Figures Lie and Liars Figure  – Why the Demographics of the So-Called “Prescription Opioid Crisis” Don’t Work

Figures Lie and Liars Figure – Why the Demographics of the So-Called “Prescription Opioid Crisis” Don’t Work

By Richard A. Lawhern, Ph.D.

Anybody who reads a newspaper or watches evening news has heard the screaming headlines:  “60,000 Drug Overdose Deaths” (or similar numbers).  When reporters seek maximum sensationalism, we hear deaths by overdose summed over 10 years or compared to casualties in the Vietnam War.  500,000 drug deaths is a much more impressive number — even though it’s mostly hype.

Unfortunately for all of us – and for US public policy makers — such numbers misrepresent more than they illuminate [Ref 1].  Public policy concerning opioid addiction which is based on such inflated numbers will inevitably fail spectacularly, just as the “War on Drugs” did in the 1980s.

When we boil off the hype, we find that the “real” numbers of yearly deaths where a pain killer prescribed to a pain patient might have been involved is much smaller — like maybe 7,000 instead of 60,000 in 2016. About half of drug-related deaths don’t involve opioids at all (thousands of deaths from heart failure or liver toxicity are attributed to Ibuprofen or Acetaminophen).  Among the remaining 33,000 deaths last year, most involved multiple street drugs and alcohol – something we rarely hear except as a footnote. The drugs most often detected by county medical examiners in 2016 were illicit fentanyl, heroin, morphine stolen from hospital dispensaries and methadone diverted from community drug treatment programs.  So-called “prescription” drugs come in fifth – but many of those drugs weren’t actually prescribed to patients. [Ref 2-4] They were diverted to the street by theft from pharmacies and home medicine closets. Under prevailing CDC rules for mortality data collection, any death where an opioid is detected among other factors is labeled “opioid related” [Ref 5].  When Massachusetts traced opioid related deaths into their State prescription tracking database, only 8% of OD victims had a recent prescription.  When a reporter breathlessly reports deaths by “opioid overdose” without clarifying sources or types of drugs, they’re essentially committing journalistic fraud.

Richard A. Lawhern, Ph.D

We also hear tragic stories about young adults who overdose and die following a sharp descent into addiction.  Many of them, we’re told, start down this path by being prescribed opioid pain killers for a few days or weeks after a sports injury or automobile accident.  Without doubt, such stories are tragic and the families are devastated. The problem is that such stories aren’t representative or typical [Ref 4].

90% of drug addicts first begin abusing drugs and alcohol in their teens or 20s.  According to the National Survey on Drug Use and Health, “…75% of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer.”  The typical new addict is a young white male with a history of family trauma, sustained unemployment, and mental health issues.  [Ref 6]

So who is the typical chronic pain patient?  According to the National Academies of Medicine, over 100 million US citizens now suffer moderate to severe pain.  Of these, an estimated 18 million are prescribed opioids during any given year, and perhaps 2.7 to 3.3 million will be managed on opioids for longer than 90 days.  [Ref 7]

Causes of long-lasting severe pain are multiple and complex.  Some chronic pain seems to emerge “of itself” for no presently understood reason, while other cases follow from injury or diseases.  It might not be helpful to imagine a “typical” pain patient, due to the multiple overlapping conditions involved.  However, broad trends are well known [Ref 8-9].

–       Back pain is the leading cause of disability in Americans under 45 years old. More than 26 million Americans between the ages of 20-64 experience back pain. Many other chronic pain conditions also affect older adults [Ref 8].
–       Women are more likely to experience pain than men (~60% vs 40%) and to experience more intense pain.  Likelihood of pain increases with age, with new cases reaching a plateau or decreasing after Age 60. [Ref 9]
–       Non-white and poor people experience more — and more severe — pain than well educated white elites.[Ref 9]
–       For certain types of painful disorders such as facial neuropathic pain, Complex Regional Pain Disorder or Fibromyalgia, the typical patient is a woman in middle age or later. [Ref 10, 11]

When the known risk factors for addiction are compared with statistics on chronic pain, it becomes clear that attribution of the US “opioid crisis” to over-prescription of opioid pain relievers is unjustified.  The great majority of addicts begin as male adolescents from troubled or disadvantaged socio-economic backgrounds – a population that is medically under-served.  Few teens will see a physician for pain severe enough to justify prescription of an opioid for longer than a few days, and most such visits involve dental surgery.  By contrast, a significant majority of chronic pain patients are women of middle age who have a very low risk of opioid addiction.

