis Program, and weeks later, committed suicide.”

And now I’m crying…

Discovering chronic pain on Reddit

I would love to be sleeping right now, but instead, I’m trying to distract myself from insomnia by discovering websites where I can find the stories of other pain patients (survivors).

Patients on this Reddit thread are discussing their current difficulties because of the opioid war, and it looks like a know-it-all pain doctor felt compelled to add his “expertise.”

https://www.reddit.com/r/ChronicPain/comments/4kdklo/opioid_induced_hyperalgesia/

ityprpain doc, 1 day ago
Opioid-induced hyperanalgesia is not rare at all. It happens to almost all chronic pain opioid users… Disclosure: I am a pain dr…

If your pain doctor has this kind of strong belief in hyperalgesia, I would start looking for another pain doctor right away. Because hyperalgesia is rare, at least according to pain patients. Your doctor’s belief in this unproven theory just means he has an excuse to cut you off. Or force you to again try other, more expensive treatments.

There is nothing that “happens to almost all chronic pain opioid users,” except maybe poverty. Oh, and of course, almost all chronic pain patients taking opioids obtain some level of pain relief. A small percentage of this patient population will suffer from addiction, but no one knows exactly how much. Most would say it’s around 5%, which is lower than the addiction rates found in the general public. But, as this Reddit poster (orangesunshine) said:

Though I thought we had decided that worrying about this risk of “addiction” made little sense in a population at significantly higher risk of suicide …

Mr. Pain Doctor has more to say (of course):

In proper opioid pain management, once short acting opioids are tried and the pt is in need of around the clock pain management, you switch to a long acting opioid to cover your “baseline” pain and then use prn IR opioids to control breakthrough pain, hopefully less than twice a day. I say “proper opioid pain management” because most drs, especially PCPs do not properly rx opioids to chronic pain pts.

Yes, this is the current thinking on opioid treatment, but I don’t think it works with the new CDC rules. And I’m not sure this theory works for most pain patients, either. You won’t know which drugs will help until you try them. Unfortunately, as can be seen in this Reddit thread, doctors are forcing patients off of opioids, and replacing them with drugs that are ineffective and have worse side effects.

Or replacing pills with patches. I tried fentynal patches a long time ago, and I don’t think any drug made me as nauseated as that one did. I laid on the couch for hours and hours, waiting for the nausea to subside and the pain relief to arrive. Unfortunately, that never happened. I tried one more time, with the same results. (Yes, I’ll say it again, doctors suck.)

Mr. Pain Doctor says the future in pain medication lies in Ketamine, which may become more available in 3-5 years. I’m not sure I agree, but I don’t know if my disagreement lies in my dislike for Mr. Pain Doctor or not. LOL. Any doctor who says that hydrocodone and oxycodone don’t work for long-term chronic pain doesn’t know what he’s talking about.

Mr. Pain Doctor’s view of the future in research:

ityprpain doc, 22 hours ago
“Also if you’re going to publish something it’d be nice to see someone do a review that looks at which opioids have the best efficacy in the treatment of long term chronic pain.”

There is nigh zero chance of that happening.

Melting_Phoenix, RA/failed back surgery/nerve damage, 9 hours ago

My neurosurgeon was prescribing my pain medication after my failed spinal fusion (this was 2 years ago) and he referred me to a pain clinic that was willing to do anything but prescribe me meds. I have spent that past two years trying every non-opioid med, nerve blocks, epidurals, CBT, facet injections, PT but nothing helped. I wish my brain chemistry was different and something like gabapentin actually helped me but it did nothing. The only way I was able to manage the pain and keep working was by taking pain killers and I honestly didn’t have any side effects except occasional constipation. Every doctor I have seen I have been totally honest with. I give them my medical records showing I have nerve damage and showing that I have tried everything and only painkillers helped lessen my pain. Apparently saying pain killers help my pain means I’m a drug addict.

I used to do bio-med research and I try to keep up with recent research. I’m sure there will be better drug options several years from now but I’ve been to the ER 3 times in the past two years wanting to kill myself from the pain so I don’t know if I can wait that long.

I know it’s hard for doctors because they don’t know who they can trust to be honest, even with drug tests people can still be selling some of their pills on the side. And I know they consider people with depression at a higher rick for overdosing so I do regret admitting that the pain made me depressed.

