So Why Isn’t There a Post Opioid Strategy?

So Why Isn’t There a Post Opioid Strategy?

By Ed Coghlan.

The National Pain Report published a story about an article written by one of the nation’s leading pain physicians about the collateral damage that the opioid controversy is inflicting on pain patients.

Dr. Jay Joshi— writing for Quartz Media—declares the medical and scientific communities are reacting by questioning not only the prescription of opioids for treating pain, but the very treatment of pain itself.

Here’s the article by Dr. Joshi.

It set off a firestorm of commentary from our readership—which is, or course, the pain community.

We at the National Pain Report have been asking—with dunning repetitiveness—what is supposed to happen if opioids are eliminated or restrictions to them are intensified?

In other words, if opioids are so bad what’s the alternative for millions of chronic pain patients who use opioids responsibly?

We have already received dozens of responses. One, in particular, caught our eye.

It was from chronic pain advocate, Richard “Red” Lawhern who wrote the following:

A really fundamental issue is implied by this article:  if opioid therapy for pain is considered to be inadvisable for people who have a history of addiction or drug involvement, then just what IS advisable?  Are there realistic alternatives?   If so, then I don’t see them mentioned here.

The Agency for Healthcare Research Quality is now circulating a draft report of a “systematic review” of over 4,000 published trials of non-invasive, non-pharmacological therapies for pain. By the time AHRQ analysts boiled down this literature, they generated only 265 trials that could be analyzed for the short-term, intermediate-term, or long-term benefits of such therapies for any of five classes of painful disorders.  Among those surviving trials, the term “Strength of Evidence – Weak” appeared over a hundred times.

In my personal view, the weakness of methods and protocols used in published trials of non-opioid therapies is so pronounced, that we literally don’t know whether they work any better than placebo.   This entire medical literature needs to be burned to the ground and done over.

In the questions he asks, is a broader question.

“If not opioids, then what?”

It’s a question we keep asking leaders in the pain community.

So, let us ask you.

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Authored by: Ed Coghlan

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I still cannot see how denying opioids for those who are in excruciating, chronic pain will save lives of those who are addicted for non-medical reasons, they will merely find another way to get and stay high, whereas chronic pain sufferers are left with little or no choices. Perhaps it makes political points to give the impression that something is actually being done to combat the increasing addiction and deaths due to opioids while actually doing nothing effective to combat the problem. Imagine if these same restrictions had been applied to the use of tobacco by smokers, the millions of people who have suffered and died due to side effects of cigarettes that could have been avoided? We all know that $$ is the reason alcohol, tobacco, carcinogenics in our foods and water, etc. are still allowed and even promoted by big business. Could it be that insurance companies are looking to save money by eliminating legitimate use of opioids?

I am 53. I have severe scoliosis. I had my first full spinal fusion at 13 T1-L2. it was after the third full fusion front and back T1-S1 that things got really bad and I started needing daily help with pain medicine. now I have broken hardware and the cervical spine at every level has been damaged.for 23 years I have had to adjust to new normals as I have watched my body fail. I was in MA taking care of my mother for 2 years. the pain got so bad in my neck last summer that I could not lift my head up anymore. as it is, I only have a few good hours a day. so my pain doctor, neurologist, and cardiologist said to go back home to SC where my home is, get the rest you need, and get with a surgeon about your neck. I was having chest pains from the escalated pain. Also, the FDA pulled the medicine that I had been stable on for 5 years. so I went through 3 months of trials trying to figure out what works to manage this level of pain. I arrived back to SC Nov. 28th. with enough scripts for one month. My cardiologist saw me immediately because of the chest pains and I fell down the stairs. the surgeon will be January, neurologist Feb. I have been rejected by the pain clinic, that I had used for over 10 years. the doctor would not come in and speak to me, would not call the MA doctors to find out my situation, or read the medical papers. He had his rule about how much meds he would prescribe a day, and I had surpassed that. So I could only stay if I agreed to reduce my meds. I said not until after we find out what is wrong with the cervical spine and meet with the surgeon. otherwise, I am bedridden. packed in ice. I explained I had just recently tried 3 different medication and this combination works for now, and I encouraged them to please call the pain clinic in MA to better understand what was going on. they refused and I was out. MUSC pain clinic which is supposed to be the best in the area, refused me the second week. they would not tell me why. I called a third pain clinic but have not heard back from them. so I have at this moment, no pain medicine in a couple weeks. I know how bad the pain is going to get. let alone the withdrawals. I have withdrawn many times before previous surgeries. i called my new primary clinic and she said all you can do is go to the hospital. i am in total disbelief. I am trying to prepare myself that I may have to sell my townhouse and fly back to MA next week and live with my elderly mother, which is not a great environment, but better than a… Read more »

I’m so sorry you’re going through this. Hang in there and keep your chin up! I ‘ve committed suicide over the pain and discovered that I’m not the one who is in control. The Creator is. Don’t stop speaking out! Keep telling your doc and go to the emergency department if your pain isn’t under control. Good luck things will fall into place.

