Anti-Opioid Propaganda and Profit

Anti-Opioid Propaganda and Profit

By: Angelika Byczkowski

I’m sickened by the tone of the anti-opioid lobby these days, which has become aggressively hostile to pain patients.

They present more propaganda than fact and attack pain patients who are legitimately taking opioids for chronic pain. They invent their own truths and blur the line between known facts and biased conjecture. Any dissent is met with hostility.

Their denigration of pain patients has reached a new low with their latest claim by A. Kolodny, leader of the anti-opioid organization, PROP:

“Anyone taking opioids regularly is addicted.”

Whether you are in pain or not is irrelevant, whether you are taking prescription medicine or scoring heroin on the street, whether you are conscientious hard worker, or living by crime, none of that makes any difference; if you take opioids you are an addict, they insist.

They do not believe in the well-known medical condition of dependence independent of addiction. Many other medications cause physical dependence and then withdrawals when they are stopped, but they insist that the same dependence, if on opioids, is addiction.

By unilaterally deciding that tolerance and dependence signify addiction, they find addiction where it simply does not exist (according to modern definitions of addiction and dependence).

Their definition includes literally everyone who takes opioids regularly for any reason whatsoever, creating a vast (and inappropriate) market for their services. Yet, if we refute their biased judgment, then we’re just in denial about our addiction.

This is the lucrative catch-22 of the recovery industry: Once accused of being an addict, anything you say in your defense is considered denial, which is just more evidence of your presumed addiction.

This biased mindset and dangerous circular reasoning is used by the groups that have been guiding our country’s opioid policies. (See PROP conflict of interest in Phoenix House rehabs)

Let us not forget how much money the recovery industry stands to earn if every pain patient is forced into a “recovery program” for addiction.

Despite their long history, addiction recovery programs based on the ubiquitous 12-step model are almost criminally ineffective (less than 20% success), so the vast majority of patients must return to them (and pay for them) repeatedly.

Unlike any other healthcare services, the additional profit generated by repeated failures creates a perverse incentive against improvements.

At the same time, drug courts are still forcing people into these unscientific, ineffective, semi-religious programs. While this seems a clear violation of the separation of church and state, the recovery industry has lobbied heavily to keep this ridiculous status quo in place.

So this industry is being handed an endless stream of customers by the government, the medical system, and our cultural misconceptions of addiction.

Anyone even spuriously accused of being an addict gets caught in the airtight dogma of recovery (your denial of being addicted is a sign of your addiction) and, instead of receiving proper treatment, they are placed at the mercy of an industry that is not regulated or controlled by anyone other than itself.

With the help of grieving parents, politicians, well-financed special interest groups, and even our government, the recovery industry has created a modern-day gold rush by exploiting the misery of pain patients.

Some percentage of human beings will always suffer life-limiting extreme or prolonged pain and opioids will always be necessary, so our prohibitionist policies regarding opioid pain medications have created a lucrative business model that cannot fail.

(See The Opioid Treatment Business Is Booming)

Angelika ByczkowskiAbout the Author: Until she was disabled by progressive pain and fatigue from Ehlers-Danlos Syndrome and Fibromyalgia, Angelika was a high tech IT maven at Apple and Yahoo. She lives in a rustic cabin in the redwood forests of the Santa Cruz Mountains just up the hill from Silicon Valley with her husband and various 4-legged kids. She spends her limited energy researching and blogging about Chronic Pain, EDS, Fibromyalgia, and healthcare issues at http://EDSinfo.wordpress.com and tweets as @ZypCzyk

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Jean Price

Marianne….I don’t get all this bit about pharmaceutical lies….fifty years ago in nursing school we were teaching that opioids could be addictive, and used by addicts for obviously different outcomes than pain control! So…what was the lie about? Then when hospice became active and in vogue in our country, a lot of patients were on huge doses of narcotics to curb their pain to help them obtain maximum relief. They didn’t overdose or become addicted, because they WERE TAKING IT FOR PAIN, their pain was moderate to severe. Pain “eats up” side effects and any issue of addiction. That’s a fact. When you take pain medication for pain…addiction is a non issue. When you take pain medication to escape reality or get high, well THEN you’ve already got a problem. The goal of an addict is totally opposite the goal for someone in pain….so people in pain don’t become addicted to a high. They DO get used to moving about with less pain and functioning more, and they do have CHEMICAL changes FROM CONSISTENT USE…LIKE MOST ANY MEDICINE, so no different than say my cardiac med…I’d need to taper it if I stopped it. Through the ages there have always been those who bought into the hype of a witch hunt mentality for one reason or another…and that’s just what this is!! Its not logical, not good medicine, and it’s hard to fight with logic because it’s illogical. It isn’t even about pain or opioids…it’s about money, and the people who are addicted to money are powerful!! But rest assured, people who take medication for pain ARE NOT addicted!! They don’t crave it, lie for it, steal it, overdose on it, kill for it, or abuse it in any way. Life is too precious to those who have lived in pain…once they find something to help lessen the pain, they can function again and that’s all they wanted to do in the first place. Be careful what you judge….I’ve lived long enough to realize you usually BECOME it!! And I’d hate seeing anyone in pain, even those who have chosen to pursue the absurdity of the new opioid farce!!

Richard Oberg M.D.

How about we just say this: Perez’s conclusions are remarkably ignorant but there’s a lot of those going around these days. What a surprise! Stupid statements don’t require a shred of truth anymore – all you have to do is say they’re so!!.

D

Good ole Marianne Skolek Perez is a reporter who is making her living off the overdose hype. They know not of the real pain they are causing. They never advocate for those who truly suffer real pain. Scott we understand, no one needs to explain to us the different between dependence and addiction. They don’t understand that having good health is having everything because they already have it. They are not ill, trying to get better. They don’t live a tormented life, where every decision is dictated by pain; a symptom of horrendous disease that will one day be the cause of our death. Your answer Marianne is: Oh, sorry the disease you have is not called cancer, so you must suffer. Who are you Marianne, nobody that’s who? You know nothing!

scott michaels

hey marianne, lets just say you are ignorant. your knowledge of how addiction works and the difference between Dependence and addiction are 2 different things. People that use medicine recreationally then become hooked or take alot more then prescribed are addicts. they will generally use anything for a high. We are dependent on this medicine for only 1 reason , to relieve pain. We dont get high, we are not knuckleheads that get loaded and then die.
people like you have uninformed opinions. Imagine you had a botched surgery that causes pain for life, Harsh Nasty pain. You are denied any pain medication, it gets so bad you search the streets and buy a bootleg illegal pain pill or heroin just to relieve the pain and it back fires on you and you get very sick and become a raging addict. Then you will know the difference.

