Montana Pain Advocates Defend Mark Ibsen

Montana Pain Advocates Defend Mark Ibsen

mtboardmedexamThe Montana Board of Medical Examiners is expected to rule soon on the fate of Helena’s Dr. Mark Ibsen. The Montana Board of Medical Examiners’s screening panel reviewed 9 cases given to it by a former employee to see if Dr. Ibsen had over-prescribed. The Montana Board will decide whether he over-prescribed and if so, what sanctions may be appropriate.

Ibsen was defended in a letter from three pain advocates to U.S. Senators Jon Tester and Steve Daines, Montana Governor Steve Bullock and the state’s only members of the U.S. House, Ryan Zinke and the Montana Board of Medical Examiners.

The March 20 letter from Terri Anderson and Gary Snook of the Arachnoiditis Society for Awareness and Prevention and Terry Conyers, a self-described arachnoiditis survivor asked that negative actions against Dr. Ibsen be dismissed because he is “not the source of the problem in Montana.” The three western Montanans said they are not patients of Dr. Ibsen.

In the letter they say “we are writing this letter on behalf of Dr. Mark Ibsen and patients suffering various acute and chronic pain conditions throughout Montana.”

They asked for the elected leaders help.

We believe regulators are targeting the wrong physician (Ibsen) . We want to bring you the harmed patient perspective because the model for treating chronic and intractable pain is failing the consumer.”

Ibsen, whose story we have been following at the National Pain Report, contends that the increase in his pain medication prescriptions are because many doctors in Montana have stopped prescribing pain medication for patients because of increased regulatory pressure on pain medication prescription practices. (Here is an op-ed written by Dr. Ibsen for the National Pain Report in February.)

Ibsen told us that he has had five visits from the Drug Enforcement Administration (DEA) this year alone. The DEA announced last October  it was rescheduling hydrocodone which has had an impact on the pain patients ability to acquire pain medications.

A survey released in March indicated pain patients are not happy.

The survey was sponsored by the National Fibromyalgia & Chronic Pain Association, Millennium Research Institute, American Academy of Pain Management (AAPM) and PRA Health Sciences.

The initial results were announced at the American Academy of Pain Medicine meeting in Maryland.

The study reveals that 88% of patients believe the change denies chronic pain patients their right to adequate pain treatment, and 72% say it is harmful to pain patients.

In addition to the DEA announcement which occurred in October of last year, the Department of Health and Human Services waded in last week with a release that stated it is expanding its role in reducing prescription opioid and heroin related overdose, death and dependence.

Ibsen thinks the federal and state government regulators are looking at the wrong issue, which they contend is narcotic pain medication abuse.

He told the National Pain Report that federal agencies report a crisis in pain, but that the government’s actions are leaving confusion for patients, pharmacists, regulators and doctors.

The chief spokesperson for the survey is Dr. Steve Passik, Vice President of Clinical Research and Advocacy at Millennium Health.

He told the National Pain Report in a recent story:” Where opioids are concerned we dramatically expanded their use and then we went from having one tremendous public health problem, chronic pain to having two by adding the problem of prescription drug abuse and the pendulum has been swinging between the two to try and figure out an effective strategy to keep people with pain treated and to avoid, abuse, addiction, overdose and death.”

We’ll keep you up to date on what the Montana regulators decide about Dr. Ibsen.

Authored by: Ed Coghlan

There are 16 comments for this article
  1. Gary at 7:48 pm

    Its called methylprednisolone acetate and THIS is the real reason why we have an epidemic of pain in America. If you have burning pain or weird and bizarre pain symptoms after a medical procedure like an epidural steroid injection for pain or a spinal surgery read your medical records. This drug commonly called Depo-medrol is very well known for causing the incurable spinal cord disease called adhesive arachnoiditis and has a black box warning in many countries that prohibits doctors from using it in spinal procedures. Although the FDA has never approved its use for epidural injections US pain doctors preform millions of these procedures a year and seldom does the patient ever hear that there is .06-.16% risk of developing this disease. Recently the FDA has issued a Medwatch alert warning the public that these injections can be extremely dangerous but it is to little to late as millions of patients have been exposed to this real and very serious risk every year. Since adhesive arachnoiditis is hopelessly incurable it is estimated that millions of American citizens have been permanently disabled by this disease and they now are treated like drug addicts by the same medical system that is responsible for causing their condition. When is the medical community, the government and the drug manufacture’s going to admit that they have all contributed to a a huge problem and put a stop to these barbaric procedures on one of the most pristine and sensitive systems in the human body- the spinal cord and then provide palliative pain relief to the suffers of this condition that has been described as causing 24/7 pain worse than cancer pain but without the relief death brings

