Opinion: Where is the Research We Need for the National Pain Initiative?

Opinion: Where is the Research We Need for the National Pain Initiative?

By Kurt W.G. Matthies, BSE, MSCS

Kurt W.G. Matthies

Kurt W.G. Matthies

As an engineer and computer scientist, a student of pain research, and as one who has lived most of his professional life with the chronic intractable pain of what has become an advanced case of degenerative spine disease over the past thirty-six years, I am therefore a highly experienced chronic pain patient. I would therefore like to comment on an article in the National Pain Report discussing a paper written by members of the staff at Stanford Pain that connects chronic opioid use with eleven different surgical procedures.

I admire Dr. Sean Mackey and Dr. Beth Darnall, two authors of this paper, for their commitment to a career dedicated to improving the lives of people living in pain. In my opinion, only someone who lives with chronic daily pain can appreciate such a commitment, and for this, I thank them.

I believe both Drs Mackey and Darnall to be well intended in their search for better treatments for those of us who suffer intractable pain. I understand that these learned people also recognize the hard fact that those who have lost control of their lives to opioid addiction also suffer, along with their families, friends, and communities. When abusers of these medications and their analogs succumb to hypoxia from opioid-induced respiratory arrest, i.e., the overdose episode, it is a great tragedy, but one that does not negate the clinical fact that opioid pain medication allows millions of Americans living with medical conditions that cause intractable pain to experience some degree of a functional life.

Last year we were told, by the nation’s highest medical authority, that approximately 40,000 Americans died from an opioid overdose. It was implied that many of these mortalities were unintentional, and therefore, preventable.

As many readers of the National Pain Report understand through the reporting of public health experts like Dr. Terri Lewis, these numbers are inflated through inaccuracies in the reporting requirements for death that vary from state to state, and county to county. In my county of Boulder, Colorado, our coroner is not a trained medical doctor, yet she is responsible for reporting mortality statistics to the CDC in Atlanta. These statistics are used in the CDC’s published mortality figures, found here.

Some of those 40,000 deaths from “opioid overdose” came from my county, yet how do we know the opioids responsible were from medically prescribed sources, or that the deaths were unintentional?

We are not even certain if the late pop-star, Prince, so famously died of an overdose of pharmaceutical fentanyl or one of the cheap fentanyl analogs flooding our communities from Mexico, Canada, and now, from an illegal drug manufacturer from a city near you. These counterfeit pills are marketed to opioid abusers disguised as popular prescription medications like the OxyContin 80mg tablet, for the recreational drug user.

I also fear that many of the thousands of Americans with chronic pain who have been recently abandoned by their doctors for reasons beyond all reason are also being fooled by these death pills, but that is another story – one about which the DEA and CDC seem to be surprisingly quiet.

As far as I know, we have still not heard from the DEA’s special laboratory setup in Carver County, which is reported to have the technology to analyze blood samples from Prince’s body to detect whether the metabolites of prescription fentanyl or those of an illegal fentanyl analog killed the popular singer.

Yet, Americans are largely ignorant of this latest assault on the body politic — counterfeit opioid pills disguised as medication. Instead, they believe the fault for this most famous death and the many anonymous victims of opioid overdose lies with American physicians and their overzealous prescriptive authority. This assault is being executed by small papers from the Salem News to the mighty New York Times, and has appeared on nationally respected television “news” programs, like 60 Minutes, and a so-called Town Meeting on the channel that brought you the Gulf Wars, live from Baghdad, CNN.

Now we have a study out of Stanford Pain that blames the opioid dependence of a small percentage of opioid-naive surgical recipients on their post-surgical pain management with opioid medication.

I say it’s poppycock.

Oh my ears and whiskers.

These are respected pain scientists.

Degrees in engineering and computer science require one to take a lot of math classes. In some dreary classroom many years ago I learned about a well-observed aspect of scientific research called “conformation bias,” also known as “Scientism.”

To understand Scientism, look to the old adage, often used in American politics that goes something like this:

“If it looks like a duck, and it walks like a duck, and it quacks like a duck — then it must be a duck.”

That old saw may be a great soundbite for Donald Trump or Hillary Clinton, but scientifically, it is pure nonsense.

