Presidents of the American Academy of Pain Medicine Oppose Oregon Proposals to Force-Taper Pain Patients

Presidents of the American Academy of Pain Medicine Oppose Oregon Proposals to Force-Taper Pain Patients

By Staff.
Editor’s Note: The following email and letter are being published as received from Richard “Red” Lawhern. Not only does National Pain Report support spreading awareness of the Oregon Chronic Pain Task Force’s proposals which would restrict opioid therapy to Oregon Medicaid patients, but also believe it is just as important to raise awareness of the ongoing effort being undertaken on behalf of those who would be impacted. Thank you to “Red”, the American Academy of Pain Medicine, and the Alliance for the Treatment of Intractable Pain (ATIP) for all of your ongoing efforts.   
Richard “Red” Lawhern’s email:
Dear Colleagues and ATIP Associates
This note provides a copy of a letter which should receive wide distribution among medical professionals as well as chronic pain patients.  Feel free to publish or extract from this, with attribution to the signatories. Thanks are extended to members of the leadership of the Alliance for the Treatment of Intractable Pain who have contributed significantly to preparation and references of this document.
Many chronic pain patients, caregivers, and doctors are aware of efforts by the Oregon Chronic Pain Task Force to force the tapering of opioid therapy to zero, for thousands of Oregon Medicaid patients. Prescribing to new patients would also be sharply limited.  If enacted, such regulations would become the most radical and unjustified denial of effective pain therapy from any regulatory body in the Nation.

Now there are deeply knowledgeable voices rising in opposition, revealing the anti-opioid bias, malfeasance and misdirection of the Task Force.  These voices include among a building chorus many others:

Sean Mackey, MD, PhD

Past-President, American Academy of Pain Medicine
Redlich Professor
Chief, Division of Pain Medicine
Director, Stanford Systems Neuroscience and Pain Laboratory
Department of Anesthesiology, Perioperative and Pain Medicine, Neurosciences and Neurology, by courtesy
Stanford University School of Medicine
Dan Carr, MD, MA
Past-President, American Academy of Pain Medicine
Richard Stieg, MD, MHS
Past President, American Academy of Pain Medicine
Board Certified in Pain Medicine, Neurology, and Addiction Medicine
Lynn Webster MD Past-President American Academy of Pain Medicine
Vice President of Scientific Affairs
PRA Health Sciences
Chad Kollas, MD
Chair, American Medical Association Pain and Palliative Medicine Specialty Section Council
Medical Director in Palliative and Supportive Care
Orlando Health UF Health Cancer Center
Bob Twillman, PhD, FACLP
Executive Director, Academy of Integrative Pain Management
Clinical Associate Professor, Department of Psychiatry and Behavioral Sciences

University of Kansas School of Medicine

It is time for Oregon Governor Kate Brown to direct the Task Force and all of its subcommittees to stand down from their efforts to restrict opioid therapy to patients who need it, or to coerce and threaten doctors who provide it.  Such efforts have no scientific basis and are directly dangerous to the health and quality of life of thousands of Oregon residents.

The letter in it’s entirety:

December 4, 2018

The Honorable Kate Brown Senior Health Policy Advisor Tina Edlund Members of the Oregon Chronic Pain Task Force Members of the Value Based Benefits Subcommittee Members of the Health Evidence Review Commission

Re: Health Evidence Review Commission Chronic Pain Task Force Revised Proposal

We, the undersigned, write to respond to the above-mentioned document released by the Chronic Pain Task Force regarding opioid medication coverage for Oregon Medicaid patients. In our view, the Task Force embraces a state-mandated treatment change that contravenes the three major national and international guidelines on prescribing opioids for chronic pain. These guidelines include: The Centers for Disease Control and Prevention Guideline for Opioid Prescribing,1 the 2017 Canadian Guideline for Opioids for Chronic Non-Cancer Pain,2 and the VA/DOD Clinical Practice Guidelines for Opioid Therapy for Chronic Pain V. 3.0 – 2017.3

It is also inconsistent with the 2019 Medicare Advantage and Part D Rate Announcement and Call Letter, from Centers for Medicare & Medicaid Services.

The Task Force proposes required changes to care for current opioid recipients that are far more aggressive than any existing guidelines or any other current law or mandate, and it does so without evidence or regard to the potential harm or benefit to patients. Many patients who stand to be affected by this proposed policy currently benefit from long-term opioid therapy to manage their complex conditions, maintain their quality of life, and participate in activities of daily living.

Below we will offer six observations about the proposed policy that raise particular concern:

1. We observe that the Task Force proposals are not supported by the very evidence review it commissioned. According the review:

a. “There was scant evidence on harms associated with tapering strategies.” (p.34)

b. “None of the newer studies since 2017 provide any information on adverse outcomes.” (p.6)

c. “All the evidence on opioid tapering was of low quality.” (p.4)

d. “Policymakers and clinicians are interested in information on the effect of tapering when it is not initiated by the patients, but we found very little information on this issue.”

e. There is low or no quality evidence for non-consensual tapering of opioid prescriptions to zero.

