Forced Opioid Tapering and Patient Safety

Forced Opioid Tapering and Patient Safety

By Ed Coghlan.

The Oregon Health Authority proposal to force taper opioid medications to zero in Medicaid patients has helped accelerate the “opioid debate” among pain professionals.

“The debate has turned into an argument of opioid yes or opioid no,” said Beth Darnall, Ph.D. Clinical Professor in the Stanford University’s Department of Anesthesiology, Perioperative and Pain Medicine, and by courtesy, Psychiatry and Behavioral Sciences. “It’s not a black and white issue, in fact the solution is in the grey.”

Dr. Beth Darnall

Dr. Darnall testified at the Oregon Health Evidence Review Commission recently and strongly cautioned against the forced taper to zero opioid dose proposal.

“A forced taper may destabilize an individual both medically and psychologically,” she told them. “Our primary concern is the well-being of patients. In our study of voluntary patient-centered opioid tapering, we apply patient-centered considerations and very close monitoring so we can collect the data on how to implement safe and compassionate opioid reduction in patients who desire this pathway, and ensure good management of their pain. Right now, data are lacking.”

Dr. Darnall has authored three books that address opioid reduction and is principal investigator for the EMPOWER study, a multi-site, 4-state pragmatic clinical trial that is investigating how to best help physicians and patients successfully reduce long term opioid use in chronic pain using patient-centered methods. The EMPOWER study was designed for patients who seek to reduce their opioid dose. The project is funded by the Patient Centered Outcomes Research Institute (PCORI) and involves over 1,400 patients taking long term opioids; the goal is to help patients reduce opioid dose without increasing pain.

“There’s a segment of patients who want to reduce opioids and never had a pathway to do it in a supportive, outpatient setting,” she said. “The goal is not zero opioids unless the patient chooses that goal,” she emphasized. Rather, the EMPOWER study seeks to help patients achieve their lowest comfortable dose over the study period. The team’s pilot data suggest this will be at least a 50 percent reduction in opioid dose—on average—without increased pain. However, the team recognizes that not everyone will achieve this threshold. The team will also conduct an observational study of patients who choose to remain on their stable opioid dose (they are not part of the patient-centered opioid tapering study) and will characterize patients who do well on long-term opioid therapy.

The tapering study, she emphasized, is designed ensure that patients who wish to reduce their opioid doses are protected and can taper safely and effectively. The priority is patient safety not opioid reduction.

“Patients work with their healthcare clinician to slowly reduce their opioid dose over the one year time frame. If they wish to go slower or pause the taper, they have that control over the process. We track their symptoms weekly and address their needs. We believe that patients are best helped when we work with them and attend to their individual needs rather than pushing against them.” The EMPOWER study includes patients with chronic pain in the design and conduct of the study.

Regarding forced tapering in community-based outpatients, she said, “evidence is lacking to show that it reduces patient risks without increasing their pain or psychological distress. There is information that indicates forced opioid reduction can be harmful to some patients.”

I shared with her a recent conversation with one of our readers (and a long-time friend) who is working to reduce his opioid intake after ten years of using them—and that he’s very worried about what’s going to happen to his ability to deal with his pain.

“There are multiple issues at play,” Dr. Darnall said. “Even once a person such as your friend decides they want to reduce their opioid dose, how their opioid taper is implemented matters greatly. Clinician training is needed, systems for close monitoring and follow-up care should be in place, and fundamentally we need to recognize that opioid tapering is not right for every patient taking opioids. While guidelines may have their place, when misapplied as a mandate, or when rigid mandates exist, vulnerable patients may suffer.” Finally, ensuring access to supportive therapies may help patients achieve their desired goals, and this is a focus of the EMPOWER study. Two-thirds of EMPOWER patients will receive one of two chronic self-management classes. The team will determine if the classes help patients have better outcomes, and which treatment is best for whom.

