A Missing Dimension in HHS Task Force Recommendations on Pain

A Missing Dimension in HHS Task Force Recommendations on Pain

By: Richard A Lawhern, PhD

Chronic pain communities are by now aware that the US Department of Health and Human Services is reviewing existing clinical practice guidelines on pain management to make recommendations to Congress concerning gaps, overlaps, and needed updates.  A 29-member expert Task Force on the subject has worked almost a year and will report final recommendations by May 2019.  A 100 page draft of their recommendations (with 446 references) is posted at [link https://www.hhs.gov/ash/advisory-committees/pain/reports/index.html].  The public may comment until April 1, 2019.  The Federal Register docket already shows nearly 2,000 comments, and the HHS email gateway has doubtless received many more.

The Task Force has done a ton of constructive work, and a lot of that work is very patient-centered.  As a non-physician subject matter expert in this area of public policy, I find a lot to applaud.  I’ve also contributed both on my own and as a co-author with medical professionals.  One very recent paper can be found at [Link: https://www.practicalpainmanagement.com/painscan/abstract/draft-report-pain-management-best-practices-updates-gaps-inconsistencies].  I have twice spoken before the Task Force in their public meetings, and submitted extensive written comments.  To save them time and work, I this week submitted an end-to-end “line in / line out” revised draft of the entire document, integrating corrections of research and highlighting concerns among pain communities.

This has been time well spent.

The Task Force still has a distance to go in a very political process.  Some of the thorniest issues go beyond what they have written so far.  Important questions that they weren’t asked by Congress beg for answers.  The Task Force whole body of work will be for nothing unless they take some bulls by the horns.  They need to make explicit recommendations to address outright misbehavior among State regulators, legislators, DEA and law enforcement.  Regulatory and prosecutorial over-reach puts physicians at risk of losing their licenses and drives them out of practice if they try to help people in agony.

I’ve submitted the following, to help the Task Force step up to this job.

Extensive comments to the Task Force make clear that overly aggressive law enforcement and hostile State regulatory policy have been key factors in driving large numbers of physicians out of pain management practice, often deserting patients without referral.  Whole areas of several States are currently without pain management centers.  To correct these conditions, reestablish trust, and attract vitally needed healthcare providers back into the field, significant and publicly visible changes to drug control policy must occur. Failing such changes, patients will continue to be under-treated for pain, while non-medical dimensions of the US opioid “crisis” continue unabated.

  • Recommendation 1: The US Drug Enforcement Agency (DEA) should be directed to develop and publish a National Investigative Practice Standard for evaluation of potential drug diversion or inappropriate prescription by healthcare providers engaging in “pill mill” activity. Gross volume of prescribing is not by itself an adequate standard for opening an investigation, absent an understanding of physician’s practice and their patient population. A consensus Standard should become recommended practice for all US and State investigative organizations.
  • Recommendation 2:  DEA should also be directed to analyze available geographic data on Scheduled drug distribution patterns, to identify US counties where volumes of opioid medications appear to exceed local or adjacent-county medical market needs.  Investigative resources may need to be focused on these counties.
  • Recommendation 3: DEA is unqualified to objectively identify medical opioids which are “subject to diversion”, and thus should not be authorized to restrict on this basis, the volume of opioids manufactured to meet medical market needs.
  • Recommendation 4:  DEA and State law enforcement should be directed to unequivocally end practices which violate judicial due process.  These practices include confiscation of individual physician assets, and release of public announcements of investigations against named doctors, prior to completion of court proceedings.  Also of deep concern on similar grounds are “Death Certificate Projects” and letters from State Medical Boards or prosecutors to physicians deemed to be “high prescribers”.
  •  Recommendation 5:  US State legislatures should be encouraged to consider review and repeal of laws or regulations which restrict doctors from providing pain treatment which they are qualified by training, licensure and experience to render.