2. The Oregon Chronic Pain Task Force is proceeding with a proposal to reduce patients to either 0 MME, 50 MME, or in exceptional circumstances up to 90 MME (circumstances unspecified), despite its own contractor’s findings that:

a. The evidence to support non-consensual, mandatory forced opioid tapering is weak to nonexistent b. The evidence regarding harms is not yet collected or analyzed.

3. Of great concern, the Oregon Chronic Pain Task Force offers no monitoring or outcome measures. Several questions must be addressed before initiating a practice that lacks evidentiary support:

a. Are these patients doing well, or are they in distress?

b. Has tapering affected their quality of life and or their activities of daily living?

c. How is their chronic or intractable pain being managed now?

d. Have any alternatives offered been efficacious?

e. Did they die, either through suicide or from the effects of untreated pain?

f. Did they have to move to another state or medical practice in order to maintain treatment?

g. Were they forced to seek out illicit substances or drugs?

h. Were they forced to self-medicate with any other substances, including alcohol, in order to manage their pain?

4. The Chronic Pain Task Force claims that the following study, Comparing Pain and Depressive Symptoms of Chronic Opioid Therapy – Patients Receiving Dose Reduction and Risk Mitigation Initiatives with Usual Care,4 supports mandatory forced tapers to zero opioids.

a. This study in fact contradicts the expected outcomes claimed by the Chronic Pain Task Force.

b. The study is a comparison of clinics that received a variety of dose reduction initiatives.

c. It is unclear if these dose reductions were voluntary or mandated. There is no evidence that the safety of patients was improved, or that their functioning improved compared to those who did not.

d. Most critically, the initiatives in this paper did not attempt what is proposed by the Chronic Pain Task Force: mandatory, unidirectional taper to 0 MME for certain pain syndromes and arbitrary dose limits for patients with differing intractable pain syndromes.

5. Also of concern is the Task Force’s reference risk assessment tools. If by this, they are referencing the Opioid Risk Tool created by Lynn Webster, MD., this tool has recently been shown to be invalid as a self-assessment tool in clinical population of people with pain as a self-assessment tool.5 Dr. Webster himself recently wrote an editorial stating that this tool should not be used. As such, the Task Force has no validated risk assessment tool for prescription opioids.

6. Finally, many of the exceptions are confusing, most notably, the notion that centralized pain syndrome is an ICD-10 diagnosis with specific, delineated meanings and therefore, treatment to relieve these pain syndromes is somehow not warranted.

a. Centralized pain syndrome is not a diagnosis. It is a term given somewhat arbitrarily and without criteria. The authors reference that centralized pain syndrome is “sometimes coded as chronic pain syndrome.” That term is also vague and applied variably. The Chronic Pain Task Force has moved somewhat from its earlier position of disallowing opioid medication beyond 90 days, but it has created exceptions that are confusing to clinicians and are inconsistent with scientific understanding of pain processing.

b. The Task Force states that the use of opioids should be avoided due to evidence of harm for patients with fibromyalgia, however, there is a lack of data to inform this statement. Furthermore, there are several high-quality randomized, controlled trials that demonstrate certain pain medications, such as Tramadol, are effective in the treatment of fibromyalgia. Two of these studies were conducted in Oregon by academic experts in fibromyalgia:
https://www.ncbi.nlm.nih.gov/pubmed/16082646;
https://www.ncbi.nlm.nih.gov/pubmed/12753877

Given that the interventions proposed by the Task Force will become the most aggressive in the nation, that they are untested, lack evidence, and are unsupported both by the Task Force’s commissioned contractor and by all major professional guidelines, we must ask:

“What evidence does the Chronic Pain Task Force have to support a policy dictating forced, nonconsensual opioid tapering policies–evidence that is not known by the international experts who wrote the CDC Guideline, The Veteran’s Administration/Department of Defense Guideline, and the 2017 Canadian Guideline?”

None of these entities has endorsed mandated, unidirectional forced opioid tapering for any specific ICD-10 codes, as the Chronic Pain Task Force has done. We thank all parties for allowing us the ability to engage with you on this matter. Your attention to our serious concerns is greatly appreciated. As the policy decisions made by Oregon officials will reverberate across the country, the decisions made will be of great interest to people with pain, professionals, and to the media.

Each signatory has expressed their willingness to work with Oregon Medicaid officials, the distinguished Task Forces, and the Health Evidence Review Commission, to detail their concerns more directly and provide any assistance that will help protect the health of Oregon Medicaid patients.