Dr. Darnall said that patient-centeredness is perhaps the most important factor to consider in the opioid debate. “People are living with complex medical conditions and have varied treatment needs. We cannot apply rigid mandates that do not account for individual differences and expect good outcomes. Even if a segment of the population would benefit from rigid mandates, we must carefully consider the needs of patients who may be harmed by them. “These are likely to be the patients with the least voice or means.” she said.

Here is a link to Dr. Darnall’s testimony in Oregon.

Empower.stanford.edu

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Authored by: Ed Coghlan

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Judy

In still waiting for them to get my pain under control and now it is not let’s lower your meds on this is a nightmare I’m doing it right and I get punished thanks” Dopers “

ChristopherTheSlain@hotmail.com

That anyone in America would even be okay with suggesting that a patient shouldn’t have the ultimate say in their medicinal regime, especially pain relief, is a f’ing disgusting travesty. My entire life was STOLEN from me by these people. You do not have the right to deny me effective and immediate pain relief. Any rights you do have are ill gotten, and illegitimate.
This was calculated. Pain Management is an absolute fraud in this country. I have 13 years of recordings and other undeniable evidence that I am unleashing now, as I lay here dying. 2006.Summer.They forced me to have Injections AGAIN in my neck, instead of medication or surgery. They destroyed my body and destroyed my life. I haven’t even been with a woman since. Never got to have the career or family or hobbies I had worked so hars for. And now I can’t even return to the medicinal regime that worked PERFECTLY for me. Now I am almost totally bed ridden.
That this is even an acceptable conversation, that it doesn’t result in complete SHAME on the part of those publishing this awefulness makes me literally hate my country. I will leave this country country, and all of the Medical Fascism and Sadistic Egomaniacs and Puritanical Prohibitionist Pigs, if I can make it a few more months…

Judy

The main point in this article is “patient’s choice”…..right now we have no choice, we’re at the mercy of those who FORCE tapering down or off needed meds. I’m sick of this.

ElizabethR

I sent the letter below to the Attorney General of my state (who is proposing additional restrictions), my senators and my representative. I’ve hesitated to speak out but we have done nothing to deserve the “war on pain” that is being waged against us.
_ _ _ _ _ _ _ _
I am writing on behalf of myself and many other patients who live with chronic pain. I am almost 82 years old and have been taking a mild, inexpensive opiate pain reliever for a number of years. I have several painful medical conditions. While not curable, these conditions are manageable, although I am never pain-free. I have tried non-pharmaceutical approaches as well as non-opioid medications to no avail.

I use my medication responsibly and as prescribed. I am not the problem. There are major differences between a 20-something “drug addict” and an elder chronic pain patient, but I fear that these differences are being swept aside in the rush to combat the “opioid epidemic”. Suffering patients are getting lost in the shuffle of ever-more stringent laws and restrictions on medication. The physicians who know and treat patients with pain are being intimidated by serious government overreach that destroys the ability to provide appropriate care. Health care professionals are running scared—this is neither humane policy nor is it fiscally sound.

So far, I have been able to obtain my medication—which makes a dramatic and all-important difference in my functionality and quality of life. My 89-year-old spouse and I are able to live independently in our own home. I am able to shop for groceries, do most of the housework, volunteer a few hours per week and care for our 3 senior cats. I am not a burden on society or my family. I do not wish to become one.

However, I have begun to live in fear. If I lose access to medication, pain could soon render me unable to carry out many activities of daily life and self-care. Pain patients are NOT the problem. Please do not ignore or dismiss us.

Rita A Kimbel

I was not tapered, it was a complete cold turkey cut off January 1,2017. I will never forget or forgive what I went through that month, it was pure torture and I nearly died from the withdraw symptoms, blood pressure spikes were probably the worst. My family doctor had no choice but send me back to my pain management doctor. He has been taking mandatory drug urine tests, monthly visits and started me back on a new opiate, it takes 3 hours to kick in then works for a minute. Upped the millegrams temporarily till MMJ licence goes through. Thank God for the neuro-stimulator I had implanted 13 years ago or I might of taken drastic measures. Not to blame my doctor’s it was all my medical insurance doings, they didn’t care what the outcome was when they had Optum RX cut me off. I’m still here, suffering as well, this is all so wrong. My friends and family can’t believe, but watched it happen to me. I wish someone had cared to check up on how my force off went, and the affect it had on me.