There are, of course, many other dimensions in declaring a truce in America’s war against pain patients and a needed redirection of its war on drugs.  Further articles here at National Pain Report will report on some of those dimensions.

Author Note:  Richard A “Red” Lawhern, Ph.D. is a frequent contributor at National Pain Report and in other popular media and professional medical publications.  He is the spouse and father of chronic pain patients.  He has over 20 years experience as a technically trained non-physician patient advocate and moderator in social media support groups and pain communities.

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Richard A Lawhern is a technically trained non-physician advocate for people in pain, with 22 years experience in patient support groups, and over 70 published papers and articles.

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Heather

I commented tonight on the task force draft. It is tremendously helpful for me to read your viewpoints. We, as chronic pain patients, can be a prickly bunch. We are really a diverse group, and our health conditions give us great grief, anger, frustration, sadness. I am glad you have stood by us and advocated for us, Red. I used to be far more articulate than I am now, and had much more energy for self-expression. What you write gives me a foot-hold. I may not have mustered the determination to leave comments otherwise because words and thoughts are slippery things when pain makes me sleep-deprived and distracted.

I follow what you write very closely and thank you so much for all of your efforts on behalf of chronic pain patients.

Lynne Hall

You wrote a report on 1, 17, 2019, I believe. I can not find it.
You indicted that people could sign your petition. Tell the task force! Please reprint. Thanks.

Susan Brucks

In a world where adequate pain control now seems like a a fairy tale, you must be awarded the mantle of Knight in shining armor. Seriously, your tireless efforts are greatly appreciated. Thanks so much for all of the information, for all of the time and for your unswerving compassion!

I don’t know how I could be productive in my job without help from pain meds. RSD can feel crippling at times. It’s bad enough my personal life suffers so badly. How would you handle a loved one going g through RSD/CRPS with help from pain meds. There isn’t a cure, only a form of some relief. Look it up please. RSD also known as CRPS. Thank you to everyone who understands this struggle and works so hard to try to help everyone in the chronic pain community.

David S.

Before my prescription was forcibly tapered by more than 2/3, I remained active and productive. Since then, I mostly watch old movies and hope that I don’t have a flareup and use more than the few allotted pills which puts me into withdrawal for a few days at the end of the month. Withdrawal is tolerable but becomes unbearable when my pain returns.
Chronic pain is enough to bear but being treated like a convicted dope addict is inexcusable. What happened to civil rights and civil liberties? It is a dangerous precedent to allow the DEA free access to my medical records without probable cause or even the slightest evidence of criminal activity.

Red Lawhern keeps hope alive.

Sandy Miller

Thank you for all you do for us in such chronic pain. I can’t find the words to let you know how much I appreciate all the work you are doing and have done to help us who are unable to speak for ourselves.

Blessings to Dr. Lawhern and all of you who are suffering. The criminals will always get their dope, while those of us who are in bed with such real pain, continue to pray for someone in this government run health program to open their eyes to see what we are going through.

Again, Dr. Lawhern, thank you, I wish I could find the words to express my sincere appreciation for caring!

Ditto to all the posts before me! Life has been hell for 15 yrs because my pain is invisible! I finally was diagnosed with Lyme disease, unfortunately it was not caught for 45 ish yrs. So I went through ABUSE by the medical industrial complex to the point I have “PTSD”! I don’t know what I am going to do when my Dr leaves the pain management business! I am one who thinks that regular family physicians can handle perscribing pain medication. This is supposed to be a free country, but all I see is government caused pain and fear of the places we have to go to get medicine that enhances our lives, a DR! I was undiagnosed and sent to a pain Dr that didn’t know me. He did a spinal block and it crippled me 15 yrs now. Desperate in untreated pain back then, I was treated like a criminal, was when I allowed a qiack to operated on my hips at 40 yrs young and my hips have gotten worse since. I feel like a #MedicalRefugee in my own country! Sad for America when the needs of a very miniscule outweigh the needs of 10 million real people in pain you could only imagine.