Scientism is the foul practice that looks, walks, and quacks like science, but is in truth, a pseudo-science that leads the researcher directly toward his or her own bias. In other words, the researcher supports his or her hypothesis with a flurry of statistical hand-waving to find exactly what he or she was looking for — evidence confirming their brilliant hypothesis.

The proof in science comes only from following specific practices in doing the work of science, and is based solely upon the repeatability of an experiment. I read the Stanford study. In spite of impressive confidence levels in the thousandths, and minimal error bars, this paper is meaningless without repeatability by skilled, independent, and unbiased researchers. Personally, I would love to hear from BigPharma on this one.

The reason why scientists publish their theory, hypothesis, methods, data, analysis, and conclusions in a formally structured paper is so that other experts in their field can test their results, preferably on another data set, and demonstrate the repeatability of the original hypothesis.

If you are interested in how science is done to avoid conformational bias, there’s an interesting and readable article on the subject, written by a working scientist, Dr. Chris Lee, available here.

From repeatable experiments, hypothesis becomes theory. Maybe one day, a theory comes to be understood as truth, as it was for Galileo’s experiments, Newton’s theories with gravity, careful observations of the planetary motions by Tycho Brahe, and three theories on the motions of the planets around the Sun based on these observations by Johannes Kepler. Today, we navigate a spaceship to a tiny asteroid orbiting a larger asteroid hundreds of millions of miles from Earth based on the ideas, observations, and experiments of these men. That is how science works.

Today’s fearful medical establishment has turned against the safe and effective treatment of pain with opioid medications that have benefitted my quality of life for over thirty years, by using Scientism to stack the deck of evidence used in today’s practice of “evidence-based” medicine.

One paper proves nothing, no matter how large your statistical sample. This paper is not evidence. It is an idea. Let other researchers demonstrate whether or not this study has any validity in medical practice through repeatability.

I could go on, but that’s enough math for any story in this news source, and as a good friend once reminded me – everyone hates math.

Allow me to add a small plug for the value of a trained physician’s clinical experience to reenter the field of pain medicine, without fear of reprisal from state boards of medicine with their standards of care. I am sick, sore, and tired of being treated for pain based on Scientism absorbed into standards of care.

With so much left to do to fulfill the promise of the National Pain Initiative, with so many unanswered questions in the science of pain and its medical management, with 100 million Americans still suffering from intractable pain, I have to ask Stanford Pain, with all due respect:

Why do pain scientists from Stanford pursue research to support the existing popular bias that the medical use of opioids, for any purpose whatsoever, causes more harm than good within the bio-psycho-social milieu of the American who suffers from pain and consents to the informed risk of his or her opioid pain treatment?

What ever happened to standards of ethical medical treatment for the chronically ill human being who suffers from intractable pain?

@kwgmatthies

@chronicpain

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Authored by: Kurt W.G. Matthies

There are 25 comments for this article
  1. Christine Taylor at 10:37 pm

    Mark Ibsen MD—You have a way with the written word.

  2. Krissy at 5:23 pm

    Great article, Kurt, and you point out so much of why we cock our heads and almost have to laugh at much of what goes on. I am de-sensitized or something because I feel like there is no end to seeing, hearing and reading more and more of the biggest load of cr*p ever put to the human race. I am fast going toward natural medicine and have cold-turkied four Rx’s in the past five weeks. I feel better. However, like you, my spine is shot and there are other pain conditions I have that are for-life, so I rely on opioids. I just keep reminding myself where these pain meds came from…the earth!

    Thank you much!

  3. Maureen at 6:56 am

    Mike, Thank you for your post. Your story is all too familiar and I welled up in tears reading it. I have gone through a very similar experience ‘several’ times in the last
    20 months since I moved to Florida. It truly is a nightmare and I want it to stop.
    WE surely are the CHRONIC PAIN EXPERTS, not those making the horrific decisions about how we have to live our lives.
    I’m very sorry that you have been set back (been there more than once) and that your inner strength had to once again be drastically challenged. Hang in there and don’t stop fighting for your ‘Pain Patient’ rights! Check out the US Pain Foundation site for what those rights are.
    I wish you better days ahead!