Ya well I have been on pain meds for over 15 yrs, this is what the doctors and government done to me, left me to defend for myself, the fentanyl and oxycodone withdraws dam near killed me, did they care? NO so now I am forced to have no energy because the pain and withdraws are wearing me down, I can hardly work, I sleep 3 hrs a night, if I am lucky, but you can bet John McCain and a some of the other poor sick politicians are not doing without!!!, I can bet our tax money is getting them the best pain relief our money can buy, and ya some may say well he’s dying, well we are to thanks to the junkies and addicts that have screwed me and many other pain patients out of there meds that kept the going and working, and providing for their family, but I guess that’s how it goes, I only hope after the DEA and FDA get to their next lying survey I hope they see the blood is on there hands for all the useless deaths THEY caused!!!!!, will it change? No it wont. We pain patients are on our own, well I hope all of them thats responsible, doctors included have to tell there family members, that hears the gun, you want pain relief, you know what to do!!!!. Cause I’m not standing against the DEA cause I have a certain lifestyle to uphold,,, way to go guess that oath, to do NO harm went out the window!!, cause just look at all the Harm you all are giving by leaving us to defend for ourselves, I only hope that when I need a liver because of the 100 tylnol a month I take, trying to have at least 1 good day a month, I hope you would at least try to make an effort!!!.

President Trump claims to belive in GOD.If he truely does please stop killing chronic pain patients.For one day all our elected officals will stand in judgement and answer for these crimes against humanity.

Rachael Elisabeth Hall

If anyone who is one of these “opioid epidemin” crazed do-gooders thought about the band wagons on which they so mindlessly hopped for 5 seconds, they may start to wonder why (IF everyone all of a sudden cares so damned much about the junkies the walk over, around or flat away from on the streets) no one is talking about the ALCOHOLIC BEVERAGES available on every corner that not only destroy lives,families and health, but look at the innocent bystanders also often devastated by the alcoholic’s CHOICES to do what they do. How many deaths? How expensive are threetypes to The System?

How about cigarettes? Cool, huh? Why aren’t smokers being discriminated against like pain patients?

You know what I think? Ya’ll do-gooders get State AND Federal tax money on alcohol and tobacco. TAX MONEY

Think about that while you killing us

I am 63 years old and I have kidney disease, COPD, thyroid disease, degenerative disc disease, degenerative arthritis, sciatic, major depression, generized anxiety disorder, osteo, and more if I could think of it at the moment. I have been on er morphine sulfate and diazepam for 15 years and my GP just cut off my diazepam and cut my ms way down and I fear another cut is coming. I am almost lifeless with no energy to do anything. My house is a mess and I hate it living this way. It was bad enough to be cut from the diazepam but now it’s the morphine too. I tried going cold turkey and by the second day I thought i would die so when my GP decides to cut me off completely I’ll be for the most part bedridden. This is hell on earth. My GP is also 78 years old and when he retires my hopes of keeping any of the morphine sulfate I am now getting is all gone and then I am gone too.

What our congressmen along with others are doing that don’t have MD behind their name is a crying shame. Everytime I hear the word opioid crisis I want to scream. The only opioid crisis we have are a bunch of uneducated people not knowing how to let our doctors determine real pain patients from folks that want to get stoned. As a pain patient myself I can say when you take your medication as prescribed it gives you life, not death. A lot of these so-called opioid overdoses are mixed with alcohol and other illegal drugs, some being heroin and illegal fentanyl…though you never hear of that do you now? How about the hundreds of pain patients that are taking their lives due to this new barbaric law? I read where one of our veteran’s… for the love of God, walked up to the V.A. Clinic door, put a bullet through it and then one one through his head for he could not take the pain anymore from where they had reduced his pain medication. Another woman walked into her backyard, poured gasoline over herself and set herself on fire. Her next door neighbor came out and witnessed this event. He said he knew it was because she could not continue to live her life in bed anymore; for that is no life! Yes they had all but taken her pain medicines away from her also. I myself am going through what other chronic pain patients are as well. For those of you who have no earthly idea what chronic pain is I will be more than happy to tell you. It is living with pain 24/7, 365!. It’s often my alarm clock in the middle of the night, especially since the cut back that not only my doctor has had to enforce, but every doctor has been forced to take with their patients because they’re terrified they will lose their license if they don’t. For about 20 years now I’ve been in horrible pain. I will spare you the details for there’s enough on this website as well as countless others to get the point across. Nevertheless after years of going to countless facilities trying to get help but always hearing,”No pain no gain!”, from people that weren’t in any more pain than my refrigerator, I finally found a kind and very reputable doctor in my town. In 2009 due to many, many prayers; he was literally the answer! He had me on a comfortable amount of pain medication to where I could live my life again. No ma’am and no sir did I walk around stoned or high. Though I did indeed walk around with my head held high for I could walk again, go to church, grocery shop, clean my house, simply live, love and laugh again. Here it is 2017. In the last year I’ve gone through what seems like hell on earth. I can plainly see why people want to take their lives. When you… Read more »