Julie

” The idea that pain just goes away is ludicrious”- Dr. Forrest Tennant the leading addiction & pain specialist in this country.
I read the comments.
1) Your pharmacy is forced to cut your dose because the DEA has cut the amount the pharma co’s can produce.
This is about depopulation. Sustainability for the planet. Too many people? Or too greedy people? It’s in Revelations, about the US.
Anyone can read this document.
Why did Congress come together 99-1 to kill chronic pain patients? It’s on the Agenda, Agenda 21 since 1993.
Veterans, sick, old, chronic pain pts are committing suicide every day. The Gov KNOWS this, but continues passing draconian laws.
It’s about reducing the strain on the economy & planet by Depopulation. Obviously, the poor, sick, addicted, old, chronically ill, or non productive go first.
YT Ken McKim ” The slow death of compassion for the chronically ill” and Dr. Forrest Tennant ” The Dr. who refused to quit prescribing opioids”. (Was raided by the DEA 1 mo after video was made). He continues to research, make videos, & train Drs. (He’s 78) to continue his work. He’s been given Gov grants, done the research, he wrote the papers on addiction & pain.
AND he refuses to break his Oath!!!! YT.
Do your research! Peace&love to all CPP’s.

Ellen

What good is what last doctor said study individualize including patient choice but DEA cuts production and most hydrocodone when a lot medical people are still scared Dilaudid I use it PR due less nausea and it’s math like all opiates MME
Already hospitals can’t keep enough IV and blood pressure in patients sky rocket they stroke
To limit legal prescription or hospitals is not legitimate rule following and needed chronic pain is palliative not addiction treatment
Diversion should be punishable by the diverting givers stealers takers not patients in need that is malpractice and human torture
I read WA state will allow pharmacy and insurance to but in
Not knowing patient as well I did not know except vaccines pharmacy can prescribe they don’t have medical license nor does insurance This is govt trying rid of week Why don’t you just gas us or kill us off quickly then torture chronic pain patients
I still maintain it is a hate crime we are singled out

Jan Poole

To KURT JOHNSTON: I would like to help you and others on this website. GO TO PHARMACIST STEVE WEBSITE. He tells people to DUMP THE CHAINS, and has a link for people to find independent pharmacies (basically owned by the Pharmacist) where you will not run into these problems!

If you can’t find the link, research your own town for these independent pharmacies, they are out there! I hope this helps!

Dale

Having nearly twenty years on a ambulance I can attest that suicidal people can be very dangerous. Those driving people to that point are akin to poking a wounded animal with a sharp stick. Having read many of the comments over the last few weeks I would say many are at that point.

Kristie1

I to suffer from chronic pain and everytime I step into see a Dr am made to feel like a criminal or an addict, even though I have no history of either. What stuns me, is there are still people out there, filling prescriptions for pain, only to sell on the black market, yet someone such as myself who has medical issues that can be reviewed, in need of pain medications, have had my doses cut in half or more and my quality of life has drastically dropped. My only other option is to look for out of state Drs(as I live in KS)because the Drs here are afraid to treat their patients. Beyond that, I suffer from extreme anxiety and panic attacks and driving out of state isn’t feasible. I know I’m not the only true pain patient caught up in this disaster, but when you have a patient that has been well controlled on pain, mental health medications, and medications for common ailments, this new regimen is wrecking an semblance of a somewhat “normal” life. I have no help, i can’t get help. All. I’m repeatedly told is, we can’t accept you as a patient or we can’t treat you. Something needs to be done. Shortly after they implemented these laws, I had a 51 yr old friend pass away due to the drastic decreases in her medication and no-one even batted an eye. This IS NOT OK!

