I am writing in response to Marianne Skolek’s column of May 9, published in the American News Report.
Contrary to Skolek’s report, Dr. Andrew Kolodny, the president of Physicians for Responsible Opioid Prescribing (PROP), is engaging in partisan rhetoric that hobbles the discussion of the treatment of chronic pain.
I have been a volunteer advocate, never a paid employee, working with the Action Network of the American Pain Foundation (APF) for the past 4 years, until the foundation ceased operations this week.
I am a person who’s lived with constant harrowing pain for over 45 years. I am not writing here as a representative of the APF, but as a person with pain and a knowledgeable advocate who has worked for the improved care of people like me — who suffer needlessly because of under-treatment and non-treatment of chronic pain.
In my years as an APF volunteer, I never once received any money or gifts from the pharmaceutical industry or was I asked to shill for their products. I don’t know anyone at the APF who was ever contacted by a pharmaceutical representative to do anything on their behalf or advocate for their products, as Kolodny would have the public believe. My work was never to advance one treatment option over another.
Drum Beat to Demonize Opioids
Kolodny and PROP have been part of the drum beat in the press to demonize one of the many legitimate treatments for chronic pain. Yes, I support the careful use of opioid medicines for appropriately diagnosed patients. But I also support evidence-based solutions to protect the public. I support the reasonable use of opioids, as one of many treatments for chronic pain, while also seeking balance between the legitimate needs of people with pain and keeping these medicines out of the hands of those seeking to use them illegitimately.
I started taking OxyContin four years ago, before switching to Suboxone, a prescription medication designed to ease detox from opiates. Over the years I’ve undergone countless medical procedures, including a dozen surgeries to deal with the fallout from a set of incredibly painful diseases: a broken spine, Behcet’s Disease, microscopic colitis, chronic epididymitis, fibromyalgia, dozens of kidney stones, arthritis and arachnoiditis. During treatment of the latter, my spine was nicked in surgery, causing irreparable inflammation of the arachnoid layer of my spinal cord. I am not alone in having such an awful list of medical conditions that cause relentless pain.
18 years ago I had to give up my professorship, my practice of psychotherapy, consultation and public speaking in the face of grinding pain; none of which I imagine Kolodny and other PROP members has had to struggle with. It was not until my involvement with the APF and my decision to use opioid medicines that I got some semblance of my life back. As with countless others, my use of an opioid medication is NOT the only treatment I use. I have used psychotherapy, physical therapy, therapeutic massage, acupuncture, acupressure, guided imagery, meditation, hypnosis and a daily spiritual practice.
The constant drum beat of biased articles without the entire context, such as those by ProPublica, needs to be challenged. All we as people living with pain want is balance. Yes, there is a growing incidence of people illegitimately using opioid medicines. Legitimate patients using these medicines under a physician’s care also run the risk of becoming addicted, but not the 40% that Kolodny recently claimed. It would be nice if these wildly inflated figures were backed up by well-crafted research producing reliable and valid evidence.
Critics claim that the number of deaths due to the “over prescribing” of opioid medicines is climbing yearly. What is rarely reported is that the cause of death among recreational or addicted users is often complicated by the person combining the opioids with other medicines, such as benzodiazepines, and washing them down with alcohol. Yes, that combination often leads to respiratory failure and death. But which of the three is the culprit? One or all of them?
Under-Treatment of Chronic Pain
There are 100 million Americans who live in chronic, miserable pain. Many go untreated and easily fall into depression and, scandalously, thousands die from suicide. My heart goes out to people who have lost a loved due to opioids. But untold thousands die yearly from pain. Whose heart goes out to them?
Because of this hysteria in the press and the constant drum beat from people like PROP many people are being dropped or denied service by their providers and left in the hell of their pain.
The state of Washington is a horrible example. After they passed draconian measures against pain treatment in that state, the number of abandoned pain patients has steadily climbed, subjecting people with chronic pain to unmitigated torture. Pharmacies are becoming increasingly more reluctant to fill legitimate opioid prescriptions. How is this effective in treating the millions of us in need of help? It must be noted that we have not seen any evidence yet that these types of draconian measures will protect the public, while providing good treatment to people in pain.
We need reasoned, evidence based solutions that will reduce illegal use of opioids while protecting the millions like me — who are no longer sitting on the sidelines of our lives thanks to the use of these legal medicines. Opioids are not the only arrow in the medical quiver. But to restrict or eliminate these medicines will subject millions of us to medieval torture.
Mark Maginn lives in the east bay of San Francisco where he is a poet, writer and social justice activist. Mark’s blog can be found here.
The views, opinions and positions expressed in this column are the author’s alone. They do not inherently or expressly reflect the views, opinions and/or positions of American News Report, Microcast Media Group or any of its employees, directors, owners, contractors or affiliate organizations. American News Report makes no representations as to the accuracy, completeness, currentness, suitability, or validity of any information in this column, and is not responsible or liable for any errors, omissions, or delays (intentional or not) in this information; or any losses, injuries, and or damages arising from its display, publication, dissemination, interpretation or use.
Opposing views, opinions and positions about this column are welcomed by American News Report and or Microcast Media Group. Publication or lack of publication of opposing views, opinions and/or positions does not imply, suggest or expressly reflect an endorsement or disapproval of the originating commentary on the part of American News Report or Microcast Media Group.