  4. Maureen at 6:44 am

    Thank you Sandy! Please know that your efforts to write all that you did proved to be well said! I understood all of it! As well as what you wrote the other day also. I feel all that you go through.
    I (we) have been through a similar journey such as yours. It’s not easy and the tides against us make it even more difficult but…
    We are strong in numbers and I truly believe that we will win in the end and this mess will be straightened out.
    Hang in there, keep focused and keep strong! You can do it…one day at a time… Maureen

  5. Carol Reinhardt at 4:28 am

    I would also like to know how much I put the insurance industry has had in these restrictions.

  6. Patricia at 9:23 pm

    Pain medications allowed me to continue my career for 15 years, they allow me to get out of bed and walk and on high pain days, they kept me from going to a hospital. I have tried the following alternative treatments: spinal stimulators, including the new Nevro stimulator; acupuncture which does help with certain types of pain, but did not help with my pelvic I.C. pain; essential oils can help with the myofascial & burning pain; biofeedback, massage, water therapy, again not covered by insurance, I was subjected to dozens of painful, expensive and unsuccessful procedures as well as endless new prescriptions several resulting in unpleasant side effects, some of which never went away.

    It is my understanding that there is some type of contraption or simulator that can simulate muscle contractions and pain similar to being in labor. I had natural childbirth with nine and ten-pound babies and the chronic pelvic/bladder/leg pain I have had for the past 25 years is very severe and I feel as though I am perpetually in labor. The medications do not take the pain away nor do they make me high, but they do allow me to have a life and watch a movie with my family; occasionally go to the store or cook a small meal.

    The fact is people with chronic pain are being ignored while the addicts that have abused prescriptions, resort to using lies, stealing, mixing opiates with alcohol or illegal street drugs in order to get high are the people getting all the attention. I am angry and terrified that politicians (instead of my doctor) will have control over my ability to have a semblance of a normal life. Yet they have empathy, compassion and support a proposed $1.2 billion for treatment even though historically less than 20% of drug addicts remain clean & sober after treatment. What infuriates me is that all these organizations & politicians are willing to accept biased statements; skewed and misleading statistics and they are allowing addicts to use the excuse that their addiction was the result of having received a prescription following surgery. No one told these people to abuse their medications, in fact, the doctors, pharmacists and the bottles make it clear how much you are allowed to take. No one forces these addicts to experiment with whatever drugs they can get their hands on and then mix them with alcohol. In order to get high addicts steal medications from family members or lie to doctors who have compassion.

    I have been on the same dosage for over 15 years and it took 10 years of suffering to finally get an adequate medication and dosage to let me be productive, raise my children and keep my career. I have never had my prescriptions refilled before the 30 days and I have never been tempted to steal or lie to abuse drugs nor go out and get heroin (I would not even know where or how to do it). All the people jumping on the bandwagon to try to stop addiction are making decisions that are causing extreme distress, fear, dangerous (lethal) withdrawal with patients who are abruptly being cut off of pain medications because doctors are afraid of being targeted. The ramifications of what is being done will prove to be disastrous because there is a big rush to try and fix it without doing proper and legitimate research. It is all one-sided, the conferences do not include any speakers that represent chronic pain patients; there are no patients on any of these committees and there is ridiculous information being sent out. For example, PROP claims that if a patient mentions they would commit suicide if they can not get their pain medications – it is a sign of addiction – NO it is a sign of addiction – it is a sign that they can not live with the level of pain they have without medications. Are there people that should try other treatments absolutely, but to expect someone – whose pain is similar to the level of pain one experiences with cancer – to switch to alternative methods is unrealistic, cruel and is a form of human torture. I am terrified because every day there is something new about what is going to happen and other than going out and consuming massive amounts of alcohol – which many pain patients have done -currently there are no other alternatives available to those of us suffering from severe, chronic intractable pain. Trust us we do not like spending all our money on pills and living in constant fear of our pain. The fact that politicians believe we need to just hang in there and try alternative solutions proves the overwhelming level of ignorance. I just wish more doctors, hospitals, pharmacies were willing to come forth and fight on behalf of their patients – the people that pay them – and the politicians would listen to the millions of people with chronic pain, instead of people (PROP) that own treatment centers and want to keep their beds filled and increase profits.