Chromered

Great article. I have been on Fentanyl for over 12 years for severe back pain due to FBS, stenosis and arachnoiditis. Doctors at the ER started me at 100mcg. In two months I was forced to work my way down to 25 mcg. Due to pain I bumped up to 37.5 mcg. My Doctor wants me up to 50.There were no programs in place or other medications to help me Tritrate down in dosage. Just cold turkey. I thought I might die. I do not wish this on anyone! Plainly barbaric and dangerous. My pain is always 5 to 8 every day now. I was forced through this by my medical carrier. Their goal is zero use and must be completed in 30 days. ‘‘This timeline and lack of consideration will have dire consequences for patients. It seems we now take better care of our pets.

Lisa Hess

FINALLY, we have someone who understands where those of us have already been. I am on Medicare and I’ve be tapered, tapered and tapered again since 2014 and not by choice and I am suffering. I’m being tapered again today another 60mg down per day. I know by next week I will not be able to walk on my own. I want to be part of this study so the government can see that tapering long term chronic pain patients are not addicted to their medications but are truly suffering from their chronic illnesses that cause chronic intractable pain. The other thing the government doesn’t take into account is that a lot of people suffer multiple chronic illnesses all of which cause chronic pain. I am one of those type of patients with 7 diseases that all cause chronic pain in my joints, muscles, nerves and every level of my spine. I am one of those patients who has been through over 25 failed procedures including 2 failed SCS routes. 20+ years of physical therapy with the last two I was excused after the tenth visit because I showed no improvement nor did the PT feel I would ever improve. A chiropractor almost broke my neck because it is so week. Heat, ice, ibuprofen, topicals are all minute solutions that stop working as soon as they are removed if one can even stand to have something on their body, I’m not one of those people. So yes, put me in your study and you will find for sure, that this mandate of 90MMED is not a ONE SIZE FITS ALL mentality to bring all chronic patients down to that level. I’ve been with Pain Management for 20 years. I’m lucky to have access because I live in a Metropolitan tri-state area, but some are not that lucky and have to depend on their PCPs for their medications. You want to education regular GPs, please do, but for those of us already with Pain Management doctors, let us alone and let our doctors treat us the way they know we need to be treated and stop putting handcuffs on all of us.

ruththella white

The medical profession is also the driving force behind forced reduction. A doctor recently reduced my pain medication while I was hospitalized sending me into withdrawal although they knew that due to a congenital heart defect withdrawal and pain sends me into valsalva which blocks the blood flow from my heart. He refused to call my pain specialist, my pharmacy, or check the database to confirm that I take short acting and long acting oxycodone. Their lack of training and opioidphobia were obvious. They didn’t know these are two different medications and my pain treatment guidelines were mandated by the APA. They gave me vistaril although they had no idea what side effects would occur with my breathing and heart. My legs started swelling, a symptom of heart failure, after they stopped my pain medication. Later, I heard the nurses laughing about it. They did not attempt to treat or diagnose my illness and ignored the fact that I developed pulmonary congestion which is another symptom of heart failure. They just sent me home. Two months later, after a second hospitalization and fourth fall, it turns out that I have MS. Chronic pain patients are being denied diagnosis and treatment for concomittant medical disorders. We are subjected to denial of our prescribed pain medication by doctors that are neither trained nor board certified in pain management.

Pamela Lee

My heart goes out to each and every soul who is caugh up in this government empossed taper to zero. I KNOW I would be bedridden if this were to happen to me. My pharmacist told be last year that it will be case of the pharmacy not getting meds as the suppliers are cut off. Sure enough, I go to get my Rx and they won’t have any in for 4 days. Going to another pharmacy today and PRAY. U have had 4 back surgeries, spinal cord stimulator, joke, PT, acupuncture, massage. Was an RN 44 years lif ring patients on and off the OR tables. Also contracted TB from a patient.
Feel like I’m kicked to the side after all my years of service. I take my meds EXACTLY how written. I have somewhat of a life.
Pamela