Anita C Spero

When I read anything by Red I feel hope. I lost my meds about 9 months ago. Now my health and life have spiraled pretty badly. I was on Norco for years (around 12) and was taken off using suboxone for 5 days. Never craved the medication. What I crave is to have my life back. I am slowly watching my business (income) die, But I am trying to keep it. I gave up my right to drive due to pain. I rarely can eat and sleeping is something the pain won’t let me do. Medication was my last hope and worked well for me. After years of trying many therapies, medications and even many guru therapies and gimmicks like body magnets, copper bracelets and other things. Before the pain took my life away I was a body builder and personal trainer. Through medication and great support from a watchful doctor I was even able to work out a bit. That’s all gone now. I am gaining weight and the stress has caused high blood pressure. I have a 5th. grandchild on the way and frankly I’m scared. I can’t care for them like a grandma should. My youngest daughter is getting married soon and I won’t be able to go, my body is in just to much pain. I loved being outside but now I have been forced by my own countries medical system to become a shut-in. Red, Thank you for all your hard work. I can not think of the right words to explain how thankful I am.

Thank you Dr. Lawhern. I have 3 choices without pain medication and cannot take NSAIDS, to become bedridden and suffer without relief, suicide or learn how to find illegal street drugs. I was bedridden for 3 months until I found a new doctor (my pcp of 9 years was forced out because he was retirement age). I had not needed an increase in med. for the past 7 years. Had a triple bypass and blood pressure was under control before and after until a new doctor tried changing anxiety med. and inspite of going back on the meds. my original doctor had me stable on, it has yet to be where it should be a year later, only additionl BP meds are increased or changed still. I believe it is impossible for these agencies not to have employees or family members that ARE GETTING pain meds and they should ALL be forced to be drug tested to prove they are taking care of their own.

Stephen

I am one of the lucky ones who still can get some of my pain meds. Just had to do my monthly perp walk into my Drs. Office to get my pain med scripts. Pull out my photo id, the receptionist tells me loudly that I am due for a drug screen and hands me a urine sample cup. After giving my sample, I have to sign for each prescription and the receptionist makes copies and fills out another log sheet. Am I a criminal? A nurse practitioner in this office started to taper me 1 1/2 years ago when my regular doc was on vacation. The same NP refused to write me my scripts last spring and forced me into withdrawal. I might be safe if I only see my humane pc doc and no other docs. Chronic pain patients have to go through humiliation, anxiety, and discrimination each and every month. It’s ridiculous!

Cathy

I applaud you, sir, for standing up for those of us who can’t. I would give anything in this world to be able to spend more time with my grand daughter, but because of forced medication taper I am unable to keep up with her. This hurts me so extreme that Out of desperation I went through my 34th abdominal surgery that has left me far worse off than before. Now I sit in my recliner every day crying for my life back. Frequent ER visits due to the failed surgery and now being tapered off my pain medication leaves me feeling hopeless. I can only hope that those people who are so against treating conditions that cause pain, never have to experience even half the amount of pain those of us live with every day of our lives.
I’m still waiting for an “alternative” to opiates which has not and will not ever happen. This feels like a witch hunt, maybe someday soon they’ll just burn us chronic pain patients at the stake. It’s a very painful and sad time to be living in the greatest nation on earth. God bless us all!

For those interested, here is the membership of the Task Force: https://www.hhs.gov/ash/advisory-committees/pain/membership/index.html

Many folks have criticized the Task Force for including only one patient advocate (Cindy Steinberg of US Pain Foundation), or on other grounds. Even CDC is represented, which many would regard as a clear conflict of interest. My name was personally proposed by a US Congresswoman, but not confirmed after I submitted my CV. However if the organizers thought they were going to easily stack the deck against opioids, they are by now bitterly disappointed. The draft recommendations are significantly more patient-centered than any clinical practice guideline I have ever read (and I’ve read a lot of them).