I spent the last 12 months in hospice. I was given 4-6months to live, I have chronic pain, I was given methadone for my pain. It works good! After I didn’t die, I went to the VA, since I am a vet. Ythey proceeded to not refill my meds, I withdrew on my own. Pure torture!! After that I of course was in terrible pain so I called the pain Mng. It took me 2 social workers a. Patient Advocate to talk to pain doctor. Who told me use motrin! They only want the accolade’s for reducing the opiates. Of course you have. Great standings for reducing opiates, you quit prescribing them. So what do we do?, This is nothing short of torture!!! If you could live one day as one of us, in intolerable pain! You would immediately fix this problem,!!! We need this issue to get to the lawmakers to get it done rite, IG anyone knows how pls speak for us!!

Raymond Walter Herbertson

All Things Considered I cannot help men think this is a political agenda the attack needs to be made at the border on heroin and Fentanyl Imo in my opinion there is no alternative treatment for chronic pain there might be Therapies or if you want to call them modalities lidocaine creams meloxicam Lidocaine patches creams acupuncture dealing with insurance regulations even the lidocaine meloxicam creams are not covered acupuncturist find a good one and then get it covered and then what happens if that doesn’t work people do not move on to heroin because they responsibly used pain management pain medication

I think a huge point is being missed. There is no post opiod plan because they (big pharma) and the FDA management doesn’t want one. The total crisis itself is a scam as it’s all about the money.

First thing that needs to be done is for the government and medical communities to stop lumping opioid medication overdoses and heroin overdoses into the same category. I understand opiates are a derivative of heroin. But every time I hear a news report or read some medical report all all overdoses are called “opioid “ or “opiate” overdoses. Most of these “opioid “ overdoses and the so called “opioid crisis “ are heroin overdoses and herion addiction. No one is distinguishing the two. This needs to be addressed by the medical community and our government.

I take my pain medication as prescribed but still every week or two weeks it’s a fight. No doctor wants to prescribe anymore. I live in Indiana where opiates are all but outlawed at this point. My neurologist just diagnosed me with severe nerve damage along with my other diagnosis’s of several herniated disks and pinched nerves. The nerve damage started over two years agony’s could have been avoided but because when they really started come down on opioids I was told by quite a few doctors that they wouldn’t treat me because they thought I was making up being in pain and “pill seeking”. They black listed me through Indiana’s INSPECT and this was all because they didn’t see anything in my MRIs to warrant all the pain I am complaining about.

These pain management doctors are not qualified to treat patients. They don’t not know nor understand what they are looking at when it comes to MRIs, x-rays and other diagnostic tests. And if you try to tell these doctors what has been seen in the diagnostic tests by other neurologists and neurosurgeons in my experience I have been told I’m belligerent, I am self diagnosing and trying to treat myself and “just want pain pills”. No I am not. I am taking a proactive role in my health. I was actually kicked out of a pain management office because I called out the pain management doctor. I kept questioning why he couldn’t see what my other specialists had seen. My specialists had referred me to this pain management doctor and he was not qualified to be treating anymore be because he really had no idea what he was doing. He had his qouta of 100 pain patients he could treat and that’s all he cared about. Which comes down to money.

One last note to think about. Our government and military have taken over and are protecting hundreds of not thousands of poppy fields over in Afghanistan. Why is that? Google it. You’ll be amazed at what is not being told about this. The Poppy is used to make herion.

And that’s the rub – why isn’t there at least something in the works *now* that will be available soon? Can’t burn all the nerves in my body, and I’m not letting any doctor put in a stim that could migrate or get entangled in nerve bundles, or otherwise operate on me (will be needing a hip replacement) unless I am sure that my pain levels will be adequately managed. After my last ER visit, I’m pretty sure if I do need surgery, it will be done in a Very Large Metropolitan area, or it won’t happen.