The demographics simply do not work.    

The contrasts between addicts and chronic pain patients are strongly reinforced by the few available studies of the long-term effectiveness and risks of opioid treatment for common pain conditions.  Not many of these studies have been conducted.  But one which stands out is a 2010 Cochrane Review [Ref 13].  Key results of this review are worth repeating here: “We reviewed 26 studies with 27 treatment groups that enrolled a total of 4893 participants….” “Signs of opioid addiction were reported in 0.27% of participants in the studies that reported that outcome….”

“Many patients discontinue long-term opioid therapy (especially oral opioids) due to adverse events or insufficient pain relief; however, weak evidence suggests that patients who are able to continue opioids long-term experience clinically significant pain relief. Whether quality of life or functioning improves is inconclusive. Many minor adverse events (like nausea and headache) occurred, but serious adverse events, including iatrogenic opioid addiction, were rare.” As a parenthetical note, we do not know in detail, the reasons for “discontinuance of opioid therapy due to inadequate pain relief”.  But one of those reasons seems likely to be under-treatment of people who poorly metabolize opioids. [Ref 12]

The President’s Commission on Combating Addiction and the Opioid Crisis released its report in early November 2017.  Although some aspects of the report seem positive, it is deeply flawed overall by its clinging to the false narrative that medically managed prescriptions in some way provide a “gateway” to addiction. Some of the Commission’s recommendations will almost certainly drive more physicians out of pain management practice and more patients into agony through desertion or denial of adequate medication. [Ref 14] Perhaps the only saving grace for chronic pain patients in the Commission report, is a recommendation for expansion and clarification of the 2016 CDC Guidelines on prescription of opioids to chronic pain patients.  If this project is approached honestly and led by pain management specialists instead of addiction psychiatrists, almost the entirety of the CDC guidelines must be thrown out and done over.  There is wide agreement among medical professionals that the published Guidelines are biased against opioid pain relief, scientifically unsupported and seriously incomplete [Ref 12].

Whether the US Government will permit the correction of its sorry record of distortions and mistakes in the so-called “opioid epidemic” remains to be seen.  But it is now clear that the demographics of addiction and chronic pain only marginally overlap.  Effective public policy cannot be based on the fiction that doctor-prescribed pills are the problem. Pill counting is not a viable solution [Ref 15].  Americans deserve pain management practices based on facts rather than sensationalism.

About the Author:  Richard A (“Red”) Lawhern, Ph.D.  is a non-physician writer, research analyst, patient advocate, and website moderator for chronic pain patients, families, and physicians.  His wife and daughter are chronic pain patients.  His 20 years of experience has produced articles and critical commentaries at the US Trigeminal Neuralgia Association, Ben’s Friends online communities for patients with rare disorders, US National Institutes for Neurologic Disorder and Stroke, Wikipedia, WebMD, Mad in America, Pain News Network, National Pain Report, the American Council on Science and Health, the Global Summit for Diagnostic Alternatives of the Society for Humanistic Psychology, Psychiatric News and Psychology Today

