How Fear of Losing Their Doctor Affects Chronic Pain Patients

How Fear of Losing Their Doctor Affects Chronic Pain Patients

By Linda Cheek.

As more doctors are attacked for treating chronic pain in the country, chronic pain patients are finding fewer doctors willing to provide treatment. Also, with the current non-scientifically based stance that opioids are bad, doctors are unwilling to treat appropriately. The VA, for example, proudly announces that they have decreased their opioid prescribing by 65%. James L. Sall, PhD, clinical quality program specialist at the VA Office of Quality, Safety and Value, stated “When it comes to opioids for chronic pain, just don’t do it,” (1)

Linda S. Cheek, M.D.

Criminal prosecution of pharmacists and physicians for prescribing and dispensing opioids is being stepped up. In August, 2017, the Department of Justice announced the formation of the Opioid Fraud and Abuse Detection Unit, which will use data to pinpoint healthcare providers who prescribe opioids.

Under pressure to curb opioid prescriptions, clinicians are increasingly reluctant to prescribe them. As a result, 73% of physicians and 82% of pharmacists responding to a recent Medscape survey say that the opioid epidemic has changed their prescribing habits.(2)

With the latest government attack on Dr. Forest Tennant, MD, a renowned expert on pain management, and with the announcement by Jeff Sessions that more investigators are being hired in the DOJ to attack more doctors, how does this affect the 100 million people experiencing pain in the US?

Increased Stress

The effect of continuous fear is increased stress. Acute stress can be explained as the “fight or flight” response. It is an innate survival mechanism—increasing heart rate, muscle tension, and blood sugar to prepare the body to either fight the tiger about to eat you, or run away. In ancient times, acute stress was an occasional occurrence. But in today’s society, it is ongoing, from the alarm clock going off in the morning, through rush hour traffic, deadlines at work, ad infinitum. Continued acute stress becomes chronic stress, and continuous fear of possibly losing one’s pain meds is a chronic stress.

Conventional medicine accepts the following results of chronic stress:

  • Cardiovascular: increased heartbeat, increased blood pressure, arrhythmias, blood clots, heart disease, hardening of the arteries, heart attack, and heart failure.
  • Musculoskeletal: Stiff neck and/or shoulders, increased back pain, worsening rheumatic diseases.
  • Gastrointestinal: Nausea, diarrhea, peptic ulcers, gastrointestinal reflux (GERD), irritable bowel syndrome (IBS)
  • Respiratory: rapid breathing, worsening asthma and chronic obstructive pulmonary disease (COPD)
  • Reproductive: lower fertility, erectile dysfunction (ED), painful menstruation, increased sexual abuse
  • Skin: worsening acne, psoriasis, eczema
  • Psychological: anxiety, panic attacks, depression, increased worry, lack of motivation, loss of temper, inability to deal with even small problems, feeling overwhelmed, social withdrawal, lost self-worth.
  • Sleep: Chronic fatigue and sleep problems
  • Behavior problems: Overeating or undereating, drug or alcohol abuse, tobacco use, decreased exercise.

Over time, stress affects:

  • The Immune System: stress depresses the immune system so sickness is more frequent.
  • Heart disease
  • Obesity
  • Diabetes
  • Increased alcoholism and drug abuse

Disruption in sleep and chronic pain is a vicious cycle. A May, 2016 article in Medscape shows that disrupted sleep is linked to lower pain tolerance and impulsivity. Sleep loss increases pain sensitivity which interrupts sleep.

Dr. Finan: “People are losing the positive emotional stores they need to be able to cope with pain flares that are needed on a day-to-day basis, and this could result, potentially, in a clustering of the disorders that we commonly see — this triad of chronic pain, insomnia, and depression. (3)

Hormones are affected, especially the stress hormone, cortisol. Patients with severe chronic pain already have low serum cortisol levels. “These patients don’t have enough of their own cortisol to heal or to make their pain medicines work,” states Dr. Forest Tennant, MD, recently attacked by the DOJ. He believes that many deaths attributed to opioid overdose are, in fact, caused by extremely low levels of cortisol. How does this happen? Acute pain causes a stress response, and as pain becomes chronic, the response is exhausted. This depletion explains the fatigue, mood changes, and other non-pain comorbidities.