The really scary thing is: if they do succeed in killing off the elderly and infirm (just think of the money they would save!), then what will happen to my daughter’s generation and the ones following? When will they have a *solution* rather than spouting PROPaganda?

I know I will not be able to live with my pain levels if I have to endure another cut in my medications. I’ll try like hell, and perhaps surprise myself and be able to hack it. But if I am already bed or couch ridden now, why bother? This is something that hubby doesn’t want to address or talk about, but he knows what will happen. I’m pretty sure my kids do too. And at 44, I should be making plans to go to the park with my granddaughter, not making plans for when I am forced to end my life.

Enforced compliance of a set, maximum dosage of opiod medication when a patient has effectively, responsibly, used more than the now “set amount” of dosage is as easy to embrace as say….torture. The “policy” for opioid prescribing physicans has been auhored, published. and is now enforced without ANY suggestion, hint, or direction for patients to resource which is absolutely crazy. ANY research into the negative, harmful effect that 90 mme daily, maximum is causing is certainly NOT being published by dot/gov. DAILY, I read of the stress, heightened pain, and social recluse that “policy” is causing. Are the patients the only people that can read? “Officials” can not understand, or do not care what negative issues that a “dfrug free” America is causing. A drug free America would be great but, “medication”, in a tailored dosage, by a physician or pain management specialist for an underlying painful health issue IS needed.

I do not believe that ust any “one” treatment for incurable, lifetime pain exisits. Cannabis may be the “answer” for some pain generating issues but it may not be for everyone. “Kratom” helps with minor pain but again, it is not for every pain issue. Opiod medication may not the answer for everyone but, SOMETHING needs be available, legal, for patients because anyone, everyone would use opioid medicaion if “they” had lifetime, incurable pain Even Jeff Sessions.The gestapo technic of enforced compliance of “one maximum dosage for all”, by HHS ,CDC,and DEA will not, can not restrucure society to the Leave it to Beaver days!

Wow. Some seriously strange posts came in there after Fedups killer bunny rabbit idea posted.It just absolutely breaks my heart to think of ppl in pain day after day,with no support possibly living in less than desirable conditions due to being denied the medications they need to be mobile and do daily house chores,running errands etc.Then one has to wonder how many children are not taken care of properly,dinners made, homework help etc.Not to mention all the grandparents of children whose parents are addicted to the real American problem HEROIN AND FENTANYL,who now care for their kids.You understand what I am saying right??? elderly ppl have painful issues.To anyone who might be in pain and lonely abandoned even by your doctor,know I pray for you,and if you pray for us,GOD WILL NOT ABANDONED YOU! DO NOT TAKE YOUR LIFE!YOU MUST LET GOD DECIDE YOUR FATE,IT IS YOUR LIFE BUT THAT LIFE WAS GIVEN TO YOU BY GOD ALMIGHTY.AMEN

I just read one comment that said; Just say no…..it makes me wonder if that person has chronic pain. I safely use opioids and also go and get get nine injections in “trigger points” and a block in my lumbar. I was born with a messed up spine. I can’t imagine my life without my meds diet,exercise. Chronic pain kills if left untreated just like every other disease. We deserve to be treated just like anybody else with a chronic illness. What’s going on in the US with the deaths are mostly involved street drugs and alcohol in their systems not just opioids. We as chronic pain patients have to stick together. Our quality of life depends on it. It’s very unfortunate that anyone dies of a overdose, they need to keep chronic pain patients out of it and publish the real truth about what all else in the system other than only a opioid. Makes no sense what they are doing to thousands of pain patients. Just not fair why do we deserve to be in chronic pain all the time for? Believe when we say we wish we didn’t have to take anything just to be able to do what everyone else takes for granted.

What next???? Give us a answer…Your gonna take pain meds from responsible folks.Its not our fault that certain Doctors have written thousands of scripts to junkies and they killed themselves with them.So when a person kills themselves bc of the pain.Do you realize some folks depend on them to get out of bed and live somewhat of a normal life.We dont depend on them to get high.we depend on them to be able to do our everyday chores.I cant do anything till I have my morning meds.If I dont have them.I set there just sit…regretting my every move.How hard is it to figure out a person hurts listen to the stories above…It all sums up to some Doctors screwed the pooch.And some overdosed bc of it and its not just some its alot.But your about to make us suffer.well. I hope you sleep well.bc I dont with meds I can only imagine without meds.My body cant take it.My heart my depression will consume me.Thank you so much

Reading this and sitting here with a 45 in my hand, I’m ready to end it. After 15 years of being on pain meds that were working for me and now they have cut me way back. I don’t have a purpose in life anymore. I feel useless. I am in constant pain. Why continue with this bull [edit].