Sincerely,

Sean Mackey, MD, PhD
Past-President, American Academy of Pain Medicine
Redlich Professor
Chief, Division of Pain Medicine
Director, Stanford Systems Neuroscience and Pain Laboratory
Department of Anesthesiology, Perioperative and Pain Medicine, Neurosciences and Neurology, by courtesy Stanford University School of Medicine

Dan Carr, MD, MA
Past-President, American Academy of Pain Medicine

Richard Stieg, MD, MHS
Past President, American Academy of Pain Medicine
Board Certified in Pain Medicine, Neurology, and Addiction Medicine

Lynn Webster MD
Past-President American Academy of Pain Medicine
Vice President of Scientific Affairs PRA Health Sciences

Chad Kollas, MD
Chair, American Medical Association Pain and Palliative Medicine Specialty Section Council
Medical Director in Palliative and Supportive Care
Orlando Health UF Health Cancer Center

Bob Twillman, PhD, FACLP
Executive Director, Academy of Integrative Pain Management
Clinical Associate Professor, Department of Psychiatry and Behavioral Sciences
University of Kansas School of Medicine


1. CDC Guidelines https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolum es%2F65%2Frr%2Frr6501e1er.htm

2. 2017 Canadian Guidelines http://www.cmaj.We wouca/content/suppl/2017/05/03/189.18.E659.DC1/170363-guide-1-at-updated.pdf

3. VA/DoD Clinical Practice guidelines for Opioid Therapy for Chronic Pain V. 3.0 – 2017 https://www.sciencedirect.com/science/article/pii/S1526590017307332

5. https://academic.oup.com/painmedicine/article/19/7/1302/4839255 https://academic.oup.com/painmedicine/article-abstract/19/7/1382/4835592?redirectedFrom=fulltext

Subscribe to our blog via email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Authored by: Staff

48
Leave a Reply

2000
48 Comment threads
0 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
43 Comment authors
  Subscribe  
newest oldest
Notify of
Angie

I am an oregon resident….who was cut way back….from 150mm….to…90mm….then rapidly tapered off…last dec…2018….i am on disability…medicaid….i would of died…if i stayed in oregon…my husband moved me to AZ…to save my life…..i have severe dehibilitating spinal condition…after a total neck replacement…n…3 major lumbar fusion surgeries….i have severe stenosis in neck…n…lumbar…arthiritis…n..cysts/tumors in neck..in spine…my last spine dr is in az….n…my pain dr. In NV…..after my last lumbar surgery…..i spent 2 years in NV…for ongoing medical care..n..pain management….my dad lives there…n…helped me…..i came home to Salem Oregon…to fall ‘victim’ into oregons opioid laws..2015..Feb…i couldnt find a dr to continue my pain med contract….so i flew back n forth to vegas for refills for 6 months…until i was able to get a dr……Dr. Julie Sherman continued my meds and entered my AZ & NV medical records..etc…on to my oregon medical record…..3 months later…..i go to my appt..to find out she had been ‘let go’…aka…fired……for prescribing opioid pain meds…..my new dr…Dr Cozens….20 year old LPN…took over….she cut my meds ……from 150mm…to…90mm…..4 months later…i was given a new Dr…and so on….5 Dr.s later….my last dr….whom i had for last 4 months…told me how lucky i was to still get pain meds…he kept trying to cut me back..n…constantly avoided giving me refills…NOT ONE TIME….DID HE ASK ABOUT MY PAIN….OR SYMPTOMS!!!…in fact ..NONE of the dr s did!…except for the first one…they fired….last october 2018….i went to pick up my refills…..my husband with me…i was UA d……lab lady filled out the pink paper…said i passed..no problem…..hubby helps me up…n…walk out…after getting my scripts….10 days later….i get a call from my dr s nurse…..saying…..i failed my UA TEST!!!!!!…UNBELEIVABLE!!!..i almost died!!!…hubby got me to AZ…..asap…

Michele

Why did it take so long for doctors to act. The damage is done in so many places

KBecker

Dontpunishpainrally.com

Angie

I was rapidly tapered off last dec…n…left with nothing n no help…my CP from spinal disease…after 4 major spinal surgeries…etc…almost killed me…as i suffered terribly….severely dehydrated…extreme high blood pressure…totally bedridden…
My husband pulled out his retirement…to get me relocated to AZ…..
I am now residing in az…alone…and have an excellent pain dr…n…neuro surgeon…was/am on disability medicaid…and was when i was in oregon….i was treated very bad..by ore dr.s…like a druggie…not one of my dr.s would even look at my medical records….or even ask how my pain was!!!…many dr.s in oregon started tapering medicaid/disibility cpp s off in 2015….i went thru ‘hell’ for 3 years…in oregon…i will be happy to share my story….let me know…thk you💖

Jeffrey Shapiro

Wisconsin’s medicaid is preventing chronic pain sufferers from receiving opioid pain meds.

I have been black listed not due to failed drug test but because I asked the doctor to amend where he put in medical records that I had multiple car wrecks which was not true. I thought it was a typo but now I realize because of being released that he was padding medical records. Then DEA, CDC has made the doctor so scared and that we’re on the bottom of the totem pole and so doctors abandon there patients and do not care if they can get in anywhere else. Everyday I wake up and I think I can’t take this anymore. I do not want to do anything illegal so the only options are is end my suffering myself. I am psychologically damaged from how I have been treated from the medical community. They just turn their backs on us. I appreciate everyone that is fighting I’ve tried to fight too but received no response. It seems that that chronic pain is becoming a racist thing to be. Physicians are bullying patients to do steroid shots or be abandoned. Blacklist a patient and say they have been inappropriate, Even in their own medical records it says that I have been a very pleasant patient. Thank you Mr. Lawhern for your dedication and efforts that you put in to protect and save what little rights chronic pain people have. A few bad apples Physicians or patience have tainted the whole Basket. All I hear about is save the addicts but what about saving people who want to function and live a good life to the best that they can and they’re taken away the only thing it helps at this point until they come up with something else. I don’t understand why don’t they create another drug before they yanked the rug out from under us. They’re just putting so much stress when you can’t get adequate or no pain control then it just it’s unbearable. I’m a law-abiding citizen and a Christian why punish me?