Pain Catastophizing

Pain catastrophizing is a maladaptive response to pain that amplifies chronic pain intensity and distress. It is a cascade of negative thoughts and emotions in response to actual or anticipated pain and is associated with amplified pain processing, greater pain intensity, and greater disability.

Pain catastrophizing has been identified as a risk factor for opioid craving and prescription opioid misuse. It relates directly to pain intensity and serves to undermine pain treatment efficacy.

Increased Use of NSAIDS

The tapering of opioids causes an increased use of nonsteroidal anti-inflammatory drugs like Tylenol, ibuprofen, naproxen and aspirin. They increase the risk of stomach bleeds, ulcers, liver and kidney damage, overdose, and even death.

Hopelessness, Despair and Death

Patients in constant fear of losing their pain meds face increased pain, hopelessness, and despair. So the last consequence of stress on chronic pain patients is death.

Death from drug overdoses has quadrupled since 1999.(4)  Suicide has increased from 30,000 in 2000 to 44,000 in 2015, or a suicide every 12 minutes.(4) A report, Pain in the Nation: The Drug, Alcohol and Suicide Epidemics and the Need for a National Resilience Strategy, predicts a 60% increase in suicide by 2025 compared to the previous decade (2006 to 2015). Life expectancy in the country decreased in 2015 for the first time in 2 decades,”(5)

But patients receiving prescription opioid therapy are not the major driving force behind drug overdoses. Instead, it is the result of patients being cut off of their medication, A study of veterans published May, 2017 in JAMA Psychiatry, found that migraine and chronic back pain are associated with an elevated suicide rate. Suicide is the 10th most common cause of death in the United States. Hopelessness also plays a part in the elevated risk of suicide. “negative expectations about one’s ability to effectively manage or treat pain could lead to suicidal ideation.”

Call to Action

Former U.S. Rep. Patrick J. Kennedy says “We have all the experts who know what to do; the think that is missing is the political will to do it.” “If our legislators don’t hear from us, they do nothing.” (4)  First, we must disassociate the cause/effect of opioid use with addiction. This is by understanding the REAL cause of addiction. Second, we must get the legislature to stop the illegal use of the Controlled Substance Act to attack physicians treating patients. DoctorsofCourage.org is one possible means for providers and patients to come together to work for the common good.


References

  1. Deborah Brauser. “The New VA, DoD Opioid Guideline Warns Against Long-Term Use” Medscape. March 17, 2017
  2. Alicia Ault. “Opioid Epidemic Alters Prescriber, Pharmacist Habits” Medscape. November 02, 2017
  3. Nancy A. Melville. “Disrupted Sleep Linked to Lower Pain Tolerance, Impulsivity”. Medscape. May 18, 2016
  4. Sullivan, Michele G. “Opioid Deaths and Suicides” Family Practice News October 15, 2017
  5. Megan Brooks. “’Staggering’ Number of Drug, Alcohol, Suicide Deaths Projected” Medscape. Nov. 21, 2017
  6. Robert Lowes. “CDC Issues Opioid Guidelines for ‘Doctor-Driven’ Epidemic”. Medscape. March 15, 2016

Linda S. Cheek, M.D. is a retired family practice/pain management physician, founder of doctorsofcourage.org and sevenpillarstotalhealth.com, and best-selling author of Target: Pain Doc. As a victim of the government’s War on Doctors, she is an activist against government overreach into medicine, the incarceration of innocent physicians, and the resulting trauma to chronic pain patients.

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Authored by: Linda Cheek

There are 26 comments for this article
  1. Jenny Picciotto at 2:16 pm

    Thank you for a well researched and informative article, for sharing your knowledge and adding your voice to this important topic. Thanks also to others who have joined this conversation in the accompanying comments with personal stories and resources. This discussion needs to happen. Thank you to National Pain Report for hosting this for providing space for such reporting and reflection.