I have been on pain meds. since 1983. I also have tried injections, every therapy known to man multiple times. Nothing helped but my pain meds. After several surgeries years ago I was told by many specialists to take my meds. and try to make myself as comfortable as I could. There was nothing else they (the drs.) could. I live in R.I. and every Dr. is so afraid of getting in trouble they won’t even consider evaluating you. I thought each patient was supposed to be evaluated individually before being taken off their meds. Maybe I am wrong. The ironic thing about all this: people with chronic pain who have lost all quality of life due to lack of opioids still abide by the law. The other type of people we call addicts who don’t even have pain, still manage to get drugs. How unfair is that? I am truly disgusted with the entire system.

It has been reported the CDC sent a banned word list to their policy analysts. These words included fetus, transgender, evidence based and science based. The suggested phrase to be used was ” CDC bases it’s recommendations on science in consideration with community standards and wishes “.

Now with that kind of standard, how can we expect, oh I don’t know, maybe policies based on scientific principles?

Holy cow, what in the hell has our country come to????

I function well on opiods. They restore my quality of life. I had side-effects with Lyrica (depression, weight gain), Neurontin (pale stools, a feeling that something was “off” but I was advised to discontinue it soon after starting), Topamax (menstruation for 3 weeks, intense depression, palinopsia), Cymbalta (an episode of intense brain fog, I drooled, had trouble controlling my hands and couldn’t express my distress).

I’d rather not take something that’s going to kill me or make me want to kill myself.

I’m not sure about marijuana. I don’t want to be forced onto it because there’s no other alternatives. I don’t know if weight gain and fatigue would worsen (problems I don’t need) or if I would have any difficulty focusing at work (when I need medication most). I also am allergic to a lot of foods and grass pollens. My allergies are so challenging that I am reluctant to try new substances. (I mean, I had difficulty breathing after eating SPAGHETTI SQUASH. Things as seemingly benign as egg yolks and coconut cause anaphylactic reactions.)

I believe the solution, if left to lawmakers will be a one-size-fits-all solution that will exclude some of us from treatment or an all-out denial of treatment. The lawmakers, media and DEA shouldn’t interfere with our medical treatment. Doctors were once respected, and were the sole source of medical treatment. Denial of treatment is unethical.

As I read these comments I believe they should be forwarded to The President’s Commission on Combating Drug Addiction and Opioid Crisis. This Commission is clearly not getting the other side of the story, that for chronic pain patients, those who from accidents, failed surgeries, diseases (ie. RSD, Lyme, arthritis to name a few) find themselves in 24/7 pain, high up the pain scale through no fault of their own. When opioids work to bring a quality of life that is better than anything else we have at this time, CP patients should be allowed access, supervised by physicians and not have the stigma of being treated as drug addicts. They need access to their medication without the constant worry that it will be reduced, or stripped away from them.

How can the US Government deny prescription pain medication to chronic pain patients, some who are veterans, with no plan for their care afterwards forcing them into withdrawal and a life of intractable pain? This is cruel and against what doctors take an oath to do. Some will surely die. What is the point of this? To torture those with pain thinking this will stop the use of opioids for those who want to get high? It makes no sense. Those getting high get opioids from the black market. Is that what CP patients are supposed to do as well?

Dr. Laura is contemplating suicide, this should sicken anyone with a heart and conscience. That’s the end result of this government plan to restrict and deny prescription opioids for pain relief. I believe a thought out plan that causes death to another human being is called pre-meditated murder.

