Opinion: Stop The War On Chronic Pain Patients

Opinion: Stop The War On Chronic Pain Patients

By Richard “Red” Lawhern, PhD

Much has been written lately about an “epidemic” of opioid overdose deaths, and a supposed need to restrict prescription opioid medications.  Regrettably, many readers will not penetrate beneath the sensational headlines to grapple with the complicated realities of this issue.  Few who aren’t themselves in pain may realize the harm that such articles are doing to tens of millions of people.

In March of this year, the US Centers for Disease Control released “voluntary guidelines” on prescription of opioid medications to adults with chronic non-cancer pain.  Unfortunately for 100 Million US chronic pain patients (estimated by the US Institute of Medicine), the document is in actuality neither voluntary nor a guideline.  Combined with recent draconian laws in several US States, the CDC protocols have become a mandatory restrictive practice standard which is driving doctors out of pain management and patients into agony by the thousands.  Patients are being involuntarily taken off opioids — or outright deserted without referral by doctors who fear US Drug Enforcement Administration prosecution if they continue to prescribe the only treatments which give many people even a marginal quality of life.

None of this is to say that over-prescription or diversion of prescription opioids never happens or that prescription overdose deaths do not occur.  Clearly both are real issues in public health, and tragedies for families most directly affected. But there is ample evidence that neither sad outcome is the core reality of drug abuse in the US.  As recently explained in Scientific American by neuroscience journalist Maia Szalavitz, “Opioid Addiction is a Huge Problem, but Pain Prescriptions Are Not the Cause.”

As Szalavitz points out, “efforts to reduce opioid deaths will fail unless we acknowledge that the problem is actually driven by illicit — not medical — use.”  Likewise, “…according to the large, annually repeated and representative National Survey on Drug Use and Health, 75 percent of all opioid misuse starts with people using medication that wasn’t prescribed for them—obtained from a friend, family member or dealer.”  The most pressing overdose problem is not chronic pain patients.  Part of the solution might be securing of potentially addictive medications under lock and key when used at home.

The largest contributing factors in drug abuse are not medical prescriptions.  Again from Maia Szalavitz,  “If we want to reduce opioid addiction, we have to target the real risk factors for it: child trauma, mental illness and unemployment.”  Not coincidentally, people who experience these problems are much less likely to receive medical treatment for any cause, including chronic pain.  Moreover,  “…in general, new addictions are uncommon among people who take opioids for pain in general.  A Cochrane review of opioid prescribing for chronic pain found that less than one percent of those who were well-screened for drug problems developed new addictions during pain care…”

There is real and valid concern for the avoidable death and destruction which are wrought by illicit opioids in the US.  But the contribution of prescription opioids in pain patients is tiny, and even the number of deaths is over-blown.  Estimates of overdose deaths vary from 18 to 32 thousand in 2014. Why do we ignore the 88,000 alcohol-related deaths that occur every year?  Or the even larger number of deaths by medical misadventure and error – the third highest cause of death in the US?  Something seems seriously out of whack with our sense of proportions.

Present public attitudes and assumptions toward chronic pain must change.  A fraction of the millions diagnosed with incurable pain conditions will be prescribed opioids.  But among that minority, opioids are a last resort and a necessary enabler of life.  Take them away, and we may contribute to a wave of suicides and a surge of people seeking street drugs out of desperation.

A huge majority of pain patients are not addicts or abusers.  Most do not get a high from taking prescription opioids, even if they become physically dependent on them for pain control.  We cannot reduce drug overdose deaths by denying relief for the agony of millions.

Richard A. Lawhern has volunteered for 20 years as a non-physician author, webmaster, and advocate for chronic neuropathic face pain patients. 

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Layla, in the 20 years I’ve been active in support of chronic pain patients, I’ve sometimes encountered attitudes similar to those which you summarize. I don’t mean this to be unkind to anyone, but protracted pain sometimes distorts perceived reality. Some (I think a minority) chronic pain patients begin to define themselves in terms of their limitations or their personal beliefs concerning the causes of pain and the politics of medicine. We can’t please everyone all the time. Just do your best to do your best, and remember that it’s almost always a mistake to define your own sense of integrity or well being in terms of others’ expectations of you.

If you’d like an extra set of eyes before the final draft on something you intend to publish, feel free to share your thoughts via lawhern@hotmail.com

Best Regards

Bill

Mary, sadly this is the way we are to be handled now. With your crises, the medical community will assume that it’s drug related since we as Chronic Pain Syndrome patients require the opiates to function as best we can considering the horrific pain most of us experience. We are considered addicts! My doctor of 25+ years is retiring early because she is fed up with the government intervention, the insurance forms, and more. She had suggested looking into a pain clinic. I interviewed a few. All of them have an intense therapy formula…read “tough love”. Late by 5 minutes for an appointment, reschedule and no medication until then BUT if the doctor is running late, that’s OK, but not us. Medical marijuana is legal here yet the clinics consider it an illicit drug since the government still has it classified as such, therefore I use it (they do monthly blood tests), I’m kicked out! They start off with cutting the prescription in half, during that time, I must take a class on drug addiction, and if I fail, I must repeat it again for a charge! These clinics are good for the illicit users of drugs, NOT those with chronic pain! Trying to find a doctor who still prescribes is becoming a study in futility, and in two months, I will not have my doctor any longer therefore no more medication, no more life! I love life, I don’t want to leave yet, but since my doctor cut my meds in half (in preparation for an operation fairly soon), the last three weeks have been hell! My fibromyalgia is quite severe along with edema, degenerative disc and cervical disease and more. What troubles me the most is that the CDC, DEA and other agencies certainly knows that we are left out yet they do nothing, absolutely nothing to correct this situation. I suppose with all the negative hype and sensationalism about opiates, CNN with interviews from those who were addicts telling their horror stories, there seems to be no hope for us. But who knows, we may be recognized after the decrease in opiate OD, and the suicide rate for the Chronic Pain Syndrome patients goes up!

