Dear CNN

Dear CNN

(There have been a great number of very articulate letters written by National Pain Report readers about the CNN Town Hall on Opioids that was aired last Wednesday. Kurt Matthies’s is worthy of republishing)

Dear CNN,

Congratulations.

You have joined other leading American media outlets, like the NY Times, and CBS 60 Minutes, in obfuscating the distinction between Chronic Intractable Pain and Substance Abuse with your recent Town Meeting on the “Opioid Epidemic”.

In doing so, you misinformed millions of gullible American television viewers about the nature of pain, pain treatment, and addiction. At the same time, you insulted and disheartened the millions of Americans who live with Chronic Intractable Pain and maintain a semblance of normal behavior only because of our access to effective and safr chronic opioid therapy.

In your terrible misjudgment, you’ve placed the problem of opioid substance abuse at the feet of those wise and compassionate physicians who understand why pain must be treated with often with chronic opioid therapy in many cases.

The “opioid crisis” is a media fabrication based on flawed CDC opioid-related mortality rates. The information regarding these flaws is out there, yet you’ve missed this story completely. It is a complicated one and can’t be told in a Town Meeting or sound byte, yet the threads of this problem in the accurate  reporting of accidental death attributed to opioids are freely available, as written in Dr. Robert Twillman’s What’s Really Driving Opioid-Related Death Rates? (http://updates.pain-topics.org/2012/01/whats-really-driving-opioid-related.html), and in the writings of Terri A. Lewis, PhD., myself, and others, in blogs like the National Pain Report and Pain News Network.

TV doctor Sanjay Gupta writes that opioid overdose is the #1 preventable cause of death in America. Why does he ignore the CDC’s own figures —  800,000 annual deaths in America are attributed to the use of alcohol.

More Americans die each year from medical error than those deaths now attributed to opioid overdose. Certainly these deaths are preventable.

Dr. Gupta and the hashtag #DoctorAccountability hint that physicians writing legitimate prescriptions for suffering Americans are behind the opioid problem. While some physicians certainly need more education regarding opioids and their use, the rise in overdose figures attributed to opioids has little to do with the millions of Americans treated with chronic opioid therapy for their Chronic Intractable Pain conditions.

For us each and every analgesic pill is preciously guarded. These medications allow us to go to school, raise a family, follow a career, participate in our communities, and in other ways, pursue happiness within our medical limits. And no Dr. Gupta, the meducation doesn’t take away all of our pain because of opioid tolerance, but the pills do provide enough relief to allow a semblance of normality in our day to day life.

Attacking physician/researcher Dr. Russell Portnoy is a low blow, based in ignorance of this great man’s part in the renaissance of pain study and treatment that blossomed during these past 35 years. Dr. Portnoy, along with countless other physicians and researchers have helped millions of suffering Americans regain function and purpose in their lives because of their pain treatment. Multimodal pain therapy is nothing new, doctor. People who live with Chronic Intractable Pain have tried every medical treatment known, and plenty that have been unproven but promised to offer relief.

Has CNN investigated how the American medical insurance industry denies many effective pain treatment modalities to the patients who need them, and who have had proven benefit with them in the past?

CNN, like the President, the Medical Industrial Complex, legislators and regulators, and the American media has mistaken the tree for the forest in terms of this crisis in American public health.

In 2011, the Institute of Medicine published a revealing document — Relieving Pain in America: A Blueprint for Transforming, Prevention, Care, Education, and Research, which states:

“Every year, about 100 million adult Americans experience chronic pain, a condition that costs the nation between $560 billion and $635 billion annually.”

Here’s the real epidemic, ladies and gentlemen — the pain epidemic that results in the daily suffering of millions of Americans, and that is responsible for more medical spending than heart disease, cancer, and diabetes, combined. Chronic Intractable Pain is a disease that causes disability and destroys lives and families, yet CNN and the other above-mentioned guardians of our society have ignored this devastating disease.

Where is your reporting on America’s  Pain Epidemic?

I wonder if any major American media outlet has the journalistic integrity to peel back the layers of this story?