References
1.     Schatman, ME, Ziegler SJ, “Pain management, prescription opioid mortality, and the CDC: is the devil in the data?” Journal of Pain Research, October 5, 2017.  https://www.dovepress.com/pain-management-prescription-opioid-mortality-and-the-cdc-is-the-devil-peer-reviewed-article-JPR
2.    Bloom, Josh, “Heads in the Sand – The Real Cause of Today’s Opioid Deaths”,  American Council on Science and Health, August 16, 2017. https://www.acsh.org/news/2017/08/16/heads-sand-%E2%80%94-real-cause-todays-opioid-deaths-11681
3.    Boyles, Salynn, “Mass. Study: Illicit Fentanyl Involved in Most Opioid Fatalities” Medpage Today, April 13, 2017, https://www.medpagetoday.com/Psychiatry/Addictions/64558
4.    Sullum, Jacob, “Opioid Commission Mistakenly Blames Pain Treatment for Drug Deaths” Reason Magazine November 2, 2017, http://reason.com/blog/2017/11/02/opioid-commission-mistakenly-blames-pain
5.    Molohon, Denise, “How the CDC Misclassifies Opioid Overdoses”  Pain News Network, January 12, 2016, https://www.painnewsnetwork.org/stories/2016/1/12/how-the-cdc-misclassifies-opioid-overdose-deaths-1
6.    Szalavitz, Maia, “Opioid Addiction is a Huge Problem, but Pain Prescriptions Are Not the Cause”, Scientific American, May 10, 2016.  https://blogs.scientificamerican.com/mind-guest-blog/opioid-addiction-is-a-huge-problem-but-pain-prescriptions-are-not-the-cause/
7.    Martin, Steven A; Potee, Ruth A.; Lazris, Andrew, “Neat, Plausible, and Generally Wrong – A Response to the CDC Recommendations for Chronic Opioid Use”, Medium,  September 7, 2016, https://medium.com/@stmartin/neat-plausible-and-generally-wrong-a-response-to-the-cdc-recommendations-for-chronic-opioid-use-5c9d9d319f71
8.    American Academy of Pain Medicine “AAPM Facts and Figures on Pain”, [Current edition accessed November 11, 2017]  http://www.painmed.org/patientcenter/facts_on_pain.aspx
9.    Grol-Prokopczyk, Hanna, “Socioeconomic disparities in chronic pain based on 12-year longitudinal data”,  International Association for the Study of Pain, PAIN, Vol  158 No 2, February  2017
10.  Lawhern, Richard, Living With TN – A Ben’s Friends Community for Patients With Rare Disorders, March 15, 2012, archived at http://www.lawhern.org/DemographicsFacialPain.docx
11. National Institutes for Neurological Disorders and Stroke, “Complex Regional Pain Syndrome Fact Sheet”, [Accessed November 11, 2017] https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Complex-Regional-Pain-Syndrome-Fact-Sheet
12. Lawhern, Richard, “Warning to the FDA – Beware of Simple Solutions in Chronic Pain and Addiction”, National Pain Report, June 1, 2017.
13. Noble M, Treadwell JR, Tregear SJ, Coates VH, Wiffen PJ, Akafomo C, Schoelles KM,  “Long-term opioid management for chronic noncancer pain” The Cochrane Library, Wiley & Sons Publishers, 2010. 
14. Bloom, Josh, “Grading the President’s Commission on Combating Addiction And the Opioid Crisis”, American Council on Science and Health, November 3, 2017, https://www.acsh.org/news/2017/11/03/grading-president%E2%80%99s-commission-combating-drug-addiction-and-opioid-crisis-12078
15. Tadeschi, Bob, “A Civil War over Pain Killers Rips Apart the Medical Community – and Leaves Pain Patients in Fear” Stat News, January 17, 2017.  See particularly, the hundreds of comments from pain patients themselves.  https://www.statnews.com/2017/01/17/chronic-pain-management-opioids/comment-page-4/#comments

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There are 29 comments for this article
  1. Ellie at 1:52 pm

    To mark Ibsen Yes Prince did die of an overdose as it’s my belief also that some1 set him up with those counterfeit pills. Yes he did thk that the Vicodin was jst that bt he was worth more dead than alive, thk inner circle! Does any1 thk that prince was no more no less thn a CPP duped, just tryng 2 survive! He did knw some1 was after him hence #just when u thgt u were safe” as tweeted by him days b4! Beautiful man!

