Andrew Kolodny on Chronic Pain – Kind Of

Andrew Kolodny on Chronic Pain – Kind Of

By Ed Coghlan.

I spoke with Andrew Kolodny recently.

The conversation was about a commentary we had published by Suzanne Stewart that he felt was unfair. We discussed what offended him and on a couple of matters he had a point (a couple of others, I didn’t think he did).

I hope that I’m reasonable and always try to be fair. So, I asked Suzanne – absent proof to the otherwise – to make a couple of changes, which she did, and we republished the story.

After Dr. Kolodny and I had discussed the issue he had with the story, I did a quick interview with him because I’ve not been able to get hold of him in the past (or as you’ll see, since).

I told him that he, no doubt, knew that chronic pain patients and patient advocates see him as an enemy.

He acknowledged that and said, “It is a common misunderstanding. I’m not trying to throw pain patients under the bus, I’m just very concerned about the opioid epidemic.”

He later stated that millions of chronic pain patients and many others have become addicted to opioids.

I shared with him that I believed the concentration on opioids had turned the debate into a binary one – opioids are bad or good, depending on your point of view – but little has been discussed about what should be done for chronic pain patients instead of opioids.

What I suggested to him was that he should write a blog for the National Pain Report aimed at pain patients and their advocates and providers that outlines his case against opioids, and importantly, what he would recommend be done for chronic pain patients if he’s successful in limiting or outlawing opioids.

He said, “I don’t think I would want to do that, but I’ll think about it.”

The days went on and I never heard back so, on September 23, I sent him the following email:

Dr. Kolodny,

Are you willing to write a piece for the National Pain Report?

I made the offer verbally in our phone call and wanted to follow up with a written invite.

Thanks,

Ed Coghlan

Haven’t heard back.

The offer stands.

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Authored by: Ed Coghlan

There are 55 comments for this article
  1. Barbara W at 11:26 am

    We need to counter his lies ,we need to demand the city of New York to revoke his license charging him with breaking all humane laws Nationally & Internationally (Declaration of Montreal) & an enemy of the people doing irreparable damage to chronic pain patients , torture , equilant of murder breaking his hippocratic Oath! HE LIES ABOUT EVERYTHING & is a control freak trying to force the hand of the FDA. We all can substantiate that he is not only in this for the money ($60 billion) but is hands down a diabolical Narcissistic SOCIOPATH!!! The CDC should also be sued for allowing this unqualified charlatan & PROP charlatans to make advisory council & Laws regarding the general public as well as Intractable Pain decisions. 1 ST of all we are entitled to put in our own bodies what we see fit just like alcohol & Cigarette. No DEA at the liquor store!

  2. Matthew J. Smith at 7:26 am

    Thank you for the youtube suggestion !!

  3. Patient with Intractable Pain at 2:18 am

    @Suzanne B. Stewart and @ Mark Ibsen, @Michael G Langley, MD

    Thanks for your outreach, persevearance, and I am sorry for your suffering (I hate to hear your story and hope you can get the treatment you ne – hopefully there will be further developmenets to reduce the underlying problem as well for you Dr. Langley). That’s messed up you were thrown under the bus. I am sorry).

    Just watch this YouTube video at one of his FedUP! rallies:

    https://www.youtube.com/watch?v=JmgvLgg2fsk

    **He wants an additional $60 billion in federal funding over the next 10 years. The first 15 minutes tells a lot of the background**.The first 20 minutes are telling.

    The/his rationale behing removing ultra high dose opioids from the market – is that the fact that there is a single pill capable of inducing respiratory depression in someone naive justifies them being removed from the market due to the harm. Want to mention diabetes and insulin – A single dose can be fatal, or cause irreversable brain damage. There are s many controls to mitigate the risk of administering the wrong dose in a hospital.

    Please watch the video

    Me – My former Primacy Care MD didn’t take me serious, missed several diagnoses and delayed treatment. He undertreated pain for a good while – it’s under decent control now – but getting ther complications (endocrine and CV effects back normal is still in process).

    Suzanne, Ed, Mark and others – Thanks for all you do. Hang in there.

  4. Dana Shore at 6:57 pm

    Just one quick note to everyone that despises Kolondy as much as I do. You can go on YouTube and check him out. They don’t sensor comments like other forums so you can say pretty much what you want to.

  5. Maureen Mollico at 6:38 pm

    Patricia, I am sorry you have to go through that!
    have been through several Pain Managment docs over my many years in chronic pain. The best one I ever had was an Anestheisologist/pain management doc.
    He knew his stuff best of all! He was empathetic, listened well and medicated me correctly. Then I moved to Florida and all heck broke loose with my management! I suffer so much more and my limitations have increased.
    I’ve regretted moving and leaving that doc in CT ever since. Best of all finding the right doc.

  6. Tim Mason at 1:11 pm

    He is out there for the money. If he can get every chronic pain patient classified as a addict* they can enter his addiction center and he can scam the insurance industry for copays. He is obviously after the Medicare dollars which will ultimately lead him to prison time. He is not smart enough to think this far into the future.
    *addict: archaic term, considered derogatory in medical professional circles.
    This term only applies to the criminal operatives that steal, kill and cheat for narcotic.

  7. Tim Mason at 11:59 am

    Patricia you are not off topic,
    You need to find one that is on the STATE BOARD. This doctor will recognize your intractable pain and you should find yourself at 120 morphine equivalent dosing after a few short months.
    Follow my advice.
    I give Ed my permission to give you my email address so we can talk. refer to this email.