Good Afternoon, Is it not common knowledge that certain areas of our Nation are asking for help from the National Guard keep the “Peace” and our streets clean from the “ Opioid “ overdoses that are crowding our ER’s ? When they had such a horrible rise amongst the Heroin over the past few years I started to see clearly why the Boards would meet and still keep Opiods out of Pain Management. They Killed the “Pill Mills” that addicted community’s of people and had no other way to go but that’s right into “America’s medicine cabinet”. It is a worry when anything like these needed Medications that help so many Millions of people with “Chronic Pain” to have quality of life. It was a huge shock to many people who relocated during this “Crisis” to find no one would treat them. Their Dr’s said time after time that “Their hands were tied”. With what I thought and by whom? How can this block cause anything but Millions of dependant people to suffer through without relief or return to Alternative Medicine that for many had already been used and Surgery that was no longer advisable for them that started them onto the next step in Chronic Pain – Opiates ! Addictive Medications yes and in the PDR it says that Patients will become “addicted” to or “dependent” on these Medications and should be used with care and monitoring to keep them safe from a common occurrence “tolarerance” adding more of the Drug to keep their pain down. Anytime you take a substance away from any one place as it has existed you stand the chance of “Black Market” and stolen Medications or those who will be so desperate to hit the streets to obtain the worst “Heroin” ! Knowing all of this would happen there was no end game no safe withdrawal or replacement they just stopped Physicians from writing for these Medications completely. New Patients entered another State in shock. Not one Dr. in my area would even discuss this it was not going to happen so get over it. Get over it ? Really it was and still is the most stressful time for many New Residents in these areas. No matter the stress it had to be done the numbers are staggering when you look at the Deaths from both Synthetic Opiates and further to the worst ever “Heroin” which as most know this is a complete game changer. We have “Young Adults” dealing to a Community of Older Adults and younger folk who have no idea what they are doing to their lives but are willing to chance it because there is no lack of Customers according to their “Sellers”. However this brings me to the Writers point. Where is the post opiate practitioner ? There is no one I can say is going to help you or anyone who is willing to lose their License to accommodate your dependably. I do not blame them. I… Read more »

We must keep opioids as a viable option. Never use them as a first line of therapy for chronic pain but when other modalities are tried and failed. There is no fair way to do double blind scientific studies on opioids because of the cruelty to the placebo crowd but we need to keep opioids as a treatment when all else fails. Just ask pain patients.

I am a working part of my community, I raise my kids, I live a life as normal as any one around me, I matter.i use fentanyl, so I can be normal.if I didn’t have it, I wouldn’t be able to walk, let alone work or be any part of my kids life. The thought of having to live in that much pain keeps me up at night, because I know I wouldn’t be able to handle that again. If you haven’t walked in my shoes. What gives you the right to take away my normal.i matter.

I’m so tired of seeing the pathetic addicts on TV. Can publicity media for pain patients and their Drs get some air time to especially on NPR? I just attended a pain patients funeral, Suicide. He could no longer get his pain meds that he taken for 20 years. Please try to broaden the discussion publically.

I LIVE WITH CHRONIC PAIN from scoliosis, bone on bone rubbing in discs, arthritis is, n NOW diagnosed with a POSSIBLE HIP replacement. I am 58 yrs old and LIVE ALONE in a apartment. The WATER is SO BAD HERE, OUR sewers stink into OUR apts. ENOUGH TO MAKE ANYONE THROW up. I HAVE TO carry cases of water in by MYSELF. If THEY WANT TO COUNT MY pills, PLEASE DO. I do NOT ABUSE my MEDS, YET WE ARE SUFFERING B- CAUSE Rich PEOPLE, MOVIE Star’s, PAY THEIR Dr’s BIG buck’s FOR WHATEVER THEY WANT, O.D. AND WE ALL PAY. THE cutbacks NOW DO NOT TOUCH THE PAIN. Do THANK YOU ALL FOR NOTHING! LEGALIZE MARIJUANA! I WILL NEVER USE ANYTHING STRONGER. NOW THAT’S MY CHOICE, N AS A RECOVERING ALCOHOL ABUSER WILL START DRINKING AGAIN. FORGET ALL THE MONEY the state’s Will generate on Recrational marijuana. Because LOOK AT the state’s THAT approved it,? THEIR generating a lot OF MONEY. SEE WHERE YOU PUSHED n punished US TO GO NOW! HOPEFULLY YOU’LL NEVER HAVE to ENDURE THIS. THANKS FOR NOTHING!

Opioid for long-term chronic pain IS the only correct solution. Done correctly and with additional education on diet and biofeedback etc. I have NO life anymore and suffer in bed most of the time and I wish death would find me often. Education for docs.

I take pain medicine for chronic pain because I have a lot of surgery. Now I have blood clot. Now it’s for me to get my pain medicine because of new laws in North Carolina. Plus of everyone that overdose, I took my medicine responsible. I have to been in pain and have to deal with the pain. I have seen people that don’t need the pain medicine, get it, I don’t understand that, I’m sorry for bothering you, but thank you for listening to me.

I do not have an answer to no opioids then what. The only thing I can think of is if all chronic pain patients end up with some kind of pump inside their bodies that sends signals to the brain so the brain will only hear the pump and the brain stops hearing the pain signals like a internal brain stimulator.

There is no cut and dry answer just like there is no cut and dry portrait of an opiod user. I am 65 and have used opiods off and on for the last 20 years, regularly for three last ten years. I do not have an addiction and went without them for several months last year after having bilateral RFAs on cervical nerves.