How about we just say this – “If you are using opioids long term, you are an addict? Truth hurts, but you cannot do without your opioids. Pharma lied and you are now a victim or as you like to call others “a junkie.”

Jean Price

It’s almost impossible to fight an illogical mindset with logic!! And there you see what’s happening! Of course when we speak out we are labeled as addicts wanting our drugs under their definition! It’s illogical, senseless, and cruel! And who comes to our aid?! Us, and mostly no one else but a few compassionate souls! Where does this end, I wonder?

L. Merlin

I’m also tired of people saying to not blame the doctors. It’s like the hearing “they’re” just following orders.

L. Merlin

I’m so sick and tired of people saying it’s about profit. It’s just a “system” to shift responsibility from the perp to the money. A patsy of an excuse. If someone is willing to leave you in pain for the money, how is it not the same as leaving you in pain for fun? Either senario is a case of being indifferent to your pain, which is psychopathic, wich is what nearly all doctors are. Even if it was for the money, that would be worse than no reason at all. A hitman who murders for money or for fun is still a murderer. A person who leaves you in pain is the same as putting someone in pain. By not giving pain relief, leaving you in pain, and the doctor doesn’t doesn’t know what they’re doing? They all know what they’re doing…from the top down.

To: Scott Michaels,

Fantastic post! It amazes me how the general public is so myopic when it comes to this subject. Doctors and hospitals on the other hand know exactly the harm they are causing. A hospital group in my area had decided to eliminate opioids completely including surgery. They have had to change their position because their legal department advised them that they were breaking EMTALA (Emergency Medical Treatment and Active Labor Act).

Hospitals have also been advised that the Medicare Survey will not score negatively if patients comment on pain medication. This of course is fundamental as to the level of government reimbursements if scored below an 8. On a 1 to 10 point scale, 1 to 8 is entirely negative. A hospital must score 9 or 10 to register as a positive. Talk about a rigged game?

The streets are literally covered with Heroin dealers. Looking for an analogy, I told my wife it was like noticing the cocktail table had dust on it. Immediately gabbing a rag with furniture polish to clean it all the while the entire house is on fire.

scott michaels

i spoke with a very high ranking doctor at kaiser permanente today.
We spoke of the guidelines. His specialty is orthopedics. He said its a terrible shame that the govt is involved in the medical profession. Although he disagrees with the whole thing, he is afraid if a democrate wins the presidency it will get much worse.
It is no secret they are in the pockets of insurance companies and rehab clinics. He said heroin and other illegal opioid drugs are gaining speed and believes that drug cartels are funding the democrates and oushing for stronger guidelines in order to grow their business.
The police will stop enforcing drug laws for fear of reprisals from the gangs.
Better vote for trump whether you.like him or not. Besides that Pence is the only gove or that is putting pain patients first and demanding doctors continue to help their patients.

Miss M

Many people are willing to post their complaints on here why are people not posting their reviews under these Doctors,surgeons,and pain specialist that no longer want to treat legit proven patients in pain that have the medical records to support their need ..
http://www.nytimes.com/2011/11/08/health/patients-grades-to-affect-hospitals-medicare-reimbursements.html?_r=0
I know I filled our my review for rating care I got after surgery and I was truthful and honest where I had my surgery No I would never recommend a dog to have care there the outside of the hospital is all brand new and nice but inside I had lived a nightmare before and after surgery
so contact Medicare if you have it and are not having any sort of quality of life

Once again, please forgive my typos. It’s 2:45am and my pain is once again preventing me from sleeping. I need an edit option.

The government, more corrupt than the Weimar Republic was prior to Adolf Hitler becoming Chancellor of Germany, is deliberately allowing Heroin and counterfeit opiate prescription pills to proliferate, creating this sense of crisis throughout the country.
I live in a very small rural area at the tip of the thumb of Michigan. I decided to retire there because it was on the water, quite, like going back 40 years in time where my car is the only one on the road (only 900 residents in the whole township). We have had 3 major Heroin dealers busted in here in Mayberry R.F.D.
this year alone. Some of my friends in law enforcement tell me that they are selling grams of amazingly pure black tar Heroin for $25 – $35. IF IT’S HERE, IT’S EVERYWHERE!
In Canada where my family is from, there was an alert for people to be on the lookout for counterfeit Oxycodone pills that actually contain a gram of Fentanyl.

Why do you ask is this happening? Well because all opiate pain killers are now Generic. Big Pharma isn’t making any money on Generics, so because of their huge lobby in Washington, they have bought off a nice chunk of the 535 members of Congress to do their bidding.

Think of it…. A brand new market of potentially 80 – 100 million customers. Instead of a prescription cost .10 cents a pill, they can create a new one that will cost $20 instead. Time to reinvent the wheel. That’s why you are hearing of new meds being created to replace the scourge of society. No not Marijuana, that was 1936 with the propaganda movie “Refer Madness”. Funny how they called it far worse than Heroin.

Big Pharma just released a cure for Hepatitis “C”. That’s right, but the cost is $700 a dose and the full course of treatment will cost $60,000. The only problem according to the Windsor Star is Insurance companies will not cover it. Much more profit involved in maintenance drugs over the course of 10 -15 years. Who cares about your liver going to Hades.

As for the pain treatment centers, my wife who works in the industry told me last week that some of the injections cost upwards of $7,000 and they don’t work for many of us. At best they are only temporary.

THIS IS BIG BUSINESS FOLKS!!!! And we are the pawns on the chess board of ObamaCare. Remember, there are no death panels. It’s just a conservative lie.

If it sounds like I’m angry, you are very intuitive.

steve

thank you for the truth. in church it seems even worse if they find out. i have no choice unless i want to lay in bed and cry. im a67 year old man and i need oxy to function. bless you.

Trudy Hill

My DR just told me he sees the federal government pushing people to medical marijuana and away from opiates simply due to the fact it is a brand new source of revenue. I live in AZ, I guess it is legal here , he says they have given him an easy computerized form and all he has to do is click. They have a list so he can prescribe it for ANYTHING under the sun.

bohica

Thank you very much for your article, Ms. Byczkowski, your post should be forwarded to every doctor, medical group and politician in the country who is involved in making the decisions that are destroying our lives.

I happened across this broadcast today and thought it may be of some interest to the community.
The investigation by this journalist does seem to illustrate a facet of the political and financial tug of war we all seem to be caught up in. From the article, he doesn’t seem to have very much perspective from pain patients so far, and appears mostly concerned with finding dirt on Big Pharma… that’s all well and good because the whole system as it is now is filthy and corrupt, but hearing this makes me even more uneasy, because I can’t help the feeling we’re about to get screwed again.