I decided to address this problem in an article on my blog and got only one comment, full of vehemence and the reader obviously misunderstood my intent in the article, as it was written. I am appalled and shocked to receive such a response to something so personal. I’m thinking of writing a follow-up piece but I’m just not sure about it, as rebuttal, or simply as my personal pain story, although this isn’t meant to be self-promotion, I’m just genuinely upset by not having more like-minded comments/commiseration.

J

Perfect analysis of current situation. But let’s face it– pain patients are easy targets because we simply don’t have the energy, ability or funds anymore to even self-advocate. Drug companies need new revenue streams– and repackaging opioids in these new “abuse deterrant” technologies is a cheap way to do it. And it is all part of a big marketing scheme to drum up support for these newer formulations to justify the high prices, especially when the generic versions are inexpensive. We need the medicine makers to focus the research on something truly needed– and continue to let us get those medicines that help us have some sort of life. Finally, on a side note– try your best to harness your own natural endorphins through exercise if possible. Better than any prescription and can last for me up to six hours. Problem is I cannot work out every six hours!! But it does help a lot when I do….

Krissy

Email sent.

j

Krissy –

Thank you for your response. Yes, I’d like to get involved. Please email me j b i e d s at mac . com

J

M.I. –

I can relate to everything you wrote, especially the part about how you’re not who you once were. I know this won’t make your pain go away but you are not alone. And your response to me today showed me that neither am I and I am grateful for that.

J,

After reading your story yesterday, I spent the day in tears from uncontrollable crying. You summed up my own personal feelings so incredibly well.

Some days I have the strength to continue the fight, but increasingly most days Twisted up in uncontrollable pain. It’s embarrassing for me, so I hide behind my pain in seclusion. I recognize it appears as false male ego or pride, but it’s difficult to let the people in my life see me so broken down. I used to be a strong individual with a very active zest for life and now I’m a shell of the man I used to be.

I’m not the husband my wife married. I’m not the father I used to be for my children and grandchildren. I cannot reconcile in my mind how the medical community can hold my life in their hands, knowingly having the cure. Incumberred, I successfully lived a good quality of life for a decade after my injury, but now with the misdirected war against the weakest of us, I simply cannot locate emphathy from anyone in the medical community, but they used to be very understanding. Relationships with my doctors once great have now have folded like a house of cards because of intimidation directed by our government.

I try so hard to stay optimist, but logically I know we are losing this fight. I have already discussed with my wife the day will come that I simply won’t be able continue the fight. I’m very tired. So very tired.

J, I’m sorry that you’ve had such an awful pain journey. I encourage you to clip and drop your story in the public comments on the June 10th “Public Meeting on Patient-Focused Drug Development for Neuropathic Pain Associated with Peripheral Neuropathy”. It is important that FDA authorities be exposed to our story. If you want help editing it to meet their 3,000 character limit, feel free to send me a note at lawhern@hotmail.com

https://www.regulations.gov/docketBrowser?rpp=100&so=DESC&sb=docId&po=0&dct=PS&D=FDA-2016-N-1110

Krissy

J – I just read your comment and feel so sad. First, please let me or any of us here know whether we can be of help to you. We are a community of good people and would love to get to know you a little! I am one of the volunteer freelance writers here on NPR and wondered if you would like to write your story for publication? You probably don’t need me, but if you did, I would help in any way. I sure wouldn’t want to see you go anywhere without helping us here at NPR. We need people like you, and we need and want to hear what you have to say. Are you interested in doing a little volunteer work with me for articles here on NPR? Just a few days ago I wrote an article (it’s on this site) having to do with the “side effects of pain!” There are so, so many, and someday I want to expand on that article and perhaps write a small book. And if we wrote your story, you could really help others. That is exactly what I found when I first made a comment here. I began to get involved and felt like I had a purpose, which made me want to do things online, research and read. So even though I still grieve my failing body, and grieve that I can’t work like I used to or do anything like I used to, I can use my mind. But before I started to get involved in reading more about chronic disease and pain, I didn’t even believe I could still use my mind. And I never thought I could write again! I figured I was too depressed, my mind wasn’t as sharp and I’d never make it through one subject. Now, about a year and a half later, I am swamped! At my own insistence, I research pain and medication, the government’s “stuff” and now starting in on insurance changes. I am astounded and grateful and feel lucky every day now. In the past, I felt like that little pile of dog do-do emo you can put on text messages! I was a pile of it and I stunk! We all need to hear each other, because we live in a world where it feels as if so many don’t care or don’t want to bother being around someone who is sick. So many of us have lost close family members and best friends because they think we are addicts, or they read things that tell them to get negative people out of their lives. And they feel it’s easier to just not have to deal with “us.” I work from my bed! I can walk and do some things, but laying down is the only way I can work. Please let me know if I or anyone else here can be of help first. Then if you want to be involved here or in other… Read more »