  2. Dennis M lawson at 6:41 pm

    PEOPLE ARE KILLING THEMSELF BECAUSE’S THEIR OPIOID PAIN MEDICATION’S HAVE BEEN TAKEN AWAY.I MEAN THE RX PAIN MEDICATION I’M GETTING ARE JUST BARELY DING ANYTHING FOR MY GREAT SEVERE PAIN,WHERE MONTH’S AGO I COULD FEEL THEM WORKING,I DON’T KNOW WHAT I’M GONG TO DO IT’S GETTING TO GREAT,I HAVE AN ILLNESS IT’S SEVERE GREAT CHRONIC PAIN THAT CAN’T BE CURED,AND FROM WHERE I’M SITTING THERE IS A BIG LIE BEING TOLD TO SEEL THE OPIOID CRISIS TO AMERICA I’VE BEEN GOING TO PAIN DOCTOR’S OFF AND ON SINCE 2003 NEVER ONCE DID I SEE AN FUUL BLOWN DRUG ADDICT I THINK THEY SHOULD GIVE US LIE DETECTOR’S TEST’S,I KNOW REAL CHRONIC PATIENT’S WHO HAVE KILLED THEMSELF BECAUSE THEIR MEDICATION WERE REDUCED OR STOPPED,IT WAS THE ONLY TREATMENT THAT WAS WORKING,I USE TO KNOW PAIN DOCTOR’S WHO TREATED PAIN PATIENT’S FOR YEAR’S AND KNEW THAT OPIOID’S WORKED FOR LONG TERM TREATMENT IT WORKED FOR MY FOR AN YEAR IN 2015 TILL THE SO CALLED OPIOID CRISIS STARTED,THIS IS WRONG THEY ARE TORTURING AND KILLING REAL PATIENT’S THEY MAY NOT WANT TO HEAR THAT BUT IT TRUE,THEY NEED TO STOP THE WITCH HUNT.

  3. Richard A Lawhern PhD at 8:38 am

    For Terri McFarland: I wrote the Presidents Commission twice and in detail, through their ONDCP email gateway. I seriously doubt that the Commission even bothered to delegate a reviewer to the rather large volume of mail they must have gotten from subject matter experts and pain patients. Their final recommendations are a profoundly mixed bag. Josh Bloom wrote a “grade report” at the American Council on Science and Health that was really scathing. And it should have been. The Commission didn’t even bother to ask for participation by pain patients or their advocates.

    I won’t burden the comments column with the full text of the letter. However, you may read it if you wish, at http://face-facts.org/lawhern/a-second-open-letter-to-the-presidents-commission/

    Regards, Red

  4. Terri McFarland at 5:34 am

    Thank you, Richard A. (“Red”) Lawhern, Ph.D. I wish you were on the Presidents Commission for the “Opioid Crisis” We so need a voice of reason to advocate for us.

  5. Lauri Blackwell at 12:39 pm

    Thanks for helping us Red! You are a wonderful writter that can get your point out in a very readable way! Now if they would just listen! Love to ALL

  6. Rose at 6:27 am

    I have serious medical problems and have lived on the edge, worrying the government will take away my source of relief. This is not the America I grew up in. My personal beliefs are that it is the “Elitist” type of thinking behind this. The “Socialist” type of government where the government knows better than you do what you need. I encourage everyone to email their representatives REPEATEDLY. I am looking into contacting other key people because what we’ve been doing isn’t cutting it.

  7. HAZZY at 9:15 am

    EVERY PERSON IN THE U.S. WITH CHRONIC PAIN, WOULD CONFRONT THE GOVERNMENT, IT WOULD NOT DO ONE DARN THING. I COULD OF SLAPPED THE HECK OUT OF MY PAIN MANAGEMENT DOCTOR WHEN SHE SAID IAM REDUCEING YOU PAIN MEDS FURTHER, THIS IS TOTAL, TOTAL B.S. !!!! THE DOCTORS AND OTHER GOVERNMENT AGENCIES NEED TO LEAVE US ALONE AND LET US HAVE WHAT WE NEED. IM NOT AN ADDICT EITHER, MY MEDS ARE GIVEN TO ME EVERYDAY, AND ARE IN A LOCK BOX, BECAUSE I HAD THEM STOLEN A FEW YEARS AGO.