Vicki

Have a lot to say on this subject. I don’t care what State your in. When a person suffers from Chronic Pain there has to be Someone or Something who will help.I know I’m one who was on massive Pain medication until last year. Was forced into a nasty rehab to safely be Detoxed. What a Terrible experience I have been going through this last year. After 30 years of being treated for a accident in 1988.

And now I’m confused cause by Florida law I’m now Retired instead of Disabled?? I know there are MANY PEOPLE like me. I would Love to join this discussion. Until I can I pray we as Chronic Pain People can get our Voices heard. Not just for Pain medication. To understand who made these Laws and how I could get my Disabled car sticker taken away and just swept under a rug saying ( Your now Retired not Disabled ) Does that take my Pain away NO! I can go on and on about this hoping to get much more Answers and Help from all People who Suffer and are Treated so badly after all these years. Thank-You

Dave Mishiwiec

Of greater concern is the failure off the CDC to track suicides of pain patients due to “underdosing”. I am betting that a survey of pain management specialists will reveal that all have patient(s) that have committed suicide due to underdosing. Why isn’t this issue receiving the same attention as that of overdose deaths from illicit fentanyl?

Eve Blackburn

Dick Hammer and every other person who believes that marijuana is the great savior for those in chronic pain I’m here to tell you that it’s not. Besides the out of pocket cost associated with using marijuana to treat pain, which no Medicaid beneficiary can afford, it does not replace opioid therapy. Nothing does. Some people cannot take it due to allergies and the like, but those who can generally use it in conjunction with other medications and alternative treatments. The act of a physician writing an opioid prescription and a patient filling and taking such prescription does not in any stretch of the imagination make you a pill pusher or an addict. If that was true, than you would be labeled an alcoholic merely from having a drink. Less than one percent of chronic pain patients go onto becoming addicts after taking opioids to treat pain. Addiction is a disease, just like smoking cigarettes is an addiction and needs to be treated as such. To interlink chronic pain patients with addiction is wholly unsubstantiated and is a dangerous thing to do to some of the most vulnerable in our society, the disabled.

Kathleen F Westover

This is horrible..I live in chronic pain due to five discs in my back that are messed up and also arthritis in my back..I live daily in pain and without meds I could not function let alone, get outta bed..I have been reduced to 120 mg of oxycontin and I still hurt but, it does cut the pain somewhat..I can’t smoke marijuana so, that is not a option for me..if they cut people off of all pain meds.. there’s gonna be a lot of dead people..who like me can’t take the pain and I would say..who EVERS bright idea it is..to cut us completely off of meds..I pray that you never need them

Dick Hammer

Opioid crisis vs. Medical Marijuana

Dick Hammer

Don’t you get it, it’s medicaid thievery at it’s best. The Oregon doctor’s are bilking, stealing hundreds of thousands of dollars if not millions from medicaid. So know the feds are cracking down/catching up to there thievery. This is how these thugs work, prescribing narcotic pain meds getting folk’s addicted. So in the end the patient suffers after being prescribed 80+ milligrams of oxycodone per day, since the Oregon state gov’t decides to crack down on these pill pushing doctor’s. Sounds like to me 90% of Oregon doctor’s have and are involved in writing opioid pain medications. It’s sad for the people who actually need the pain meds, because their the one’s who’s going to suffer, unless medicaid pays for alternate pain meds such as medical Marijuana. Here in the southeast the ass backwards state’s, Georgia, Mississippi, ala-fuck-in-bama, it’ll be 50 or 60 more years before any type of medical Marijuana would even be considered. Due to greed and the corrupt law enforcement that’s selling the marijuana on the black market. The southern state governments/governor’s will do everything they can to keep weed illegal so they can continue living there lifestyle selling and importing illegal drug’s across the Mexikan borders. Well I know I gotten off track in regards to the Oregon pill pushing doctor’s, but if there’s an alternate pain medicine the people of Oregon should be eligible for it, and medicare/medicaid pay for it. To stop the opioid crisis I’m for 100% marijuana legalization across all 50 state’s just so the sick people who need medication can get some form of pain relief. Damned these state government’s and these thugs [edit] pill pushing doctor’s. Shame on you both.

lewis Bridges

Welcome to Socialism & Big Government and people want to give the government more control and free health care for all . Well here is exactly what it will look like.This is wrong !!

Matt

They should give all pain patients the national suicide prevention hotline phone number. These idiots are essentially driving pain patients to the grave.