J

I have CIDP, Small Fiber Neuropathy and Fibromyalgia. I spent many years going from doctor to doctor just to find out what was going on with me. 2 years ago a neurologist said I had small fiber neuropathy, said there was nothing he could do and sent me to a pain doctor. From April 2014-Sept 2014 the pain doc prescribed me: Pamelor, Cymbalta, Savella, Topimax, Amitriptyline, Lyrica, Gabapentin, Gralise, LDN (low dose naltrexone), Lidocaine patches, Lidocaine/ketamine cream, Voltaren Gel, Trazadone, Mobic, Amrix, Flexiril and I’m sure there were more that I just can’t remember at this moment. NONE of these drugs helped with the pain, but ALL of them had horrific side effects – dead libido, hallucinating while dreaming, feeling drunk without drinking, 40lbs of weight gain in 2 months and my all time favorite, “discontinuation syndrome” (that stands for withdrawals, but because the medication doesn’t make you ‘high’ they call it something else so they can keep pushing these drugs as alternatives to real pain medicine). After 5 months of trying drugs that were made for other illnesses I went off them cold turkey. Not the brightest idea and I wouldn’t recommend it to anyone, but I’m one of those people that when I’m done, I’m done and I wanted that poison out of my system. I had a pretty awful detox with exactly the kind of withdrawals one gets from quitting opiates cold turkey: nausea, diarrhea, stomach pains, inability to eat, brain fog, feeling flu-ish, crying spells, anxiety spells, chills, fever and with the bonus Brain Zaps (something you don’t get from opiates). I eventually found myself an amazing neuro who suspected more than SFN and he diagnosed me with CIDP. My first visit with him I explained how disabled I was because of the SFN and he said, “Didn’t anyone tell you that small fiber neuropathy has the quality of life equivalent to someone who has massive heart failure?” Um, no. He then printed me out a three page article saying exactly that. With the added CIDP diagnosis my quality of life is even worse now (didn’t think it could go lower than zero, but it has). Pain, constant muscle spasms and the inability to do anything remotely physical without A. My heart rate skyrocketing over 170 bpm, B. Experiencing severe pain within 10 minutes of that activity and C. Experience 2-3 more days of severe pain has kept me in bed for almost 2 years. Every now and then I try something, like doing a load of laundry, and i pay for it. My life is at a stand still. I have no future. I cannot work, but can’t get SSDI because I’m a stay at home mom that used to (every now and then) book a commercial, but didn’t have enough work credits when I became disabled. I’ve tried every drug and done everything my doctors have asked me to do, but NONE of them will discuss my chronic pain and quality of life. I’ve… Read more »

Becky Carlin

I too, have chronic pain…every day! I took pain med, prescribed by drs, and they worked some..for pain. They also clouded my brain and left me groggy. I had to stop them, I longed to be active, as I once had, like so many of you.

My big question is WHY, why is this happening in such large numbers?

There are some answers!

I began to study nutrition.and holistic health, to find that the answers (to some) may be found in books, written by PhDs, like The Microbiome Diet, by Raphael Kellman.

Also, The Swiss Secret to Optimal Health, by Thomas Rau, MD, The Allergy Solution, by Leo Galland, MD or Eat Dirt by Dr Josh Axe. A mind of Your Own, by Kelly Brogan, MD is another good resource.

While I have pain today, it it manageable, without medication. I hated how they made me feel, and how they got a close family member hooked, and will never be the same. My family will never be the same.

Epsom salts baths, stretch every am, know your food and what triggers your pain, and exercise. I also often use a massage chair. All of things help, and my mind isnt cloudy.

Be well!

Tina

I agree Howard. I have DJD, DDD, CTS, Severe Fibromyalgia, and more relying on Opiate pain meds for daily pain management and never abuse the meds. It’s taken quite along time to accept the new me with my physical & psychological limitations and experiences. I miss many things I used to enjoy and the friends I enjoyed them with. I often dream about working. At times when the pain is less (after taking a dose) I used to be inspired and hopeful thinking maybe I could work a little, but then I experience the pain with fatigue again and know it’s not possible to be a reliable employee knowing it would be only 2 hours or less maybe once or twice a week and impossible to say which days or times. I usually have about 3 hours a day for getting necessary things done. I only bathe once a week or less, never wear makeup anymore, eat very simple meals that can be made in a few minutes, going out with friends and family is very limited, instead of cleaning house I tidy up a bit, and have a gardener to take care of things I used to enjoy doing myself, and I’d have a housekeeper if I could afford it since I can’t vacuum etc. When I go out with family, it’s limited to about 3 hours including drive time and I’m usually wiped out the next day or two. I’ve come to appreciate TV and FB very much. Simple things that used to take little time are overwhelming taking several days to complete. People can no longer count on me when planning for anything because I may not be able to make it when the time comes. Making it to medical appointments is the only thing I push myself to get done, and sometimes I have to reschedule, but try not to if possible. I’m still working on letting go of the guilt I have from this. Being dependant on others is difficult for me to accept. Patients and Pain Management Doctors are suffering due to the abusers of illegal drugs and recreational drug users. It’s just not morally right. Thank goodness the CDC guidelines are not law prohibiting prescriptions, so doctors can still use their discretion in seriously needed cases. I had an anxiety attack and suicidal thoughts when I heard about the new CDC guidelines from my doctor. Sadly, many doctors are afraid to prescribe Opiates due to the CDC Guidelines and I’m fortunate to have a supportive doctor who understands my need, however he still does his best to reduce his patients pain meds and wean patients off Opiates as much as possible. My pharmacy does’t carry the prescription on hand (most in my area don’t), so they order my prescription monthly a few days ahead of time, and I plan with my doctor accordingly. The rate of suicide will definitely increase in cases where patients who are truly in need aren’t provided relief from… Read more »

Jean Price

Krissy…I’m not quite sure how to respond to your query!! Im really confused about what I may have commented regarding this article that led you to think I felt you’d written it….as I know Dr. Lawhern did and even addressed one of my comments to him by name! I’m sorry if you felt I’d confused your writing with others in this and in the past, or addressed questions to you personally in comments on those other articles. (I know there is another person, Jeanie, So perhaps you’re thinking of her…or not). But I don’t recall any questions I may have ever asked you personally in ANY articles or referred to you not answering to replies from those articles! Please email me at jeankprice@hotmail.com if you have further need to clarify this or specific examples. What I do know is that you work against many personal odds to write and inform and support those with life limiting pain. And if I have in any way upset you or confused your writing…please both accept my apology and let me know. I wouldn’t want that to happen, and if it in fact did, I’d like the opportunity to explain or correct it. Although in the past we may not have always agreed with some issues or action, I value your input and the price you personally pay to give it because of your own issues of pain and functioning limits. Please let’s settle this and clear the air if we need to.