  7. Lisa Davis Budzinski at 9:08 pm

    Sandy M that commented 7/13, states you have CPS. I’m not sure how to contact you but through here. I’m LIsa, VP of CPSFoundation. Please contact me either on Twitter: @lisadbudzinski & send me a DM or Facebook. We at CPSF want you to know there is support & information we can provide.

  8. Sandy M at 3:30 pm

    Dear Mr. Matthies,

    I agree with Maureen, your letter was written so well, I would give anything if I could write half as well as you do. As a result of my right thalamic hemorrhagic stroke in 2001, I was left with a condition known at Thalamic Pain Syndrome (or Central Pain Syndrome as it is also called) and the pain is so bad, the only way I can describe it is to tell someone to Google it! If I didn’t have it myself, I would never understand it if anyone tried to explain it to me. I had polio as a child, and have Post Polio, then I had the hemorrhagic stroke that left me with this horrific pain. I worked with a doctor for 4-5 years just for something to give me some relief. There is no cure for this condition, and research? I have no idea, Seems the government has money to watch a shrimp walk on a treadmill and for CEO’s to take long extended trips with their office people to unwind or whatever they do, but they don’t have any money to help us with chronic pain…..oh, that’s right, we will get addicted! After actually over 15 years, getting medications to the point I can exist, and being 68 years old, I don’t think so!. All they are doing with the studies they do, is hurt those of us who actually need pain meds. It will not stop druggies from getting their kicks. I had back problems and had every kind of injection, steroid injections, procedures for years until they discovered I
    had Scoliosis that had been progressing so bad I was going to be paralyzed or in a wheelchair for the rest of my life. I had surgery from the the T-3 to the L5-S1, a posterior spinal fusion with Decompression, Instrumentation, a,complete Fusion, with multiple osteotomies, transforminal Lumbar Interbody fusions at L4-5 and L5-S1, and Instrumentation that took 12 hours to complete. Also, have all the autograft, aallograft and bone morphogentic (I think it is) protein put in. I’m not walking leaned over, but I’m still in pain. After my stroke, I tried to go back to work and couldn’t even multitask, I tried for months and the pain was so bad, I was in tears most of the day. Thank God I worked for a good company, who put me on disability, then 24 months later, I had to file for Social Security. Well, I am past 65 years old now, and my husband who was a firefighter for our city has had our insurance cut because Illinois is SO BROKE, and which had a lot to do why I went ahead and had the back surgery, it was the main reason I went ahead and had the back surgery after changing my mind two or three times. I knew this would most likely happen. We cannot afford $2000 a month for insurance so now we are going thru Medicare, which is an absolute nightmare. So much paperwork, starting all over again, beginning with the first time I was ever in the hospital, even childbirth! 47 years ago, and I can hardly sit up, and my writing is so bad, it looks like a shaky mess. So, yes, I take medication, but if I didn’t, I would not be out of bed at all. I can’t clean my house anymore, I can’t afford to have someone do it for me. My husband is good to help, but some things, he just can’t do. We both have had stent inserts for heart problems. So, I thank all of you for being able to tell your stories so well. I apologize for not making sense, but I just have a difficult time and to think I was a legal secretary for over 30 years and can’t even put a letter together. So, I’m having to start with a new primary care physician after having the best for almost 30 years and my neurologist who prescribes my one opioid is semi retired and only taking care of me because he knows this condition is not known about by very many neurologist, especially primary care physicians. At least mine didn’t know about it.. So, I don’t know what will happen. I take Neurontin because the generic didn’t work and I have Zanaflex for my muscle spasticity and pain, and they’ve already said they will deny that, the generic is okay. Well, I’ve tried the generics, my gosh they are cheaper, and also several times and these just do not work, I will pay for it myself if I can get someone to prescribe it for me. Our old primary care physician was just starting to take over my medications when May 1st came around and we were dropped from his insurance so she is not on the list of doctors now and she wouldn’t be able to prescribe the opioid anyway. It’s only for break through pain and only last an hour or so if I lay down, and I have cut back myself, because I know they will have something negative to say. In fact, I’ve cut back on all my meds because I am so afraid they will not understand, therefore I’m in such pain, I haven’t even had my youngest two grandchildren over in a month. They are good kids, no problems, but I just hurt so bad, I am unable to enjoy anything. This condition also affects my skin, making clothing hurt my skin, it is hard to find something to wear that is comfortable. My body is on fire most of the time, I usually stay in pj’s all day, I can’t walk very far because I feel like my legs are going to collapse, yet to look at me, you would never know anything was wrong with me. You cannot see PAIN!. I wish I never had to take another pill, it certainly isn’t for any kind of high because I have problems taking medications anyway, and it has taken me 15 years to just get a little relief so I can do a load of laundry. Now, I’m starting all over again, like so many of you are, and I just plain dread it!. Thanks for listening to my ranting, but it has taken me hours just to write this and I know it makes no sense, I just hope you understand that I understand what you are going thru also. .