  8. Maureen Mollico at 6:43 pm

    I saw Dr. Kolodny on The State of Addiction Special on TV tonight. Neither he nor his female co-speaker Kelly Clark could give specifics on what to do for those of us who need opioids for chronic pain if production were stopped.cshe mentioned ‘programs’ but not what they were!
    It is all such a huge mess! Like a bunch of chickens running around with no heads.
    @Joyce, perhaps it is your husband’s pain levels and depression that have aged him so much. Pain wreaks havoc on all of us. It is extremely tough to live in pain day by day. It takes exhaustingly amounts of work for us to live this life in pain, and not give up. Opioids do not take all of our pain away. It takes the edge off so that we can have some semblance of life…
    Addicts become ‘addicted’. We do not. We are NOT CAPABLE of becoming addicted. We do not get high from our meds and we would do anything to not have to take them. That’s the huge difference between us and addicts. We have different brains. Yet, medications can do things to our bodies for sure. They are chemicals, our bodies do not like them. Yet, we need them in order to live, in pain.
    I’m so sorry that both you and your husband suffer from his chronic disease. Hang in there.

  9. Danny Elliott at 9:36 am

    Joyce Noel, you seem to be very concerned about your husband. You write about the pain lines that have formed on his face, which makes him appear to be much older than he actually is. I can’t imagine what it’s like to be the spouse of someone suffering from chronic, intractable pain. I know it’s been difficult for my wife. However, because of an injury she’s currently dealing with, I think maybe I can successfully illustrate the point that a few of us have tried to say to you.

    Long story as short as possible: My wife is a beast cancer survivor. She had a mastectomy and, during the same surgery, plastic surgery where a muscle from her back is wrapped, thru her armpit, onto her chest in order to create the outside of the “new” breast. For 10 months post surgery, she suffered from significant pain in her back. The surgeon gave her pain meds for a few months but apparently didn’t believe or understand how much pain she had. At the same time, a coworker/friend was able to give my wife pain pills that this co-worker’s mother got every month but only used a small portion. She didn’t sell them, just tried to help my wife. After the 10 months, the surgeon went back in and found where scar tissue had become entangled with some nerves, causing the pain. The surgery fixed the problem of her pain but, by this time, she’d become physically and, especially, psychologically addicted to the pain meds. The initial cancer diagnosis rocked my wife’s foundation, as she was an avid runner. The pain meds seemed to become a crutch for her grief and helped her be in “a good mood” and deal with work better.

    After many very difficult years (and the near implosion of our marriage due to her stealing my medicine after she was promoted & we moved to a city far away from the “helpful” coworker), my wife beat “The Dragon” and quit abusing pain meds. I was, and still am, so proud of her! That was about 3 years ago.

    Then, on Aug 20th of this year, she missed a step on our staircase and really messed up her foot. She had a “Lisfranc fracture”, which meant she fractured 4 bones in the middle of her foot and dislocated the largest bone, tearing ligaments and tendons. Her surgery was on 8/30, requiring 4 pins in the fractured bones and a fusion of the largest bone w/ 2 permanent screws. While I’d never heard of this injury before, I now know it’s a very serious one and the surgery/recovery is extremely painful. Full recovery will take 1-2 YEARS!

    She told her surgeon about her addiction issues. While he acknowledged that he’d be careful, he said there was no way she could endure the pain of the surgery w/out pain meds. She took her last pain pill a couple of weeks ago. While it’s been tough, she’s been very strong in refusing any more meds.

    HERE’S THE PART I WANT TO SHARE WITH YOU: I used to be able to tell if she was using pain meds w/in seconds of coming into contact with her when she was abusing the meds because she was super-happy, super-funny and had energy to burn. However, during her recovery from surgery, the only way that I could tell she had used medicine was that her pain level was lower and she would get sleepy. I asked her about it and she immediately said that she’d always wondered why I didn’t get what we call the
    “Happy- Happy, Joy-Joy” euphoria feeling when I took my medications. She now understands that when there is severe pain, the pain meds seem to go directly to the source of the pain and reduce it. After the injury & surgery, not once did she feel (or display) any euphoria or “Happy-happy, Joy-Joy”.

    My point is that chronic, severe pain sufferers certainly develop physical DEPENDENCE on opioids, but there’s a huge difference between that and addiction. This is a scientific fact that you can research yourself. Your husband very well may need more or stronger pain meds as time goes on because of the dependence he’s developed. But, unless he’s abusing his meds, I sincerely doubt that he has become addicted to it. As long as his condition can’t be cured or fixed, don’t you want him to be as comfortable as he can possibly be, regardless of how?

    I hope this helps explain where I am coming from with my comments. And I pray that your husband is having a less-painful day today. Good luck!

  10. Rita KIMBEL at 9:14 am

    Tim Mason
    I think it’s going to take time to get this straightened out, it’s only coming to light now,after 10 months, how horrible the chronic pain community is suffering. Everyday for me is about managing pain in all ways possible. It’s become costly to say the least, an increase of 300 bucks a month. Every trip to PM is another 60 bucks and is miles to the city and the increase in new scripts adds to it. Hope it doesn’t take to long for the CDC to re write so I don’t go totally broke.

  11. Danny Elliott at 8:43 am

    Excellent comment, Kim. I, too, have been on a stable dose of strong opioid pain medication. Over the last 15+ years, I have only had 2 adjustments (increases) to my daily dosage. My biggest fear (other than being completely cut off of my meds) is reaching the highest level of my meds where there’s no more increases possible. That, on its own, has been a big motivator for me to not ask for any increases, except for the 2 times when I was never able to get my pain below a #7 (on the 0-10 scale).

    Also, as you wrote, the gentleman in question could have very well developed more severe pain due to a worsening of his current condition or possibly by new problems that are the result of his current condition. Of course, there are situations where tolerance does increase, reducing the efficacy of the current drug regimen. That’s not his “fault” or a “character flaw” on his part. It’s a situation that I’m sure he would like to avoid, if at all possible. But, that’s not always the case.