John Quill Taylor: while your treatise from May 26th is interesting, I must still observe that it begs the questions: what do you want to see happen concretely, and WHO should make it happen?

Krissy

Jean Price – I read all of my replies, however this isn’t my article. I’ve noticed you’ve addressed me in comments in other articles that I didn’t write also. If you have a question for me specifically, put it into a comment on one of the articles I wrote. I certainly haven’t meant to miss or ignore anything you’ve said, or any questions you’ve asked. Maybe you thought I wrote this?? Let me know.

Thanks,
Krissy

Krissy

John, I am trying to figure out what you are saying that we don’t already know. We do not blame our doctors, we have great compassion for those who are addicted and whose families have lost lives, and we are aware of what drugs we are taking, where they come from and what they are made of. Maybe you can give me an idea of what you are saying that the active pain patient might not be picking up, like me. Thanks.

HOWARD

Thanks, for opening peoples eyes, not all opiod pain med user’s are not addicts, Ive been on them for 16 Years and they aren’t abused by me !!!

HAZZY

AMEN, Mary !!!!!
Iam in Pain Management and every month i have to just about stand on my head to get my meds !!!! Mine are in a lock box and then in a safe, because of theft !!!!!! These doctors who deny us with Chronic Pain, they will get a cut and write a prescription for thereselves. We that dont abuse and follow the law, need to leave us a alone

Mary,
I have read so many stories that reiterate ours. The medical community treats law breaking addicts with more compassion and empathy. How many times have you heard recovering Herion addicts proclaim they are “X” amount of days clean, while they take their daily trips to the methadone clinic. I WANT TO SCREAM!!!

There has been a coordinated effort by the media to blanket the air waves with Orwellion propaganda to convince the general public that the stereotypical opiod consumer was dragged into the abyss by stealing Grandma’s prescription.

1) I am not a criminal and refuse to be branded as such.

2) I have never exceeded the amount allocated by my doctor. I have never asked for an increase, gave an excuse that I lost my medication, or used them in any
irresponsible manner.

3) I refuse to become a slave to the government begging to be treated with respect while they attempt to humiliate and dehumanize me.

4) I am a responsible, intelligent law abiding adult that uses pain medication for legitimate reasons.

5) I am NOT an individual who uses opiates for recreational purposes. I am NOT a criminal. I suggest the parties concerned punish the criminals.

Mary

Matt, I had a very similar experience. My Doctor of more than ten years retired. I was unable to find another doctor to treat me despite my well documented clear need for treatment! I went home and suffered the most horrendous pains, writhing on the floor in and out of consciousnes! Found unresponsive by my husband who had to call an ambulance! Upon arrival they were unable to detect my blood pressure because it was so high! I was in hypertensive crisis! They were shocked that I didn’t stroke out! Even though my pain and compliance with med taking was well documented I was referred to chemical dependency treatment by the ER where I was brought! Where I absolutely refuse to go! I don’t have addiction issues and never had! Shame on these doctors for lumping us all into the same category! Pain is complex to treat but that does not make it okay to dismiss us like trash! They say you can’t die from withdrawals! But you and I are proof that you can! People die from strokes! People die from heart attacks! Many people are gonna die as a result of these changes! And it is not gonna be the drug addicts! For they will always continue to find a way to get their precious HIGH!

Stephen Rodrigues, MD

The idea of sham acupuncture is ill logical. Why sham something in the first place?? The only reason to sham is if you do not believe the patient is in pain and you are attempting to prove to others that they should not try acupuncture. Both are based in stupidity. We know it works based on 6000 yrs of use. Duh! Then to realize that Hackett, Travell, Simons, Rachlin and Gunn perfected the idea of using a needle to cure pain out of the body. Wow – what an oversight!! This scheme is a way to deceive everyone into thinking that acupuncture is worthless. This idea imprisons people into using the only 3 options that are being offered by allopathic physicians – nothing, medications and surgery. Today our healthcare system is a perfect criminally minded conceived and designed way of distributing medicine. We are not questioning authority. This idea of sham acupuncture started about 60 years ago when scientists crossed the line against God’s creation to replace a “knee” for “knee” pain. Today, I call knee replacements, back and craniotomy surgery assault, battery and robbery of body parts for the treatment of pain. All 3 of those are not ethical, logical reasonable science-based there simply made up. And when man makes up something any gains a benefit we know where that takes us – into hell. To explain sham acupuncture we have to update and clarify some definitions. What is pain? What is acupuncture? There are 2 types of pain: 1) Pain of death and dying and 2) Pain of life and living which is what we all are talking is about. Pain of life and living is stored in our muscle system. The only way to rid our bodies of the pain of life and living in our muscle system is physical therapy. The use of a thin filament metallic needle to affect a cure in the body is simply a form of physical therapy. So in reality you cannot really sham physical therapy so you can’t sham acupuncture with any validity. To perpetrate the idea of a sham attempts to do a few egregious and sinister actions against a human being: Deny that pain is in the body. Deny that pain is in the muscles. Deny that physical therapy is effective. Deny that chiropractic care is effective. Deny that acupuncture is effective. Deny that preventative and holistic care is effective. Deny that the voice and testimony of a patient is the only truth. Deny the fact that an MRI is only forensic evidence and is worthless in the office setting where pain of life and living is concerned. Deny that pain of life and living in muscles can only be assessed, tested, treated and eradicated with touching, kneading and feeling. Deny the fact that images can not see the exact location of pain pathology. Deny that pain and suffering exist in that the AMA and our academics and specialist are the center of this genocide. Deny people the… Read more »

CP Patient

Acupuncture is no more effective than sham acupuncture. PT is effective for some, but I have been to so many sessions, found someone with extensive experience that helped. It didn’t take all the pain away, but some. I still can’t function with just solely PT.