Dear Marijuana Industry

The marijuana industry includes two different markets: legal and underground. You would think that the underground market is bigger in states without medical cannabis programs, but I don’t think that’s true. The type of program a state creates — the number of restrictions to access (like cost, taxes, location), and lack of reliability, consistency, and quality — all help to determine the size of the underground market.

As far as I can tell, the amount of police focused on marijuana enforcement doesn’t seem to affect the size of the underground market. Of course, in states where cops have a more enlightened view of cannabis, the underground market can flourish — sometimes, to its detriment.

Every grower (and dispensary) believes that their cannabis is the best, which of course is impossible. In the past, strength would determine value, but that’s changing rapidly. However, for most bud lovers, strength is the most important thing. After all, the stronger the bud, the less you have to smoke. And the less money you have to spend.

The problem with determining the “best” bud is that the effect is so different for every person. If you just want to get high, it seems like any bud will do. But if you’re using it as medicine, then it takes a long time (and a lot of money) to figure out what kind of bud is best to treat your medical condition.

What have I learned in the past three years using medical cannabis? I haven’t found strain names to be helpful, nor the distinction between indica and sativa. More often than not, hydroponically-grown weed is stronger and has a cleaner taste. I’ve tried plenty of strains from personal growers, none of which are worth mentioning. I also haven’t found test results to be helpful, or protestations of THC percentage without back-up. I don’t know when cannabis testing will become standardized — or how patients are supposed to understand it — but after much study, this knowledge hasn’t been helpful to me as a patient.

What I’m saying is that it’s a large learning curve from picking up your medicine at the pharmacy and swallowing some pills, all the way to medical cannabis. If the medication your doctor prescribes doesn’t work or has intolerable side effects, your doctor just prescribes others. And then there are the combinations and off-label uses — a pharmacopia of choices. It took a year and half for me to find the right combination of pills, but even after three years, I’m still learning how to find the right bud. Of course with medical cannabis, my options are a lot more limited.

A problem arises when growers and dispensaries get their feelings hurt when their strains don’t work for some of their patients. They get protective and often blame the patients, when really, it’s no one’s fault. Does Pfizer get mad at patients if their pills don’t work? No, because they know their pills will not work for all patients. That’s just illogical.

What I’d like to see is a more compassionate and empathetic treatment of patients by the medical cannabis industry, both the legal and underground markets. Don’t blame patients when strains don’t work. Like a doctor, help them find other alternatives, even if it means a loss of business. Because what goes around comes around. And there’s plenty of business for everyone.

Dear Marijuana Industry (and government regulators): This might be about money (taxes) for you, but this is about medicine for patients. This is about easing suffering. Try to understand our side of these issues. Because as long as the legal markets treat patients like cash registers, the underground markets will continue to thrive. To be honest, both markets are unreliable enough to drive patients to other, less safer drugs (like Kratom) — and no one wants that.

I don’t know about other medical cannabis patients, but I’m very tired of putting up with all this shit. That’s right, I said shit. And to add to all this shit, the marijuana industry knows it has a problem with being white and male-dominated, and as a woman, I’m here to say I’m tired of that, too.

Dear Marijuana Industry: Get your shit together.

Could Marijuana Help Treat Painkiller and Heroin Addiction?

http://www.hightimes.com/read/could-marijuana-help-treat-painkiller-and-heroin-addiction

Advocates argue a growing body of scientific literature supports the idea, pointing to a study in the Journal of Pain this year that found chronic pain sufferers significantly reduced their opioid use when taking medical cannabis. And a study published last year in the Journal of the American Medical Association found cannabis can be effective in treating chronic pain and other ailments.

But the research falls short of concluding marijuana helps wean people off opioids – Vicodin, Oxycontin and related painkillers – and heroin, and many medical professionals say it’s not enough for them to confidently prescribe it.

In Maine, which is considering adding opioid and heroin addiction to the list of conditions that qualify for medical marijuana, Michelle Ham said marijuana helped her end a yearslong addiction to painkillers she took for a bad back and neck.

Tired of feeling “like a zombie,” the 37-year-old mother of two decided to quit cold turkey, which she said brought on convulsions and other withdrawal symptoms.

Then, a friend mentioned marijuana, which Maine had legalized in 1999 for chronic pain and scores of other medical conditions. She gave it a try in 2013 and said the pain is under control. And she hasn’t gone back on the opioids.

“Before, I couldn’t even function. I couldn’t get anything done,” Ham said. “Now, I actually organize volunteers, and we have a donations center to help the needy.”