The draft recommendations to Congress clearly aren’t perfect, and perhaps can’t be from the perspective of any one advocacy group. I’ve been among the few voices demanding that whatever the Task Force finally produces must be grounded on medical evidence and data, and it must balance the clamoring constituencies.

I think the idiots at PROP are by now spinning in their as-yet un-dug graves, because their positions are almost fully repudiated. CDC is mad enough to spit nails for the same reasons. But I’ve doubtless ticked off a few people on the other side of these arguments too: I’ve pointed out that alternative and “integrative” therapies have very little and very weak medical evidence, though they do help some people, some of the time.

I will write further on these subjects in the coming four weeks before the public comments to the Task Force are closed out. Meantime, thanks to those who have validated my input — and to those who have not. All of us are working for the same objectives, even if we choose different phrasings. Let’s try to remember that politics is “the art of the possible”, and the Task Force is a profoundly political process.

Monty

I don’t understand why the misuse of opioids by some is taking away the legitimate use of pain medication for patients care. Watching my wife being forced off Oxy after 8 back surgeries over a period of decades is painful!

When a doctor right up front tells you he is afraid of being sued after treating you for pain over 20 years, that is leadership talking for his medical facility.

Come on medical professionals, “do no harm” as the oath you took to practice medicine states. Please allow those with legitimate pain live out the rest of their lives iwith some relief. Don’t let the people who mix illicit drugs and die, make you run like frightened rabbits!

Again, do no harm. You are, and don’t want to face the fact that you are doing a major injustice to those who need pain relief!

Cindy Calhoun

Thank you for all you do!

JAnice

Did anyone this last weekend see a program on SHOWTIME Sunday called the circus. There was some discussion on opioid chrisis. Wonder if it would be advantageous for SHOWTIME to
Receive all these replys from individuals caught in The crossfire of this god forsaken bogus governmental agenda. Would it be a help or a hinderance? What if SHOWTIME could film an ACCURATE portrayal of everything and all the trauma cronic pain patients so sadly go through. Parlaying this filming into a binge watch type series for an all day Saturday /Sunday chronicling of events show. ???
Bless all of you. Stay strong. Pain
Wears on us all. My heart is broken for the disappointment and heavy handedness all have suffered and endured.

Terri James

Thank you Doctor Lawhern for everything you do for all of us. I will continue to pray that this does not fall on deaf ears or blind eyes. As we all know; this treatment is more than barbaric. Drug addicts who don’t know what pain is are the ones that overdose, pain patients who have had their medicine taken away or decreased to the point where it isn’t helping are committing or contemplating suicide. Large difference there. No one on the face of this earth can tell me that our president and many of the others that are doing this to us don’t know what chronic pain is and what the repercussions are to someone who’s not treated properly. There is a deep-rooted evil somewhere in the midst of all of this. Decades from now, when we’re all dead and gone it will more than likely be published in our children’s history books. I wish there were a way to get this out to the millions of people who don’t know it exists so they could comment as well. Two thousand plus comments and this is affecting millions. To this day I don’t know if it was by accident or by the grace of God that I stumbled upon the National Pain Report. I like to think it was the latter. Nevertheless something has to be done. The United States is torturing its people, not to mention their veterans who fought so hard to make this country what it is today. I’ve said it before and I’ll say it again and again, “the land of the free and the home of the brave”… well at least they got the second part right.

Cora

Firstly thank you very much for your concerted efforts to reverse the damage being caused to the patient physician relationship and the care provided.
Secondly, I wanted to make clear that Canada is fairing no better with this issue and has blindly adopted the US CDC ‘guildelines’ since January 2016. Chronic pain patients are being treated much the same here as in the USA despite the fact that all the punitive action against chronic pain patients has not translated into a decrease in overdose deaths.
Thirdly, even though physicians here may not be raided and their practices shut down by an entity like the DEA, physicians here are running scared and abandoning pain patients and or enforcing tapering and withdrawal of opiate prescriptions without a sound clinical reason.
Fourthly, physicians in Canada are being monitored closely by their governing liscencing bodies and receive threatening letters if they prescribe more than the 90mg equivalent to individual patients and if they are ‘overprescribing’ opiates in volume when its a pure reflection of their patient population.
I’m sure that nothing will change here unless things change in the US, so I wait like many others. I am so thankful for all the people like yourself Dr Lawhern that are willing to step up and do the right thing. Cheers!!