  2. Rita KIMBEL at 3:55 pm

    I’m exhausted, the pain is taking over my life. The cost has become too much, I can’t afford it. Every month I visit my PM doctor and hand him $60, then the fear of being denied by Optum RX and detoxing again because of prior authorization not going through in time for medicines to arrive, I’ve been there a few times this year. I pray my PM doctor doesn’t decide to give up, he runs in 2 states now trying to help chronic pain patients. He’s tired too. What has this new CDC requirement done to us. I don’t want to give up, but it’s hard to be positive in all this, no one’s going to come to my rescue and give me back the oxycontin needed(spinal cord injury). I will suffer now after all these years learning to accept the fact of permanent injury by the hands of another(chiropractic manipulation). Has anyone gotten an answer from the congressman or state representatives they’ve written to? I haven’t, but Fox29 did respond that they will try to follow up with me, that was months ago.

  3. Rick Martin at 11:41 am

    Please copy/paste the following links and send to:
    60m@cbsnews.com
    sundays@cbsnews.com
    KLAS TV is a CBS affiliate.
    ===================================================
    KLAS TV CH. 8 CONCLUDES WEEK LONG OPIOID SERIES
    BY AWARD WINNING GEORGE KNAPP, INVESTIGATIVE REPORTER.

    “This is the most comprehensive detailed analysis on TV of
    patient suffering, suicide, CDC deceit/fraud, and lack of media reporting
    of whats really going on in this country when it comes to prescription
    opioid medications and the patients who undeniably benefit from them.”

    If your time is limited, please watch Sept. 1 newscast, Nov. 6th, 6pmnewscast,
    Nov. 6th, 11pm newscast and Nov. 10th 11pm newscast to start.
    I hope if these indicated ones are viewed, they will
    be incentive to view all the videos.

    #OurPain is the operating title, with new stories airing each night at 6 and 11 p.m. starting Monday, Nov. 6 with how politicians and the media have exploited and muddied these issues.
    Sept. 1st, 2017 Original announcement for the series starting in Nov.
    http://www.lasvegasnow.com/news/i-team-the-opioid-conundrum/803064908

    Mon. Nov. 6th 5pm newscast, to preview the 6pm newscast.
    http://www.lasvegasnow.com/news/ourpain-opioid-crisis-leaves-legitimate-pain-patients-struggling/852347092

    Mon. Nov. 6th 6pm newscast to start the series.
    http://www.lasvegasnow.com/news/ourpain-the-other-side-of-opioids/852432872

    Mon. Nov. 6th 11pm newscast:
    http://www.lasvegasnow.com/news/ourpain-opioid-prescriptions-go-down-deaths-continue-to-rise/852502570

    Stories/links from KLAS TV that were not aired during the newscasts
    http://www.lasvegasnow.com/news/the-personal-side-of-pain-teresa-winford/852292642

    http://www.lasvegasnow.com/news/the-personal-side-of-pain-meredith-lawrence/852306426

    http://www.lasvegasnow.com/news/the-personal-side-of-pain-don-reitmeyer-iii/852314447

    Tues. Nov. 7th 6pm newscast Dan Laird MD, Mark Ibsen MD
    http://www.lasvegasnow.com/news/ourpain-doctors-caught-in-the-cross-hairs/852978367

    Tues. Nov. 7th, 11pm newscast: Lear of Lear Jets interviewed.
    http://www.lasvegasnow.com/news/ourpain-patients-share-stories-of-being-cut-off-from-medication/853057947

    Wed. Nov. 8th, 6pm newscast:
    http://www.lasvegasnow.com/news/ourpain-pharmacies-refuse-to-fill-some-pain-prescriptions/853812980

    Wed. Nov. 8th 11pm newscast:
    http://www.lasvegasnow.com/news/ourpain-woman-says-she-is-made-to-feel-like-a-drug-addict/853866792

    Thur. Nov. 9th 6pm newscast
    http://www.lasvegasnow.com/news/ourpain-find-out-the-most-dangerous-drug-on-the-streets/854533608

    Thur. Nov. 9th 11pm newscast
    http://www.lasvegasnow.com/news/ourpain-how-money-factors-into-the-opioid-debate/854655309

    Fri. Nov. 10th 5pm newscast talks some about the VA and Va patient interview
    http://www.lasvegasnow.com/news/ourpain-opioid-crackdown-leaves-veterans-in-pain/855279151

    Fri. Nov. 10th 11pm newscast Final report/recap
    http://www.lasvegasnow.com/news/ourpain-line-between-street-drugs-and-prescriptions-blurred/855397073

    The CDC Guideline for Prescribing Opioids for Chronic Pain – 2016
    needs to be suspended & re-written with input from Pain
    MGT. Physicians plus designated pain patients.