  9. Slaved by Pain at 3:10 pm

    Thank You, but, all of our efforts, will not be heard….It will get worst before it gets better.
    But Thank you for taking the time to educate and inform us. I have been in chronic pain for 42 years of my life, I worked and continues living a productive painful life for 30 years of those, until my body totally gave up, and to add to my already painful life, I was “injured’ 2 years ago at my physicians office leaving me bed-ridden for 20 months, so, like I said, all we can do is “wait’ and see what happens, millions of us are dependent on the Government for our medications, we are at their mercy. It is going to get worst for all the millions of pain patients that depend on pain meds. hopefully, things will change…..hopefully.

  10. Mike at 1:12 pm

    Thanks for a great answer to the Stanford study. Unfortunately no one in a position of power over pain patients wants to hear it, and so the harm it does to patients who truly need relief continues. Many of us now go to appointments where the new doctor is stiff and suspicious, giving us the look that tells us the next question will be “Are you addicted to opiates?” Or the all time favorite, “Do you have a drug problem?”

    I have taken methadone for 7 years for pain that had held me captive for years previously. Once my doctor and I had found a medicine and dose that worked to control the pain from the damaged nerves that tortured my feet and back. I took the same dose daily, careful to follow the “plan” and thankfully I was able to reclaim my life. I was again able to go for walks with my wife. I rarely missed work because I couldn’t bend over, sit at a desk, walk on what felt like sharp rocks or the sharp jolts that played my toes like an accordion. The medicine worked. 

    It does occur to me that if I was going to abuse drugs, I would have chosen a medicine that had some sort of physiological payoff. For instance, when looking for that worked well for me, we tried time release morphine. Now that medicine sure had a punch. Unfortunately I wasn’t looking for punch, I needed relief and morphine didn’t work for me. 

    Last year, what all pain patients dread, my doctor retired. I selected  young doctor new to the practice thinking she might be good for me. At our first meeting, I asked about the pain program I was on – the one that strictly controlled my prescriptions – day, time and amount. The one that required regular drug tests. The one that had given my life back to me and that I followed faithfully. She said I was fine, she could see that I did not ask for meds early, and that I had never failed a drug test. She said not to worry, I was one of the good ones.

    Then two and a half months ago her office called me in for an appointment to discuss meds. Uh-Oh. It began with a series of questions before getting to the reason I was there, it was time to change the program – her demeanor was different, suspicious it seemed to me.

    There had been a study (Stanford, I believe) that showed patients were actually better when weened off of opiates. The researchers found their subjects’s pain was controlled with less or no medicine – that part of the need for medicine was driven by these mini withdrawal events throughout the day. She then said my insurer wanted all of its patients tapered to a dose the was about half of what I was taking. They had somehow discovered overdose deaths dropped dramatically when the dose was kept below this arbitrary level. 

    As the problem free patient I always tried to be, I agreed to the taper plan set to begin the week she left on maternity leave. I received the taper plan from the pharmacist, and a huge red flag jumped off the page, the end point was two thirds less than I was taking. It seems she had been dishonest with me, and did it in a way that left me unable to protest. 