Lee Fong article and interview:
https://theintercept.com/2016/05/31/congress-boosts-rehab-but-gives-opioid-pushers-a-pass/

http://archive.kpfk.org/mp3/kpfk_160613_053001counterspin.MP3
direct link to audio
(the topic of interest brgins approx 10 minutes into the broadcast)

Lee Fong article and interview:
https://theintercept.com/2016/05/31/congress-boosts-rehab-but-gives-opioid-pushers-a-pass/

http://archive.kpfk.org/mp3/kpfk_160613_053001counterspin.MP3
(the topic of interest brgins approx 10 minutes into the broadcast)

oh, and as long as I’m posting the above links, I was just reading this the other day also:
https://www.reddit.com/r/news/duplicates/4nidwx/dea_wants_inside_your_medical_records_to_fight/

Heather

Thanks for your comment as it means alot to see some physicians in here backing patients in REAL PAIN, who SUFFER DAILY. I believe alot of Drs. are not speaking up because they are just sick and tired of the nonsense and the new ones are going to be what we have to deal with with unfortunately. I call them the “New Generation” as they are being taught and dictated in school as to the government way and the new CDC, FDA, DEA, and pharmaceutical ways not how to truly treat a patient. My pain Dr once said as he has been in the field for 30 plus years I’m not worried about any of them I do my drug screens and will practice as I always have and will treat my patients no matter what, they will not SUFFER because someone making some crazy law. It is all about documentation my friends. And he has been nothing but good to me and treated me with respect and dignity. As for some of the other Drs I can’t say the same, especially ERs they are the worse. Yes I know they are all about acute care but we go in with symptom to and the first thing they look at is our med list and discharge you. NO testing at all. And this has happened to me several times as my husband has had to carry me in unable to walk and they did absolutely nothing and wouldn’t even let us use a wheelchair to leave as he carried me back out. As a nurse this is disgusting, inhuman, and neglectful practice. I immediately filed a complaint and called my pcp as it was a weekend and he is the one who told me to go and he called that Dr and had a few words with him and wanted me to go but I chose not to for fear of retaliation or they will just immediately say we are not here to give you any pain medication. I’ve told them several times. I don’t need your paim medication, I’m not here for that, I have a problem that needs to be addressed. They always continue to carry on about it. But I stand up for myself and speak the truth back to them not saying I’m a nurse until it unless I absolutely need to. Bit itbshouldnt be this way. Florida is the worst. We recently had a lady due as she went on as a chronic sufferer and they didn’t want to listen to her that something was wrong amdnshe refused to leave when they discharged her so they called security and the police and had her escorted out in handcuffs amdnshe got into the parking lot SOB and told them and fell out they told her and yelled get up thinking she was playing and she died of a PE a sooo. This goes to show what is going on and there is more but just 1… Read more »

Teresa C

Right on point with this article. Money IS the reason for policies in the USA, it sure isn’t because the facts support any new ones made. Or heck, the old ones for that matter. Y’all know how excited I was to finally find a pain doc? I still am BUT…………….you just knew there was a but didn’t ya? The belief of this clinic is the CDC guidelines are spot on. My mama said my face was a picture of ‘What the h*ll?’. I attempted to educate and then decided to shut the h*ll up before I lost my only hope for a life again. I am continually shocked by the kool-aid drinking public who accept and believe what ever is said the loudest is fact. Christ, this isn’t rocket science! If it was at least then there would be some level of supposed intelligence involved in the decisions.

Therese

Thanks Matt. You also sum it up pretty well yourself, “The corruption is impossible to comprehend.” This is all so very wrong …

Valiant

All the effort used to write these well articulated and lengthy comments could be much more well spent speaking out to your representatives.
Don’t just sit there — raise your voice! Every time we speak with a legislator, their first request is for a patient story to illustrate how badly further patient protections are needed. Any experience you may have had — medical debt, costs, access to drugs or clinical trials, or just the everyday troubles of dealing with a medical condition– are an important part of explaining that need. Don’t discount the importance of your experience! Sharing your story may be the single most important and far-reaching thing you can do to help patients nationwide.
http://www.npaf.org/npaf/app/share-your-story?1&engagementId=111993

Absolutely Therese,

Completely agree with your comments. My stress level increases 2 weeks before my next appointment. Stress contributes to pain as all of us know. Many people are disgusted with our military water boarding our enemies? All for money, corruption and control, our government is attempting to privatize millions of citizens from our doctors and herd us into the hands of addiction clinics.

We could eventually end up having to admit that we are addicts, not sufferers of chronic pain. Be branded as such. The corruption is impossible to comprehend.

I found a great article from inside sources. Take a moment and read it. While there is so much to read on the net, this one sums it up nicely.

http://www.insidesources.com/dysfunction-lobbying-and-conflict-of-interest-in-the-debate-over-opioids/

Therese

Yes, prayer!!! Every day I come here searching for answers, trying to determine how best to plead my case at my upcoming pain management appointment, and every day I wind up in tears. It is still weeks away, but I am so distressed I feel I’m on the verge of a nervous breakdown. The mountain of information is overwhelming; the more I read and attempt to add to my arsenal, the more confused I get. Not that I’ll have much say in things anyway. How on earth am I to fight against such a monumental issue that is in no way going to change in time to help me? Prayer.

Tracey – I also thank you for posting the Kolodny interview – amazingly similar to us, indeed.

scott michaels

Nobody stops using ANY DRUG
unless they are done. MORE OBAMA NAIVE STUPIDITY. THROW MONEY AT IT.
THE SUCCESS RATE IS 3%. FOR REHAB CENTERS, UNLESS THEY GIVE YOU SUBOXONE, JUST ANOTHER OPIOID.
WHAT ARE THEY GOING TO DO WITH THE POOR PEOPLE THAT LIVE WITH CHRONIC PAIN WHEN THEIR PAIN RETURNS AND IT WILL IN A BIG WAY

The Internet is flooded with articles about the gold rush boom in addiction centers.
Make no mistake about it, this is designed to take away the ability of doctors to prescribe pain meds and transfer the business to corruption.