  4. Renee E Mace at 12:35 pm

    Does anyone know of a pain doctor who treats pain patients and is not afraid to write prescriptions for pain medications in Spokane WA? I need a doctor who treats all of me instead of just chronic pain medications because if you are treated for all then the doctor can see how increased pain make my blood pressure, my acid reflux and my anxiety raise up and this is not good for my health. I am willing to try almost anything to get pain relief but if nothing works or kind of works, then the doctor needs to treat it without being scared of loosing his/hers practice. I like my Nurse Practitioner but with my medications being lowered, I am in so much pain that I am now confined to bed. Also I am being lowered on my clonazepam which are causing me major withdrawals and panic attacks which raises my pain levels. I wish that once educated about your medications that I can choose or not choose certain medications, for it is my life to make that choice. I need my low dose anxiety pills and my pain medications and my herbs and supplements. I understand the risks but in 16 years I have never been addicted to them. They have gave me a life despite being a chronic pain person. I wish the doctors could treat me and include me and ask me what I think might help me.

  5. m brown at 11:31 am

    Christine,
    I agree with you. I have made this point before but it bears repeating:

    “Many states have legislation for THE RIGHT TO DEATH WITH DIGNITY.” WHERE ARE THESE STATES NOW???

    What about a pain filled ”

    “RIGHT TO LIFE WITH HUMANE TREATMENT FOR CONSTANT CRIPPLING PAIN WITH PAIN RELIEF AND DIGNITY?”

    THERE IS NO-NO-NO DIGNITY IN BEING TREATED LIKE A CRIMINAL. BEING RED FLAGGED,BEING DENIED WHAT HAS WORKED FOR YEARS. being judged. WHERE ARE THE HUMANITARIANS HERE? DOGS ARE TREATED BETTER.

  6. Ibin at 10:43 am

    Why is research, fact with the positive effects of prolonged opioid medication use that is recorded, documented as a beneficial medication for pain management NOT being recognized? The negative impact of a misguided “policy” from the CDC absolutely enforced by the DEA is causing so much harm. Daily, “normal” ability to function, ability to be self managing, self providing, and the reality of negative physiological, psychological harm monetary harm, and suicide is totally ignored with “policy”.The forced reduction of appropriate dosage for the patients that have used opioid medication for years and decades without any….negative results should be enough evidence, documentation that those that use prescribed opioid medication responsibly are benefiting from appropriate medication. It IS simply asinine or worse, dictator like treatment from evidently, the DEA. I am a nobody but, I offer ANY testimony, backed up through documentation of decades of positive use of opioid medication to every representative or medical regulator that I contact.I will continue to advocate with every means that I can to the “elect” of the positive use, beneficial use of medication and remember who gives a damn when it is time to cast my vote. I can testify that with medication reduction, I can no longer operate my business of 35 years and am forced to file for SS Disability which I will be denied for about 3 years as per the “record” of disability approval in my state. LIFE savings at age 59 are disappearing. Pain rules day and night. 23 years of a reasonable, normal life even though pain persisted with an appropriate dosage prior to….the CDC misguidedline. pain management “policy”. Opioid medication and responsible use of, is an effective treatment to remain a self providing,self sufficient person, patient; to the best capacity each….individual….patient can. It seems that torture with medication reduction or worse, the inability to locate a physician that will even prescribe medication is a criminal act, enforced by the DEA. It does not appear that with over a 60% reduction of prescribed opioid medication, NOTHING toward drug overdose is being achieved, however, the patients reduced in medication and those that can not even find a source to be treated with opiod medication are suffering the consequences of a failed”policy”. It would be great if we lived in a perfect world. We have surgeons, physicians that treat our disease and injury and they attempt to stop the pain caused by different health issues but, their tools for treatment are “regulated”. I truly do not know what it will take for our health conscience regulators to see that opioid medication has far more beneficial use than negative abuse. I hate to use the cliche’ word but, it is not fair. Continue to advocate, make your voice heard, “bother” every one of our “elect” that is paying no attention to the harsh, hurtful effect that the one for all dosage is causing. It is ridiculous for the patients that have beneficial use of a scheduled substance, medication that has so positively affected so many lives with positive documentation to have to fight for appropriate treatment for our pain issues especially when their is no other treatment available. Fight on, write on, speak on and never stop because we all have been accused, tried, and convicted of a crime that we have not committed. No due process, but still convicted of an inpropriety in regard to medication use and drug overdose. I don’t need dot/gov interference between my physician and my pain issues. I HAVE 23 years of documentetaion without negative issues along with millions of other patients that IS totally being disregarded.The patients through a dictator “policy” ARE facing physiological, and psychological…….. worsening health. I personally will not stop voicing my opinion but, when backed into a corner, no where to run, we have to fight.