Most states with medical marijuana allow it for a list of qualifying conditions. Getting on that list is crucial and has resulted in a tug of war in many states, including several in which veterans have been unsuccessful in getting post-traumatic stress disorder approved for marijuana treatment…

My comment:

While some in the medical industry and the government believe there isn’t a difference between addiction and dependence, medical science shows there are plenty of distinctions between the two. So, instead of saying that we should use cannabis to treat opioid “addiction,” the more precise (and palatable) term might be that it should be used to treat opioid “dependence.”

Take out your heating pad

http://well.blogs.nytimes.com/2016/03/25/seeking-painkillers-in-the-emergency-room/

(3/25/2016) Seeking Painkillers in the Emergency Room, by Helen Ouyang, M.D.

Helen Ouyang is an emergency physician at NewYork-Presbyterian Hospital and an assistant professor of medicine at Columbia University.

Physicians need to know that if they don’t prescribe a narcotic because it’s not clinically indicated, or worse yet, because the patient already has an addiction problem, that they have the backing of administrators at every level, from their own department to the head of the hospital all the way up to state officials. If patients are seeking narcotics and have a documented history of doing so — and become combative or refuse to leave after discharge — they may need to be escorted out of the emergency room by security and their treatment terminated to avoid interrupting the care of other patients…

I’m guessing that every patient who has been diagnosed with — and given the label of –“chronic pain,” has a “documented history” of “seeking narcotics.” When someone is in enough pain to seek medical attention, what do you think they’re looking for? A heating pad?

Will this include any patient who asks for painkillers any time in their lives? If you ask your dentist for some Vicodin after you have a cavity filled, will he write that in your electronic health record? “Patient was seeking narcotics.”

This is what I want pain patients to know: If you go to the emergency room for any reason, keep in mind that you will no longer be able to complain about doctors refusing to treat your pain. No one in the administration of the hospital will help you (unless you have connections).

For those patients who don’t suffer from chronic pain, you will face the same problems. A doctor refuses to treat your pain? Too bad. A doctor refuses to treat your pain for hours and hours, so that she can determine your addiction potential before giving you an opiate? Well, the pain didn’t kill you, did it? Shall we depend on our legal system to put a price on your suffering?

Under comments:

Joe Snyder, Houston
Cartilage in both knees are gone from jogging in early ’70s. Synvisc (hyaluronic acid) injections had limited effectiveness in quelling pain, and less so, as time went by. I have high pain tolerance (I.e., hobbled about with ruptured Achilles’ tendon for several weeks before diagnosis). I was able to tolerate knee pain during the day at work, but at bedtime I became more conscious of the pain and had trouble sleeping. All I required was a small, occasional dose (1-2 times a week….maybe) to allow a semblance of proper sleep time. The two “pain management” docs I saw were glade to take my personal info and charge Medicare (>$600) for a single office visit; and, then deny further “treatment”. Frustrated and sensing few options I had Total Knee Replacement a year ago. Not much improvement. I feel that if I was prescribed a small quantity of (in my case hydrocodone/ acetaminophen) I could have avoided a very risky surgery. I am a 75 years old semi-retired pharmacist.

Mary DeForest, New Mexico
I guess this is a Prebyterian problem. I can’t get anything for pain for obvious trauma, like being attacked by dogs. I had part of my nose-including bone-removed, a section of my lip, and tissue between those 2 places removed. I was in agony, and I had nothing for the pain. Presbyterian is cruel. I’m told that it is because I’m a senior citizen and they don’t want me addicted at this age. I don’t even take NSAIDs because of stomach problems and gastroentology keeps telling other doctors to tell 60+ patients to take NSAIDs, because of internal bleeding.

rebecca
Sometimes those of us in chronic pain end up in the ER because our pain spikes and the meds we *have* are no longer sufficient to keep it under control. Chronic pain isn’t a steady state, it has peaks and valleys. Sometimes my migraines are worse than others. Sometimes I can get rid of them with the meds I have, sometimes it gets bad enough that I need stronger medication, and the only place for that is the ER. I do get meds from my pain specialist, but he tells me to go to the ER when those stop working, so what should I do?

Your doctor tells you to go to the ER because he doesn’t want you calling him when you’re in a flare. Because he won’t help you, just like the ER will no longer help you. You asked what you should do, when the answer is obvious to me:  All these “experts” are telling you to suffer. And to stop asking for help, because they refuse to give it.