A&B in Colorado

I honestly don’t think any of THEM care how we feel or what happens to any of us “chronic pain patients”. They are actively working hard and going to extremes to get rid of all of us one way or another!! I pray it stops IMMEDIATELY somehow!!

Eve Blackburn

Oregon Pain Action Group thanks all of the pain experts that have lent their expertise in fighting the draconian policies that the Oregon Health Authority is proposing for chronic pain patients on Medicaid in Oregon. Although their misguided opioid prescribing policies are directed at Medicaid, it will surely trickle down to all of Oregon. Especially given that 80% of the healthcare is contracted out to coordinated care organizations (CCO) here in Oregon.
Thank you for helping keep it real

Caregiver 24/7/365

I don’t think it’s much of a stretch to consider and debate whether denying legitimate pain control medication to pain-afflicted people should be considered a “crime against humanity”. Seriously. It’s taking on the shape of an avoidable destruction of lives and, in some cases, the ending of life itself.

What, if not this fundamentally flawed and cruel idea, IS the meaning of torture? In a very demonstrable way, intractable pain imprisons people by depriving them of the activities that previously defined their lives. Medication allows them to walk outside that prison for at least a small percentage of their time on Earth. And please spare me the advice to try other medications. We’ve tried them all; most of them have horrible adverse side effects and those that do not are like using a pea-shooter against a runaway train.

The proposal WILL destroy what’s left of the lives of those who follow all the rules under the care of superb physicians with specialized training in pain management. Some of these hopeless, ignored, and disregarded (i.e., “disposable”) sufferers would give up and take their lives without the relief provided by prescribed opioid medications. I know one of them, and have shared a glorious life with her for 50 years of marriage. She is hanging by a thread these days.

Someone needs to explain to me, someday, where you find people to serve on a Task Force who are so oblivious of, and/or in denial about, the suffering they would cause fellow humans who are just trying to cope, day by day, and salvage some aspects of their former productive lives. Who ARE these people? We must find out so that we can send them copies of the obituaries.

John

I’m in the middle of being forced to taper off meds that enabled me to live a normal life for over 25 years. I’m miserable and suffering and it’s grtyibg worse. This is an interesting article as are many in this blog but I need info I can use to change my situation. Is there anything I can do?

Excellent. As a stage 4 cancer patient that federal Blue Cross decided my cancer was too rare and could not help I had to travel the world and find a cure. 4 years and now cancer free But Trashed My Body Doing It! Very painful. I am always told to taper off meds! Frankly, people who drink and smoke and use recreational drugs and then die on overdoses have nothing to do with pain management. They are after a buzz and they have plenty of providers. Get serious folks! Anyway see:
http://Www.cancer-diet-exercise-supplements.org
I know I lose everybody after diet and exercise!
Thanks Mark Miller

Sammy Jones

I was doing fine, now they can’t get my blood pressure under control. Caused me to fall break my knee. [edit]. When did an addict become more important than a need. Dam they can’t see a person’s medical records and tell anymore if they are in chronic pain. It’s [edit].All [edit]!

Erica Guenther

I have rheumatoid arthritis and it is debilitating to say the least! Practicing medicine seems to be a long and schooled road to obtain a license. I do not understand because it does not make logical sense that the medical community needs another board of washed up idiots telling licensed Dr’s how to practice medicine nor is is any business of a self appointed unregulated (who is watching them) board to tell me how I feel when I am feeling it or how to treat me. I am 1 who is stuck with CHRONIC PAIN. Along with degenitrating joints. We have no problem pushing all these FANCY NEW MEDS that have more side effects and not enough time in the system to know long term affects. These hit the market daily without an eyelash batted. If a Dr of how many years that is a human being is not capable of doing their jobs which includes medicating paitents then we as a society of a free country have devolved to a Nazi minded wasteland. WHY IS EVERYTHING A DOUBLE STANDARD? AND WHEN WILL THIS BOARD amongst society learn WE CANNOT REGULATE MORALS? Nothing is perfect because we are human if u think for 1 min. This Will help so called addiction. Then I for 1 am calling you simple liars. And you know better. Addiction has been prevalent for 100s of year’s there is a beer stand on every corner. Double standard. Let my Dr’s do their jobs without the 1st thought being will they loose their license because they treated me. I see the compassion in most every dr I have ever had To help me and why I am there to be helped. This [edit] has gone on way to long. Will bad slip thru cracks HECK yes. We are human. Get off of the backs of sick people and their Dr’s PLEASE. And thanks for all the love and care to all Dr’s medicine is called the arts of science not perfect but a field we need to get out of unless we have been to school and pounded hospital floors saving lives helping sick etc..💝😷 respect y’all and thanks for helping l
and want to blow my own brains out because of PAIN

Brenda Bennett

This is discrimination against the poor for the govt to stop ppl on medicaid from getting needed pain meds. I thought our country was getting away from discrimination!!! We’re going backwards

Pat crane

It’s about time that someone stood up to those who think they should make decisions for everyone on pain med. Pain meds like any medical treatment should be between a patient and their doctor. It’s ridiculous that insurance co. Medicare, Medicaid or anyone but the doctor and patient can decide what medication is needed.