Look to the blogs, the patient support groups, and talk with real people who deal with moderate to severe pain every day. Talk to the real pain doctors who treat us. Talk with America’s leading pain physician, Dr. Forrest Tennant, MD, PhD. Talk with the American Academy of Pain Medicine. Read the Journal of Pain Research. Talk to the International Academy for the Study of Pain, whose 2010 Declaration of Montreal declares that every human being has a right to effective pain care (which doesn’t mean a day’s worth of Vicodin followed by OTC ibuprofen after a root canal, as suggested by a recent pain study.)

It is here you’ll find the real horror show, and maybe then you’ll learn how inflammatory reporting on the “Opioid Epidemic” stigmatizes and harms millions of people who already suffer daily due to a national mass hysteria known as opioiphobia.

The information is out here, so get out and look for it. Are you journalists or a mouthpiece for the Medical Industrial Complex?

I leave you a few unbiased facts regarding chronic pain treatment with opioids and addiction from award winning medical writer Maia Szalavitz:

http://blogs.scientificamerican.com/mind-guest-blog/opioid-addiction-is-a-huge-problem-but-pain-prescriptions-are-not-the-cause/

Please stop whipping up fear and start reporting the facts about America’s greatest public health challenge — the pain epidemic.

Sincerely,

@kwgmatthies

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Authored by: Kurt W.G. Matthies

There are 27 comments for this article
  1. Bernie Stevens at 1:54 pm

    It is good that you are helping to find other ways to help those of …us in chronic pain. Of course, I am sure you are also reminding people that although not preferred sometimes opioids at present are a necessary answer. It is about time someone pointed out that someday we very well may have an excellent alternative .Thank You.

    This was left on Dr. Lynn Webster’s facebook page.by this writer

  2. John S at 6:57 pm

    Dr. Lynn Webster has a picture on his Facebook page that really hits home.

    It’s a tiny radio held between two fingers and its Pro Opiate

    The bottom of the picture had what looks like a six foot stack of Bose speakers in rows of 5 / – Anti Opiate – get the idea

    Check it out on Facebook because it sums up what we are up against.

    Dr. Lynn Webster MD /. He’s not happy with the misinformation being spewed across America by the drive by media.

    Thank you ,

    John S

    ps; if there is a way to upload a picture please let me know

    John S

    lynn r webste

  3. Bernie Stevens at 4:31 pm

    Your deliverence of calm effictive information is good to see. But I am not sure anyone at CNN or the FDA or the CDC will give it a second thought. The FDA has way too much power now & the CDC is only looking for praise from those with money and even more power. Maybe someone will notice when we have to turn to lots of Tylenol & Alcohol to dull the pain. Let the blame fall on their shoulders then.

  4. Kay at 7:27 pm

    Extremely well written letter! I will just add that I left several responses to CNN about that program, which was so biased and unfair.

  5. John S at 4:22 pm

    I just heard on the news – Last year over 16,000 teen age Americans were treated for self induced alcohol poisoning.

    They all drank flavored hand sanitizer to get high or drunk.

    Sixteen Thousand is a big number. Has anyone else heard of this new way for youngsters to get alcohol. Just go to any Drug or Grocery store and no ID is required

    Look real hard to find this in the news.

    Thanks,

    John S

  6. Rhea at 10:26 am

    I have been through the multidisciplinary approach, and I found that, for me, this approach was more stressful, causing even more pain. My insurance wouldn’t pay for the “extras” such as physical therapy or the group sessions discussing our mental health. I did, however, get relief from injections. The office visits with Physician Assistants were always brief, and was the only way to receive prescriptions. I never saw the pain specialist after my initial office visit.

    I felt as though I was being treated as an addict. I had to bring my bottle of pain pills with me to my appointments and of course, a urine drug test had to be done once a month.

    One problem with this is that people in rural areas do not have access to this type of approach without having to travel to major medical centers.

  7. Cynthia Fierros at 10:06 pm

    Thank you! Couldn’t have said it better, here’s praying they actually take to heart what you had to say… For all of us let me again thank you.