  7. Kurt W.G. Matthies at 10:03 am

    Thank you, Dr. Cheek.

    This anxiety is bot ubiquitous and pervasive in the community of pain patients who receive opioid therapy for long-term intractable pain.

    Yet it is virtually undocumented and unrecognized in the medical literature.

    People in pain will find help managing this and the many other comorbidities common to long-term intractable pain syndrome through a partnership with a good pain psychologist.

  8. Richard A. Lawhern, Ph.D. at 6:30 am

    Leslie Meadows, I published on this subject too on National Pain Report: “An Open Letter to the Presidents Commission on Combating Addiction and the Opioid Crisis – You Need to Hear a Tenth Voice”

    http://nationalpainreport.com/an-open-letter-to-the-presidents-commission-on-combating-addiction-and-the-opioid-crisis-you-need-to-hear-a-tenth-voice-8833880.html

    In this open letter I made the point that chronic pain patients and their doctors were not represented before the Commission and that the resulting policy recommendations were deeply biased and in many cases poor public policy.

  9. Christine Smith at 5:22 am

    Hi.. I am a 46 y/o chronic pain patient and have been for 17 years! I am also a RN for the last 17 years!
    Let me just ask … i dont hear or see anyone talking about this being a violation ofpatients right to bepain free and that a patient has the right to choose and/or participate in their own care? How do people that is not even in the medical field or who is not MY PRESCRIBING DOCTOR ?…. have the right to dictate my treatment my care when they know absoluty nothing of my individual situation? Where is the consitution and advocates attorneys and why has this been allowed to go on?
    I will find a way to fightand fight hard i will findsomeonewilligto take these people all the way to highest court of kaw isnttheir anyone any dr or lawyer willing to fight!????
    Christine

  10. Drew P at 3:38 am

    This is a fantastic and well written article. We certainly need more of this in our pain management community! I am on my 4th pain management doctor in 5 years, and I am lucky to be treated at one of the top hospitals in the country where I am transferred to another pain management Dr automatically.

    I dont know what I would do if I had to find a Doctor on my own as most Dr’s will NOT accept new chronic pain patients. I thought about moving to another state a few months ago and I researched Pain Management Dr’s, but I quickly found out it was futile as many Dr’s are getting out of pain management due to the federal government’s over zealous oversight.

    Doctors are being bullied by the DEA and other government organizations that are misusing the law.

  11. Leslie Meadows at 9:08 pm

    Great speech where were you when WH had meetings? Where are & were the knowledgable doctors & pain experts??It is to late now the only thing we can do is attempt to broker Sessions into another meeting. This WILL KILL PPL, so they had rather kill us than dope pushers/addicts & the sobbing parents don’t help!

  12. Ellie at 6:12 pm

    Tx u Linda & know my💜goes out 2 4 what all these awful law enforcement ppl have put u through & u still r able 2 recognize what we as CPP are & continue 2 go through. U R one of many brave Doctors, but there are also so many that really do not care about their patients, but l believe you do. I wish u continued strength in these coming years 2 not only fight 4 yurself but we as CPP also. 👏 2 u & yurs & know that God’s providential love will prevail over these corrupt politicians with little 2 no medical background!

  13. Rick at 4:28 pm

    Cdc to intractable pain patient.
    ‘Here’s a bottle of whisky. Drink it till you fall, then visit our treatment center investments and we’ll have a mental health expert look at ya. Can’t be THAT bad.’