    This forced me to start reading. I also did an experiment. I increased the taper plan so that I could see how I responded to less medicine before the point of no return. I dropped my dosage to fifty percent the day I received the taper plan. Then every 10 days I dropped another 10% until I got to the two thirds level. 

    I found I could get by at the fifty percent level, I just needed to ice my feet after work and cut walking back to shorter ones around the block. At the two thirds level my back was normal again – the old normal where I can’t bend over or sit on our soft sofa anymore, and I’m missing one to two days of work a week. Fortunately I’m near retirement and have begun the process to leave 3 years earlier than I planned.

    I am a realist and I can see politics and the abusers have combined to take away my lifeline. There is one option left if my doctor won’t listen to me, I could go in and insist I need detox and then once there tell the therapists I’m an addict and can’t stop. They’ll cluck “good, now we can help you,” and they’ll send me to a methadone clinic where I’ll be able to get the dose I say I’m addicted to, the one that gives me good pain relief….

  11. Doug at 11:47 am

    AMEN, and I’m an Atheist. The funding for all these pseudoscience studies need to investigated and published. When we find out that all these fact less so called scientific research is found to be funded by the very same government agencies who have been attacking the pain medical profession we can claim bias due to conflict of interest. We must knock their house of Cards down before it gets any worse. Now we have the Surgeon General saying that opiates don’t help chronic pain and is basing this statement on these bull***t scientific research.

  12. Katie Olmstead at 11:30 am

    Thank you. I am tired of the hysteria. I also take opioids daily as part of pain management for CRPS, along with rest, movement, acupuncture, careful time management. It is my norm and without the pain meds, my life would be even more of a nightmare. Thanks to the media buzz, now if I mention to someone that I am taking narcotics, they gasp. Oh no! Don’t do that!

    Please! It is my life and my doctor knows exactly what and when I take my meds. I am out for the best quality of life that I can maintain. Looking forward to the Boston Globe article that is probably coming out this Sunday on living well with chronic pain.I hope it will offer a bit of an antidote to the hysteria.

  13. Maureen at 9:56 am

    Mr. Matthies,
    I wish you a ‘feel better’ kind of day.
    I too greatly suffer from intractable pain.
    I just want to say THANK YOU very much for the time and effort you put in to
    writing this well written and informative narrative.
    I’m always so amazed at how so many folks write the same or similar words that I think and feel, on this site.
    It blesses me to know that I am not alone, even in my darkest hour, knowing that we are in the same boat.
    I’d love to run a TV commercial about our lives in chronic pain. Or how about a block buster movie?! 🙂 Would that get their attention?
    Maybe, just maybe, then someone, outside of our community, would open their eyes, hearts, and minds to our sufferings and stop the judgements, the med issues, and offer empathy. Am I a dreamer or what?! ha ha
    If I had the resources…I would surely do it though.
    I am so so tired of the fight with the doctors, the fears of ‘what’s next?’, the negligence and the hurt.
    Keep up the awesome work that you do!! I remain grateful for you.

  14. dave at 9:36 am

    You dont have to be a meta-researcher like JP Ioannidis to understand theres more to science then science. Scientists are subject to being all too human- just like the rest of us and so, even the pain specialists who believe they should rule over all pain care not only in America- but worldwide are just fallible human beings.
    As Ioannidis has pointed out- allegiance bias, nepotism, inertia, convention- are part of research. The reproducibility project was created to try and address the fact that as much as 70% of research cant be reproduced-and that essentially means it is a scientific failure.
    We also know journls as prestigous as Nature- have submissions that have missing data-and so are essentially fraudulent.
    Science and scientists are for sale-as are professionals. When the IOM report assembled its members they were to have no vested interest in the report. A few months after the report was finished i belive Dr Mackey got a grant of over a million dollars- as did Dr Turk and also the connection between some of those that wrote the report and pharmaceutical companies was also exposed.
    So again, pain specialists and scientists- just people. I am not aware of them subjecting their research to the reproducibility project. Their research is as fallible as the rest and i dont care for their bias of calling people in pain catastrophizers.
    Its up to those who genuinely care about people in pain to be vigilant and active over researchers and their scientisms, biases, and all too human excesses and deficiencies- and there is no shortage of any of those

  15. Mark Ibsen MD at 7:55 am

    “What ever happened to standards of ethical medical treatment for the chronically ill human being who suffers from intractable pain?”