  12. Tim Mason at 8:23 am

    Dr. Kolodny’s remedy for drunk driving (alcoholic arriving) would be to BAN GASOLINE.
    He thinks much like a fool.

  13. Kim at 6:43 pm

    Joyce Noel,
    Not every person is addicted to opioids. Not every person needs increases as not every person gets used to the opioids and therefore need more opioids to cover their pain.

    I can say this from personal experience. I had been on a narcotic from age 13-45. I only increased my amount when I attempted college. I stayed ALL THOSE YEARS with only 1-6 tablets a day. As I decided to become as fit as possible, and as the past had shown, the more exercise I did, the more my pain went up. So I was working out 3 hours a day 7 days a week. I went up by 1-2 tablets. My doctor wanted me to go back down and sent me to Physical Therapy.

    During the intake appointment, the very last minutes of the appointment, the therapist had me do one exercise with several repetitions. I left his office in the most severe pain I had ever been in. It took 4 years to find out the intractable pain was due to adhesive arachnoiditis, which the PT exercise brought out. I had two major surgeries which did not help and it took 4.5 years to finally get the opioid dose high enough to help. Genetic testing showed I was a fast metabolizer of the opioids. So now for 3.5 years I have been stable and actually dropped some meds on some days. But, I have never needed another increase once we hit the correct level. I am about 10x over the CDC level, but if left alone, I would likely be able to live though without much quality of life as doing things makes the pain uncontrollable.

    So your husband may have gotten used to his meds and needed more. Heck, he may have had more injuries to his back and needed more, but just like the CDC you and they cannot generalize all people as the same. We all are different, unique individuals.

    I saw a psychiatrist as one of the first”pain management” labeled doctors in the 1990’s. He used antidepressants. I wasn’t depressed but it was supposed to create more serotonin and that was to help with pain. Instead I ended up a “Black Box” victim and was constantly trying to take my life or self injure. I guess that is where Dr. K thinks he is some gift to the pain community. The whole PROP group should be ashamed at all the murders they are responsible by forcing CPPs into suicide. It is murder, because they are and have removed many of our lifelines. I am just waiting until my lifeline is removed. I thought palliative care would at least be the salvation for some of us, but from those I have talked to in palliative care, the doctors there are also now afraid to do high-dose opioid prescriptions. So it seems as if there will likely be no path for those who suffer intractable pain when the dosage limits go into affect, except suffer until your body quits or suicide, likely with something other than pills, if you are a fast metabolizer!

  14. Larry at 6:42 pm

    Don’t all the organizations that include heroin deaths with other opiate and opioid deaths in order to create statistics know they are being disingenuous? Yes, of course they do. Isn’t heroin an opiate not an opioid? Shouldn’t opioid and opiate deaths be separated when compiling stats? As a long time opioid user aren’t I entitled to know how many people actually die each year from taking oxycodone or oxycontin? Why do I have to read stats including heroin deaths? The chances of me ever going near heroin are exactly 0%. I take medicine prescribed by a doctor. I don’t buy drugs on the street from a drug dealer. I wouldn’t know how, I’d be afraid to go near a drug dealer and I have no desire to take an illegal drug. Please stop including me and people like me in with heroin addicts when you compile your phony stats.

  15. Tim Mason at 10:03 pm

    Rita,
    What has been done in the dark will be brought to the light. Those that “pulled the wool over the eyes” of the CDC will SOON be revealed. A federal agency was hoodwinked. Thousands of people were injured due to this type of Greed.
    I believe things are going to return to normal for legitimate patients like yourself.

  16. Kris at 9:22 pm

    If you think about it this Kolodney is using his Professional License to advise about patients he has never seen and knows nothing about the individual conditions of any of them. In addition he is recommending to those same patients {who have chronic intractable pain} to use on a frequent daily basis two very harmful medications {motrin, tylenol} that are meant for only occassional use for temporary mild discomfort and he has no legitimate background in the management of pain only addiction plus hes in lifetime recovery from alcohol. Is he aware that liver failure rates have gone up dramatically? Its my belief its time for his state medical board to start an investigation for trying to practice outside the scope of his license without the required knowledge and credentials, thats what I think.

  17. Joyce Noel at 10:31 am

    Kel B. Opiods are an addictive substance. Take thw opioid away and the person will experience withdrawal. And like heroin you build a tolerance. So give a person the same prescriptioenour 9 years it will not be enough. And over those years my husbands condition has also deteriorated. So even with his meds he ia in pain

  18. Dana Shore at 8:44 am

    I would also like to say that it would not surprise me to see Kolondy’s bank account and assets to increase as his Opioid termination has made plenty of room for big pharma’s “new earth shattering replacements” for opioids that cost more and from my first hand experience are worthless, a joke to be exact. But he will be singing all the way to the bank if my suspicions are correct.

  19. Dana Shore at 8:29 am

    Ed, thank you for trying to get some type of honest comment from Kolondy. Should they ever appoint a real head of the FDA there will be a job waiting on Kolondy at CNN. Kolondy has thrown thousands, maybe hundreds of thousands of cronic pain patients under the bus using false info, stacked committees and slanted reports.