  14. Richard A. Lawhern, Ph.D. at 2:51 pm

    Interesting and well researched article, Dr Cheek. I would add two additional references if I may — one of them published here on National Pain Report:

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

    http://nationalpainreport.com/figures-lie-and-liars-figure-why-the-demographics-of-the-so-called-prescription-opioid-crisis-dont-work-8834839.html

    Likewise of interest is “Psychogenic Pain and Iatrogenic Suicide” was published on the Global Summit for Diagnostic Alternatives of the Society for Humanistic Psychology:

    http://dxsummit.org/archives/1002

    In the first of these articles, I demonstrate that there is little overlap between groups of pain patients who are prescribed opioids versus addicts who buy them in the street or steal them from home medicine closets. In the second paper I offer evidence that by the simple act of calling a patient’s pain “psychogenic” — and thereby invalidating a patient’s concerns about poorly managed or misdiagnosed pain — a doctor may increase the risk of suicide by 250%

    I personally believe that the present war on drugs has devolved into a war against pain patients. And it is bloody well time the war was STOPPED..

  15. Laura Robertson at 1:18 pm

    I have lived with chronic pain for nearly two and a half decades. In 1993 I was hit by a truck. I was diagnosed as having a back and neck “strain” (whiplash), and told I would be better and back to work in six weeks.

    I wasn’t. Three months in, not pain managed and completely sleep deprived, I was sent to a physiatrist. In his office I burst into tears. I was labelled ’emotionally labile’, and sent to a psychiatrist, who proceeded to tell me the pain in my back was all in my head. I tried so hard to work with the experts to fix my head… by the one year anniversary of the accident, I was actively suicidal and hospitalized.

    On top of the severe pain, sleep deprivation, and worsening isolation (my marriage was the one fatality of the accident), I struggled with depression for several years, and developed an almost crippling anxiety disorder. The auto insurers, the lawyers, and the insurance company doctors, all of whom were paid outrageous amounts of money (hired to discredit me), left me feeling absolutely shattered.

    I spent eighteen years in bed. I have been undermedicated and left in tortuous levels of pain, life-threateningly overmedicated, not medicated at all – and suicidal.

    Finally, I got into a pain clinic. Thanks to the most incredible doctor, Ellen Thompson, I began to recover. She came out of retirement and followed me for four healing years.

    I get nerve block injections every Tuesday. I take oxycodone, and for which I am grateful, and very afraid of losing. I don’t want to be forced back into bed, isolated, in pain, and struggling to find value in myself and my life.

    Because I am mostly pain managed, and there are critical things I can do to help, I have a life. Exercise, eating healthy, pacing, positive thinking, relaxation and daily meditation all play a role in living with pain.

    I am now an active advocate for Persons With Pain. I host support group meetings, and run an online discussion forum. I have just been invited to be on two provincial committees as the patient voice for people with chronic pain.

    I have my work cut out for me, because on a committee of thirty-five members, including the Ministry, the OPP, the Coronors Office, CPSO, and a host of voices for addiction, there are only two of us speaking out for opioids as a reasonable option for pain management. The media bias, poor education of physicians and the general public, and the tragic voice of addiction is going to damage and kill those of us trying to get through the day effectively pain managed.

    Take away our access to opioids, and we have no choice but to turn to the street, where we are at high risk of overdose and death. Unless we are choosing to kill ourselves, in which case we are at high risk of overdose and death…

    One other thing I wanted to say in realtion to this article. Chronic pain is not just a physical health issue, it is a mental health issue. PTSD, depression, and anxiety spectrum disorders are common, as is suicidal ideation. Chronic pain does have a mortality rate. A completely unnecessary, extremely tragic one.

    And anyone who goes to a doctor in pain, trusting they will be helped, and is instead judged, labelled, shamed, stigmatized, and refused treatment, is going to be emotionally scarred.

    In the population I work with, I see something I have started calling STSD. Systematically Triggered Stress Disorder. Anxiety about going to the doctor, not being believed, having to fight tooth and nail for compassionate care and pain management when we are exhausted and incredibly fragile is actually iatragenesis in action. Harm done to the patient by the health care system.

    And it can be lethal. Something has got to change, and fast.

    People in pain are dying.

    Laura, Ontario, Canada
    chronicpain@bell.net

  16. Alan Edwards at 9:06 am

    Excellent article. Scientifically accurate and describes what Im going through with pain treatments.