    They are gone, Kurt.
    Gone with the wind.
    And
    Frankly,
    The CDC, DEA, US Congress, CNN, Boards of Medicine,
    Don’t give a damn.

    The IOM report of 2011 is ignored.
    The national Pain Strategy also.
    The simplest solution to this crisis:
    Put a marker on EVERY pill manufactured and dispensed in the US.
    Then
    Retrieve information from dead people about what killed them.
    Like the VIN number on your car, or the characteristic rifle patten on a bullet, or
    Fingerprints and DNA,
    We can solve this.
    If we want to.

    I am trained to observe, record and respond to my patients. That is the art and the science of medicine.
    In Montana, prescription OD deaths are down 75%.
    80 % of my patients are off opiates entirely.
    I have accessed the prescription drug registry over 6,000 times since its launch in 2012.
    Yet
    I am fighting for my professional life, because I had the temerity to use Science as I was trained and licensed to do.

    Go figure.
    Inquisitions
    Pharisees
    Chief priests
    Obfuscation over clarity.
    Hypocrisy.
    Sky is falling.

    Sounds like a religion, not scientific inquiry.
    You are so right.

  16. Rk at 7:04 am

    It is such b.s. that these IGNORANT idiots are lying about those who get prescribed an ooiod following a surgery and become addicted most likely they were addicts before or justvwired to he one be cause I’ve had many surgeries between ages 26 and 36 and eevrybtime I was given pain meds I rarely took them they made me so sick the last time I remember being prescribed Percocet and I got so nauseated I took one and had dr order me something different and threw them out . and whatever I got instead I didn’t even take them all and ended up throwing them out. Unless someone is already an addict or wired to be,they don’t get addicted from this. It is insane.

  17. Carol Reinhardt at 5:58 am

    I have been dealing with spinal pain (with multiple diagnoses and causes) for years. The current national discussions and panic over opiod misuse and “epidemic” of opiod-related deaths has too often ignored the perspective of chronic pain patients – such as me – for whom legally-prescribed medications are a critical component, along with meditation, physical therapy, etc., of our long-term care. I have had concerns about the legitimate basis of the current national panic – as well as the one-sided perspectives of those involved in the public discussion, which has severely impacted the medical care of countless patients for whom judicious use of prescribed opioids is a legitimate component of their ability to maintain an acceptable quality of life. It is refreshingly to know that someone who is thoughtful and well-informed is speaking out to question the sources of this panic.

  18. Danny at 5:32 am

    What a well-written, thoughtful and persuasive article! Thank you, Kurt W.G. Matthias!

  19. Adrienne Upton at 5:30 am

    I enjoyed this tremendously. So nice not to hear how we can do it with magic fairy dust and a prayer. I’m not trying to be rude but some of our lives would not be lived even without opioid and devices to walk, shower, reach, grab, you name it. Not to mention other non opioid medications. Crawling, fighting to maintain any form of independence, only to have someone want to take a very important decision we made, away from us by politics. I am meticulous with all my medication and keep a notebook of dates, times, symptoms, etc. They really need to get their facts straight and this article does a lot of that. Thank you. Great forum.