  20. Michael G Langley, MD at 8:20 am

    Patricia, you are right about the anesthesiologists. Up until about ten years ago, they spent all of their time in the OR with minimal contact with real patient care. I lost my license when these “experts” felt their education was better than mine. Used by the state medical board. I was educated in pain management by the University of the Pacific in receiving a Certificate in Pain Management. I was board certified by the other “American Academy of Pain Management” that has multiple disciplinary care as its backbone. But, it accepted dentists, chiropractors, physical therapists, etc. That made it an enemy of most MD-s. I spent my entire general surgical residency treating acute pain. I had a graduate school education, prior to medical school. I had a young anesthesiologist teach me about pain control. Peter Pan was his name! Anyway, what I learned through casual acquaintance and the treatment of a fellow anesthesiologist, of Dr Pan’s, set me up for a rewarding and very successful practice treating people in chronic pain..(until the “experts” got me). He and I treated his phantom pain with great success and he survived ten years after that pain free! Sadly, the Academy that the anesthesiologists set up denied recognition of my very complete education. Most anesthesiologists “grandfathered” in! Compassion and being better educated than 90% of my “colleagues” proved to be detrimental to my patients, who were the real losers in the end. I have cauda equina syndrome from a spinal cord injury that resulted in a very similar case to your adhesive arachnoiditis. I, ironically, suffer at the hands of physicians afraid to adequately treat the chronic tingling “neuropathy” that I have in my left foot. I get a good nights sleep every couple of nights interspersed with unnerving tingling that keeps me wake for a couple of days at a time.

  21. Claire at 8:12 am

    Shame on you for punishing sick, disabled people! Some people get hurt or have a painful disease and they will NEVER get better. But punishing them because other people want to break the law makes no sense. This is CRUEL! SHAME ON YOU!

  22. Kel b at 11:15 pm

    Dr Langley, thank you for your response!
    To Joyce, to say ” the chronic pain person will become addicted” is like saying “the person who drinks alcohol will become an alcoholic”. 1% of patients become addicted.
    Patients need to be RESPONSIBLE and ACCOUNTABLE!!!
    Kolondy- you are going to be responsible for all the suicides! If pain patients are so addicted and dieing why are there so many??? If so many have been treated for so long, 10, 20, 30 years; how is it they are still alive?? Could it be they actually took their meds as directed? Could it be the meds actually took enough pain away that they’d managed to work, have and care for their families? Which is all any of them ever wanted!!! Big difference between prescription doses and street doses. Go after the drug dealers and do everyone a favor.

  23. cynthia o at 8:57 pm

    Kolodny’s view is that only two situations warrant use of pain meds: terminal illness and post-surgery (temporary)…..why would we even talk to this fool? He is causing unspeakable suffering throughout the nation. he is sadistic.

  24. Lisa Hess at 4:04 pm

    It is status quo of Koldony. He didn’t like Suzanne Stewart’s write-up. He is used to getting what he wants and once he gets it, he’s done. I’m sure that is exactly what happened here and I heavily doubt you will ever get an article from him unless someone else writes another article against him, then he will come back for retraction. He’s molded to a devil who doesn’t give a damn about anyone but himself and his pocket.

  25. Suzanne B. Stewart at 3:38 pm

    What Ed is saying is spot on exact! I know in my heart, that some of what I had originally written are Kolodny’s “opinions”, we all are aware of those; because he’s proven his opinions over and over again to all of us. But it’s true, there were two issues to which I could not find an exact citation. I rewrote the article with citations down to the details. This time there was no reaction from him? The fact that he thinks Intractable and/or chronic pain patients should be able to be ok with Tylenol or Ibuprofen is just laughable. It reads on the bottle of Tylenol “for minor aches and pains”. Obviously Andrew Kolodny, Psychiatrist; has not ever lived with chronic intractable pain. What’s interesting is that he doesn’t treat Chronic pain either!
    How is he able to dictate what happens to the chronic pain patients?
    What I find also odd, in a way, is that he thought what I wrote was “unfair”? What about what he’s doing to a large number of chronic pain patients? I want to scream that it is UNFAIR that he is responsible for the rise in suicides due to the immediate drop or quick tapering of our pain communities medications that are & have/had been used as directed and reasonably. He has our communities deaths from suicide on his conscience, on his hands. He is lying to the people, tugging at unknowing, good peoples heartstrings, so to speak. By telling them that these medicines are killing people and they are dangerous etc.; he is getting many of these people side with him! They are only “dangerous” if misused or taken improperly, just like anything else! Water is dangerous and you can die if you drink too much!
    The Dictionary’s definition of “enemy” is = a person who is actively opposed or hostile to someone or something. Also it states that “enemy” is a thing that harms or weakens something else. Well, Andrew Kolodny M.D., may harm us and we may die due to suicide or increase BP and HR from higher pain levels; because of his opinions. This is on his conscience as well. But he will never weaken the strength of compassion and endurance in the chronic pain community of the USA.
    What I don’t understand is why can’t the government officials see through him?
    Why don’t they see him trying to have “saving the addicts” (certainly not saving the chronic pain patients) as being his claim to “fame”? Why can’t anyone else see that he owns treatments centers with a “revolving door” policy and he makes a ton of money off these poor people? He tries to tug at the heartstrings of those who have lost loved ones to addiction. Chronic pain management and addiction management are two different areas. Those who have lost someone want all Opioids gone now, because someone that they love has passed away due to addiction and /or the misuse of opioids. That’s horrible and terrible and unimaginable to say the least. But Well, now we, the chronic pain community are losing people daily; due to the quick tapering and abrupt ending of opioid treatment to chronic pain patients. Chronic pain can kill as stated in the National pain report article from June 20, 2017. The terrible true fact is that Opioids don’t kill people any more than guns kill people? If you misuse either of them, you can die. If you don’t follow the instructions of a legitimate pain management physician; (*who went to school for many years longer than Andrew Kolodny, to learn specifically about how to manage chronic pain), then you have a higher chance of dying from overdose. One can overdose on insulin that they have in their home for Diabetes. Just as someone on High blood pressure meds, anti-depressants and other medications can overdose if they misuse their medications. We are not children and if we are responsible adults who are doing well on opioid therapy and do not get high, do not ask for more, are not groggy or foggy from the medications, and we don’t take more or less than prescribed; then we should have a right to live our lives in as little pain as possible!
    They need to totally get rid of the CDC guidelines start over from the beginning. They need to do so with educated pain management physicians and not PROP and /or treatment center owners who stand to make money from the drop in pain medications. This entire conversation has the pain community afraid, panicked and in more pain because of their fear of living in pain or dying because they cannot live with it.
    It seems to me that Andrew Kolodny will not write in this blog because he knows that Ed Coghlan is an upstanding publisher. He doesn’t allow people to use propaganda or say things that cannot be proven. This Health News magazine has a great reputation and that is because many peoples voices are allowed to be heard. Ed offered Andrew Kolodny to have his voice heard here, in this venue. But that won’t happen because here, he is the “enemy” and not the “star”. These are only my own private views.