    Amazing how many doctors are inept, scared, but mostly worried about their reputation. If they prescribe an opioid, they are criminals. If I take Lortab for severe chronic pain, I’m a criminal. The pharmacist views me as a criminal. When the prescription is filled, I am reported to the local police. Then I suffer a lecture from the clueless pharmacist in public. She does not know or care that I have chronic untreatable neuropathy, advanced degenerative disc disease,spondylitis,rheumatoid/osteoarthritis, stenosis, nerve damage, brain damage, cerebral palsy, severe spasticity, hydrocephalus, macrocephaly, insomnia, ganglion cysts, migraine headaches, touch neuropathy and neuropathic pain, myofascial dysfunction and cancer. Skin cancer causes me no pain. Oh, and amitriptyline withdrawal for a year now which nearly killed me and was as painful and debilitating as all of the above. This is not a complete list of my painful maladies. Bad doctors, the fda, pharmacists and politicians have the gall to assess me as a criminal. After 15 years I have not and will not die of respiratory arrest. Thanks to Dr. Cheek for an accurate, caring article. Shame on those who support suffering including veterinarians. A sad situation.

  17. Byron at 8:37 am

    I urge you all to contact your elected representatives, both State and Federal, and make them aware of your position. Best people to speak to are District Directors, Regional Directors, Chief of Staff, and health care legislative assistants. Speak out at town hall meetings, send emails, and make phone calls. Visits in person are best of all.

  18. David Cole at 8:08 am

    Sounds like exactly what’s happened to me. Opiates saved my life. 10 years ago I was five foot seven and 400 pounds, I gained 180 lb over about 5 years, I tried treating my pain with alcohol for those 5 years, so I could stay at work. Finally got so bad I had to quit my job. I went to the doctor and told him it was time to step it up because I didn’t want to take opiates in the beginning. I had everything associated with being overweight. Sleep apnea, high blood pressure, diabetes, fatty liver, you name it I had it. After receiving a prescription for opiates, it took me about 4 years, but I was able to lose about a 170 lb, sleep apnea, high blood, pressure diabetes, all of it was gone and I did it without no medication. Then about 2 years ago they decided to start cutting my pain meds, now I’m in bed 90% of the time again. I figure I’m right back in my deathbed now. The suicide thoughts, depression, anxiety and stress is killing me. I’m now writing my suicide note, I’m not suicidal I love life, I have seven grandchildren I love to be around them, but not when I’m in so much pain I just yell at them. I have neuropathy and it’s very difficult to control the pain. I’ve taken two mind-bending courses to learn how to deal with it, these techniques are absolutely useless when you go in 2 pain levels 5-6 constantly, this all leads to pain levels in the death zone, anything or me about a 6 pain level brings on suicide thoughts, anxiety depression and stress so bad you lose your mind. During that time you have no idea what you’re doing you’re going to die. So I’ve decided to start training my brain to automatically do something that will get these people’s attention. I just have to make sure that nobody else gets hurt about me. Maybe I’ll jump off the hospital roof and stream it live on Facebook or something. I can guarantee I will not die of a drug overdose or shoot myself, because these idiots don’t understand, they would say it’s because of the drugs or the gun. NO, IF I END UP DEAD, IT’S BECAUSE OF UNTREATED PAIN. END OF STORY

  19. J.Martin at 8:05 am

    Besides Drs/healthcare professionals radically decreasing dosage and/or totally stopping opioids for persons being treated for chronic pain, my pcp recently stopped my fiorinol(rx’d for migraine/tension headaches). I had been rx’d these for yrs. and his statement to me was “I am no longer prescribing ANY SCHEDULED MEDICATION to my patients.
    I suffer from osteoarthritis, tmj and lyme.
    We all need a platform to put a stop to this illegal torture that this current government is rapidly escalating.
    How to do this is what frustrates me…Keep calling and writing representatives. Non- stop. This is insane.

  20. HAZZY at 7:31 am

    IAM A DISABLED VETERAN AND NOW IAM BEING THROWN UNDER THE BUS BY THEM !!! MY PAIN MANAGEMENT CENTER CUT MY PAIN MEDS AND MY HEART DOCTOR HAD TO CHANGE AND RAISE MY AMOUNT OF BLOOD PRESSURE MEDS…………….LEAVE US THE HELL ALONE, BEFORE YOU GIVE A PERSON LIKE MYSELF A STROKE.