Alex

@Chris: I too use Walgreen’s and I am not having the problems you are talking about. I only get one script per month after a monthly visit to my pain Doctor and I go directly from his office to Walgreen’s to pick it up. I have never had the quantity cut, nor has the pharmacist ever told me anything about the “manufacturer forcing tapering”. After reading your post I called my pharmacy and asked if any of this were true and they said they had no knowledge of any such practice. Since I live in one of the most heavily affected states in the “Opioid Crisis” my meds visits have changed for every quarter with a call for a refill of my opioid prescriptions in between to monthly visits, occasional drug tests and pill counts, but that’s it. Nothing on the pharmacy side and I think (I’m no lawyer) but if a pharmacy actually did what you are describing and the result of their forced tapering regardless of your doctor’s prescribing history was something happening to you because of lack of medication they would be wide open for a huge lawsuit. As I said I am not a lawyer, but 41 years of business ownership in a lawsuit crazy industry I have learned quite a bit and I do think you’d find grounds for a very large lawsuit.

cindy

IN REPLY TO KURT JOHNSTON’S POST –

I live in FL, and get my meds at Walgreens, and have no problem. FL state law now bans opioid Rx’s from being more than a few days, but this does NOT apply to chronic pain patients. It applies only to people after surgery or some other new condition.

Since the new law went into effect a few months ago, my pain doctor’s office stamps my Rx’s with a word like “CHRONIC”. I forget exactly what word they use, but that allows any pharmacy to fill the 30 day supply.

Your post makes me wonder where you live and if somehow you are being lumped in with short term users by mistake.

I also have a hard time believing the story about your pharmacist’s conversation with the manufacturer. It doesn’t sound right. She has the right to fill Rx’s pursuant to federal and state law, and so could not get in trouble for attempting to do so and so that threat sounds false. She also could go to other manufacturers. I think there’s something else going on, or you misunderstood. I strongly advise you to go to another pharmacy. And to find out exactly what your state law permits and doesn’t permit.

TO THE PUBLISHER – I wish this comment section would be set up so that people could reply to each other. I have no idea if Kurt will see this or not, and it may help him.

cindy

When I first heard about this issue of forced tapering a few months ago, I was terrified. I wanted to see what would happen now if I tried, and I dropped my daily methadone intake by 1/3. Almost immediately, I became profoundly depressed and just shy of suicidal. After about 5 days of that, I went back to my normal dose and my mood improved immediately.

How many suicides will there be due to forced tapering? Simply due to suicidal thoughts brought on by dosage change?

On top of those who, after awhile decide that they can’t live with the pain — which I know would be me — as I am quite sure that I would have killed myself by now due to 10 years of intractable pain where no other medical approach, including PT, electrode devices, and non-opioid Rx’s, has worked.

And today is the 10th anniversary of my pain — my surgery which left me this way was 10 years ago today.

Alex

I have been in chronic pain since the 90’s. Following a work related accident in 2013 the pain I was left with for life became intolerable. The pain was so bad that at one point I believed my only option was suicide. With the help of a chronic pain Doctor who is very well known for his work with CRPS and RSD I began a low dose regimen that included and opioid, morphine. Since then I have regained the ability to walk, I have returned to my life long work as a On Site Construction Manager, I am back to hunting and fishing and pursuing my passion for outdoor and wild life photograph. My quality of life is such that people who know me forget that I live with pain every day. Yes there is a mental component to it and it plays a large part but the opioid pain medication I take twice a day has given me back my life. I have not increased the dosage in over 5 years and my goal is to never increase it. Living without morphine for me would mean no life at all, and I am pretty sure that I wouldn’t be here to write this had someone forced me off of it.
It is my personal opinion that prior to putting a person on an opioid a Doctor should include a psychologist who specializes in chronic pain to work hand in hand to insure as much as can be that this patient would not be a high risk for addiction. Am I addicted? Yes, and I would go through withdrawal should they remove my meds. But – and this is a big BUT, I am also not the type of person who would seek out an illegal uncontrolled drug to take the place of my morphine. My Doctor and the treating psychologist were comfortable making the diagnosis after a few sessions with me.
Evaluating the patient, not only for their ailment but for their addiction potential is a responsibility that should fall on physicians. They cannot be all knowing, but the extra caution in the beginning might just be worth it to the patient in the long run.