  8. HAZZY at 9:05 am

    TO RENEE MACE: YOUR BLOOD PRESSURE RISES BECAUSE YOU ARE IN PAIN, I ALSO HAVE HIGH BLOOD PRESSURE. WHEN I DON’T HAVE MY PAIN MEDS, MY BLOOD PRESSURE ALSO GOES SKY HIGH. THE DOCTORS AND THE GOVERNMENT KNOW IT, BUT THEY DONT CARE !!! WE ARE ALL JUST JUNKIES.

  9. Karen C. at 7:10 am

    Thank God for giving us you (Red) to be our voice. I have RSD/CRPS in both feet, legs, and hands. It is traveling up my body at a break neck speed. Without pain medicine I would have already taken my life.

  10. scott michaels at 7:49 pm

    from Ehlers-Danlos Syndrome & Fibromyalgia
    2016 Deaths per Day & Causes: Few Rx Overdoses
    From Twitter Dystopian Novelist‏ @dystopiannovel:

    2016 deaths per day & cause:

    16,850 heart disease
    16,500 cancer
    1,315 tobacco*
    1,205 preventable hospital errors
    684 medical error
    175 OD (all drugs)
    121 suicide
    109 car accident
    101 alcohol*
    98 gun
    59 Fentanyl*
    41 heroin*
    ~40 CPP* suicide
    39 Rx opioid*
    <10 legal Rx opioid only OD

  11. gayle at 5:36 pm

    Thank you for this article. I have Multiple Sclerosis for 20 years and have been on a low dose of opioid to enable me to walk and have quality of life. I have never misused my medication. The pain never entirely goes away but I’m able to walk and have a life. I am 61 yrs old and scared to death that the government will eventually not let my doctors prescribe my medication. I am one of millions out there that rely on medication for quality of live. Where are our rights? How do we get the government to understand that we are not drug addictes? We just want some pain relief and to live life.

  12. Maureen Mollico at 5:18 pm

    Red, Thank you for yet another very informative, well thought out and researched, excellent, detailed, intelligent and extremely helpful writing.
    You are an incredible person and I am, as always, forever grateful for all that you do on our behalf and for your wife and daughter. I continue to encourage you to never give up. You remain in my prayers.
    Ditto to all of the comments made! Maureen Mollico

  13. Wendy P. at 12:44 pm

    ✴✴Bravo✴✴
    Thank you Dr. Lawhern for your articulate and concise article! I truly appreciate your including statistics and footnotes. ➡This article needs to be repeatedly distributed as a press release to ALL news outlets! Your article provides me with exactly what I need when emailing reporters in response to propagandist blarny being disseminated as ‘factual news’. I will be sending links to this article frequently! Thank you again, I am truly grateful and appreciate you.

  14. HAZZY at 12:18 pm

    I WOULD LIKE TO SEE A DOCTOR THAT HAS CHRONIC-PAIN ISSUES !!! I’LL GUARANTEE YOU HE WOULD WRITE AN OPIOID PAINKILLER FOR THERE SELVES, IN A HEARTBEAT !!! THEY NEED TO REALIZE CHRONIC PAIN IS NOT FUN. SO, IF A DOCTOR SUFFERED WITH CHRONIC PAIN FOR YEARS LIKE MOST OF US SAY’S HE DOSEN’T TAKE A PAINKILLER, I’D CALL HIM A LIAR !!!!!! RIGHT TO HIS FACE !!!!

  15. Renee E Mace at 12:03 pm

    HAZZY: I like you am being lowered on my pain pills, so low that I hurt so much that, I get both hot and cold sweats, my eyesight starts to go and my pain levels are so high that I feel like screaming at the top of my lungs for someone out there to care. I have high blood pressure and I talk medications for that, but my pain makes my blood pressure levels so high, that I can not function and then between every dose, when the dose starts to help, I have 15 to 30 minutes of some relief and then the next 4 hours my pain spikes up to a 9 on the pain scale. I have Central Pain Syndrome in both my legs and I had a life until my state, WA and the CDC stepped in and took it away because God forbid, I might become an addict. I am not an addict, I do not crave, think about my pills, my pills are my life support, helping me make it day to day. Thank you Richard A. Lawhern, Ph.D for caring for all of us that lives have been ruined from miss information that the media spreads without all the facts.