  26. Cat at 3:29 pm

    I think his response (or lack thereof) is indicative of what he plans to replace opioids with for legitimate chronic pain patients. Nothing. That is of no concern to those who are legislating our medical care. But you can rest assured they and their family members will never be deprived of any type of care they need, including opioids.

  27. Alan Edwards at 2:28 pm

    Mr. Kolodny has not been in chronic pain for decades. Not severe pain. He offers no help to cancer patients either. He needs real brutal pain that lasts forever to change his mind. Opioid epidemic? Where? How many have died taking horrible opioids for chronic pain in my part of VA in the last 20 years? NoneOnly 1 in 38,000 go that route and they are criminals. Many writers on NPR and doctors should be banned or lose medical licences. Torturing pain patients with severe illnesses, and cancer patients is UnGodly and wrong. But who believes in God nowadays? God who created opioids with the same molecular structure as endorphins in our brain. I never expect to get published.

  28. Patricia Booth at 2:20 pm

    Tim Mason, Your comment on being board certified in Pain Management, brought up something that has been on my mind.. A lot. I won’t even comment about Klonody… we all know he is worthless, to us. I recently had Four months, to locate a new “Pain Management” physician or Clinic. I will say that I too suffer from Adehisive Arachnoiditis, Clumped Caudia Equine nerves, and a ton of other painful spinal issues. I have been on high doses of opioid since 1994. I went through a list of over 105 doctors listed under “Pain Management” … all of course turned out to be ANESTHESIOLOGISTS. Only 3 out of the list considered prescribing opioid. Of those 3 none would accept me as a patient. Well, one would, but would taper me in ONE MONTH to CDC guidelines. I eventually found a pain management Dr. But, the point is how can all these ANESTHESIOLOGISTS advertise as pain management, when they do not receive the traing? Sorry, I know I am off topic here.

  29. Don Davis at 12:16 pm

    Kolodny is one of the main enemies of the chronic pain patient.Physical addiction largely
    goes away in 72-96 hours. Chronic pain can and often does last a lifetime!

  30. HJ at 12:00 pm

    Dr. Langley,
    I’m so very sorry. Pain patients ARE volatile. Chronic pain is cruel because it turns into a cycle of pain interrupting sleep which heightens pain, which interrupts sleep which feeds depression. Dr. Kolodny ignores the vulnerability of the population, which you sadly are aware of and empathetic to. I am glad you shared this story and I can’t begin to imagine your pain. Thank you for fighting with us. Please keep lending your voice and your experience.

    I am fighting for my mother, too, who is in far worse pain than myself. None of us need the kind of stress and fear that the current anti-opiod rhetoric is bringing about. Dr. Kolodny has no conception of suffering or empathy.

    Again, I’m sorry that this happened. So much is so broken, so we have to fight. Your efforts are deeply appreciated and desperately needed.

  31. HJ at 11:45 am

    He should be willing to talk to the chronic pain patients. He also pledged to “Do No Harm.” He is allowing the misconception that addicts and chronic pain patients are one-in-the-same and thus, he absolutely fails to help either by not clarifying the needs of each subset. Harm *IS* done when opiod users who have improved quality of life and who are NOT abusing their medications are forced to discontinue those medications.

    He should speak to the populations that his assertions affect. He is no expert if he only values his own output while denying any input.

    There is a brand of medicine that I’ve encountered that takes a view that the patient knows nothing of their plight, that the experience of the patient has no value, that doctors should make all the decisions “in the patient’s ‘best interests.'” In my view, even dogs would get better treatment because a vet would listen for a whimper of pain.

    It flies in the face of the collaborative, holistic view of medicine that I thought was emphasized and valued in today’s world. We are are nameless, faceless non-beings and it does not matter if our quality of life is damaged, if we can no longer work, if we can’t give of our selves in personal relationships. We are non-people… and will get worse care and less regard than animals.

    I personally challenge Dr. Andrew Kolodny to share his views and address how pain patients who do not abuse their medications should “adjust” to not being productive members of society, to not being able to participate in family life, to not be able to engage in activities that give meaning to their lives — and how they are meant to carry on despite such a profound sense of loss. What does he think the chronic pain patient experience is like? What does it mean to him?

  32. Neldine Ludwigson at 11:32 am

    Silence, the biggest killer of all. Silence from every politician written to, silence as the answer to any questions as to how to survive without the narcotics that made life semi bearable. I truly despise the word OPIOID, and once it was physical dependence for pain patients, now all addicts, and therefore, JUNKIES. Sad way to go. Every internet and real life troll is free to label and mock us. How humane.