RFA is an option in some cases but it is expensive, temporary, and has more potential side effects than opiod therapy.

I think we have ineffectively took Opiods out of an equasion where a MUCH LARGER percentage of people were helped than those who abused it.
People abuse Alcohol, but what are we doing there? America did not make it illegal and almost impossible to obtain, and yet millions a year die with Alcohol related accidents or illnesses.
Now that I am not able to have the medications I once did, I drink more and take alot of ibuprophen WITH Acetaminophen.
There is a greater probability that I will become addicted to alcohol now, and adding all the OTC pain relievers is twice as hard on my body.
Shouldn’t the prescribing physician be able to gauge my condition and control my Opioid Perscription?
Who is monitering my alcohol and OTC pain meds…No one.
I have read that more people die from overdoses of Acetaminophen than Opiods.
I am beginning to think there is nothing but some kind of hidden agenda in all this Opioid talk.
Only when you are living life on a daily basis, are you qualified to make these decisions.
The research has left out why addicts become addictive.
Of all user of Opiates, only 10% (maybe a little higher) have addiction issues.
What is the percentage of Americans are addicted to “something” that is harmful to themselves or others.
America, we are not solving addiction by removing people’s pain meds.
That problem will just escalate due to seeking other alternatives to cope with Chronic pain.
I think all this is BS.
I have been on Opiates for 15 years.
Moved to where I could not get them, and there was no issue to not taking them EXCEPT FOR PAIN!!
Now I feel useless. Can’t have the quality of life I want.
All this is just propaganda.
Lets move on.

Wishing for legalization

Good question. I’ve been able to cut my morphine dose down considerably, but not completely, by using cannabis. It was also the only thing that helped me sleep through the night.

But until we make it a legal option, that doesn’t help much. And even so, I still require a moderate dose.

My Dr was closed down.after being turned away by 2 because they said my morphine equivalent was too high I finally got to see a dr.without even discussing it with me she wrote a med that wasn’t covered by insurance.cost $614. After being without for acwk she changed it(again with out talking to me to see if it’d been tried in the past) . to a med that in the past I’d tried and it didn’t help. And still isn’t and makes me sleepy. I’m azombie in pain now.. instead of just keeping me on what I’d been in for yrs that helped Without all these awful side effects.because it doesn’t have abuse deterrent in it.iv never abused meds.i only want to function as a human being.and be able to at least clean alittle and raise the grandkids iv had to take in because parents are addicts.its hard to do when you can t walk.they need to go after the heroin dealers and leave us that don’t want to get high only have a life without excruciating pain alone.

I found a treatment that had a good study behind it and it requires very little money much different than the treatment my friend is using: virtual reality for chronic pain,he had to invest in a gaming system and vr goggles.He puts on his goggles and goes for a swim.Me, IAM trying what they call “The Harvey” you just purchase a full body bunny costume and a bag of carrots,now this must be done on a empty stomach,oh also you need a shovel and a good friend.your friend buries the carrots in a public park and the CPPs put on their bunny costume and hop around looking for the carrots until the cops come and shoot the bunny.waahla the CPPs are free from pain for eternity! And your family might get some money for wrongful death.It deppends if it’s rabbit season or not

Kratom, medicinal cannabis alternatives

“Just say no”….

Realistic alternatives to opioids comprise a very much needed question, Ed. And it is a question which the CDC and our legislators almost entirely avoid asking or even permitting their critics to ask. Thanks for giving my thoughts on Dr Joshi’s article a wider circulation. I urge your readers to join in lobbying their legislators in person to demand answers and challenge the prevailing false narrative on chronic pain versus addiction.

Sincerely
Red Lawhern
Co-Founder and Corresponding Secretary
Alliance for the Treatment of Intractable Pain

Humans have 5 different types of pain receptors in their bodies. Which respond to what medication varies patient to patient and many severe cases need to cover all five receptors with 5 different Meds. The 5th is for cannabis, the most effective painkiller I use it and all my doctors approve although it’s illegal in U.K. I have safely been on opioids for 11 years (and never been high or exceeded my prescribed dose) but also epilepsy Meds which work as very effective neuropathic painkillers like Topiramate, Oxcarbazepine, Quinine (helps reduce muscle spasms), Clonazepam (ditto), Tapentodol (only 10% opiod and very effective) and lidocaine plasters. A good Pain Management Consultant should know about and prescribe these Meds. It takes several consultations to get the balance of Meds right.