Please just read these few articles;

http://commonhealth.wbur.org/2016/03/opioid-treatment-business

https://www.bostonglobe.com/business/2014/04/12/while-heroin-epidemic-rages-bain-seeks-profit-drug-treatment-centers/SVDjqnSOcsZKzhoTm6imKJ/story.html

Jean Price

I’m not sure time is the biggest issue for our physicians not speaking up for those with life limiting pain. Unless you’re talking about time equals money. Even then I think there is something else at play here. There are three main types of care when it comes to the medical care people need. One is the acute care model, where the patient has a medical need, the doctor is the expert and fixes the need, and the patient lives happily ever after. If this care model is used for patients who aren’t fixed, who have continuing medical issues resulting from the original care need….then the doctor was the expert and did what they were supposed to do…so the patient MUST then be considered the problem!! (Very few things in health care fit the acute care model, maybe strep throat or a sutured cut or possibly an appendectomy, if there are no complications or adhesions that result. Unfortunately, many doctors practice acute care routinely and therein lies the problem. The patient is seen as not fixed, and the doctor doesn’t view his skills as lacking, therefore the patient is at fault…., so why would any doctor go out on a limb for them?!). The second type of care model would be rehabilitative, where the patient has a medical need that results in a life long change, the doctor can only fix so much if it and then becomes the teacher who coaches the patient on how to deal with life from here on…since a major health change and life change has occurred. This would be like cardiac care after a heart attack or stent, or kidney disease, diabetes…the type of diagnosis that means whatever was wrong cannot be fixed, but can be lived with. The doctor is responsible for the teaching, coaching, and care needs and the patient is responsible for the learning and changing to accommodate their condition. (Pain care probably also fits more in this category.). The third model is end of life care, like hospice, where the doctor cannot fix or teach the patient so their role becomes one of compassionate care, as a peer…treating the patient as needs arise, and not abandoning them. Also allowing that they are a co-journeyer in this phase, and the patient is, in a sense, in charge. Most physicians weren’t taught other mindsets than the role of expert. So when a patient doesn’t get better, they often can’t switch to the rehabilitative role…and the patient becomes the real problem…regardless of the fact the patient is blameless. This easily allows those in persistent pain to become the problem and any treatment issues they may have become secondary to that fact they have somehow misbehaved and created their own problems. Again, why would any physician speak up for a patient or group of patients that they felt had done this…especially when it was about taking opioids!?! The issue of care models and the inability to shift as needed impacts much of the medical… Read more »

Robert Brown

Richard Oberg M.D. – I suspect the failure of your profession to speak up relates to at least two things, among many. 1) They are too busy working. They are not paid political hacks/activists. 2) If they dare speak to the media, this happens: “A Pain-Drug Champion Has Second Thoughts” (http://www.wsj.com/articles/SB10001424127887324478304578173342657044604)

Tracey,

Thank you for your post and the link you provided.

The convoluted logic Dr. Kolodny pontificates in that article is impossible to reconcile. The hypocrisy is mind boggling.

He is successfully hijacking the use of opioids for his own personal gain.

To receive treatment for chronic pain, we must first submit to being branded as addicts. A submission that becomes part of your permanent medical record.

You are now a slave to the state. What choice will people have?

SUBMIT and be BRANDED AS AN ADDICT

STOP- PROP !! and that corruptIon associated with it. To SUBVERT the MEDICAL COMMUNITY without help from key political help would be impossible.

May God have mercy on all of us with chronic pain.

Tracey

Great article that hits the nail on the head. So Kolodny believes that anyone who takes a prescription opioid on a regular basis is an “addict.” Could someone ask Kolodny why he’s such a hypocrite? Please ask him why it’s okay for him to actively advocate (and prescribe) prescription opioids (Bup and meds with Bup – Suboxone, etc) as a first line treatment for addiction and on a long-term basis to his patients while trying to deny those of us with legitimate physical pain the same access to that same class of medications (opioids, which are specifically to reduce physical pain). The following is an interview that took place back in March 2015 with Kolodny (notice how closely his views on treating addiction with Suboxone – aka bup – aka an opioid – matches how we feel about our medication within the chronic pain community): Kolodny: “I think that the first line of treatment to those addicted to heroin or painkillers is Buprenorphine or Suboxone. We worked very hard to get doctors in New York City trained and able to prescribe Buprenorphine. ” Interviewer question: “Isn’t that something for the short term? I mean do you feel people should be on Suboxone for a long time? Sometimes you hear of people on it for a year or 2 years. Don’t you feel it should be something really used short term and then just tapered off of it?” Dr. Kolodny: “Why would you say that?” Interviewer: “Because then aren’t you substituting one drug for another? I hear of people abusing Suboxone as well.” Dr. Kolodny: “Yes, but how long someone is on it has nothing to do with the abuse of it. There is some diversion. Sometimes it’s not prescribed responsibly. Sometimes a doctor won’t check the urine to make sure the patient is taking it. Some doctors don’t give more than the prescription as if somehow the prescription alone will magically cure addiction . Many people need more than Suboxone unless they are very stable. You do see some people trading it for other drugs and it ends up on the black market. I don’t think you have abuse in the sense that people are getting high from it. If your opioid addicted and taking Suboxone regularly it’s not possible to feel high from Buprenorphine. Some people do need it long term. Once patients come off of it, it’s much harder for them to do well. Once they come off their chances of relapse are greater. For some patients the right decision for them is just to stay on it. Nobody wants to be on a medicine long term. Think of people on medicine for high blood pressure or diabetes. I mean if some diabetics could lose weight or eat properly they might not need their insulin or pills. That is the better way to go, but we would never say “ oh, you are just getting your insulin or pills for 6 months or 8 months and then you’re… Read more »

Richard Oberg M.D.

Michael G Langley, MD – thanks much for the validation and also Jean Price – you both know how ‘the system’ works so well…. or when it doesn’t. I’m disabled from complications secondary to bad psoriatic arthritis and, isn’t it interesting (or again disgusting), how this new paradigm just showed up and became ‘too bad so sad’ for ALL patients. No matter those of us in the profession with long records of fighting to stay in practice partly due to effective long term opioid therapy or frankly anyone in that camp who were doing just fine. I know you know well Michael – if all of medicine were subject to the same level of scrutiny, much of the ‘sanctity’ bestowed upon our profession would evaporate resulting in some very bad outcomes across the board including moral issues no one wants to talk about. Even though prolonging many oncology patient’s lives, chemotherapy also kills large numbers of patients sooner than their malignancy would have and some not – should we stop treating because of that and especially if there’s no chance of cure?

Much like your skills in reading scans, I was an in-house multi-boarded pathologist and occasionally got the ‘you’re not a real doctor’ nonsense (from clinicians) as if my diagnostic skill sets everyone daily depended on (and physicians based treatment from) somehow ‘disqualified’ me from making statements about our profession which was kinda nuts. You’re dead on about politics trumping ‘smarts’ in this society and I’d add even within our medical culture.