  20. Bruce at 4:53 am

    I studied engineering also, and repeatability is the hallmark of scientific research. That’s where scientific proof is derived from. I’m turn, that’s what makes it SCIENCE. Beth Darnall’s submission is the blueprint for a POLITICAL argument, where the pursuit of truth is subverted by the desire of the author to use select, flawed and incomplete data to support a personal bias that benefits themselves first and foremost.
    A set of information with the requisite control subjects that is analyzed in order to lead one to a set of scientific truths, wherever that ends up being, neither makes the author look good OR bad, nor is that the focus of the investigation. It just IS. Like pain – it just IS. While the otherwise physically healthy people in the political and law enforcement community treat pain as an annoying complaint, even as something that can be controlled through thoughtful misdirection, I can’t tell you how ridiculous it sounds when your feet are being ripped and twisted and smashed from neuropathic pain. Psychology is a science, but it doesn’t have a thing to do with controlling chronic pain. I’ll keep it brief – I went into a 24 hour clinic to address some symptoms oandnce, the young intern chirped about the many supplements she took to improve her state of being, and I said look, i used to be healthy, and the difference you need to understand is that I no longer am in control of my body – my body controls me, I have to acquiesce to the signals it sends to me. All day long. Her response of sheer amazement scared the hell out of me. I mean, that’s as basic as you can get. Is that what you people think, that we can control this agony? And no offense, Beth, but psychology is what people used to study when they wanted to get an easy path to a degree, and the lazy professional lifestyle you have chosen is manifest in your most recent paper. Like the man says, it aint science, and quit picking on the weakest segment if society. We’re in desperate straits already, we don’t need your help.

  21. Dave at 4:53 am

    You dont have to be a meta-researcher like JP Ioannidis to understand theres more to science then science. Scientists are subject to being all too human- just like the rest of us and so, even the pain specialists who believe they should rule over all pain care not only in America- but worldwide are just fallible human beings.
    As Ioannidis has pointed out- allegiance bias, nepotism, inertia, convention- are part of research. The reproducibility project was created to try and address the fact that as much as 70% of research cant be reproduced-and that essentially means it is a scientific failure.
    We also know journls as prestigous as Nature- have submissions that have missing data-and so are essentially fraudulent.
    Science and scientists are for sale-as are professionals. When the IOM report assembled its members they were to have no vested interest in the report. A few months after the report was finished i belive Dr Mackey got a grant of over a million dollars- as did Dr Turk and also the connection between some of those that wrote the report and pharmaceutical companies was also exposed.
    So again, pain specialists and scientists- just people. I am not aware of them subjecting their research to the reproducibility project. Their research is as fallible as the rest and i dont care for their bias of calling people in pain catastrophizers.
    Its up to those who genuinely care about people in pain to be vigilant and active over researchers and their scientisms, biases, and all too human excesses and deficiencies- and there is no shortage of any of those.

  22. Jacqueline Schneider at 4:38 am

    I also suffer from chronic/intractable pain due to two rare spinal diseases, advanced spinal ddd, and arthritis. Thank you for this brilliantly stated article. Only those of us who truly suffer from this level of pain understand the impact it has on our lives and how the responsible use of opioid medications is the only thing that allows us to function on any level.

    People will manipulate facts to fit their agenda. The chronic pain community is suffering from this unjust attack on the “opioid epidemic”. It is a sad state of affairs, and leaves patients without any recourse or access to pain treatment.

  23. Laura Burkett at 3:34 am

    Thankyou Kurt
    I to suffer from degenterative spine disease. I am having an especially pain challenged month along with my fearful primary care docter reducing my opiod… 4 10 325 that allows me to lead quality life. Your article puts into words what I am not able to do. Articles such as the Stanford is one of several research bias pieces of garbage my docter has presented to me to explain his decision. Thanku again I am not unique 😄

  24. Carl Dobs at 3:24 am

    I agree Mr. Matthies!!! It is rarely if ever reported in any of the current literature that opioids kill by ONE basic mechanism: They suppress breathing and in worst case scenarios stop breathing altogether. In the early stages of this failure of breathing all other bodily systems work normally. There is talk these days of using Naloxone(Narcan) to reverse this respiratory suppression, and it will do that at least temporarily. In the days before Narcan, overdose initiated respiratory failure was treated with ASSISTED RESPIRATION….and in the field that was old fashioned “Mouth to Mouth Respiration”! That would still work today and a huge number of the overdose deaths could be simply prevented by assisted breathing, whether mouth to mouth or by use of a mask and bag over the mouth and nose. It is cheaper than Narcan and should be easier to come by.

    One caution, an overdose with illegally imported fentanyl has the potential to transfer a fatal dose to a first responder. That would not happen with medically prescribed fentanyl patches.

    Mr. Matthies, you are so right that there is real science out there but it is being actively suppressed by the current anti-opioid mob hysteria!