  2. Dennis J. Capolongo / EDNC at 11:41 am

    Sadly the majority who live with chronic pain are grossly misunderstood by the powers invested on punishing their caregivers. The plight of those seeking relief can be defined in one word, “horrifying”. It’s all enough to drive one completely insane.

    The DEA and State Medical Boards must understand and accept the realization that many chronic pain sufferers didn’t ask for their ailments but are the result of botched medical procedures and interventional techniques, with many not even FDA approved.

    Once this is established in the minds of the enforcers who are desperately trying to limit opiate access to disqualified candidates, then maybe they will comprehend the need of those who do qualify for opiate treatment to maintain any quality of life!

    By grouping the abusive apples with the good, government agencies are performing a grave injustice to many who are legitimately suffering. Clumping those who have no medical reason for their prescriptions with those that do, these governmental entities are denying the only viable medical treatment for thousands who are legitimately suffering as a result of a true neurological deficit.

    Therefore I have recently proposed to the FDA and to the DEA that legitimate candidates for opiate treatment(s) be identified and given proper identification. This government issued ID will help eliminate any confusion on behalf of pharmacists, physicians and law enforcement agents who are unknowingly criminalizing anyone and everyone who consume opiates in the United States regardless of their diagnosis. Only then can we fairly separate the two.

    The efforts of the ASAP and others to help Dr. Ibsen are outstanding and should be seen for the gallantry that it is! Yet this intrepid effort begs a question? What has gone so wrong with our medical system in the USA, that pain patients must now defend their care providers at such high levels of government for their plight to be recognized?

  3. Coonhound at 4:29 pm

    IMO this case is not about Dr Ibsen, though he does deserve to be commended for standing up for himself and his patients. Its about eradicating opioids from the medical system regardless of a patient’s condition. Denial of care w/out regard to individual circumstances. Just think about it for a second. A doctor treating patients with documented histories of painful conditions being sanctioned for over prescribing. What are the limits on how much of each pain medication can be prescribed and where are they posted? To my knowledge………………… nowhere.

    Why? There is simply no ceiling on opioid dosing. Medical textbooks say that a patient should be titrated to a level of medication that controls the pain the most w/out causing too many side effects. How the morphine equivalent # got out there I am unsure of as many doctors say it is almost impossible to come up w/ an agreed upon equivalent amount for other opioids on conversion. Ask 20 doctors and you may well get 10-20 different conversions for each drug converted, as pointed out and explained in much greater detail on Dr Fudin’s site
    http://paindr.com/one-size-opioid-dose-does-not-fit-all/

    Of interest. *In Montana, if a doctor wants to terminate a physician patient relationship they must give the patient a 30 day notice and continue to treat them until that period is up.
    IF in MT, or in any state it seems anymore, when a physician’s license is pulled or they are arrested, no such notice is required, the doctors patients are left to fend for themselves often in severe pain and opiate withdrawal. Most are NOT helped as were those who Dr Ibsen took into his practice. Why? Fear of what is happening right now to the good doctor. For details see Chapter 3 section 5 of BOM from link below (an interesting dichotomy) https://drive.google.com/file/d/0BxgGvgRMOUrUTUhhNkNpd3RLVDg/view?pli=1

    SO how are they to determine that the well intentioned Dr Ibsen is ‘over prescribing’? The problem IMO stems from the fact that law enforcement needs to get the he** out of medical care. They are not qualified and simply do not care about patients legit or not. They are only interested in #s. With 219 million Rx (*2011)
    written IF even half of them were diverted they could in no way supply the number of addicts given in press releases and sensationalist news specials on our ‘prescription epidemic’. They clearly show addicts going through a months Rx in 4-5 days so the numbers just dont add up.