I’m always curious about other physician’s takes on what’s going on – why do you think our profession is willing to allow this to be taken away AND watch subsets of patients deteriorate?? I personally couldn’t sleep at night and know many aren’t happy about it yet still aren’t speaking up. What’s happened to you also happened to me and my dermatologist wife with Ehlers-Danlos and POTS yet there seems to be some collective ‘shrug’ from our colleagues – why not some action? Why are we allowing physicians (like Kolodny) with the least rigor in training and practice have any say in this whatsoever? Patients can’t be expected to advocate for themselves and everyone in medicine knows it. I’m really curious what you think and thanks again.

DParker

Opioid prescriptions the past three years — 2013, 2014 and 2015 —have declined. Physicians who prescribed opioids without other treatment modalities have begun to titrate patients doses and adding a multitude of alternatives before the Centers for Disease Control and Prevention (CDC) guidelines were enacted. In a May 20th 2016 article, New York Times reporters Abby Goodnough and Sabrina Tavernise write, “IMS Health, an information firm whose data on prescribing is used throughout the health care industry, found a 12 percent decline in opioid prescriptions nationally since a peak in 2012. Another data company, Symphony Health Solutions, reported a drop of about 18 percent during those years. Opioid prescriptions have fallen in 49 states since 2013, according to IMS, with some of the sharpest decreases coming in West Virginia, the state considered the center of the opioid epidemic, and in Texas and Oklahoma.” Cleary Healthcare Providers have headed the call of overprescribing and have resisted prescribing opioids. One man’s opinions that was instrumental in the creation of the CDCs opioid prescribing guidelines has gone to show his true agenda and proclaimed, “Anyone taking opioids regularly is addicted” regardless of evidence based medical knowledge. Whether you are in pain or not is irrelevant, whether you are taking prescription medicine or scoring heroin on the street, whether you are conscientious hard worker, or living by crime, none of that makes any difference; if you take opioids you are an addict, they insist (Byczkowski, 2016). What is far worse is that the public and the United States Government is listing to Dr. Andrew Kolodny’s agenda and disregarding his conflicts of interest as leader of the anti-opioid organization, PROP (Physicians for Responsible Opioid Prescribing) and the owner/president of Phoenix House Drug Treatment Center (A notional for-profit organization that has treatment center throughout the country), which is systematically spearheading a notional ban on opioids. If long-term pain patients have opioids discontinued too quickly and are not correctly titrated over time, they may seek treatment for dependence, not addiction from drug treatment centers. Hence, if all people who take opioids are addicts’ dependent chronic pain patients will inadvertently seek drug treatment rather than pain treatment (especially if it is unviable), creating a drastically larger consumer base for the addiction industry. This “all are drug addicts” pronouncement feeds Dr. Kolodny’s gravy train agenda with butter milk biscuits wheels; It is absurd that no one is calling attention it. By trade, Dr. Kolodny is an Addictionologists who treats opioid use disorders with some of the same types of opioid medications as pain management doctors use to treat pain. Methadone and Suboxone are both used by Addictionologists and Pain Management Specialists alike, in their medicated treatment arsenal. Yet chronic pain patients are demonized for using opioids to treat their pain and are recommended to use over-the-counter medications, which have their own set of dangerous and sometimes deadly side effects. There is a double standard here and hypocrisy that no one seems to be noticing. There is a national movement… Read more »

Heather

This is a letter a wanted to share from a stand up Dr to his patients with chronic DISORDERS. Please Read A Letter to Patients with Chronic Illness by Dr. Rob Note: The following post from my blog had an incredible response in the chronic pain community and across the web. Clearly this is a very important issue and this letter touched a nerve that has largely been ignored. Dear Patients: You have it very hard, much harder than most people understand. Having sat for 16 years listening to the stories, seeing the tiredness in your eyes, hearing you try to describe the indescribable, I have come to understand that I too can’t understand what your lives are like. How do you answer the question, “how do you feel?” when you’ve forgotten what “normal” feels like? How do you deal with all of the people who think you are exaggerating your pain, your emotions, your fatigue? How do you decide when to believe them or when to trust your own body? How do you cope with living a life that won’t let you forget about your frailty, your limits, your mortality? I can’t imagine. But I do bring something to the table that you may not know. I do have information that you can’t really understand because of your unique perspective, your battered world. There is something that you need to understand that, while it won’t undo your pain, make your fatigue go away, or lift your emotions, it will help you. It’s information without which you bring yourself more pain than you need suffer; it’s a truth that is a key to getting the help you need much easier than you have in the past. It may not seem important, but trust me, it is. You scare doctors. No, I am not talking about the fear of disease, pain, or death. I am not talking about doctors being afraid of the limits of their knowledge. I am talking about your understanding of a fact that everyone else seems to miss, a fact that many doctors hide from: we are normal, fallible people who happen to doctor for a job. We are not special. In fact, many of us are very insecure, wanting to feel the affirmation of people who get better, hearing the praise of those we help. We want to cure disease, to save lives, to be the helping hand, the right person in the right place at the right time. But chronic unsolvable disease stands square in our way. You don’t get better, and it makes many of us frustrated, and it makes some of us mad at you. We don’t want to face things we can’t fix because it shows our limits. We want the miraculous, and you deny us that chance. And since this is the perspective you have when you see doctors, your view of them is quite different. You see us getting frustrated. You see us when we feel like giving up. When… Read more »

Hello Dr. Langley,
It seems you have a unique ability to give us details about the assault on Physicians who receive intimidating letters from the CDC and DEA.
Also, the plethora of new PA’s (Physician Assistants) graduating brain washed with the government propaganda are having a tremendous influence with their doctors.

During one of my regularly scheduled office visits, a newly hired PA at my wife’s hospital while still waiting for her credentials, entered my room and without reviewing a single ounce of my medical history, began to castigate me over my use of Oxycodone. I immediately told her to leave and filed a complaint with the hospital.

As Jean Price so eloquently stated, we need a formidable lobby, one with the influence of, as an example, the National Rifle Association. Every time a lunatic, crazy psychopath commits a heinous crime, all firearm owners are branded as “Gun toting, Bible hugging racists with IQ’s of sub 60 by the enlightened socialist intelligentsia. All the while they have an armed team of body guards.
We desperately need a lobby.

Dr. Langley, you have the unique prospective of being on both sides of the fence.
If someone such as yourself cannot garner sympathy, which of us stand a chance?

Does a list of respected physicians exist that understand and support our position? Can we organize a lobby to fight this insanity on floors of Congress?
Could we solicit individuals to offer an inside, day to day life of a person who suffers to a local newspaper? I have tried myself, but no one was interested in even returning my phone calls.

If this is allowed to continue with no light at the end of the tunnel, we can expect our lives to be shortened by excessive stress to our bodies. God forbid, certainly the suicide rate will roll off the charts.
Bottom line, if we don’t aggressively fight now, our rights will be lost.