  33. Renee E Mace at 11:25 am

    Ask him if ever in his life did he have to sign a contract with his state when taking a medical prescription from a qualified doctor? Ever one I tell about this says this isn’t the America that I know and love, it’s unconstitutional! I agree but that is my life as a chronic pain sufferer, I go into the clinic every month and get called in to take my pee test, then I sit back out on the hard plastic chairs in the waiting room with a bunch of people in that same boat as myself. Then I get called back to a room to have my pills counted and then I am told, we have to lower your prescriptions even more. I ask, why haven’t I passed all my tests? The answer is yes, but if we do not lower you more no matter how much you are hurting, we will loose our clinic and if you are not happy with this, try to find another doctor, which they and I know isn’t going to happen. So Dr. Kolodny, when is the last time you had to do this? This is insane, we pass our test and still our pain is not treated, just lowered and we are in the same category as a drug addict. I have never abused drugs or alcohol so why then am I as others like me being punished?

  34. Afraid in Canada at 11:06 am

    The bigger problem here is we are afraid to tell our pain specialists & Drs that we know we can’t do it & that we can’t see living with this kind of pain. Why? Well, I’m from Ontario, Canada. The 1st question out of their mouths is do you have any plans to kill yourself? (Yrs ago I tried 3x’s to do so!). I tell them I have no active PLAN I just pray to God at night to please take me in my sleep. This is when I’m medicated but not doing well. So what the he’ll is going to happen when they literally cut my meds in half? I hear all the time of regular Drs getting nervous & just not refilling prescriptions at all! What do they think is gonna happen. Everyone is gonna go through a rough patch & then everything’s all right? We were put on the meds for a reason. I’m not talking about an accident & your supposed to be on for a month & can’t stop, I’m talking about chronic illnesses, that are recognized by the medial community by the way, that are life long. I’m going to be honest here. I live on $1,000 a month, on disability, but have a drug plan so prescribed meds are covered. Every alternative treatment I’ve looked into costs are incredibly high! How are people supposed to be able to pay for those things. Those treatments don’t take away or solve our chronic pain or I would beg, borrow or bleed for them. They are just temporary fixes! So when my meds(which are paid for) are taken away, and we have no money for these other treatments. What options other than living with horrific non stop 24/7 pain do we have but to say good bye. To get back to why we don’t tell our Drs. It’s because they would admit us to a psychiatric hospital & have us drugged & put under watch. Well, to me that’s like being a caged animal! I’m not “thinking of suicide because I need better psych meds but because I can’t live in the pain! So I feel I can’t be truthful & upfront about how I feel for that reason & I know it’s a concern of others even though they might not voice it. I’m not saying if I don’t get my drugs I’m going to kill myself as a promise. I’m fearfully saying that even though I’m a young grandmother of 4 who loves her grandbabies & doesn’t want to leave them, confuse them, but I’m terrified that I will be driven to it by the pain. I already have very little quality of life & a great deal of pain, even on meds. What will I feel when they either cut them in half or take them away cold Turkey? I will end this conversation with these 2 words. “HELP US”!!!

  35. Kim Miller at 10:44 am

    I feel that there’s an obvious reason Kolodny does not reply to your requests from NPR to address chronic pain patients’ concerns when he believes their only truly helpful pain relievers, opioids, should be outlawed. He is not concerned with the plight of pain patients in any way. His only concern is promoting the use of HIS preferred opioid; Suboxone.

    When Kolodny asked for examples on Twitter of people being harmed from abrupt tapering or sudden stoppage of opioid medications, I noticed our responses were being muted. People sent numerous responses to HIS REQUEST for examples, but he apparently did not want these responses showing up on his Twitter feed, so they didn’t. I saw a handful, but my Twitter account was busting with retweeted examples.

    How else do you explain this, other than he wants it to appear as though he cares, but his apathy knows no bounds.

    Kim Miller
    Dir of Advocacy, Kentuckiana Fibromyalgia Support Group
    US Pain Foundation Ambassador

  36. Bob Schubring at 10:41 am

    In the aftermath of the Civil War, hundreds of thousands of wounded survivors needed pain relief in order to function. This created a shortage of the drug Laudanum, made by boiling opium poppies in whiskey and filtering out the plant fiber debris. This poppy product had to be imported from British India or French Indochina and the sellers wanted payment in gold or silver coin.

    American traders who plied the coasts of South America found they could buy with barter, using their US paper currency to finance the barter, the coca-plant leaves from which they made cocaine. Those traders sought to make a profit off the Laudanum shortage by promoting cocaine as a substitute for laudanum. Cocaine, of course, is now known to trigger heart arrhythmia, a condition that’s easily detected with electronic heart monitors. But it would be 50 years before the first cathode-ray tubes made the electrocardiograph possible, and no one in the 1870’s saw evidence of cocaine-induced heart disease. What was known to American doctors, is that their Civil War veteran patients became constipated from taking laudanum, and if they switched to cocaine the constipation cleared up. So the cocaine traders began promoting the idea that their cocaine was a safe, healthful alternative to foreign opium.

    I tell this story because it’s very much like Dr Kolodny’s story. He’s become the victim of his own success, just as were the cocaine promoters of 1870’s America. He has firsthand knowledge of the heroin addiction problem, and since he’s a mental health professional, he’s fully aware of the difficulties an indigent mentally-ill American has, in obtaining treatment for any mental disorder. Poor people find it easier to get illegal drugs at an illegal crack house, than to get treatment from a doctor for what’s making them feel crazy. Fixing that problem, means diverting money away from the nation’s failed Drug War, and instead, using the money to make it easier for people with no money, to buy mental health care from professionals.

    Instead of courageously advocating for that change, Dr Kolodny clings to the Drug War’s language and it’s metaphors. When scientists found, a decade ago, that the opioid drug morphine is made endogenously in the human body where it functions as a metabolism regulation device, ( GT Stefano and R Kream, “Interactive effects of endogenous morphine, nitric oxide, and ethanol on mitochondrial processes”, Arch Med Sci 2010; 6,5 pp. 658-662) instead of altering his thinking about how the mechanism of addiction works, he clung to the previous, failed theories because he could use the language and context of the failed theories, to win an emotional reaction from his listeners. That backward-looking approach, embracing ignorance, guarantees failure.