Misty Hoffman

Thank you from the bottom of my heart Mr. Lawhern. I hope things begin to change. I want to live.

Some thing i forgot to mention, a doctor told me to write my congressman/ senators about how this is affecting me personally and not getting treatment for pain and I told the doctor I did. The doctor mentioned she gets tired of election year because they always asking her for donations. So the powers that be are asking Physicians for donations so they can run for political office. Seems a conflict of interest in patient care exist. That’s why you don’t hear physician squawking 4 undertreated pain / patient abandonment . The powers-that-be just asked the poor for their vote and the ones that have money to help those who want to be in power. Another hum moment.. also read a article that says Oregon State not giving women opiates 4 hysterectomies. Also read on the paper they gave me for surgery says opiates are for trial use only. I going 2 ask her what does a trial mean.

Dick fort

I hope all of this actually works and that they loosen up alil with legit paitents and give the doctors some room to do there jobs without fear of loosing something they have worked there whole life for… I just hope all this work doesn’t get swept under the carpet and we cronic pain paitent not actually seen, there needs to deff be some.chsnge you have good legit people who have illnesses or cronic diseases or cronic incontrable pain who are going to street drugs killing themselves or just saying enough and shooting them selves or committing sucide cause they can’t get any relief from the constant pain and suffering….. So I hope they hear us and I hope they see us and I hope they see there creating a worse problem and see there killing more and more legit good honest human beinngs law abiding citzens. I hope they hear us , I hope they see us , and I hope they actually do something

Adele Eichler

I just want my life back.

F.S.T.

Dear Dr. Lawhern,

There you go again, tirelessly advocating and defending and caring for a segment of “the least of these,” those of us whose chronic pain itself left us wounded, but now dying beneath the wheels of the War Against Pain Patients’ big regulatorial bus.

There are no adequate words to thank you; no adequate lofty tomes of thanksgiving. I just want to extend my hand of gratitude and I know I speak for others.
Your hard work and compassion will be remembered for a long time.

Thank you to Dr .Lawhern & Terry Lewis for your efforts. & the 2 thousand people that sent in recommendations. But what I don’t understand is why isn’t there more recommendations coming from pain management doctors / Physicians that are allowed to prescribe opiates to HHS. I cannot find an adequate number how many pain management Physicians there are in the U.S & no way to find out how many Physicians that are allowed to prescribe. Where are their voices & recommendations & why aren’t they squawking & why isn’t there more news articles about how they’re upset about this whole situation of under treatment of pain of their patients, possibly themselves & the possibility of prosecution that they face of losing their license? Seems strange to me then only people in pain & the Dr.Lawhern,Terry Lewis trying to fight to change the minds of the government .yet the mass of Physicians that are not fighting for their own patients but seem to be happily going along with this Ludacris under treatment & abandonment of patients. That should tell us all something what’s up with that? Not only is it going to put a hurt on pain clinic Physicians but also surgeons. I remember yrs back it took at least 2 mos to see a surgeon now you can get in within a week & 1/2. Hum?

Tess

I really hope they are not playing both sides and truly putting pain patients first.I don’t have much hope and am completely defeated by bias and lies that keep pushing antiopiate agenda

Signe Topai

Don’t forget that patients need to have a Class action suit against Doctors and health insurance that refuse to treat their chronic pain. Refusing to treat us is against a Doctor’s oath to “DUE NO HARM”.