Michael G Langley, MD

Can’t add much more than Dr Oberg. I am one of those physicians driven from from pain management. Ironically, I now suffer from post traumatic neuropathy that occurred when I broke my back and damaged my spinal cord in the area of the cauda equina. I am having problems getting enough medication for the pan. They have no problem giving so much gabapentin that it slows my heart. It may have even caused a reversible stroke! But my doctor want s to get tests and consult with neurologists that don’t know what neuropathy is! Sadly, I have more education than my FP and I don’t have much trust in her judgement. She wondered how I could read CT scans and MRI-s as well as a radiologist. After a major in anatomy, in graduate school, with gross anatomy and neuroanatomy, along with reading them, daily, throughout my five year residency, I likely have more education than the radiologists that read them for me! But, I ran into problems with doctors who said “You act like you think you know more than us!” Sadly, it was not acting! I would have been pretty stupid to have not learned more than the doctors with one year internships that went directly into practice. I had double the education they had! But, politics trumps “smarts” in our society.

Jean Price

The statement from our head of the CDC is ludicrous…and sad. If I heard this in the hospital as a nurse, I’d laugh at the stupidity of it! But the saddest thing to me in all of this…our family and friends and yes, even our doctors aren’t speaking up for us! They aren’t telling these witch hunters that we are valuable, viable, family oriented, community oriented, people who do a great job of maintaining a life which is narrowed by the boundaries pain sets for us…yet livable BECAUSE our medications and other therapies help us achieve this!! They aren’t saying our only goal is to function…not take pills and lay in bed or become semi comatose!! They aren’t holding up all that we struggle to do and all that we accomplish because of our muti therapy approach to our pain care, which includes opioids but is not limited to only them!! They aren’t advocating and adding their voices to ours. And you can bet the families and friends who deal with addicts are speaking up about the evils of opioids. And so do other people with “credentials”, regardless of the fact they have their own agendas! Like their doctors, albeit so they can line their pockets! Many people have said WE must speak up, we must write letters, we must get involved…yet seriously when we do this I think we are seen as just addicts wanting our fix…and this does little to prove our point. Like Dr. Oberg said, our physicians aren’t challenging this! Except for a very few special pain management physicians and a few compassionate doctors out there, physicians in general have abandoned us and no longer seem in touch with the reality of pain care! Patient’s views have always taken a back seat to that of the professionals when it came to care needs and treatments. So it is little wonder we aren’t listened to. If those who are creating this bedlam have money as their goal, our goal should be to hurt them in that area, with law suits and lots of negative PR to the general public. I’ve said it before, but it’s worth repeating…we need a nationally known, respected ally to carry our banner and pull some weight with the public…one who also has a large circle of influential people. Or several spokespeople who can champion our cause at the public level and influence those with the power to deny us appropriate care. Maybe we should flood Erin Brokovick with letters asking her to help us in fighting this unjust scenario. Surely there is someone who would understand and would see our dilemma…anyone with common sense could! A single person reaching out to one do these potential advocates has less chance of succeeding than if the approach was made by the Pain Foundation or another organized group. Yet if anyone comes up with a way to reach someone and has the contact information…let me know. I’ll certainly give it a go! I’ve reached out… Read more »

I.Hollis

Absolutely Spot On Angelika!
They are going after the wrong people! Patients and doctors aren’t causing the “opioid epidemic”
The gaslighting of pain patients…damned if you do and damned if you don’t, by so-called “addiction scientists” who are really greedy sociopathic narcissists has got to stop.
It’s so hard to focus on healing and quality of life when you constantly have to defend your life, and if you do then you are guilty! CRAZY MAKING with the twisted logic based on lies and half-truths.

Sara B

Here here. Although I think treatment should be an option for addicts and people withdrawing from medications, my understanding of addiction is that it mostly can’t be cured with abstinence. Addiction comes about when people feel hopeless, and unless they can somehow restore hope in their lives, our modern addiction treatment probably won’t work. (I’m talking about addicts here, not patients). Not that treatment isn’t worth a try.

As for patients, I agree with everything you said. Some people choose to not take opioids and be in pain, and more power to them. I believe we all should have choices. But it’s not a character flaw for those of us who choose opioids to get a little pain relief. I think it should be a last resort, handled very carefully, and that It’s a very imperfect solution, but….. Until NIH or big pharma comes up with something that works, we’re stuck with it. BTW, if NIH and big pharma had invested in alternatives, we may not be where we are today.

Prohibition has never worked. Addicts will find something to be addicted to. There is no upside to the current opioid war. I don’t want doctors prescribing opioids to addicts either (I’d like to think that they serve as a good “gatekeeper” though), but is the current situation accomplishing anything? I don’t think so.

Grrr… This makes me so angry. That’s all I can say. As well as scared. WHAT is going on in the world? What kind of future are we looking at? It’s difficult to get other types of meds as well, not just pain ones. It’s like pulling teeth to get regular stuff as well. It’s like sometimes my doc doens’t want to give me anything. I have to remind her to even write my prescription. She’s a new doc, and probably has hundreds of patients, but geez, look at my chart already.

scott michaels

you are correct. IF YOU OWNED A CHAIN OF DRUG REHAB CENTERS YOU WOULD SAY THE SAME THING AS WOULD I. THE PROBLEM IS, THOSE THAT ARE SUPPOSED TO K OW THE DIFFERENCE ARE JUST SHEEP. THEY ARE LISTENING TO THIS GREEDY PERSON AND HIS COHORTS, WITH NO REGARD FOR FACTS OR TRUTH. THEY ARE NO DIFFERENT THEN A SLEEZY CAR SALESPERSON THAT SAYS THEIR CAR WGICH JUST NEEDS REPAIR IS TOTALLY MESSED UP AND YOU NEED TO BUY ANOTHER. THEY ARE IN THE UNSUCESSFUL BUSINESS OF DRUG REHAB. KOLODNY RUNS A BUSINESS THAT HAS LESS THEN A 3% SUCCESS RATE ON TOP OF IT. THEY BRING PROE IN FOR AS LONG AS THE INSURANCE COMPANY PAYS THEN SENDS THEM BACK OUT ON THE STREETS. HIS OWN COUNSLERS ARE DRUG ADDICTS AS ARE MOST. many of them relapse also.
THE DIFFERENCE IS, 99% OF HIS CLIENTS WERE RECREATIONAL DRUG USERS AND 99% OF CHRONIC PAIN PATIENTS OnlY USE THERE MEDICINE AS DIRECTED. WHEN A REAL PATIENT IS SUDDENLY TAKEN OFF THE MEDICATION, YES THEY GO THRU WITHDRAWLS, BUT THE BI BIG BIG DIFFERENCE IS NOW WE ARE BACK IN SEVERE PAIN AS WELL. RECREATIONAL DRUG USERS ARE JUST FINE AND CAN GO ABOUT THEEIR BUSINESS. WERE NOW STUCK IN BED WITH TREMEBDOUS PAIN AND AGONY.
THATS THE DIFFERENCE AND HE WHO SHOULD BE JAILED FOR STEELING AND TORTURE OF PATIENTS AROUND THE COUNTRY

Kurt WG Matthies

What I’ve find to be most damaging about this orchestrated confusion about the nature of living in pain is the big lie that physicians who treat chronic intractable pain appropriately, with opioid medication, are responsible for the 40,000 deaths a year c associated with opioid use.