Yvonne Yeager

That should be illegal you can’t make somebody have to endure pain everybody will be killing themselves then what are they going to do rise up against suicide and forbid it? People are sick people have pain this is getting ridiculous!!!

Angie Riddell

A great big THANK YOU to the physicians who care enough about their patients and the field of chronic pain for standing up and doing what’s right versus rolling with the flow of b.s.this “task force” is trying to pull/pass. I hope that none of them, not one, ever have to deal with chronic pain and just having to take medicine to (barely) function. Each physician who has disagreed with the Oregon proposal is well-educated and familiar with what patients go through and why. Their knowledge through their education and experience definitely exceeds those who are trying to pass this bill. Again, a major THANK YOU from a chronic pain patient… I appreciate you, your help and your wisdom.

Carole

Thank you for speaking up and clearly outlining the issue with the proposed Oregon mandate! Dose anyone know if this letter has yet been set up into a petition format that we can easily access and submit/sign? If so, please post the 🔗 in these replies and I will do my part to sign and spread the word for signatures.

Michele Berland

Nobody has the right to cut pain meds from people with chronic pain unless you have lived in there shoes you have no idea how we feel my pain is so bad sometimes I can’t even get out of bed but now that I am on pain meds I can live somewhat of a normal life.

Meg

I am able to participate in warm water aerobics three days a week, do my own shopping, spend limited time with family and friends, keep my house reasonably clean, and enjoy increments of my life because I am prescribed pain medications. Before that time, I was in bed 90% of the time. Who would choose to send others to suicide without any research into the benefits of treating pain? That will be my only option if my medication is removed from my life. Studies, if anyone bothered to conduct them, would show that opiate deaths happen to addicts who are not under the care of pain management doctors. Period. I am not an addict. I am a pain patient. Idiots need to stay out of this and allow the doctors to handle the patients. vssMU

I will say this too, it’s not the pain medication doesn’t work because it does if you at the right strength, but like all of them, you need to switch for three months and then go back you can usually start at a lower level. As far as fixing our backs NO,. But that’s from the doctors and researchers not finding away to not make our backs to stop hurting and making pain pills not addictive. And all the money Big Pharma would lose not needing pain meds any more. Now that the DEA is putting pressure on us. They make a pill a couple of pills that work for people like the duloxetine. So it will block the nerves and pain receptos. You can’t take something away till you fix the actual problem. Then we all can go off of pain pills happily. When you can’t work and can’t do anything, because you are in so much pain, those are the ones with real pain and will try almost anything the doctors give them to not need pain meds.

James Jones

I was forced off my pain meds in Nebraska and have since lost my life and have been living on the streets as my productivity and abilty to function on a somewhat normal level has been hindered in a significant way. Not only has my pain increased by 100% but most days it takes me hours to get out of bed, off the couch or from the back seat of my car or wherever I am sleeping. One thing I can say for certain is unless you have personally dealt with legitimate chronic pain that requires surgery or causes you non-stop around the clock irritating sometimes debilitating pain you won’t understand why the need exists to take opiods. From a “rights” perpspective” I have also learned and came to see America as becoming more and more of a country that is far from free. As for the “opiod crisis”. The poeple who do abuse can be compared to when you tell kids they cant, shouldn’t do something etc what do they do? Exactly the same logic applies. Because we “grow up” that doesn’t mean certain general behavior always changes. Look at how Portugal handles all drugs and there’s a good starting point for America. Seriously if you want to look at the real problems let’s start with Alcohol, then right onto bad food or fast food. Look at the numbers of death related to either of those 2 and there is another answer. This isnt rocket science.

TSH

Yes!! Thank you for standing up for people in pain. My story is long so I won’t go into it all. I have tried everything out there…my Pain Management Dr tells me when something new is out. We firgure out the pros and cons and decide if I’ll try it. All that has worked are opioids. I get so few they don’t even last. I’m grateful…because a few days of relief from this pain helps. Quality of life??? Yeah, I have that, a couple days a month.

Susan Domokos

In 2011..at the very beginning of this crazy…. I was FORCED to go off 75mcg of fentanyl after my Dr retired and nobody wanted to deal with me…I had a heart attack…crazy sugars…sucked down crown…fell down.. alot..and ended up in a lock down psych ward for 8 days….
TO THIS DAY…6 years later…I still have fentanyl brain…crazy stupid pain…and scared to open my mouth…scared to go to ER unless about my heart…. scared to even start any convo regarding this BC so far NOBODY gives a [edit]…tired of professional medical people looking at and/or treating me funny…list goes on…I BEGGED to be tapered and medicated for the withdrawal symptoms…and the head of the hospital said NO…WE AREN’T A REHAB …and SORRY..
I am still messed up in Ohio 😎 ❤✌