    Stories surface with surprising regularity online about holes in the ‘closed circle’ including a massive diversion recently uncovered at Beth Israel (2014) of 200,000 oxycodone pills, http://www.pharmacypracticenews.com/ViewArticle.aspx?d=Operations+%26+Management&d_id=53&i=August+2014&i_id=1090&a_id=27995
    St Vincent Indianapolis (2007) of 600,000 hydrocodone pills diverted, several CVS pharmacies in CA, several hijacked tractor trailer loads, not even going to try to figure how many millions by pill mills in just FL and TX alone, etc. BUT all you see on tv or print news is about patient abuse and diversion. This is utter BS as it is blown so out of proportion it is sickening. All the while addicts have been getting the pic of the litter while upstanding taxpaying citizens with disabilities are left to fend for themselves and discriminated against like junkies off the street.

    Collateral damage of a well intentioned war on Rx drugs? Maybe collateral damage of bureaucrats simply seeking to find a cause to justify their bloated appropriations after the US population has made it clear they are sick of trading liberties and tax dollars fighting a weed that causes little harm other than lowering the user’s IQ a few points. Since this drug makes up over half of the revenue in asset seizures and appropriations the DEA needs a cause and fast.https://www.youtube.com/watch?v=DUmYdpRlfcs
    Meth dealers and ‘cooks’ offer little in return BUT chain pharmacies and doctors offer much better pickings.
    The actions of pharmacies and physicians were predictable as was the fact that legit patients would be collateral damage. they would fight and blame each other as the DEA sat back and watched (protected by unwritten rules laid out to the former but officially not out to harm any legit patients) At first snippets were given in press releases about protecting legit patients, you hear little of these one liners anymore. When you cut supply and put fear of incarceration so high that many doctor offices have signs posted such as “We do not Rx schedule II or III NARCOTICS” in the waiting rooms and lobbies of their practices the ‘epidemic’ and the means of stopping it have gone beyond the pale. Pharmacists dont even take the time to use the resources given to weed out legit patients from scam artists/addicts/dealers by using the PDMPs but just use ‘instinct or profiling’ or simply refuse to carry certain meds or worse price gouge pills for cash only; becoming little more than the drug dealers these initiatives were meant to shut down. Try and complain to insurance co about in-network pharmacies not upholding their legally binding EOB booklets which are stated as a legal contract between insur co and beneficiary using Federal Guidelines (law) for Medicare Part D? Ignored from pharmacy to insurance co to CMS to BOPharmacy. What good are laws, rules, guidelines if they are not upheld even upon appeal.

    The only solution to this problem is to do what the US House of REPRESENTATIVES did in response to DEA raids on LEGAL MJ DISPENSARIES. They simply defunded the DEA on these operations and forbid them from assaults on these legal businesses who were complying w/ state laws which were set in place by the most democratic means known, the public referendum. see link:
    http://www.westword.com/news/us-house-votes-to-defund-dea-medical-marijuana-raids-in-colorado-other-mmj-states-5900032

    https://www.youtube.com/watch?v=DUmYdpRlfcs
    If it can be passed for a former schedule I NARCOTIC deemed of no medical use surely we can get the DEA to back off cutting off PROVEN MEDICATIONS from disabled citizens w/ documented illnesses and injuries. MJ for a stubbed toe but nothing for someone w/ lupus or failed back surgery? (I have lupus ‘overlap’/MCTD and 3 collapsed vertebra but am refused at 6 of7 pharmacies @ the medical center where i have received care at for over 5 yrs). Let us stop complaining and begging for help and let’s make it happen, write your congressman now.

    We need to pressure our representatives in Congress to DEFUND THE DEA and get them the heck out of the examination room, pharmacies, and any other part of the medical system which they terrorize and are utterly unqualified to judge.
    Transfer the medication manufacturing quotas to some organization more qualified as well. DEA has proven they are deceitful and inept at handling this task as proven by latest GAO report seen here:http://www.fdalawblog.net/fda_law_blog_hyman_phelps/2015/03/a-bitter-pill-for-dea-gao-releases-its-report-on-drug-shortages-and-deas-management-of-the-quota-sys.html

    219 million Rx referenced from link below:
    *http://www.sciencedaily.com/releases/2015/01/150115163541.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed:+sciencedaily+%28Latest+Science+News+–+ScienceDaily%29

  4. Kimberly at 9:24 pm

    I am not a resident of Montana, but following this story has been showing the faults in your State. You are not alone as those of us who suffer with intractable pain are being made to suffer nationwide.