Counterfeit fentanyl, long a part of illegal “heroin” and now found in pills being sold on the streets as pharmaceutical medications as OxyContin and Norco, is responsible for many of these overdose deaths.

Yet medical authorities call for reduced treatment of pain and suffering for those who need essential medication after surgery, dental extractions, cancer, and the chronic intractable pain of disease based on inflated mortality rates inaccuratly attributed to the legitimate and essential treatment of pain.

Stop blaming physicians for the failure of a “war on drugs” that funnels tens of billions of tax dollars into bureaucratic agencies who criminalize pain medicine practioners and punish millions of Americans who suffero with the daily intractable pain of chronic disease.

Jeanie

Recently it was reported by Fox News that President Obama has joined the increasing chorus seeking to stop access to opioid pain meds. I have enlisted my family and friends to fight against the government-sanctioned witch hunt against pain patients. It is enough that we must battle our multiple painful diseases, without Big Pharma and the federal government adding additional burden.

Misti M

What a Beautifully written article that describes how people are being treated ,by who and why…… thank God I have a caring MD who does treat me… but he is 1 that leans more toward getting people off.. he lowered my dose and my Blood pressure shot up he said he wanted to wean me off ( this was after guidelines) and I did not say a word my body spoke for me high blood pressure and my MS went into over drive new symptoms and all falling down after a neck surgery that went bad half success half failure my left arm is literally deteriorating wasting away from pain and not being able to use I have been on pain management low dose oxycodone for 5 years DDD,Fibro,MS,scoloisis of spine,neck fusion, spinal tap nerve was hit and messed up R leg and neck steroid shot a nerve was hit in neck that cause severe pain after neck surgery into L arm … so now when L arm gets cold I have no use of arm at all many times I have contemplated going to ER but know it will do me no good until Doctors tell me the truth of what is going on what Exactly it is if I will recover or not neuro did ask if I have help but isn’t telling me why I guess like my husband keeps telling I have to demand that they tell me , I am scare to know but this week will be seeing doctor I told him if you do not want to treat my pain send me to the pain management doc we have 1 in our hospital who my SIL sees so I know there is 1 …. but he says he will take care of it I must be legitimate what is funny so many people who say they get blood tested and urine tested like a person on probation like you ‘re a criminal I was urine tested for 4 years a couple surprise tests and always was spot on 1 time I had taken more but I have not been urine tested in 2 years since neck injury no blood test either My SIL has never been urine or blood tested ever she has been deformed from surgeries done on her back since a young girl …no doctor or her parents believed her she was in pain her back has scolosis and it was caught too late to fix .. this isn’t bragging just I am just confused is it the state people are in or just doctors policy to force tests ? is it a money maker ? I get put on Fental patch when pain gets unbearable but can easily go off it doesn’t get me high and really doesn’t help much…

W H Hulley

People who do not have pain—have no basic understanding as to what those of us with pain 24/7 must live with.,,,,,,and that includes much of the medical profhas but oneession…..who treat persons with pain.Just review the medichal training towards an MD degree. Those of us with RSD (in my case….whole body) have a difficult time locating an MD who has knowledge beyond medical school. Even our Famous George Washington University School of Medicine has only a single course on RSD…….my doctor teaches the course. The majority of published medical texts up until two years ago have nothing within the printed text about RSD. Given the simple fact that 40% of returning injured vets from recent conflicts acquire RSD. Even the VA has limited knowledge within their medical staff regarding RSD. Foreign Countries have a better knowledge regarding the issues of a person who acquires RSD. Most RSD sufferers in this east coast area, if they do not have a local or regional MD available……will travel over the border into Canada for treatment, Similar to west coast residents will travel into Mexico for treatment……and the cost is far less outside of the USA.

Thank you Angelika,

I support and agree completely with your article and compliment you on it’s concise points.

I have stated in other national pain articles that this Orwellian propaganda war is attacking the weakest of our country. Those with debilitating conditions that restrict their ability to fight against this egregious abuse.

I am dependent on my pain medication to live some assemblance of normality.

An employee is dependent on their car to go to work. A diabetic is dependent on insulin. The human body is dependent on water.

The problem is that these individuals are completely aware of the harm they are causing. They know full well that the result of their lies will lead to enormous pain and potential death for those of us in chronic pain. They show the same emphathy as the Nazi’s did for concentration camp inmates and may I go one step further, their agenda may be to eliminate those they deem do not contribute to tax base.

How can I be living in a country who is capable of causing such harm? To look into the lives of any of us and know how difficult it can be to perform the smallest of tasks that normal people take for granted.

How can I be living in a country that could allow a citizen to live moment to moment in excruciating pain? Pain so intense that it’s impossible not to see the permanent lines of agony ingrained in our faces.

All the while allowing 20-30 billion dollars of illegal drugs to enter our country by Mexican drug cartels.

Since the 70’s, we were told Marijuana was the gateway drug that led to Herion. Now the government has found a way to extort revenue from it and it soon will be totally acceptable. Ontario has now legalized it’s use. How long will it take before Michigan will follow suit in the same way they did with gambling.

The United States Constitution states that each of us have a God given right for Life, Liberty and the pursuit of Happiness.

Danny

Excellent post, Angelika! We live in a society of “sound bites” and “headlines”. Most of these anti-opiod groups are comprised of people who are academic “experts” (who don’t function or work with people who suffer chronic, intractable pain), appointed government officials (whose lack of real-world experience is similar to the academics) and, especially, addiction “specialists” (who see EVERYTHING through their addiction-colored glasses). The addiction groups have become a very powerful force, lobbying against narcotics in eevery instance, in order to get THE MONEY. How can these people be so callous, thoughtless and non-sympathetic?! Because of MONEY. “The LOVE of money is the root of all evil.” Thanks for the inciteful and informative post, Angelika!