  16. David Wieland at 11:59 am

    The claim of the National Survey on Drug Use and Health, “…75% of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer.” What they fail to also admit is that approx 72% of these people were already using other illicit drugs BEFORE they swapped and started using prescription opioids for no medical reason. This is shown on Table #6 in their own study http://archive.samhsa.gov/data/2k13/DataReview/DR006/nonmedical-pain-reliever-use-2013.pdf

  17. Richard A. Lawhern, Ph.D. at 11:39 am

    For DIS May: I think you may have me confused with someone else. I have never presented at Harvard.

    For other readers: If you found value here, then share this article in social media and with your local news editors in papers, radio and television. I will be speaking to some of these themes on Coast to Coast AM Radio to an audience of millions of people, in the early morning hours (4-5 AM Eastern) Monday November 27th, in an interview with George Knapp. Knapp was principal reporter in the excellent television series just concluded on Las Vegas Now Television, tagged as #OurPain.

    I am available to speak with other media reporters, and a major archive of my previous published work can be read at http://www.face-facts.org/Lawhern.

    My thanks to the editorial staff of National Pain Report — and not on my own behalf, though I am grateful for the opportunity to write here. Rather on behalf of the thousands of pain patients whose voices otherwise are rarely heard in our national dialog on drug addiction versus alleviation of pain.

  18. William Dorn at 11:27 am

    Mr Lawhern please send copies of this to all members of congress and the president.I dont think most of them even no the facts.If they did maybe they would get these cruel guidelines changed.Send it to the major media also..The truth must get out or we are doomed.

  19. Jean at 7:11 am

    Listened to DHHS represent to Legislators this week that a huge number of overdose deaths were due to prescription opioids. They had a graph that showed otherwise, yet verbally described it incorrectly.
    This was followed up with a graphic showing ED admissions for overdosing, and over 50% were uninsured self pay.
    Thief comments that this was a middle to upper class problem..
    While the third point may be true, I don’t know..the first two make no sense. To obtain the medication in dosages and amounts they seem to be concerned about, one would have to be seeing a pain specialist. Even with insurance, the cost is daunting, not to mention the required referral’s, MRI or confirming test and records, and periodic drug screenings. Without insurance?
    And then they are paying out of pocket for prescriptions? Showing an ID every time? I would be shocked, frankly, as I have seen the printout showing how closely morphine equivalents are monitored.
    This kind of information is years out of date…

  20. CathyM at 7:03 am

    Thank you for this!! I’ve been trying to do the numbers myself, smelling a journalistic hype, and am not surprised by your figures. But I’m frustrated and discouraged. Even my own family members have been taken in by the hype and when I try to give them the data, they become suspicious of me! It’s disheartening how gullible people have become in some ways, while becoming skeptical where they should accept data… I don’t know what we can do except keep speaking out – I’m going to link to this article frequently!

  21. Mark Ibsen MD at 6:55 am

    Red:
    Let’s also remember this:
    Most pills on the street are counterfeit. ( think Prince, who died of fentanyl after taking what he thought was hydrocodone).
    Massachusetts found only 8% of pill od deaths had a recent Rx for their medicine.
    Most of these of course are mixed od deaths.
    AND
    Because most die of mixed ODs
    They have now placed a black box warning on Rx opiate and
    Benzodiazepines together,
    Leaving many pain patients to choose between pain and/or anxiety,
    Which increases BOTH.

  22. HAZZY at 6:53 am

    I WENT TO MY PAIN MANAGEMENT DOCTOR YESTERDAY ( WELL A P.A. NOT A DOCTOR) SHE CUT MY MS CONTIN DRASTICALLY, I’VE BEEN TAKING 90MG 3 X A DAY, NOW I WAS REDUCED TO 30MG 2X A DAY AND 60MG 3 X A DAY, SO WHEN I START GOING THROUGH WITHDRAWAL !! ARE THEY GOING TO HELP ME ???? NO !!!! SO ALL THIS OPIOID ABUSE I DO NOT FALL UNDER, I’VE BEEN ON THESE MEDS FOR OVER 23YRS AND IAM 65 YEARS OLD………….GOVERNMENT NEEDS TO KEEP THERE NOSE OUT OF PEOPLES CARE, AND SO DOES BIG PHARMA !!!!!!