  21. Jen Turner at 7:20 am

    Well if you know what we can do about that please let us know! Like you said it seems like no one is doing anything and pain patients are in too much pain to fight. I know because I live it.. please post any petitions we can sign or anything we can do

  22. Jen at 7:19 am

    Well if you know what we can do about that please let us know! Like you said it seems like no one is doing anything and pain patients are in too much pain to fight. I know because I live it.. please post any petitions we can sign or anything we can do

  23. m. brown at 6:55 am

    Thank You for this very good article, one of the most accurate ones I have read this whole nightmarish year. This is how this witch hunt has affected me in the last 30 days:

    I recently moved to Springfield, MO and experienced blood pressure of 217/97 and the accompanying migraine type headache. The Cox South ER doc was wonderful after I got in but the diagnostic “doctor” he referred me to was unimaginably horrid.
    I was very nervous to go see her, her department name: Diagnostic Medicine (in a heart clinic) making me think she would diagnose why my bp was so bad as to cause me to suppliment my bp meds at least once daily.

    Her nurse checked me in, took vitals then she came in and sat down (I had asked for NO MEDICINE AT ALL I JUST WANTED A DIAGNOSIS- (BEFORE I LEFT IDAHO MY DOCTOR REFILLED ALL MEDICATIONS.) I was expecting a good checkup and adjustment to my bp meds if necessary.

    She began: I will NOT give you xanax .05 one nightly for stress, I WILL NOT GIVE YOU CODEIN COUGH SYRUP FOR ESOPHAGEAL COUGH (I have an eroded esophagus, hiatal hernia and ulcers and cannot take otc cough or cough drops and horrible allergies and my other doctor had said codeine was the least allergy prone relief) I WILL NOT, I WILL NOT.

    She NEVER touched me. Just gave her speech. I don’t call that doctoring.

    I got up and left after asking if she was going to figure out why my bp kept jumping. She replied “it’s down now. The nausea and headache was gastric. Take your meds.” (I still have ALL SYMPTOMS)

    I asked.. “What, do you think we patients with chronic issues should just give up and die?” She just smiled at me. It made my skin crawl.

    I have tried to find another doctor- half heartedly. Are all doctors going this way? I know I need to find one but confrontations aren’t my thing. Maybe I should give up.

  24. Sherry Bender at 6:18 am

    I have had chronic pain over 25 years, it started out with fibermyalgia and now I also have stenosis, sciatica and arthritis. I can’t take nsaids or anything that will iritate my stomach as I have severe acid reflux, after they removed my gallbladder. I take hydrocodone up to 5 a day, if needed. This keeps me to be able to continue to work, I am scared every month I go to the pain management doctor that this is the month they are going to tell me they are cutting me off. At that point I will be bed ridden; I don’t want to lay in pain the remaining years of my life. I am 61 years old, I don’t know how long I am going to be here, I had a heart attack in June and had a stent put in my heart. Please whoever is listening out there, we are not the enemy, the large majority of pain patients are responsible people that know the consequences of over taking pain meds. We all know there are problems out there but this is the wrong way to address the overall problem and attacking doctors who are sworn to take care of their patients to make them comfortable is insane. I feel sorry for anyone who has to live like this and pray it never happens to you. I would give everything l have, money, house, possession if someone told me that tomorrow when I wake up all my pain would be gone l would not hesitate, you can have everything. I don’t remember what it feels like to wake up pain free, have a good night’s sleep and feel revived anymore. Unfortunately this is my life as well as many millions of other people out there. Please have a heart and remember that we did not ask for this, we are just trying to live the best we can under the extreme conditions we now have to live with.

  25. Sandie at 5:09 am

    Excellent article Linda. I appreciate doctors like you speaking up. I do believe the only way we change things is by our voice and the legitimate pain community is coming together. Those who remain vocal and those who advocate for those who cant be as vocal are shaping the face of the intractable pain pt. A group smaller in number than 1999 2010 2015..the real deal are left. We cant stop we do we die. Pain will kill you. As you already see. But as we organize as we reason as our facts bear out there is the cpp and we must must must fight for the right to be treated with effective medication!

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