Samer, Illinois
Government agencies played a huge role in creating the problem during my medical school years and residency “pain is the fifth vital” was pounded in…

Many doctors blame the fifth-vital-sign procedure for drug abuse and addiction, as if that makes any sense at all. And, pray tell, what’s the alternative? Doctors should stop asking patients to rate their pain? Just like Medicare should stop asking patients to rate their doctors, right?

Health Nut, Minnesota
Working in the medical field, I disagree that the fault of opioid abuse falls into the hands of physicians. I remember our hospital being “written up” by the insurance companies for not providing total pain care of our patients as our ER physicians said this was going to happen if we complied with federal government in management of pain. We offered non narcotic pain relief and counseling instead. But the government forced our hand on this issue. We are, once again, acknowledged for our low patient satisfaction scores for our decreased opioid use in our ER. Its been a lose-lose situation for us, and I can imagine, most hospitals!

An insurance company writing up a hospital for not following federal guidelines for the management of pain? Huh? I’m too tired to look up the specifics of these guidelines, but as far as I know, it’s mostly about doctors rating patients’ pain as the fifth vital sign. But that’s not only a requirement of the federal government, it’s also followed by international organizations, too.

I’m sure there are a small percentage of ER patients who are just looking for drugs to treat an addiction, but the majority of people who are forced to go to the ER are not drug addicts. People use everything they can to manage pain, including over-the-counter drugs, ice, heat, etc., before they even get to the ER. So, an ER offering only “non-narcotic pain relief and counseling” is the stupidest thing I’ve ever heard.

And then, when you place blame on low patient satisfaction scores, you’re basically just blaming the patients for not agreeing with your anti-drug ideology. You mean patients in pain are not satisfied with anti-inflammatories and counseling? Gee, who would have thunk it?

Briam, usa
The heroin dealer around the corner won’t say no

Honeybee, Dallas
Then let them go to the heroin dealer.
But remember that 9 out of 10 won’t to a heroin dealer.
Instead, they will go through withdrawal and get their lives back.

Yes, it’s probably true that 9 out of 10 patients denied treatment for pain won’t go to a heroin dealer — it’s not like they’re easy to find. But suggesting that most patients who go through withdrawal will then get their lives back is utter nonsense. In fact, when it comes to the treatment of addiction, the opposite is usually true — those who experience the torture of withdrawal are usually even more motivated to relapse.

Let’s see what else Honeybee has to say, shall we?

Honeybee, Dallas
To be fair, it doesn’t sound like any legitimate user is going to be denied any drug.
I don’t see the problem. Yes, there will be a few more hoops, but nothing ridiculously unreasonable. Huge mistakes were made with alcohol and tobacco; I’m glad the govt and the doctors are trying to prevent a similar disaster with opioids/opiates.

I suppose there will be a lot of people who refuse to see the problem — that is, until they experience the problem for themselves. And it’s unreasonable to compare alcohol and tobacco to opioids, just like it’s unreasonable to compare opioids to cannabis, especially when we’re specifically talking about the potential for addiction. This is a person who obviously believes the drug war has been a success.

Honeybee, Dallas
Note how many of the chronic-pain claimants have a host of other health issues and constant problems abiding by the simple 30-day refill policies (“I got sick” or “I went out of town” or “The pharmacy charged too much”). This is textbook addict behavior and addicts want their drugs on demand with no questions asked, no hoops presented.

So should the doctors enable the addict or cause them to suffer withdrawal? Objective observers will say to step the addicts down gently but firmly. Yes, they will suffer. Yes, their pain will feel worse. But they will survive. Cutting them off is necessary, but we also need to help them withdraw.

Hillary Clinton, is that you?

familydoc, brooklyn, NY
I reach for narcotics rarely now and haven’t found my patients to be in more pain. It may sound lame to hear doctors recommend therapy, heat and a variety of complementary approaches to pain but I’ve found it returns patients to functionality faster than masking the pain with narcotics…

Perhaps your patients stopped complaining to you about their pain, or maybe they see a different doctor when they’re in pain. Perhaps your patients have learned to find their pain relief elsewhere, instead of from their doctor.

What sounds lame is to pay a doctor to tell you to plug in your heating pad. Too bad you can’t take a heating pad wherever you go, right? You went to medical school for that? I’m paying you to refer me to a heating pad and a therapist?

(It’s like these doctors have never heard of the internet, where advice is plentiful and free.)

I think it’s hilarious that doctors have created their own downfall, making themselves obsolete. Just freaking hilarious. 🙂

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…