  8. Maureen at 7:14 am

    Mr. Matthies,
    Thank you for the time and effort you put into your intelligent, informative and very well written post.
    I began to watch that CNN report and turned it off within minutes… as I felt my stress level rise.
    Thank you also to all others who commented to Mr. Matthies writing.
    Bravo to all of you for posting ‘just the right and sensible words’.

    As I was reading much of the posts I wondered… ‘do those whom the writings are directed at…ever even see/read them??’
    Thank you Krissy for your great suggestions!
    In the midst of such media nonsense…I find it ever so comforting to know that there are so many of you out there who know and share my own feelings and ways of living in chronic pain.
    I remain forever grateful to The National Pain Report and the US Pain Foundation for their support.
    We need to remain united…stronger and stronger each day.
    Fight on Pain warriors!

  9. Barbara Bavier at 11:15 pm

    EXCELLENT letter! Bravo!
    Let’s hope that this time, our collective voices are loud enough to be heard.

  10. Layla Rose at 6:02 pm

    What an amazing an well-written letter. Way to go!!!

  11. Kimberly Rosenberger at 5:53 pm

    Well said, exactly to the point

  12. Doug at 2:32 pm

    Great and very informative letter.

    The truly unbelievable thing about Anderson Cooper’s town meeting and the way it presented opioid addiction while at the same time discriminating against people with chronic pain who use opiates to maintain a hint of life quality is the fact that if there was any reporter who would know discrimination, it should be Anderson Cooper. Living most of his life in a lie because the homosexual community was discriminated against by nearly everyone, and is still discriminated against by a lot of religious organizations, Anderson Cooper should be able to see the signs of this overall government discrimination.

    I mean, when a gay couple was denied a marriage license by a clerk in Kentucky using religion as an excuse it was national news for several months.

    When a bakery on the west coast refused to bake a wedding cake for a lesbian couples wedding, again national news for a long time.

    Now the transgender issue in North Carolina has been heading up the news right behind the antics of Trump..

    While I agree that there is a problem gripping our country with heroin and illegal opiates, this letter told the absolute truth about those of us still lucky enough to receive pain medications and holding on to them with everything we got.

    What really upsets me is that we are simply trying to get our voices heard and every single national level news outlet refuses to tell our stories, the big 3 alphabet agencies, (CDC, FDA & DEA) are working really hard to block our access to these life saving medications, and the addicted along with families of unfortunate accidental overdose victims are screaming so loud that that we can’t be heard. We are called addicts and drug seekers. We are treated lower than dirt but if I were a gay man and wanted to marry another man and was refused that right, Anderson Cooper would be all over it.

  13. dockut at 1:13 pm

    I agree that CNN’s Town Hall broadcast was a joke. Not one “specialist” knew anything about pain and addiction medicine. Shame on Anderson Cooper for presenting a group of so called experts, as knowledgeable authorities, when in fact, they didn’t know anything about the topic. In the world of pain and addiction, they are what I call LAMES.

    One exception is that prescription medication overdose is a “fabrication”. Not true! Prescription narcotics, benzodiazepines and opiates, make it to the streets hundreds of times more frequently now than ever. Consequently more people are NOT taking these medications as prescribed and are overdosing. Fact! But, before you come unglued, the ~ 12% incidence of Prescription OD, as you rightly point out, is a far cry below those that die from alcoholism, diabetes, heart disease, etc… But keep in mind that the approximate 12% incidence was ~3% just a few years ago.

    I almost regret opening these articles, regarding my field of Pain & Addition Medicine, because I inevitably read comments from patients, my fellow physicians, reporters, even our governments FDA, when I’m obliged to show respect when, in fact, I’m offended by their lack of knowledge being pompously presented with such authority.

    Chronic pain patients are anxious about losing access to their opiates. On the other side are those “lames” that are trying to limit access of opiates to everyone. Both are the extreme and not scientifically based. So much so, that every time I try to show what are the proper uses of opiates, my words are misunderstood or spun to the point of being personal attacked.

    THIS ARTICLE IS A GOOD ONE.