The duloxetine blocks that signial where it saying your back is hurt from prior damage. This really works so I. Telling you all to give it a shot. From Morphine and oxy and wasn’t completely working for my pain to where I’m at at needing nothing. So at the end of the month I will be off. I will get 60more oxy just incase. But I’m hoping I will not need it. This is the first and only medication that after 2hrs it took my pain away.
Like I said it’s antidepressant, so if you can get over the label, and try it, it will work. I don’t even in take my Lyrica. Haven’t taking that in almost 3 months.
I was also one of the youngest girls to have endometriosis. Was told the pain was in my head the doctor’s were not educated enough on it. And when I was in such pain and no one would help I almost ran my car off the cliff. So I know how people feel, the funny thing was I got a historectomy at 21on Oct 31st, I didn’t have pain for 5yrs till I hurt my back. So thanks doctors for telling me it was in my head. Also I never became addicted to the medication. I went threw body with drawl my leg would go crazy, headaches and nausea. It took me 2months getting off methadone. After 15yrs. When my doctor switched me to morphine it has taking me 3months and taking the oxy to supplement for the body reactions. And I’m down to 30 mg a day the body reactions are subsiding too. Never had my mind said got to have the drug. Why??? Because I was having real pain so 30 years of pain medicine and now the duloxetine that does work,. I would start at 40, and after a month if need to go up to 60mg. I had to go up to 60mg to get off the morphine because otherwise I would still have more pain than I wanted. Don’t get me wrong I still feel a little pain but tynol or ibroprphen can take care of that if I need to. That’s usually in the morning when I need to take the duloxetine. So I wait 2hrs and no pain. I would never tell people to try it, if it didn’t work for me…..so please try.

Michael Kastner

So well written and there really isn’t much I could add. The fact the Governments are trying to control this problem is appalling. How dare they and the good Lord help them if they experience a tiny bit of the pain we all do. Things would be very different then. We must stop Oregon before it becomes a very bad model of what may yet come.
It’s all so wrong.

April Dawn

I can’t begin to express how grateful I am for this. Please please know that there are endless amounts of people – all over the country – in crisis about how we are being “treated” for our pain. Even those of us who have always taken medications appropriately, and the medication was clearly making a huge positive difference in quality of life – and this was documented ever doctor appointment – with specific examples etc. we are being punished we are being forced to reduce our pain medication – all of us to 120 total opioid amount – a completely meaningless amount that does not take into account any of the specific medical needs of each unique person and conditions. I am in hell due to increased pain, I can’t go to any social/spiritual functions, I am missing medical treatments/appointments. I am in endless agony. Pain is my only consistent now. Please keep fighting – for all of us.

Rjc

Thank you. After 20 years tapered. I am now a 65 y/o heroin addict

Greg Denton

I am a Vietnam era vet I broke my back and my neck many other injuries I’ve been diagnosed all sorts of things one of them chronic pain just recently after being in Montana a short time this VA forcibly reduced my pain medicine now my world is upside down they labeled me an addict and took away my meds now my quality of life is in the toilet I’ve had 28 years of sobriety from alcohol but reconsidering going back to drinking just to manage my pain on a daily basis this is horrible since I have PTSD and major depression and I tried to commit suicide way back when when I was drinking alcohol . I was at a very low dose of an opioid after being on a high dose after two shoulder operations one that didn’t take causing severe pain I was using low doses of medical marijuana in Oregon to get off the higher doses of opioids that I was on my life at the low dose of opioid combined with a low dose of marijuana made daily activities and life manageable but now that’s not the case it’s almost like my life isn’t worth living now and I certainly wasn’t treated like a veteran should be treated and I’m also scared because this VA did not recommend anything to treat my chronic pain I will not go back to see this provider at this VA now all I think about is what is my life going to be like

So I have been on pain meds for hurting my back from my job, and cancer. I was put on methadone for 15 yrs, ended up with cancer and fibromyalgia, my doctor switched to morphine and the oxy. It got to the point it was enough, getting tired of taking pain pills I had researched but found the medication they had I tried and it did not work. So 3months ago I was telling him it wasn’t lasting always very honest, never took any ilkegal drugs or alcohol. So when I told him it wasn’t enough, he said he said, I was playing a game. I was mad I was having pain. So I left and researched again. Found an article that said taking one antidepressant had a 18% chance of working compared to taking two different antidepressant had a 45% chance. So when I went back to the doctors I told him what I found. I saw a different doctor because mine was out of the office. He said let’s try duloxetine it has worked for some others. It was worth a shot. I needed to take the oxy but I waited so I could take the new pill which was only once a day. As soon as I got it I took it. It takes 2hrs for medication to get into your body. 2hours later my back was numb and tingling. I didn’t need my oxy. It worked, so I had only took the oxy when I need to and tried to get off the morphine.
But I have found dwindling off the morphine and taking the oxy when my body has a reaction to me lowering the morphine was the way to go. So two more months i take 30mg a day now and oxy when it goes crazy. My leg and nausea and headaches have eased up now that I have gone down on the oxy. so I’m hoping end of the month I will be off the morphine and the oxy is no problem be to get off of.
The one thing I will tell you is the most you get off the duloxetine is 60mg once a day, so take it at a time that is never a problem for you. 2nd if you forget just take it, because you will start to feel the pain coming back. Also what duloxetine does it blocks the signial from the brain to the nerve …cont

Heidi, Seattle WA

I find it interesting that Oregon was the first state to legalize assisted suicide, and is now encouraging suicide for low income, vulnerable people. Hmmm. Trying to get rid of the ‘undesirables’?