Wanda

My pain doctor abandoned me. I have been cutting my pills (morphine 30mg) in half and then half again. My Norco is gone. I have 11 plates and 22 screws in my spine. When I walk a knife is in my back and it feels like someone is turning it. I pray I can keep working. I feel so hopeless. It’s unbearable. Doing this in 30 days! No doctor will even treat chronic pain anymore. The government sure scared them.

Andrea

This is the link to the EMPOWER study for all who may be interested. This study has become a welcome a safety net for many undergoing forced tapers.

https://empower.stanford.edu/

KURT JOHNSTON

Sorry my prior post went blank. Opiate tapering is now being done at the Pharmacy level. I just dropped my usual script off which will be one of the last as my physician is worried about his license, but the pharmacist took me aside and told me that pharmacy orders to manufacture are being cut in half by the manufacturer. That the manufacturer is saying the legal pressure must be shared so she said from now on she will either be out of meds or will only be able to partially fill an order so your script may be fort 120 and you may get 60 and the rest are voided so she said it is forced tapering by manufacturing companies. She said she went right to the head of the manufacturer and he told her he was going to report her to the state licensing authority for her persistent attempts to get full orders. She said she was only trying to help her long time patients but that since CVS and Walgreens now demand diagnoses on the scripts and the only will give 7 days of meds. I really feel hopeless at this point. We true chronic pain patients are discriminated against for our medical conditions and there never seems to be any at all compromise by governments to assist us. So, what now? I will have the embarrassment of going through withdrawal and the finger pointing and then the inability to sleep or ambulatory because of the pain. My days of being a grandpa are over and I don’t know what to do with this situation. All this with my Physician and pharmacy in 2 weeks. This McCarthyism train aganist opioid has hit me full on and there is no justice.

Chris

Thanks to The National Pain Report “Ed Coghlan” for your efforts to make sense of this and actually have an understanding that in debates there are two at least positions. There is no debate in mandate! Or intimidation through the use of guidelines that are being imposed! Thanks again- great article! 🙂

Cheryl

What the “government” doesn’t realize is one size does NOT fit all. My husband has voluntarily reduced his pain meds by 2/3. After surgery he feels the pain is better. It has taken approx 1 yr to get to this. HE made the decision, his doctor did not ask him to reduce the meds.

Most ppl don’t want to be on these meds. You are a slave to doctors, pharmacists, insurance company and your calendar. All the while you must also maintain some sort of quality of life.

Ppl on Medicaid are being forced to wean without any control over their own lives and medical conditions. Since when is it OK for the government to stick their nose in a patient’s medical record? What about HIPPA and all of the privacy notices you have to sign before an appt?

Just because someone is in need, doesn’t mean their rights are less than mine. I think the government needs to start over and go back to where this all started. That beginning is with the physician, not the patient. After all, the doctor controls the prescription pad. Some doctors give pills a free a Halloween candy, trade scripts for sex, sell scripts and even take pills themselves. So I ask, why are the true patients in need being penalized and hurt physically, mentally and emotionally? Don’t they already hurt ? I beg the authorities to rethink this solution.

Just remember, sooner or later an election will come up. Then it is the patient’s turn to make a decision that may affect someone who made a decision about their lives.

Good luck and prayers to all.

Steven

Sorry , Data is only lacking to the people who are not goig to die when they are reduced to whatever they simply cannot live with. I vannot live at 200 or 90 or 0. We who are that sick are now just dead .