    Every reference given is legitimate and correct. Dr. Forrest Tennant, MD, PhD (a friend and comrade), American Academy of Pain Medicine, Journal of Pain Research, International Academy for the Study of Pain, Montreal Declaration. I assure you there are more and they all say the same thing I am saying here. This includes CDC’s and US Dept. HHS recent publications. As far as I know this problem was first published in 1986 by Dr. Cousins (Australia) article claiming that the treatment of pain in America was tantamount to malpractice. The WHO and CDC jumped on Dr. Cousins article and asked Thomas Jefferson University to gather the top pain specialists and generated Acute, Chronic, and Cancer Pain Treatment Guidelines that were sent to every hospital in the US free of cost in the early 90s. I was one of the authors. This was the true advent of pain management as a specialty. Decades later we are still dealing with the same issue. Pain patients argue for more access and “lames” argue for less. I side with the pain patient but ask that you realize that we do have a problem that is that many non-pain physicians are dolling out narcotics without regard to the patients well being or even those unethical patients finding a loophole in the system to make money off unscrupulous physicians.

    Chronic pain patients are closest to the truth but forget to realize that, as a whole group, chronic pain patients form a bell shaped curve from the least to the most intractable. Often it is the worst chronic pain patients on these forums that have no other option to prevent their suffering than opiates. I know you exist and I am truly sorry for your situation. It is a disaster, and you do have me as your advocate for access to opiates. But we need you to care for all of our chronic pain patients by helping to help others not get to the point that you are at now. Understand that Pain is not a disease but, instead, a symptom of an underlying disease or injury which varies from patient to patient. Opiates should be used to prevent suffering but pain will always be present in nature. This is why every reference you sited says that there must be a multidisciplinary approach to find every possible tool a patient can use to treat their underlying problem with the hope that it lessens the symptom of pain so the patient doesn’t end up as one of the few chronic pain patients that only have opiates as their sole tool to prevent suffering.

    HERE IS WHAT WE KNOW:

    Opiates are not used to treat Pain but, instead, should be used, to prevent SUFFERING from pain.

    Pain is not stagnant; it varies from hour to hour, day to day.

    ER opiates are seldom ever indicted, except when all other treatment modalities have been exhausted, or when physical dependence is not a long term concern as in cancer patients.

    Pain is a symptom of an underlying pathology.

    Opiates do nothing for the underlying pathology but instead simply mask it, thus allowing it to progress, while adding additional morbidities.

    When acute pain is treated with opiates, the intent is to prevent suffering long enough to allow for natural healing. You misrepresented the root canal example because all the literature states that it is acceptable to treat patient’s acute pain for weeks with opiates.

    After weeks of pain, it should be recognized that the underlying pathology is not improving.

    Patients with persistent pain should be referred to an integrated multidisciplinary approach that includes interventional treatments, none opiate meds, physical therapy, and behavioral therapy.

    The intent of an integrated multidisciplinary approach is to find all the tools a patient can use to control their pain with the hope of preventing further chronicity and opiate dependence from developing.

    THE SOLUTION:

    This has been around for decades but still not followed. If it was we wouldn’t be where we are now and there would be a lot less chronic pain patients and even less suffering from pain. For more than 25 years of trying, here I am again trying to get the word out.

    Physical Dependence and Addiction are part of the same coin as Pain Management. This is a specialty that is not for primary care physicians to experiment with. It is a separate specialty!

    All physicians, regardless of their discipline, should not prescribe any form of narcotic for more than a few weeks without having the resources, and time, to safely and effectively treat their patient’s pain and medications. The most effective way, by far, that can be used to treat these patients is with an integrated multidisciplinary approach that includes interventional treatments, non-opiate meds, narcotic management, physical therapy, and behavioral therapy. If you can’t do this then you should not be prescribing narcotics for more than a few weeks.

    Quit with all the nonsense. Every “pain” fellowship, every literature review over the last 30 yrs to include the recently published “National Pain Strategy” from the US Dept. of Health and Human Services, and the US Centers for Disease Control & Prevention “Opiate Guidelines”, along with every reference in this article, all say the same thing; Refer the patients you have within weeks if you do not have the resources to provide an integrated multidisciplinary approach. Scientifically proven. Not opinion, just fact, period! What part of this don’t physicians get?