    Someone needs to make better care of mental health available to this nation’s poor. Until that’s done, poor people will go to crack houses instead of to doctors, and few of them will recover. The backward-looking approach to mental health and addiction, that ignores the pre-existing mental problems the addicts had, before becoming addicted to what the crack house sold them, refuses to acknowledge that the pre-existing condition ever existed. Ignoring it’s existence, leads to the dangerous prediction that a single course of treatment will cure the addict of addiction, and to leave the present Drug War apparatus in place, to prevent a relapse.

    The reality of relapse control is very different. Portugal and Switzerland both have legal heroin available to treat addicts. They’ve found it far cheaper to have the drug available to treat addicts’ cravings, than to hospitalize or jail the addicts for having cravings. Jail space in Portugal and Switzerland is reserved for people who harm other people…regardless of whether ethanol abuse or cocaine abuse or opioid abuse or ordinary meanness was a factor. Neither nation requires a massive surveillance state to enforce it’s drug laws. Teaching addicts that compassionate care is available if they show empathy to their neighbors, and that harming one’s neighbors to get money to buy drugs will result in punishment, is working in Portugal and Switzerland.

    Compassionate care, of course, can not only be dispensed for addicts. It has to be available to the general population for all medical needs. The person who develops a chronic pain because of an injury, requires truthful information about the treatment choices that are available, to give informed consent to treatment. Repeating what was believable to a friendly audience at at Richard Nixon speech in 1974, means maintaining a backward view that rejects all new knowledge about drugs and other therapies for painful illness. It’s even more harmful to apply this philosophy to treating pain, than it is to apply it to treating pre-existing mental illness in addicts.

    Inviting Dr Kolodny to learn from us, is absolutely the right call. He needs to stop looking at the failed theories of the past, and get caught up on what’s being learned in the present.

  37. Kathy Galm at 10:29 am

    Here is a solution!!!
    I am an adult over 18 and can make choices for myself without having anyone tell me what I can and can’t do when it comes to not breaking the law.
    Since contracts seem to be the rage right now, I would gladly sign a waiver that states I know the side effects, I know the possibility of dependency or addiction and even possible death to let them off any guilt trip, legal action etc. It’s my choice to have my pain treated. This would end the concern in every direction. Leave me and my doctor alone…..I have enough to live with everyday of my life without being concerned that some bureaucratic nut wants to tell me to live with my pain when there is a simple solution to this problem. Let’s fight for a new policy. A whole new contract!!!

  38. Kat Koe at 8:57 am

    I don’t understand who Kolondy thinks he is by saying chronic pain patients are addicted to opioids. Every time I see it written that there are millions of patients addicted to prescriptions I get angry because he’s referring to us. If he is so educated, as he claims to be and is on all these committees and has swayed all these people, then why doesn’t he know the difference between addicted and dependent. Why doesn’t he understand that there are serious and excruciating conditions and opioids are the only medication that will bring relief. Why won’t he talk to us, the real sufferers? Why won’t he target the heroin and fentanyl users? Are we easier targets? We need to let him know about every pain patient suicide, every patient surgical pain nightmare, every pain patient excruciating story!

  39. Danny Elliott at 8:49 am

    Dr. Kolodny’s name is highlighted when he’s first mentioned in this post. By clicking on it, I was able to get his email address. So, I wrote him a little letter and, while respectful, said to him the things I’ve wanted to say since he appeared on the scene. I hope others will do the same. It may be our only chance.

  40. Intractable Pain Person at 8:29 am

    Joyce, not all pain patients “will become addicted”. Most recent statistics tell us the number is 8-10%. Yes, we are probably all dependent, but not addicted.

  41. Rick at 8:29 am

    Listen, I think we are overlooking the morale to this story,…

    SUZANNE got thru to the head of the snake! How awesome is that??? Great work Ed for facilitating this advancement.

    Now we need a strategy to press on.

    We CANT allow this state sponsored ‘torture’ to go any further. What about growing a coalition of physicians to strengthen our credibility, like Michael.

    Keep pushing! & many thanks to everyone lobbying for justice for pain.

  42. F.S.T. at 8:25 am

    I have but one thing to say to “Doctor” Kolodny:
    Just as one might be worried about alcohol, one shouldn’t drink.
    If one is concerned about the opioid “epidemic,” one shouldn’t take them.
    Now leave the rest of us alone.

  43. nana at 7:36 am

    …I’m not trying to throw pain patients under the bus, ..”. What is he trying to do then?

    tilted reports, vague information that CANNOT BE VERIFIED, studies data mined from sources without all the information included..

    just opioids are/were/will be… without supporting data like WHICH OPIOID.. HEROIN? ILLEGAL FENTANYL? what other symptoms presented with these data mined patients? Does the state being touted in the media support this data on their own website? Current? (not 4 years ago but last year when opioid problems were lower than the previous 10 years)

    Of the opioid deaths, some same questions.. when they came into the hospital with opioid problems.. were they in pain and needed pain relief? Were they having a (very painful) heart attack? Appendicitis? Or were they all.. “another patient with too much opioid in them?”

    (I would doubt the later, not all of them reported)

    It is easy to skew a report to share your belief. Not so easy to justify, get accurate reports, verify information the last minute before sending in results.

    Do you all realize these reports are maybe 20 to 40 patients? Easy to get bad information when the population is so large and (paid) studies look at so few patients then se an algorithm.

  44. Maureen Muck at 7:17 am

    Dear Ed, I give you props for reaching out to Dr Kolodny. If there is ever a chance people will open their minds to chronic pain, we must at least reach out to the naysayers. Disappointing if expected response.