Renee Richardson

**correction-I mentioned to say I’ve not wanted to kill myself. Sentence at bottom of post is correct.

Renee Richardson

Martha Arnston,
Did you ever get your meds back?? Where did you get this info you shared w/your doc?? Will you share please? I may have to use it on the 13th.
Anyone know what the new law is past the first one they made what-1-2 yrs ago?? Or what they’re trying to do?

Renee Richardson

I have FMS,endometriosis,DDD,DFJD,spondylothesis,spinal stenosis,3 herniated discs that can’t ever repair w/out surgery,moderate scoliosis that continues to curve,bone spurs,osteoarthritis in knees-starting in ankles,hands & elbows,chronic migraines,IBS,OAB,narcolepsy & primary hypersomnia & finally CRPS.

What’ll they think of next? You know now, they’re also trying to make it illegal for GP & FP etc..
to prescribe opiods & making everyone go to a pain specialist? Imagine it w/all the ins. comp. refusing to pay. I think pain patientd sjould go to a pain specialist, but after they get your chronic pain under control w/lowest dose possible to where you can at least function even if you still have some pain then they send you back to your GP to continue the same regimen until your pain progresses. Again, that’s just my pee-on’s opinion. Just another lie no doubt. The sad thing is its not just the propoganda it’s also everyone they reach including all medical students as this is whst they’re taught. Dependance & addiction are 2 different things-look it up. All they’re going to do is cause more suicides, criminals & even more over populated jails & prisons. Again, all which gov’t etc..standing to make $. I say, educate yourselves people. Properly! I’ll admit I’ve wanted to kill myself but before getting help myself & after the legal ruling when Dr’s were afraid to give help & I was in so much pain I did think to myself-I’m better off dead! I’m on lowest dose too. Idk what I’d do if I had to live w/this extreme pain the rest of my life. They probably don’t even care about that.

Heather

I totally agree. It is inhumane and neglectful on the CDC part especially who has created havoc amongst pain patients and opioid usage, not taking in mind like you said those whose use heroin or any other illicit drugs who are so called addicts as well. Well as a medical professional I am absolutely apprauld at the nonsense that is happening to our medical world. Pain patients who are treated by legit Dr and who have legit diagnosis confirmed by bloodwork and diagnostic testing along with the drs examinations should not even be apart of this huge ring of nonsense. There are addicts everywhere and always will be and always has been bitbtjst doesn’t mean that we are or that we should have to suffer anymore. Maybe they should take a look a antidepressants who have a worse addiction than most opioids and way more severe withdrawal symptoms trying to come off of them. It is horrible. We not want to have to take all these meds but unfortunately our genes or accident or whatever may have caused someone’s diseases and disorders have lead to the use of opioids and is the last resort to have a half way decent life and to be able to move just a little instead of being bedridden. I see and understand some of the standpoint being put out by CDC but they need to rethink what they are and have already begun to create and that is pain patients left with no meds or drs afraid to prescribe or either being made to do dose reductions. Which understandably if a patient has been stable to attempt but most are not and it is causing a rise in suicide rates. I have already written to CDC and the FDA, DEA, and White House in regards to what their plan is for increase suicide rates as it is rapidly occurring. I have a group of 2000 women with disabilities and have spent many many endless nights up all night trying to talk others out of ending their life. I have even had to go as far as sending the police to send for well checks. So this is serious. You will always have addicts and those who are on the street selling drugs. You will never stop it but it is not our fault and we do not deserve to be punished or ridiculed and called names such as “addicts” that we are not. WE ARE REAL. WE ARE IN CONSTANT PAIN. WE HAVE CHRONIC ILLNESSES TJST REQUIRE MEDICATION. So I will just leave you with my diagnosis and let you determine if you think I have pain. Just remember also CDC folks one day you or a loved one will be in pain and need pain meds and you want he able to get them. Then what. Oops I forgot you all get what you want while the rest of bus SUFFER. Can’t wait to see how many attorneys start practice for this. Hum.… Read more »

Richard Oberg M.D.

Outstanding summary Angelika! Absolutely correct in every regard. The one major thing I’ve found disconcerting (or outright disgusting) is the failure of my profession to speak up loudly about any of this outside of few individuals. Why don’t more? Lots more?? Hospital based physicians that I’ve known (by and large) don’t think very highly of psychiatrists or their addictionologist subsets. Most of it is entirely subjective and doesn’t require a physician-level education. Charismatic people (Dr? Phil comes to mind) work just as well with people in an outreach setting and severely mentally ill people are a welcome ‘turf’ to psychiatrists when other physicians don’t want to deal with that subset of patients – which doesn’t mean that they think those patients are going somewhere like those needing coronary artery stinting or bypass surgery. They’re just going ‘somewhere else’ and everyone’s happy they don’t suffer from those type issues or be subject to whatever medieval thinking their practitioners may possess. One thing’s for sure and unlike any other field of medicine – once you’re in their hands you lose all control of your autonomy – there is no leaving ‘against medical advice’ without serious repercussions. You can have major surgery and walk out of a hospital ‘AMA’ which is generally a bad idea – but that’s not the case with medieval medicine which also comes with potential legal sanctions again not found in any other field of medicine. We still tolerate this in 2016?? Bri has the best summary of the atrocious repercussions of this I’ve ever read in one of these replies. We’re locking people up or stigmatizing like we did centuries ago and the verdict of the provider carries weight not found anywhere else in ‘real’ medicine, all the while, the DSM continues to add categories arbitrarily classifying you as mentally ill. Their psychiatric assessments can brand you for life over the subjective opinion of one (or many) goofy individual(s) who may have serious mental issues of their own – provider biases are NOT vetted by any objective professional standard considered ‘standard of practice’ in other much more objective medical fields. So how we get here now’s pretty obvious – these are the same individuals (ie: Kolodny) who are creating this mess for chronic pain patients via the CDC conduit and I don’t understand why primary care physicians haven’t stood up to it en masse. I DO get why PROP’s done this so bizarrely upside down and data deficient – very little they EVER do is data dependent. Do physicians want out of opioid scripting so badly they’re willing to sacrifice their legitimate patients this way and just succumb to media misrepresentations of an exaggerated ‘epidemic’?? Physicians, however risk averse, are generally wary of anyone taking away their autonomy and will fight to preserve it – but so far have dropped the ball completely. If there is any ‘soul’ left in medicine, it’s time to speak up for it before all of primary care gets redefined as something not… Read more »

Carolyn

If they are truly concerned about deaths they should consider how many will commit suicide to escape constant pain if medications are not available. I chose not to use them except for short periods of the year the pain is MOST UNBEARABLE when