  14. Joan Hamm at 12:42 pm

    What is the immediate question that is asked when we hear someone has passed? ” Did they suffer ” ??? Well for me it’s YES!!!! For six years now. Many people know what I am saying. The abuse by some Drs. And hospitals and nursing homes to people who are in real horrible PAIN attacks. We annoy people because we suffer and moan in pain. Meds do ease the pain to allow us to function as best we can. The addiction should not be discussed when the meds keep us alive and able to do some more good for others in our lives. No one should suffer!!! Some people have more empathy for adying bug than they do for human life who really needs meds to survive. If those with no empathy got a pain disease I wonder how they would feel then?

  15. J.M at 10:59 am

    It’s a very sad day for all of us and I don’t know what is going to be the answer as we are all labeled addictes now if we consume Any opiates longer than 30 days. The doctors are the ones who put us on these 25 years ago for our extreme pain which has only become worse and we then we’re working and functioning.
    No one wants to be able to function without pain medicine more than us.
    I am a perfect example, I was given a option this week take the next 30 days to decide herbal medicine or 30 days of opiate for a limited amount of time.
    And of course that will come with restrictions and I was required to sign pain management contract

  16. Cora at 10:48 am

    Thank you for your great rebuttal to this debacle taking place in the media raising awareness of one medical issue, addiction, while actually damaging the accessibility to proper medical care for a whole other population of chronic disease sufferers that include chronic pain. With the current restrictions on safe opiate prescriptions in Canada abuse of opiates is still rampant. It is obvious that the actual bonafied use of opiates is not the issue. It’s the illicit use that’s the problem. It horrifies me to think that it’s all going to get worse if we do not take a stand for ourselves. Also I am shocked that it is becoming ok to not only under treat chronic pain but now it seems acceptable to bully a very vulnerable community. It’s no accident that our chronic pain community is being targeted. We make very easy targets just from the nature of our condition as we are all vulnerable and we have little in the way of energy reserve to advocate for ourselves never mind our community as a whole. Please everyone out there lets stand together to fight this fight. If we stand shoulder to shoulder on this we can carry each other

  17. Krissy at 9:42 am

    Kurt, wow, brilliant. I was unable to watch but will comment as well.

    I have suggestions, and that is to

    1) print all of the comments and articles related to the CNN story — even those on their website — and send them by Fed X as a private package individually, to the CNN producers and reporters. If we can double-whammy, triple-whammy, or whatever we have the power to do, please respond to ideas any of us have. A packet in a nice folder with a header page would possibly get on a desk or two, while comments online are viewed once and possible forgotten. I would even go so far as to send these packets in a wrapped box with a congrats balloon on it (through a UPS Store or other) so that it looks like a gift. Just anything creative will help, I believe.

    2) second, take all the info in electronic form and gather it and send it to sites like FAIR. We need a site that takes information that is untrue and picks it apart. We al have notes and stats and research to arm a good reporter. Some of us on FB are talking about doing that too, but it is a slow process to get things done on FB.

    3) third, we should all be looking for an attorney willing to take this information and look at it. This would be someone who might be interested in one enormous lawsuit toward the government as soon as possible.

    4) I am looking (and we all should be looking) for a high-level reporter who wants to take on this subject and really run. I had an interview with a Minneapolis-Star Tribune reporter who contacted me after he saw a comment I made somewhere. He was hung-ho, and wanted to catch me between airports on a certain day. It was all set until he stopped answering my emails about specific time and location for the interview! My guess is he was either told not to do the story or did some research and landed on the other side of our fence. Argggggggg!

    Grandbaby was born yesterday, so I will be on and off of email. Anyone can reach me at 30yearfreelance@gmail.com or kandiapple.mac@gmail.com.

  18. Paul Clay at 8:39 am

    This is the best rebuttal of sorts I have ever read. This is also very informative about the truth in chronic pain.