  45. Carla Cheshire at 7:05 am

    I’d love to hear what Kolodny recommends for chronic pain patients who are prescribed opioids as nothing else works to ease their pain. Seems he is ducking that issue as well as seeing the drug as the problem not those who abuse it. Kind of reminds me of the Republicans and their 7 years of voting to abolish the Affordable Care Act yet they had nothing to replace it with and gee it looks like they hadn’t thought about the consequences of their actions at all. Makes me wonder why these people are leading anything.

  46. StevefromMA at 6:38 am

    How can you trust Dr. Kolodny, who obviously just has a political agenda to further his own needs but has no concern for people.

  47. Dave at 6:35 am

    Im not surprised Dr Kolodny has not presented a blog.
    I think it will be hard for him to justify to readers of npr that he is genuinely concerned about the overall wellbeing of people in pain for his focus has been for people in pain to avoid addiction to opioids regardless of how that effects their symptom burden treatment burden disease burden or experiential wellbeing. He seems to have ignored patients autonomy and principilism of medical ethics. He seems to believe a key purpose of pain care is to avoid addiction regardless of how it effects real live people in pain. In this regard i think it is hard for him to claim he is not an extremist.
    But kolodny just like Portenoy cant be solely blamed for the hysteria and cruel extremism in opioid care. Too many doctors and government officials were careless as well.
    Time will tell if Kolodny will become more thoughtful and caring toward people in pain.
    But i think now people in pain realize the need to organize and counter the cruel fascism and fascists who believe society and people in pain must obey them despite the them lacking caring and respect for individual choice and natural rights.

  48. Joyce Noel at 5:54 am

    Unfortunately unless you live with pain or have lived with someone in pain, you have NO idea what you are talking about. Yes opiods are addictive. Yes the peraon in chronic pain will become addicted. I invite youbto visit my husband. At 53 he looks 70 because the pain lines are permanently in his face. To take his meds away would put him over the edge and he would kill himself. I know this for a fact. I would then in essence sue the doctors and big Pharma for murder , wrongful death and anything else I can think of.

  49. Matt Smith at 5:51 am

    Andrew Kolodny doesn’t care about pain patients outside of the revenue that he views them as for addiction treatment centers and suboxone…. If his work on nehalf of PROP, etc., hasn’t made that clear then his lack of response should.

  50. Ibin at 5:17 am

    The total elimination of opioid medications available to patients without any alternative to manage pain would be a worse disaster than the current CDC “guideline” of course. A stance on any issue can not always be “proven” merely with numbers, or statistics. Real harm can be initiated through seemingly goodwill. Any stance on an issue under debate needs to be realized by the affected as well as the unaffected, the bystander. Hesitancy to justify a stance, screams bias. Why the bias if “only” goodwill is intended?

  51. Tim Mason at 5:04 am

    It is better to try and fail than to never have tried at all. In my opinion, to comment on treatment of the chronic pain patient, both cancer pain and non-cancer pain (in my case adhesive arachnoiditis) peer reviewed articles state no difference in that pain intensity, a physician must have a working knowledge of this pain. This knowledge is gained in one of two ways. 1. You either have the pain or 2. You are board certified in pain management.
    Perhaps the reason you are not getting any response is they Andrew Kolodny does not have this experience.
    Again, this is just my opinion. I too would like to know what recognized knowledge base he has as well as the millions of viewers of the media outlets he used to assassinate the character and treatment of a large part of our society.
    Most importantly, the family members of those whose lives were cut short by
    lack of access. to needed medications are owed an explanation thru the same organ of communication he used to speak before. National Television.

  52. Person with intractable pain at 4:47 am

    Klodney has no rebuttal in the face of these facts, hence the silence. Great article Suzanne.

  53. Rita KIMBEL at 4:28 am

    That’s what I expected, every letter I’ve written to my local and state representatives has gone unanswered. I’m sharing how I live with constant pain and how the change in Opiate regulations has affected me and my family. Not one reply, none. I ask what they can do for me and that I would like a reply. All I can do is not vote when it comes time for their name to be on the ballot, that’s not solving anything and doesn’t satisfy me. I think it’s fear of being caught agreeing with an opiate user, my oh my, they want us to just die from pain related conditions rather than allow us our medication.

  54. Eileen at 3:37 am

    Just follow the $ trail, addiction is their way to it, as you well know Ed. Pe sonally I believe that is all he cares about the $ & making a name 4 himself. There is knw way I would ever take his suboxone as this is supposedly 4 addicts. Just like most ppl I want to live a good life & being made semi comfortable has in the past afforded this. Presently am suffering on a taper but I am on a mission to find a good doctor who will take care of all of me as I feel they are out there. Tx u for all you do Ed.👏

  55. Michael G Langley, MD at 3:31 am

    you won’t hear from his arrogant…! He is unwilling that he is responsible for the many unneeded suicides that he, and his ilk, have driven people, in poorly treated pain conditions to resort to. They don’t wish to acknowledge that the 1% addiction rate, among suffering chronic pain patients, is a better trade off than the 100% death rate of suicide. His promotion of the drug war comes out of refusal to see that the actual statistics don’t support his war on patients. The tenant of “do no harm” seems not to be applied to us pain patients. I suffered emotionally, from my refusal of treatment, of an elderly chronic pain patient, when he killed himself. It happened just prior to his son’s high school graduation. The patient tapered off fine. But, when the pain had kept him awake, for three nights, he did not live through another one. For the life of me, I can’t understand the reasoning. It is better to prevent addiction…a treatable problem, than to force his patients, who depend on him. into a premature death from a suicide!? That is abuse of his patient’s trust!

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