Once the CDC guidelines too effect, oh you Should do acupuncture (despite low quality evidence).

It’s a placebo effect for some at least.

Just spend 20 minutes in PubMed -I don’t have hundreds or thousands to waste if there are multiple randomly controlled trials that say it doesn’t work. If there was a good chance that It would that’s different. I use some other CAM’s but they have evidence behind them.

I will say this. The media is actually perpetuating the “evil of the epidemic” on a near daily basis. Politicians jump on the wagon. Now there are freaking dedicated units to tackle it. Go after the non-legitimate people, not the patients who take them responsibly.” Write your local maybe national news media.

Recently the CDC reported a significant number of suicides are on the increase. I wonder where that came from – but they will never acknowledge it.

Under no circumstances is suicide the solution. I am not advocating it, and beg anyone who feels they no longer wish to live to please seek medical attention immediately and call the National Hotline.

Things will eventually get better. It just takes time………

Mike,
I agree with your comments, it’s the main reason the government took over 1/6th of the economy.
The America people said no to Obamacare.
Congress said no to Obamacare yet the administration shoved it down our throats.
Joe the Plumber was lied to. We all were.
Big Pharma is making Big money selling Lyrica. There’s no money in a generic opiod based medications.
And you are correct. The aristocracy will never be denied what they want or need.

The two biggest lies are; (1) The check is in the mail. (2) Hi, I’m here from the government and I’m here to help.

Mike

DR Rodrigues: your comment to Elizabeth about the insurance companies, you know it is election year and the big wall street and insurance company people have money on there minds 24/7 and I believe they very well planned this out to stir up the CDC to do something and in return you know it works in politics, you pat my back and ill pat yours. It is all about the money. These people are the very first ones that when its there turn to be hospitalized, there the first ones to cry for pain medications.

How many of you, incumberred by chronic pain whose Doctor that once empathized with your pain and without warning on your regularly scheduled appointment, turned 180 degrees and dropped you cold turkey.
“I sorry, but I can no longer prescribe your necessary medication because the government is telling me (strong arming me) I can no longer do so.

Do you remember when you developed a relationship with them over years of office visits? You knew about their family, how proud they were to tell you that their son or daughter was going to University? You knew their birthday, where they went on holiday, and one day with hollow eyes they no longer recognized you. No plan to responsibly cut back my medication, just good bye.

I should mention that my compiled medical records with MRI’s, CAT scans, X-rays look like the Encyclopedia Brittanica validating my condition.

That happened to me in July of 2015. It took 2 1/2 weeks to find a new doctor and in that time, I suffered a minor heart attack. I endured not just the pain I suffer every minute of everyday, but also instantaneous withdraw from going from 60mph to zero in a second. I went four days and nights straight without sleep on two seperate occasions until my body finally gave out and shut down. My wife who is an Assistant to the CEO of a hospital worked tirelessly to find me a new physician. I can tell you it wasn’t easy even with her position in the hospital.

At one time, physicians had integrity. Now with the new March 2016 CDC guidelines ( NOT LAW) it has become even worse. My current doctor at first told both me and my wife that what happened to me was inexcusable. When he received the guidelines it was DeJa Vous. It took a conference with the hospital administrator in charge of all the new government rules and my doctor to change his position. She simply explained he still retained complete autonomy to prescribe what he believed was required.

My point is that it’s not just the responsibility of patients to fight the Beast, but doctors as well. They are no longer doctors, they are becoming employees of Big Brother. They must also stand up and take the mantle of responsibility or very soon they will be nothing more than clerks with fewer patients.

Stephen Rodrigues, MD

@ Elizabeth WeinbergMay 26, 2016 at 11:13 am
Perhaps it is being skewed by these Insurance Companies who no longer wish to cover the cost. So, is that the problem? They are continuing to generalize the definition of pain?
Yes, the definition of pain has been truncated for expediency purposes.

The definition of pain today is not reality based as the one that is needed in the office setting. Ie 0-10 is meaningless. These terms are also meaningless in the office setting; Somatic, visceral, and neuropathic, burning, tingling, shooting, stinging, or “pins and needles, stabbing, piercing, cutting, and drilling pain.

In the office setting, pain is a “feel” or signal from inside, just like the perception of an itch. Pain in the office setting is 100% feel, “feel-back” and feedback in 2 way dialogues. The patient’s voice in the ONLY purveyor of all the evidence and is expressed as; “I have pain here, ouch that hurts and that is the spot.” “Hey doc what you did made that spot or area feel better.”

Every scientist in this world, honorable and truthful professionals, know that pain is unique and different for every case, and every human. —> Sadly no. Based on hundreds of conversation with academics and specialist, this is not even close to being true. Since these folks do to talk and touch patients their perceptions of pain is virtual and not reality based. These no talk and no touch scientist are still working on a static illogical construct of pain.