  19. Sandra Gordon at 8:35 am

    Brilliant. Thank you.

  20. sj at 6:53 am

    Thank you for this letter. I was also dismayed to find Bill Maher, quite the famous pot head, to have the director of Malibu drug addiction center on his show railing against opioids after Prince’s death. If the most prominent pot head in our country is upset about drugs of another sort, what hope is there? I have several (not one, not two but several) debilitating diseases all of which have “chronic pain” as the headliner symptom.

    Medical marijuana will never be an answer for me. I cannot function on marijuana. I cannot function with chronic pain. I tried to wean myself off pain medication and couldn’t go below 4 a day. At 3 I was able to function only 5 hours a day (and my job/commute is 10-12 hours a day). I will be completely disabled without the 4 a day which is not enough in some circumstances so I try to reduce it when I’m having “a good day.”

    I have been at 4 for almost a year and it’s a struggle when I have a Lupus flare or an arthritis reaction due to the weather or over-activity or nerve pain or muscle spasms. I don’t dare try to increase it in any way, shape or form.

    I don’t dare ask a question or try to change an appointment.

    I don’t dare not go to my regular pharmacy when I have a prescription and they are closed. I must wait for the next day.

    And if I’m having a good day the day before a dr. appt, I still take all my medication (whether I need it or not) lest I get screened and something comes up negative and they think I’m selling my medication.

    I live my life in a constant state of “Don’t act like an addict! They will take away your pain medication (and hence your livelihood)!”

    Terrible way to live. And when you have the media and famous pot heads railing against it, goodness gracious. It’s horrible.

  21. Leigh Peltier at 6:30 am

    Kurt – thank you for the statistics. Thanks for supporting my contention that my controled use of opioids over the past 18 years has helped keep me employed, maintain my independence and enjoy life. I am one of those pain bloggers and we have such a great community. We all get it. Thanks again for this.

  22. Richard A. Lawhern, Ph.D. at 6:29 am

    Many of the points in Kurt Mathies’ letter need to be made in more letters to public media. MANY more letters. Unless tens of thousands of chronic pain patients and supporters of patients make their voices heard, medical standards of care will soon be even more compromised. To learn where you can write and at what length, readers of the National Pain Report might start here: http://www.ccmc.org/node/16179

  23. Mary Allen at 4:34 am

    Thank you Kurt Matthie for your well written letter. I just want my life back. I know many others who have a chronic illness feel the same. Please be with us (CNN, FDA, CDC, etc…), not against us. If there was an alternative, effective treatment for my condition that was covered by insurance I would use it in a heartbeat. But there isn’t. I did not ask for this pain and it is not my fault that no other treatment option exists for me. Please don’t tie my doctor’s hands further and take away the one treatment that does exist that allows me (and others) any quality of life.

  24. Ewa Roy at 4:32 am

    This is a great letter, that you may want to consider sending to our President, who is also on his crusade to punish pain patients even further.

  25. Doc Anonymous at 4:01 am

    To the point and well written as usual.

    Here is a more professional look at the numbers behind the illicit drug overdose death rates form the DEA itself: http://www.dea.gov/divisions/phi/2015/phi111715_attach.pdf

    Note that Heroin is present in 51% of controlled substance overdose deaths and I submit that chronic pain patients are NOT using heroin except in a very small number. Note also that fentanyl is one of the most frequent opioids present, but we now know that illicit fentanyl and not prescribed fentanyl is the substance that is adding to the heroin death rates. This is illicit fentanyl that is being added to counterfeit pills that are sold on the streets as mimics of prescription opioids.

    The TRUE FACTS are that prescription opioids are a minority of the drugs used in overdose deaths. The inappropriate focus on the properly prescribed opioids diverts attention away from the real problem: the illicitly produced heroin, fentanyl and other opioids and their illicit entry into to country. The failure of the DEA to control these illicit problems is probably why they are trying, so far successfully, to shift the blame to the legitimate chronic pain community. Unfortunately their tactics will only help to perpetuate the illicit channels for controlled substances and their associated deaths. They will also result in more torturous suffering for the Americans who legitimately use opioids.