William

If they don’t pass this fast many more will die. Why cant they fast track this. We where never the problem.

S. Dixon

Great recommendations for the DEA and State authorities.

Ricardo

Thanks Red .
A few important questions about this group .
Who is involved . Are there any pain management specialists ,pain patients? Anesthesiologists , Neurologists , organic chemists, pharmacists and pharmacologists ? Will the addiction treatment industry be once again deciding the needs of Intactible pain patients ?

Will Kolodny and PROP once again use a government agency to make de facto law ? That was why the went to the The CDC,run by Kolodnys former boss and fellow Suboxone evangelist Tom Freiden .Who along with Kolodny had been bribing doctors in NYC jails and psychiatric facilities to the tune of $ 10,000 each to become a Buprenophine doctor and push their opioid of choice on detainees awaiting the resolution of their legal issues . How do they say no to Buprenophine when the jail psychiatrist can use refusing it against them in criminal prosecution that can send them to prison or if they accepted to Rehab which are funded by taxpayers . Phoenix House gets millions in state and federal funding . With out court coercion ,rehabs such as Pheonix House will go out of business.
This is a huge conflict of interest.
Then the PDMP s .Kolodny and Brandeis receive millions in states and federal grants along with the payments from physicians and pharmacies. Every prescription is sent to a PDMP and due to the poor interpretations of third party doctrine law enforcement can access PDMP s with out a warrant .
Law enforcement has no need to know what medications we take. Insurance companies can access the information as well as researches from any where . This is very serious problem and few people understand that their very personal medical information is,being bought and sold as well as gathered by law enforcement agencies.

This could be helpful in making the public aware of what the inhumane cruel treatment of intractable pain patients also will impact them .
How do we explain Opioids are the best option we have ?

Sandy

I know two Ex-DEA agents. Neither of them are qualified to make pharmacological decisions and have dangerously aggressive, controlling personalities. One of them was hired as a TV time salesman, don’t know what management was thinking. When TV time sales staff fail to get their money collected on a sale lose their commission. Rule, plain and simple. He would become very aggressive and abusive to me as the Business Office manager if he had to be docked, sometimes because he hadn’t really made the sale. DEA needs to be abolished and replaced by social workers, medical staff and folks with great pharmacological knowledge.

I can’t even get Tramadol for my dogs not. Large dogs tend to get early arthritis, hip and knee pain. Anti-inflammatory drugs do a great amount of digestive damage with no visible results. Tramadol brings the puppy back out in your old friend.

Timothy Mason

Great Work, Josh Bloom is publishing my article on Chronic Pain, Cancer Pain and proper algorithms.

Hoping the legislators get this message. It’s righ

Here’s Hoping the legislators get this message. It’s right on target the bulk of this mess seems to lie within the bulk of our government. And the DEA needs to get out of medicine! Thanks for bringing this point to everyone’s attention. I’ll do my fair share to share it

dave

I disagree with Red on the good work the PMTF has done. They were morally wrong not to call for parity and policy representation by people in pain. Irt is clear that the establishment of the PMTF was to ensure experts that are friendly to the opioid crackdown contained the voices and just demands of people in pain rather than respect them. Congress and dhhs had and have the right to call for responses to comments on the recommendations- they failed to do so. And so it is clear Congress and DHHS meant to relegate those commenters they disagree with to moral and civil vagabondage. So, needless to say, by design the PMTF was a farce with regard to considering the voice of so many people in pain.
Let me add further proof to my contention. I made a comment iniitially to the task force-and like others though I received a confirmation- my comments were not published. My email to Dr Singhs assistant was deleted from my computer-which required DHHS to go to the trouble of obtaining special access to my computer and my two FOI requests to DHHS on my comments were ignored. Now dont get me wrong- I am not very concerned if DHHS considers my concerns- but I am concerned about DHHS and Congress respectfully recognizing in our Republican form of government they have an onbligation to enlarge and refine the public will- instead they chose arbitrarily to largely enlarge their professions and dismiss the will of individuals in pain.
Calling for better experts or a better Congress will miss the mark. We need structural changes at every level of our pain care system to insure each and every person in pain is empowered to have much more control over pain research, policy, and practice.
Let us not strain at gnats and swallow camels. We need to chew on camels- we need to tackle the big issues in pain care that government and the health care industry has failed at for so long. We need a new bundle of rights and multistakeholderism. Instead we have fascist 1984 system