Stephen Rodrigues, MD

You misunderstand my intent. I’m 100% certain of what I know and most important of what I do not know. I’m also 100% secure in the fact that I know the differences and I’m protected by the laws of universe, the biology and pathology of pain.

A Botched surgery usually does not yield abject misery, pain and disability. Botched means to means the wrong side, not a good cosmetic outcome or leaving parts of the pain pathology inside, etc. A botched surgery can easily be remedied by second corrective procedure.

If pain continues after a surgery to treat pain simply means the surgery was based on the wrong sets of data and thus malpractice.

MRI can only offer forensic, dead or old evidence so spurs are an indicate of tertiary findings from a primary cause – Muscles. Treating spurs – the tertiary findings – will yield pathetic clinical outcomes.

Joint amputations, spinal destructive and drilling holes in the skull are ALL Unnatural treatments for pain thus by legal definitions are assault, battery and theft of personal property.

Long-term medications only for the treatment of pain are also illogical and unethical thus malpractice.

All long-term, chronic, invisible, non-structural, and severe pain syndromes have to be muscular in origin. This is based on the laws of biology and pathology of human diseases.

NO matter what names, classifications or diagnostic terms may be used by Allopathic providers, they should always think muscular derived pain. A “hanging chad” of a diagnosis is a false diagnosis. These floating Allopathic diagnosis are simply a need to group signs and symptoms into neat yet arbitrary and imaginary definitions.

All diagnosis must be match with a reasonable set of treatments which will logically remove the pain pathology and thus restore the patient back to normal.

The beauty of hands-on PT with and without intramuscular needling is that it can be applied in a customized, personalized and tailor made to the patient’s needs. This takes into consideration for the vast and infinite varieties of human lifestyles and DNAs.

I’m 100% certain that if many who suffer without receiving the proper treatments will be locked in pain jail hell and that is a crime.

S. Dixon , I applaud your speaking out, and encourage others to follow your example. There is a list of media gateways in the comments thread for one or both of my blog articles here on National Pain Report (search on “Making Ourselves Heard” in the search box just below “subscribe” at the top of this page.

Thanks for sharing,

S. Dixon

I reached a decision this evening, that though I’m a chronic pain patient which limits me, I can still be heard. Every network and “mainstream” media outlet, and the advertising that pays for their programs, is going to hear from me, each and every time I see or hear an unfair statement or program about opioid use. I’m a fair person, so the programs (there must be some) that depict the truth will also hear about their job well done.
Thank you for speaking out and a job well done.

Michael

I wonder how many people that were on the death list from opiates that the CDC claim to have died were patients that were on a low dose of opiates, or the wrong type of opiates?

Joan Hamm, I sense that you and I seem to be in basic agreement on the general directions for improvement in outcomes for chronic pain patients. Reducing opioid meds for people in whom they are effective at stable doses, clearly isn’t a good answer to the public policy issues raised by widespread addiction to ILLEGAL rather than prescription drugs. It’s an apples and oranges comparison. As I have suggested elsewhere, we can’t solve the problems of illegal drugs by forcing millions more people into agony.

I’m unclear about how you think I might be harming the interests and concerns of chronic pain patients. But my objective is to challenge the CDC guidelines that are forcing so many doctors out of pain management practice and so many patients like yourself into abject agony.

Go in Peace and Power,
Red

joan hamm

Dear Dr. Lawhern. Thank you for your seemingly kind responses to my comments. I mean no disrespect and totally confused. It seems to me what I read is intelligent but has nothing to do with people who suffer but to hurt even MORE the people who suffer everyday who are not helped
To take away from them is hurting them to an end result of suicides to innocent people who know meds ease our pain to be able to live life. These people do help others in various ways. To reduce our meds is not the answer. Most of us have been thru proper rules tests etc to establish the fact they have a disease which is pain. Why are we not doing the right thing by going after Drug dealers and users who use it for fun??? I never got high from any med. My meds know where to go to ease my pain since I started them. I can live a fairly normal life which means visit family.. Do errands and don’t use the system or take advantage of any organizations or person. There are those who really need help and I manage to volunteer for some. These are the real pain people who should not be attacked. If I were a policewoman I could have made many arrests to people I see selling to young people. Then continue to find the bigger dealers. That is the problem. Aloow these drug users who can’t get no more drugs get help thru detox and educate them. Alcohol is the same. Focus more on helping Alcoholcs. They need proper Detox and someone to talk to. If done right there would be less relapses. So detox and rehab one needs who is an abuser. It’s the big time dealers and smalltime dealers I see on the streets you gotta STUDY!!! But of course the crooked pharmacy companies and crooked drs who only work for money will lose money. So a person above or a politician will be blackmailed or paid to shut up. So who pays for it… Studies that hurt innocent people with a pain struggle every day who when get meds that Help them to live life they want to live. And can survive on meds…some stupid study will hurt because of the above. So we moan on here…but wait your 911 calls will triple. The suicides will triple,.the lawsuits will triple…the families who love these people who NEED meds legally will triple in problems to show up in various ways because they love their family member who is in pain. TRIPLE and more!!!

joan hamm

To whoever writes thesereports…your reports are based on national collected status. You need to go after the drugs sold on the streets. What’s stopping you? Are you or politicians getting threats from the big bad guys who operate the drug practices done. So you come up with a study that punishes real sick people who suffer with severe pain. You back yourselves up with cells in our bodies claiming it’s ouf fault and then reduce drug meds to people who need them meds to survive. Stop your trying to brainwash people. But go after the big problems. The big dealers and ones who sell on the streets. Are you afraid of these people and bad Doctors? Leave us innocent pain Sufferers alone. We have facts showing our pain diseases.