    I, too, live in a state where doctors are so fearful of prosecution they have forgotten the reason they should have gone into medicine, to help people. Dr. Ibsen, from my perspective, is doing the right thing in helping patients in pain. When he found he was being had by a patient, he stopped giving him opioids. The other day on a group I belong to, a woman from Spain was shocked with what is going on in this Country with pain patients. As she put it, the doctors treat the pain patients and it is the job of the police to arrest the people who are pretending. Now with drug registries, every doctor should be treating pain patients to get as much relief as possible to have the best quality of life possible. Dr. Ibsen should be given a huge thank you for his willingness to help pain suffers. Most every doctor agrees that for 90% of patients a maximum of 80-120 morphine equivalent dose daily will take care of the normal chronic pain patient. But when you have patients with CRPS, Fibromyalgia, adhesive Arachnoiditis, you are talking of a level of pain above bone cancer, thought to be, one, if not the worst cancer. We don’t suffer from chronic pain, we suffer from intractable pain. Some patients require into the 3.000+ morphine equivalent just to lower the pain and they have no quality of life.
    First it was one by one that doctors stopped offering help. Then as the DEA started prosecuting doctors , it reversed to maybe one doctor in multiple counties being willing to still prescribe to help prevent the sure suicides that will come from not being treated correctly. My personal belief is that the accidental overdoses are not accidental. They are tired of being under treated and are taking their lives,

    I was told my disease is incurable and all that there is for me now is palliative care. But where are the palliative care doctors. The few I find I hooked up with Hospices only caring for the cancer patients. Sending palliative care patients to pain management doctors is a huge mistake. Most won’t even admit that adhesive arachnoiditis exists because it is usually an iatrogenic disease. It is recognized as a rare disease by NIH and it is orphaned because doctors like to diagnose patients,that very likely have some level of arachnoiditis, with failed back syndrome, flat back syndrome, anything but what it is and what it requires, good palliative care.

    My adhesive arachnoiditis leaves me unable to sit, to stand. I can walk with a four wheeled walker 29-25 minutes covering 0.18-0.2 miles in that time. That amount of exercise makes my day even more awful. I have constant care takers and I have no quality of life. Suicide crosses my mind quite often, but I fear that the only sure way would be with a gun ad my body processes the pain MEDS too rapidly. I should be getting the care that palliative care doctors are supposed to be there for, but since they aren’t there we have to rely on our PCP to help us and not hurt us as many pain management doctors do. And they harm us emotionally immediately treating us as criminals, drug seekers. We are being forced to sign contracts and if our pain flares and we take extra, they throw us out and black ball us. And it is there incompeto to make life tolerable.

    So, I urge, the Montana Board of Medical Examiners for the State to think twice about taking away a doctor that is trying to fill the void left by the other doctors who have abandoned patients in serious need. The doctors have forgotten why they should have become doctors to begin with.

    Please apologize to Dr. Ibsen and then thank him for his help to all the abandoned patients in his surrounding counties. If you think some policing needs to be done then pay attention to drug registries and look for people cashing in multiple prescriptions from different doctors. If there are lying patients, and I am sure there are, it is not Dr. Ibsen who is, or should be the police. Let the police weed out the bad patients. Let the good doctor continue to treat his already severely hurting patients.

    One day the person wishing there was a Dr. Ibsen to help with severe pain, could be you!

  5. Melanie Lamb at 1:29 pm

    Mel waking from PTSD dream in hospital: https://youtu.be/pRLXsoH0GM8

    Arachnoiditis Survivor Portrait & Workshop Invitation: https://youtu.be/1WLyAHdWGNs