Lisa

Please help us. This isn’t going to stop the opioid crisis. It is just creating another. I will have no life without my pain meds

Carol D

Thank you for fighting for those of us who live in chronic pain. I know that if I was forced off my medication with no proper solution – I would be among the suicide group before long. I know this as I have attended 3 different pain self management classes/programs and the opioids I am on now have worked for me at the same dose for years…. This is my workable solution to give me reasonable quality of life.

Lace Holland

I am one of the millions who has tried nearly every medication imaginable to help my pain from Ehlers-Danlos. I have 5 herniated discs, multiple neuropathies, chronic debilitating joint pain, and pain of other sorts. My first relief after years of efforts was Percocet and oxycontin. I’ve been able to maintain a dose of oxycodone of only 40mg per day for over 2 years, but it has allowed me a life with my young children. There are days where I know I need more, but in this anti-opiate climate we have achieved, I dare not ask.

To take away opiates from those who need them and use them properly is to take away their lives. They may be alive, but they will simply exist, unable to execute even the simplest daily tasks. Perhaps those Medicaid dollars can then be spent on caretakers who can bathe them when it hurts too much, shop for them as the excessive physical strain is unfathomable, and help care for their children on the days they can’t leave bed. Then, more money can be spent on the effect of their “poor diet and sedentary lifestyle” they will be blamed for when the Oregon government decides to stop adequately treating their pain out of ignorance.
To the Oregon government: Please do not allow a witch hunt with doctors who only wish to properly treat their patients, and please don’t punish those who are truly in pain and only helped by opiates because there are those out there who missed. Be strict, but be just.

Brian Gilbert MA

I have been a chronic pain patient for 18 years. I am also a healthcare professional with many decades working with people who have addiction issues and chronic pain. To arbitrarily single out a population that is Medicaid or Medicare insurers is in its self going after a very underserved unrepresented community and our country. I would like to personally thank the doctors who obviously listened to the first day in medical school to do no harm to patients they serve. The Oregon pain Group has made arbitrary and dangerous decisions using a population that is often just proportionately under represented so why not pick on the weakest link first. The use of actual scientific evidence seems suspect at best in this study or incomplete and antiquated is used to make decisions that have a great impact on many people. The more draconian the laws we come against a important issue as pain management the pendulum has swung to the extreme where a mandatory termination of medication is proposed.
We are lucky to have such intelligent rave scientists willing to advocate on our behalf that there are actual cases where pain medication is warranted and not everyone is a three headed monster for their ongoing use of something that allows them to at least function at a basic level in society. Bravo to these individuals that have signed the letter opposing the restrictions and draconian efforts not based in science to just take away something that has helped people. Even the screening devices that have been used a self assessment report it really does not have validity in pain management has been shown for what it is. I support the CIGNA tours of the letter addressing this important issue and I’m grateful I do not live in Oregon and I will share this article with my pain MD.
I think it is essential that we advocate and lobby for our right to have access to medications that will give us a quality of life.

Steven

I went to the supposed meeting where paients were to be listened to by the commitee. We were given 5 minutes. Also, a doctor was given five minutes total. Thes people are hell bent on depopulation and TORTURE for the PP community. The AICPA treats animals with more dignity by putting them down.

Victoria Palmieri

PLEASE KEEP UP THE FIGHT FOR PAIN PATIENTS. I’ve heard of too many patients who ended up committing suicide because they couldn’t get their medication and their lives were not worth living with that amount of pain. I, myself, would be bed-ridden without my
medication.

Donna S

Just Amazing! As usual, what I do Not see being at all adressed is what patients are supposed to replace their pain medication with. Acupuncture? Yoga? Just going to a gym? Bio feedback? Etc?
Oh, and will insurances cover Any of these alternatives? Look what has happened with the medicinal marijuana. Patients cannot afford the High costs without being insurance covered such as with opioid prescribed medication.
Chronic Pain Task Force…Get Realistic! What you are initiating just well could be a mass chaos of many many people with real debilitating pain being uncontrollably suffering, resulting in anger, depression, lack of functioning in their daily lives, and most likely leading to black market purchases and many many more suicides.
Is this just another form of trying to alter population?
People need More assistance for their existence!

Kimberly Ann Balogh

In Colorado Drs are forcing patients off Pain Medication weither you are on Medicare Medicaid, or have Private Insurance. All my Dr cares about is her lisence. My pain meds were taken away in May 2018 for no other reason than Doctor’s DON’T CARE about Patients & think we ate LIARs. I worked in Medical for 25 years & never thought I would see a piece of paper put before patient care

Marjorie Booker

Wow. A group of doctors standing up against the lunacy. Thank you.