Karen

Thank you! As I read further and further into this article the tears streamed down my face. I suffer day in and day out with Fibromyalgia, Chronic Regional Pain Syndrome, RA, Sjogrens and Raynaud’s. Needless to say, I am in a lot of pain, even on a good day. I had already previously commented for HHS. I pray that the needed changes will be made.

Janna Crickmore

Thank you for using your expertise to bring common sense back to these regulatory agencies

Randy Lamartiniere

I also have replied with comments several times about the repeated mentions of the opioid overdose crisis and the push for buprenorphine use in pain patients.

Jandriene

Thank you, Dr. Lawhern, for advocating for us CPPs….and for such a well-written, thought-out document.

Helene

You are my hero Red. And a true champion of chronic pain patients and the doctors who are trying to treat us. Thank you so much.

Marianne Perez

And who would be the esteemed members of your “task force”? Can’t seem to find reference to it.

Naomi

LET ME START OFF BY SAYING I BROKE MY BACK AT 17 IVE HAD 4 BACK FUSIONS, A REALLY BAD SLEEVE GASTRONOMY SURGERY THAT MY STAPLES HURT DAILEY IN MY STOMACH, I HAD CERVICAL CANCER IN 2011 HAD A FULL HYSTROMTOMY I HURT DAILY STILL FROM THAT, IVE HAD BOTH KNEE SURGERYS, RT ROTER CUFF SURGERY THAT HURTS DAILEY STILL, RT SHOULDER BIOPSEY SURGERY, IVE HAD A JAW SURGERY FROM MY EX MANY YEARS AGO, U HAVE ARTHRITIS, FIBROMYALGIA, AND MY RT HIP POPS OUT OF SOCKET BY ITS SELF I HAD A MRI 2 WEEKS AGO AND THEY SAID ITS FROM ALL MY BACK HARDWARE AND THEY ALSO SAY ALL MY PAIN IS FROM MY BACK HARDWARE, IVE HAD TONS OF CORSTINE SHOTS, AND EVERY INJECTION THESE DRS CAN THINK OF AND IT JUST NAKES MY PAIN WORSE NOT BETTER! SO DONT LET THESE DRS FOOL ANYONE WHEN THEY SAY OF WE HAVE A FIX TO THESE PAIN /OPIDS PROBLEM THE INJECTIONS BECAUSE THEY DONT WORK, MEDICARE WONT PAY FOR ANY OF THEM , I HAVE A HUGE BILL NOW FROM ALL THEM INJECTIONS. AND ANOTHER THING IVE BEEN ON PAIN MEDS BASICLY MY WHOLE LIFE NOW AND FOR ANY DR TO TRY TO TAKE ME OFF I SEE BASICLY ,THERE IS NO WAY TOO. IM ALREADY SUEING 4 DRS FOR HOW THEY TREATIBG ME LIKE SHIT AND GETTING READY TO SUE THIS ONE IM WITH NOW. IF THINGS DONT GET ANY BETTER! I THINK THE DEA MAYBE THEY SHOULD GO TO SCHOOL TO ACTUALLY WRITE PRECPTIONS BEFORE MAKEING ANY JUDGEMENTS ON THE PEOPLE THAT ACTUALLY NEED THEM! ALL THIS IS GONNA DO IS HAVE A HUGE INCREASE OF PEOPLE IN PAIN THAT CANT TAKE THE PAIN ANY LONGER TO COMMIT SUCCIDE AND THEN WHO IS THAT GONNA BE ON THE DEA TO SUE BY OUR FAMILY MEMBERS OR THE CDC? JUST SAYING! PERSONALLY IM TIRED OF NOT HAVEING A QUALITY OF LIFE ANYMORE DUE TO MY INCOMPETENCE DRS AND CDC AND DEA! TIRED OF BEING IN CHRONIC PAIN IT SUCKS!