    Arachnoiditis(adhesive-empty sac sign)Mel26june11: https://youtu.be/NxsenvqYClw

    Arachnoiditis Melanie Lamb: https://youtu.be/mwcKwsI5pNo

    Medical harm must stop now. The corruption within the medical industry needs to be exposed, and those responsible need to be held accountable. I am a medical malpractice poster child and yet not one single attorney would take my cases on. I will post the link to part one of my story. Part 2- a pain Dr in Hot Springs, AR performed a botched pain pump procedure on me. Placed the pump in my hip. Placed the catheter in my spine where my dura sac isn’t even attached to the bone wall vertebrae. I began recording my visits with him. It was also a recalled pump providedby medtronic. On my last refill, 3 days prior to having to my neurosurgeon remove the pump- he refilled it- and cut it off. Threw me into immediate withdrawals, I almost died- (which was his intention) to in turn have his hospital OD me on fentanyl. Do you think they documented that?
    I now live with adhesive arachnoiditis with empty sac sign, full body rsd/crps, raynauds, gastroparesis, and many other complications that come worth it. Yet- these Dr’s … these criminals … still walk, still work, attorney’s protect them- and I promise to be part of that change.

  6. C. K. LAURENCE at 8:37 am

    As a victim of Arachnoiditis (see posts on my website http://www.cklaurence.com), I am horrified and feel further pain on behalf of a physician who has done nothing but try to bring relief to those of us who are wrapped in a tangle of barbed wire each and every day of our lives, and even though we struggle in Arachnoiditis Hell to find our way back to the lives we know, end up watching the grains of sand slip through the hourglass–as our bodies and lives grow too feeble to continue.
    Surely someone is knowledgeable enough to recognize that this doctor is on a white horse and fighting to save those of us who have been attacked by Big Pharma and the hacks who, regardless of the legitimate studies that have clearly shown that the true villains are those who continue to produce the drugs and inject us, without revealing the incredible dangers that are possibly facing. I know this because I am one of those who struggles to get through each and every day of my life.
    This doctor needs to be thanked and honored, rather than facing the taunting he now faces. For shame!!!

  7. marty at 5:05 am

    This Doctor deserves an award for his work with pain management, not the crap he is going thru. Sure there are people out there that abuse drugs but it’s people like him that can weed them out. I have had several friends over 60 just this past year that have committed suicide because of lack of being able to get there pain pills. Trust me if you live with chronic pain you will understand. You want to be normal but it’s not in the cards for some of us. Our pain killers are sometimes the only way we can count on making it to the bathroom, or making a sandwich or any of the other little things people take for granted. Might not last long but just to have my pain to a dull roar for a short time makes me push on. Congrats to this doctor for still knowing what his oath was all about and for caring about human life. Give this man a medal!!

  8. Gary at 12:18 am

    Montana has rates well above the national average to both spinal procedures and negative patient outcomes. A conservative estimate of new cases of adhesive arachnoiditis diagnosed and un-diagnosed is 1,000,000 new cases each year in the US alone and it could be 10 times that number.
    The truth is hard to find for several reasons. There is no tracking of patient outcomes from risky procedures like epidural steroid injections and since adhesive arachnoiditis which is believed to be quite rare is so hopelessly incurable and extremely painful and a life sentence of unremitting pain few doctors will admit this degree of harm to their patient. So then adverse event reports are seldom reported to the FDA, State medical boards have been reluctant to sanction a doctor for off label use of a drug without the FDA approval and the .05%- .10% rate of harm has been apparently an acceptable degree of risk to the medical community. What has finally become the tipping point in all of this…… the unbearable cost to the federal disability programs like Medicare. For example a young mother requests an epidural nerve block during childbirth and is one of the rare complications that develop adhesive arachnoiditis and is now 100% disabled and will require care ( and pain meds ) for as long as she lives. It will cost the disability system millions of dollars over the coarse off her illness. Multiply that times 1,000,000 new cases every year and add that to the previous year and it is easy to see what is driving the war on pain patients. No country can pay the incredible cost of this mountain of disability that has been building up for 20 years or more. This is one the reasons why pain patients cannot get the medications they need to control their pain… it costs too much Over 100,000 people each year are hospitalized for complications from taking NSAIDs and far more die as a result of NSAIDS than perscription drug overdoses but not a word about them.

  9. Rainey at 11:38 pm

    I have been following what has been happening Dr. Mark Ibsen. I just haven’t known what to say.

    By taking on other physician’s pain patients, Dr. Ibsen is also taking on their risk. He is doing a great service not only to people in chronic pain, who have been denied a basic human right, but also to his fellow physicians, who are too weak willed to stand up for their patients.