Alex

For many patients forced opioid taper (especially rapid ones) ARE dangerous. Effects such as severe nausea, dehydration and even grand mal seizures can occur. This poorly thought out plan for forced taper is the result of ignorance combined with administrative power. These administrators are not trained as doctors or pain management specialists. The token inclusion of psychiatrists or “addiction expert’s” does not provide the medical expertise needed to evaluate this issue. Pain patients who are stable on their opioid dosing and compliant have no need to be tapered. It is incredibly frustrating to see these unqualified administrators exercising their “We know what is best for you, your own doctor does not” doctrine. Pain patients such as myself must speak out and demand proper , humane medical treatment. Making prescription pain medications difficult to obtain will only force some desperate people to resort to alcohol or even illegal drugs to relieve their daily suffering. Contact your state representatives, even a short note is better than doing nothing. I am drafting my letters today. They do not have to be perfect, just be honest and send them out ASAP!

Kathy

How I’d like to be able to see Dr.Beth and have her talk with my Dr. From KAISER about entering me into Clinical Research @ Stanford.
I’m at present tapering off MS continued after 20 yr RX from Chronic Pain Management program…they put me on it after methadone…they prescribed.
I’ve had 2 Anterior cervical fusions with graft and plating..my pelvic crdst is in my neck!
And cadaver bone. 1990-1995
I was pregnant and fell then domestic violence…
I’m in pain again..while tapering and am e cersicing daily..taking 3 pills instead of 4… Pharmacist said my taper might end at Christmas.
I had Diverticulitis from opiates slowing my system..that was painful!
So My Dr. Told me Opiates caused it and I decided I’d had enough of horrid side effects and it was time to go off opiates all together.
I’m 59..female..a twin..and have been active in my health.
I’m a Kaiser Permanents patient, But my surgeries were done elsewhere..not Kaiser. My Neurosurgeon was Dr. John Grollmus..amazing..may he rest in peace.
My Ortho was Dr.Charles Moulton..he passed also…I’ve wanted my records but cannot get them.
I want to be in a Chronic Pain Management study for years…no Dr ever asked me…
I’m ready.
I know CBD oils can cause liver damage…I’ve been having Liver problems since the bout of diverticulitis… I’m in California. Northern area .
Contact me…about chronic pain studies..research and clinical trials…
I want to help those like me feel better…I know its got to be possible.
Chronic pain takes a part of your Brain….I feel as if I have Alzheimer’s sometimes due to Chronic pains effect on my brain.

ThankYou,
Kathy. A. O’Connell
20495Highway 116
AptB
Monte Rio, CA.
95462
707-865-5241

Mark Zobrosky

Thank you for the Story on Dr. Beth Darnall and her “Patient Focused Study”. I am one of those Intractable Pain Patients who has tried many pain relief options from massage to physical therapy, through four back surgeries, spinal cord stimulator and finally found relief in a measured dose of opioids. Dr. Darnall’s approach and study are the first that I have found that focused on the patient first and foremost. Allowing the patient to make decisions based on their physical and emotional well being. She places the patient at the center of the process and then provides tools for the patient to use to empower them to attempt tapering, completely at their discretion. This allows patients like me to attempt to taper my dose down to a comfortable level, at my pace, using Physical and Psychological tools to provide patients like me to attempt a taper with new instruments in my pain relief “toolbox”. I had attempted to taper my opioid dose down last year over a three month period. I failed as the pain was far worse during the tapering period. However, if given the opportunity to try again, using a “patient centered” approach with the tools offered in Doctor Darnall’s approach, I would be glad to try the process a second time. The patient focus along with added tools would give me the hope to try
!

Dragonfly

I have ran into no one who gives a [edit] about how this affects pain patients. I been in pain 12 months. Begging for help and now im labled as a drug seeker in my medical chart. I have not went to the streets. I stay home with no quality of life trying to survive off of the drugstore shelf. How long can i keep taking BC’s, benedryl, lidocaine patches with 4 hours of sleep a day. My dr refuses to give my pain management back. I suffer from ehlers danlos type 3. Now my ribs are popping out of place. It is just excruciating and Im not even allowed to go to my local ER because they have put drug seeker in my chart. What are we suppose to do. SCARLET LETTER O FOR OPIOID USER.