Thomas Kidd

My hometown Hospital ER now has Police officers posted outside and in the ER. I am sorry but I see no progress being made. I and thousands of of other chronic pain sufferers continue to spirl downward. Just last night I was talked to like a criminal and mocked tauted by the police officers in the ER. I am at the point of giving up. And honestly, if I can get the funds together I am contemplating going to Canada and asking for political to be allowed to live there. Hitler was a choir boy compared to our government and their policies towards the sick and dying. I at my wits end. My state just passed a new law forbidden ER doctors from helping the chronic pain suffers in any way and police officers are now stationed outside the ER entrance and inside following the doctors and nurses watching their every move. Russia would be better to live in than our once great country. On 9/11 judgment began on this hypothetical and sin laden nation, and invoking God to bless America is a most foolish waste of our time. The Creator will not reward wickedness. We are a mockery of the concept of liberty and freedom. The other nations of the world are laughing and rejoicing that the great Bastian of freedom is crumbling down to rise no more. I fear that the demise of our once mighty people who garnered respect and admiration from millions of people who longed for personal liberty and freedom from tyranny is near gone. Yet our elected officials sit in supposedly people appointed positions without compassion and care for the ones who voted them in. The Governors look the other way to the suffering and continue in their self deluted concept of religion. Greed and power drive the minds of the once caring and commpassionate. If anyone doubts what I said about Kentucky’s Hospital ER’s just drive through our state. I can provide pictures if needed. If it’s not happening in your pretictular location just wait. Brace yourselves as much as possible CHRONIC PAIN SUFFERERS.

Martha

Again….many, many thanks Red. Your valient struggle to fight for CP patients, who most days are too ill to fight on their own behalf…is applauded & very much appreciated.

Mark Ibsen MD

Well done, Red. Thank you. It’s a start.

Gary Raymond

Other “Missing Dimensions”, Dr. Lawhern:
1. NOBODY, including physicians, and particularly lawyers, are qualified to dictate pain management policy unless they are suffering from chronic pain themselves.
2. Addiction may appear during the natural life-cycle of opioid therapy. Addiction is not a crime. Crime occurs by withholding effective analgesics. That crime is called torture.
3. Administering and managing long-term opioid therapy should always include the possibility and costs of rehabilitation. Rehabilitation may resolve addiction, but rehabilitation will never stop chronic pain.

Thanks Red, Sadly, this is all too late for some of us. The elite see us as needless eaters that must be eliminated ASAP!

Jul

Thank you R. Lawhern for taking the time and patience to comment. I especially agree with your recommendations 3 and 4.
I will be a continuous support person as I am one of many abandoned by a medical doctor due to responsible usage of prescribed OPIOID ANALGESICS..

Laura Thomson

Thank you for your continued fight to help those with chronic pain. Untreated chronic pain needs to stop for the very reasons: It is inhumane, it leads to disability, and it attacks the CNS causing additional expensensive health issues. The strongest opioid I have been given for CRPS is tramadol and have been forced to stop even that. The only option I was offered for pain in 3.5 years was a spinal cord stimulator that I had implanted in October 2018. I was only sent home after that surgery with my tramadol. A week later when I went back to see the doctor he saw my struggles to sit in a chair and only then did he give me a one time prescription for norco. How does this happen after such a brutal recovery surgery like this? After that surgery I had another surgery in January for gallbladder removal and I was told before the surgery they could only give me 10 pain pills because of the CDC coming down on everyone. This is all so wrong. Thank you sincerely for being our voice.