Patient

I can describe what will happen when the “War on Pain Patients reaches its peak and things radically change. “Unintended Consequences”.

How many times do we have to go through the fact that legislating things to the nth degree and making politicians and Special Interest Groups glorified “experts” to realize that legislation is NOT the solution? And when we do legislate things, there are more and more bills Whether to filibuster the floor, or a bill in opposition to a previously passed one. You know the drill.

Joan, there is no reason to be embarrassed. if you’re not in a position to make a donation to MIA, then don’t. Just click off the donation box at the top right. The important thing is to contribute to the discussion of chronic pain and addiction which is unfolding there.

Jean Price

Therese…I’m truly glad you got a giggle out of that story, and yes….it is crazy!! When the death of an entertainer who obviously had nothing in common with me as far as his drug use, and (and whose Doctor also took such liberty and violated his “do no harm” part of the oath he took)…when this impacts our care as patients who have daily, persistent pain…then we have to laugh!! Nothing else would fit the scenario, would it?! And he repeated that it had nothing to do with me!! That is about the lamest thing a doctor can say about his treatment decisions for a patient! But isn’t it true for all of us…these changes in our care have absolutely nothing to do with us!! Isn’t that a kick? Another laughable matter!!

Krissy

I was just wondering if you read your replies. I have asked several questions in several articles, but I get no information back from you.

Thank you

Stephen Rodrigues, MD

@Elizabeth Weinberg

I’ve been around here for a while pecking around peddling what it turns out to be the perfect set of treatments for the pain that we all will get from life and living. If PT is masterfully applied there is an inherent guarantee that this therapy will work.

This is as valid and true based on how nature and the human body works. Just like;
water for thirst, sleep for tiredness, Vit C for scurvy, and Appendectomy for an infection. PT is the exact treatment for pain in the body – muscles

It is so simplistic yet easily overlooked because the clues are 100% invisible and personal.
NO one really believes people can have this much pain. Pain level 1-10 dose is not a fair way to ask you about your pain. Pain of muscles can only be assess by how people feel. NO one really tries to validate the locations of your pain with touch.

Pain is not cancer attached with a death sentence. Not a lot of compassion for you all. No group will organize to “walk a step” for your plight.

Our society cannot connect the dots of that the #1 final self treatment options for pain is suicide.

You all have been betrayed (we all) by a few sinister minded academics, physicians and MDs leaders know that Chiropractic care, myofascial acupuncture, dry needling and wet needling will cure muscular derive pain and dysfunctions away.

Another of the deceptive tactics is to water down all of these options so people will think that they do not work. It is then a logic step to then conclude that, “well I guess it does not work.”

This is a huge part to the deceptive set up – The Doctor will say, “See I told you it was not going to work. Are you ready to schedule your craniotomy, joint replacement or fusion for your pain??”

Way back I thought that Acupuncture was a the only answer and yes it is needles are the perfect medicine for the pain.

NO med school training is given, sparse post graduate training is offered at a HUGE extra cost. So not many providers are versed and trained as masters. Even the master Gunn training is time and effort out of your programmed job without the possibility of getting reimbursed for services and efforts. Can you imagine millions of American can have their pain rubbed out with lots of manual labor or needling, if you all are simply given the chance.

See C. Chan Gunn, MD. You can find more info on these topic on my FB pages.

Alert editors – on these post I really do not spend a lot of time on syntax or typos. Not my skill set. As you can see. Read thru these errors for what are the science facts. Or not. The edited versions are on the way.

Cathy M

Dear Dr. Stephen Rodriguez –
I would NEVER trust a doctor who is “100% certain” – the infinite variety of human life and the human body means that it takes listening and hands-on evaluation, and anyone who comes into that with complete certainty that he has already figured out the answers would send me running in the opposite direction. JMO. I have had excellent PT, but it does not solve the problems of botched surgery or bone spurs.

Therese

Jean, I write this with absolute empathy for the shock and dismay you must have experienced upon hearing it, but “It’s about Michael Jackson!” gave me a much needed giggle this morning. Complete craziness.

joan hamm

Dear Dr. Lawhern thank.you for your support. It was kind of you to take your time to do so. I will do what you said.

joan hamm

I went on the Mad in America site the first thing popped up was make a donation . I have no money to donate now but it makes one feel like crap and embarrassed. It is to keep the site open. I have no problem with this but I left the site with the Dr. On the main site. Will try again later. But I volunteered for campains and embarded with make a donation site with a story to entice you each time. One is to have dinner with the candidate plane and hotel paid for with a possible solution to finally see my candidate. I get 2-4 a day!!! I have little in my checking. Now on the mad in America site same thing..asking for money.starting at 10.00. To keep site open. Stress makes our pain worse due to cells etc. I don’t need any more stress because we can’t donate at this time. What do you do???

Jean, to respond to your thought: one way that we can make ourselves heard might be to follow the link to the article I mentioned elsewhere in the comments thread. A lively discussion is underway at Mad In America, between a few professionals who contest the facts and references offered in this article, versus a larger group of pain patients who have their own experience to offer. The potential audience for this discussion is in the range of tens of thousands of people. I invite you to get a login at Mad in America, and join the discussion.

See http://www.madinamerica.com/2016/05/stop-the-war-on-chronic-pain-patients/

Jean Price

Well said, Dr. Lawhern….I’m hoping your words of truth are acknowledged by the public and the powers that be. I’m not sure how to do it, but I’d love to see this or an abbreviated version of this article on Facebook to reach the general public ….like a PSA. And also sent to newspapers as an editorial article or PSA. Does it already have a wider distribution?