    Perhaps some of Dr. Ibsen’s colleagues have not been able to keep their pain patients because they already have too many negative factors driving up the cost of practices (license sanctions for meaningful infractions, malpractice lawsuits, criminal charges…etc). And perhaps the person who was tailgating me when I was speeding really did have to get to a bathroom.

    I sincerely hope Dr. Ibsen is able to get out of his difficulties with the Montana Board of Medical Examiners and the DEA unscathed. They are lucky to have him.

  10. denise at 10:14 pm

    i understand what nancy is saying i have fibro and many other issues and i get nothing for pain…because i dont want them to call me at a whim and say come in so we can count your pills…or come in for a pee test…im 54 yrs old..what little meds they gave me didnt do a dayum thing and they refused to up it saying to easy to get addicted….how about just get me as close to pain free as possible i even asked for the pain pump and they said that was for cancer patients and patients with real pain…i guess me having fibromyalgia, degenerative disk disease, osteosprosis, anklong spondolosis, diabetes, neuropathy, arthritis, ulcerative colitis, and many other things…appearantly i dont have real pain…some days i want to just end my life but i am to big of a coward to do it..and that sucks too i cant even do that right ….

  11. Jon McHann at 9:30 pm

    I hope the State of Montana is prepared to have blood on their hands due to the impending suicides that follow the wholesale cancellation of the the ONLY humane medical treatment for MANY of us.

    These are people! And deserve to be treated individually, as they did not contract the same illness or diseases in mass.

    On behalf of 1500 members of LWA, life with arachnoiditis, I humbly request these State and Federal regulators to urgently take a step back and view the entire issue.

    Jonathan McHann
    Co-Founder LWA

  12. Walt Davis at 9:00 pm

    If the state of Montana does not pull its collective head from ass, I fear that it will lead the country in suicide rates. When will the morons in office get it figured out? you do not need to to tell me what i need..I have a doctor , wife, and a Priest…I do not need a bozo …Free Ibsen!

  13. Thomas Bresnahan at 7:20 pm

    although I’m not a resident of Montana I too have been harmed by a doctor giving an Epidural Steriod Injection that was injected INTO not on the outside of my spinal cord. I have been to the Mayo Clinic and have met with 3 very highly regarded Neurosurgeons, all have told me their is NO cure for my condition, Adhesive Arachnoiditis! The informed me I would spend the rest Of my life in pain and that the only treatment was strong pain killers, opioids. A doctor caused this life destroying condition! I lost my job, my wife and now live in pain everyday on Social Security Disability. When I go to get prescriptions filled I’m questioned like a criminal! Prior to this happening I worked in a very busy Cardiac Catheterization dept of my hospital. I work long hours and was on call. I worked with a small team of people who saved people’s lives everyday! It was a very rewarding job, a job I loved. And now I am permanently disabled! I’ve learned one thing Pain Management Doctors only want you as a patient if you will submit to injections or having devices such as pain stimulators into your body. The will not keep you as a patient if all you need is medication each month. WHY? It’s all about the money!,

  14. Danny Long at 5:14 pm

    This is yet another example where “the powers that be” are turning everything upside down.

    The moral/compassionate providers are always target by the corrupt system, while the providers who are intentionally/negligently causing human suffering are given the green light to do “as they please”.

    Now the population in “true need” and the moral/compassionate providers are being targeted across the board. UNACCEPTABLE.

  15. Nancy Ribok at 9:05 am

    I have written before. Usually long comments. I have known about deaths of patients with fibromyalgia. Fibromyalgia is not a fatal disease. They have died because they couldn’t live with the pain, they ended their own lives. I also know that many many fibromyalgia patients have considered suicide as an option for pain relief. Chronic pain sufferers need better treatment, which may include opioids. This refusal of pain medication is inhumane and wrong. Patients need and have a right to be treated appropropriatly. Patient and doctor needs to work together and develop a plan for adequate treatment. Which includes a lot of teaching, a lot of follow-up and adjustments.
    I guess this is longer than I expected.

  16. Bob Twillman at 7:58 am

    Although I’m happy to acknowledge that the American Academy of Pain Management was one of the parties designing and carrying out this study, the meeting at which the results were presented was the meeting of the American Academy of Pain MEDICINE.