  23. Linda at 6:30 am

    I know enough, by God’s grace, (that I don’t deserve), That YOU are being used. God is using you in a most powerful way to ease suffering of His children everywhere.

    I feel blessed, really blessed, to have found you. Your support and work and the folks who write in, keep me going.

    I love your post today! Both It and you give me hope, so I can keep pressing on day by day.

    Thank You

  24. Leigh A Peltier at 6:18 am

    I’m a chronic pain patient with Rheumatoid Arthritis. I’ve had it for 20 years. Responsible use of Vicodin over these 20 years has enabled me to continue to work my full time sales job and to keep a fairly active life. Without opioids, I know that would not be the case. I’ve used them responsibly and regularly when I’ve had pain. I’m not sure what will happen when I can no longer get a script.

  25. MalindaC at 5:46 am

    BRAVO, RED.

    This is a very well thought out and written article. You have taken the time and put in the effort to research, document and put in one paper what we have been finding if we are patient enough to research the truth in this very inhumane War on Pain Patients.This is so needed in this time of insanity, this time of what accounts to malpractice by Kolodny and our government.

    Everyone should have a laminated copy with footnotes so they can begin to spread the good news. The truth.

    We thank you.

  26. Karl Zaremba at 4:48 am

    Thank You Very Much for further clarification of what is going on. There is also a financial component of what is happening that no one is discussing. There are prescription opioids hitting the streets that should not be there. It is not all raiding the medicine cabinet. Another discussion I suppose. Thank You again for bringing some sanity to the conversation. Let us all hope that people are listening.

  27. Terry at 4:45 am

    This was the most informative article I’ve ever read on chronic pain. Bravo!

  28. D. I. S. May at 4:30 am

    Finally, an article with actual reliable facts. Richard Lawhern was the one presenter at the Addictions 2012 conference at Harvard that spoke truth, made sense, did not confuse clinical criteria with managed care regulations; for the rest, I will never attend addiction conferences at Harvard again.
    It is worth noting in this context, of the above article, that acts of treasury in 1914 in California and Florida in 1915, criminalized opioids and cocaine in the first place. Why treasury? Well, the goal was, in California, to keep Asian immigrants out of the work force (a bastion of white male power), in Florida, people of color immigrating from the Caribbean were the target population. It should be clear from what is noted above that what would be consistent here is a designated group to be kept out of the work force: women. Paid as much as 75 cents on a man’s dollar in 2008, since the recession women’s salaries have fallen below 75 cents on a man’s dollar. It is also important to note that among behavioral causes of death in the US; while use of tobacco products remains number 1, inactivity is number 2. People in chronic pain have a great deal of difficulty moving. Denying women in chronic pain appropriate medications for pain is a death sentence, as well as a mechanism for keeping them in poverty. This is wrong. The ‘paid for media’ is not unbiased. Pfizer was convicted of racketeering: do you think that EVER got published in the news? Nope. The physician providing expert testimony was so disgusted he left his practice and started an advocacy group, trying to help physicians advocate for truth in the media. That is sadly not likely to do much good. But iif the people in the United States became educated, and adopted the personal authority citizenship in this country is supposed to confer, then the corruption absolutely swallowing our children’s lives whole could be reclaimed. Every person in the United States is responsible for the corruption, greed, lies and hostile take over of financial power by less than 1% of our population. MADD, mother’s against drunk driving dd more to save lives than any politician ever did. Get moving ‘ordinary citizen’. Start doing anything but watching television, listening to paid for media broadcasts of ‘news’, including newspapers. Talk to real people with actual experiences, and start getting honest yourself about how well you have exerted your personal authority in the service of those you care for.

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