I remember so clearly years ago when my family doctor decided not to refill my medications, after ten years under his care…with compliant use and progressive medical issues involving pain. He told me it wasn’t about me!! Excuse me? How can it not be about me when I’m so severely impacted by your decision? Well, he said then…it’s about Michael Jackson!! And not wanting his office under scrutiny or his files being open for investigation! I understood then that the medical community was sounding taps for the diagnosis of chronic pain!! And the new diagnosis being birthed was “Chronic Drug Use”!! My second saddest day as both a nurse and a patient regarding health care… the other being when HMOs started up!! And their witch hunt continues full steam ahead, leaving those in pain to pay the price…not those who use drugs illegally. How can something so simple be so misunderstood….and how can people’s pain and quality of life be sold out for others to capitalize on?! Including our government!! Sad doesn’t quite cut it anymore!

lindamarie

THANK YOU ! Chronic Pain changes who you are…it is absolutely no fun…and without opiates I wouldn’t be here…done deal…(and I speak from experience.)
Now what I think is behind this is that big pharma wants to make $$$$$ on their latest and not so greatest drugs. they do not work. and they cost a ton. We know. And we are taking the hit. They get huge bucks for the Garbage that does not work. We don’t have the time, energy or $$$ to try and find out. I have worked with those in pain…and then now I am one of them. God Help us. and this Dr. Great Post. This world is becoming a cruel place to Be.
Thank You So Much for writing this. And standing up for Us. This is sickening. Cruel. etc. beyond words…

Elizabeth Weinberg

Dear Stephen S. Rodrigues, MD,

I am completely in tune with what you are saying and what you can not say. I would very much enjoy being able to connect with you, because as you know there are not many people who are “able” or “willing” to hear some of the truth of what is occuring not only in the USA but of the fingers that will spread and implement this everywhere until it’s ends are met.

My spam email is bijouxprincess@gmail.com I check it rarely, but I will check it in hopes of you contacting me. I truly hope for this!

Liza

mary eischen

I guess we neeed to FLOOD the CDC with phone calls and emails, and who ever else to get our voices heard…the pain I am in right now would bee 100 times worse if not for getting some relief from my oxycodone… I would rather be dead.
Thaank you for helping us to be heard.
Sinccerely
Mary

Stephen S. Rodrigues, MD

I just reviewed this article that I submitted in 2013, http://nationalpainreport.com/chronic-pain-is-manageable-with-the-right-therapy-8819887.html The statements hold true today with only a few caveats: Today I’m 100% certain: A. The treatment of choice for muscular derive pain problems and dysfunctions is masterful application of the full force and broad spectrum of hands-on PT with and without needling. B. These options are perfectly matched to benefit the pathology of disease embedded deeply within muscle tissues. C. Without PT human muscles will devolve, become atrophied, dystrophic, contracted and fail to work properly. D. Ultimately muscles will fail, just like cardiac muscle will fail thus leading to not cardiac related deaths – but in this pain syndrome deaths occur by suicides. E. Chronic pain is the only medical malady which is “cured” by suicide by those who are imprisoned in pain hell. Today I’m 100% certain that this entity is behind our plight today. They supported the original breaches and today are tacit complicity in support of these genocidal behaviors for-profits: https://en.wikipedia.org/wiki/Wilk_v._American_Medical_Ass%27n#Judge.27s_findings_in_the_second_trial I try not to use some words any longer because they evoke the dark sides of human behaviors – bigotry, ignorance, judgement and are then rejected due stubbornness as in group think and closed minded behaviors: Acupuncture, Chinese, Chiropractic, myofascial pain, trigger point, Travell, Gunn, alternative, complementary, wrong, lie, and a few others. Today I try not to use these terms because they are strickened with incompleted concepts and thus too flawed to be use in the office setting: Migraine, Trigeminal Neuralgia, sciatica, Disc Disease, Degenerative Joint Disease, Arthritis, Inflammatory pain etc. In place of those inaccurate terms, I use more practical and reasonable terms in the office such as: 1) Migraine and TN are in reality simply are pain in the head, jaw, face, neck, side of head etc.; 2) Sciatica in reality is simply pain in the upper or lower back; pain in the buttock or hip area; 3) Arthritis, Inflammatory and DJD are all simply pain of life and living; muscle derived pain and dysfunction and pain pathology. 4) Pain of death and dying are easy understood and not to be confused with long-term pain. ie appendicitis, strokes,blown out gallbladders, blood vessels, tumors and heart attacks. I’m also 100% certain that these surgeries are man-made and invented simply for profits or as tragically flawed fall-back or default standard of care choices. NONE of these fit into the laws of biology as we use them today. These standard of care options by legal definition are assault, battery, robbery of body parts under flawed and false pretenses due to misinformed consent: [without first offering the proper use of Hands-on PT] 1) Joint replacements for pain. 2) Back surgery for pain. 3) Skeletal component reconstruction, rearrangement or removal of parts surgery for pain. I’m certain that everyone has wondered, “Why do people continue to complain about pain after they have had the science-base perfectly designed “Corrective Fix It” surgery??!!” These surgeries are not even close to being scientifically based, they are all human invented… Read more »

Michael

That was a good discussion with Dr Lawhern and Dr mark Ibsen
Montana has the worst pain program in the US I used to live in MT and only visit in the last 40 years. Dr Lawhern is far ahead of what most pain people would realize. He is right on with his post, I know a lot of pain patients dont like the truth.
I now live in Wa. state where the CDC has used the pain law here that was put in place in 2011. If you have a certified pain DR. he will prescribe what he feels is right for you, it might be 10 times higher than the CDC says.
I think but dont know something is not right with the CDC and the medias interpretation. I dont know what other states are doing but if this was made more clear it would take the pressure off pain patients