This society its all about THE MONEY not care we send ours sons and daughters to some foreign country to die,come back her and men and women in pain but i said years ago othey want the MONEY i use accunpture for a long time it work but it come from a different culture so insurance u do not have a copay u pay the full bill and then the insurance will pay u back a part of the total bill for accunpture, CREATED A COPAY FOR ACCUNPTURE pass this on we pain patients or seem to make money off of
LETS CHANGE PEOPLE
STOP THE pills all the time their other ways WE AS A SOCIETY MUST CHANGE..DOCTORS, HEALTH INSURANCE,PHARMACEUTICALS COMPANY THEY MUST CHANGE in treating pain
Am a Vietnam veteran era vet they gave us pain pills and back to work its going to take GENERATIONS to change were we are now,this is NOT a overnight solutions it will take time and caring about PEOPLE

I live in Delaware county pa.And all but a very few Doctors are prescribing pain meds .The people with pain problems are tired of being in pain day and night.Know they are going to Methadone clinic which down the road will start more problems.

Dr.Jay Joshi hits this very important issue right on the head! He is exactly right those of us that have chronic pain, I’m a man 60 years of age that has been hit by a vehicle on my motorcycle 3 years ago breaking my left hip ankles shoulder blades massive concussion leaving me with metal screws rods into my hip and leg. Back in 1993 I was shot in the chest with a 20 gauge shotgun causing severe damage to my stomach chest loss of help the liver sternum having paralysis in my right diaphragm lost part of the right lung gallbladder all these are major complications that I live with daily. If I had not had access to narcotics pain management directions of other things possible to do with my pain chronic pain I would not be able to exist today thank you dr. Josh you for your Insight

If they take away my pain meds, all I have left is a bedridden life. I won’t be able to work, lose my home and the State will have to take care of me. My social security will go to the state. I have scoliosis, 11 plates and 22 screws in my back.

TO ALL THE SCIENTISTS AND ” PEOPLE ” WHO HAVE NO IDEA WHAT ITS LIKE TO ” FEEL PAIN ” and/or ” LIVE WITH PAIN ” …24/7 I have a few questions for you ….dont you think most including self… tried everything prior to narcotics pharmlogical and non pharmalogical? What is wrong with this world? I am a nurse and an administrater … i have been a chronic pain patient since 2001! I have reduced when i can i have even went off i have tried every therapy you can imagine! Do you know physical therapy wanted me to pay 200 out of pocket for copay until i met my deductible they recommended i complete up to 3 sessions a WEEK!??? Who can do this ? Have you tried acupuncture they say have ypu tried massage?! Its all about money have you tried injections ? Ohhhh yes ! The steroid had me gain 80 pounds my bp to sky rocket and left me suicidal and i had pain worse than i did before due to a rebound effect!!!! What gives you all the right to say what works what gives you the right to take my quality of life my right to be pain free the right you keep makin demands to all this amazing non effective therapies that costs thousands of dollars it puts the patient unable to hold a job ..they spend their savings & retirement ..just to try everything else bc you think you are more educated or have the right to tell me what and how i treat my pain bc you think you are the experts on what addictive and whats not I have tried everything under the sun .. the doctors ..pharmaceutical .. you so called caring people these so call non pharmological and our freak of nature government & specialists who care so much about us chronic pain patients …yet if you cant afford these other “so called therapies or treatments ” they refuse to see you?!!! Oh yesssss !!! we are making you crooks rich ! Why hasnt any of the people that is so concerned about addiction look at alot of other things that are addictive yet is legal on every dtreet corner ” ALCOHOL” yeap ? It causes addiction ? It causes your life to be unmanageable and wow it even causes DEATH? Decades of this going on yet no one say or address this or crack cocaine and heroin being brought to our country ! You all are having the elderly suffer all bc you are worried about them having apill that causes addiction? You fools you hypocrits and i am ashamed to say im in the medicall field ! I cant take it anymore i cant take the seeing people suffer or myself i have lost everything on 2001 i had a accident instead of me collecting disability i tried everything bc i didnt want to become addicted i was bed ridden for year and a half i… Read more »

The lack of compassion and understanding of chronic pain sufferers to even consider removal of medicines without a strong affirmed and dedicated path to relieve pain equally is absolutely barbaric.
When a person needs opiods to prevent suicide due to extreme suffering beyond control, it is not an addiction issue, rather a life saving measure.
Autoimmune diseases that cause extreme pain are on the rise, especially in children. One only needs to be a member of FB groups to understand this. Sad. One such disease that is on a rapid rise is Lyme. Lyme arthritis has caused people to end their lives due to prolonged extreme suffering. Another genetic disease called Ehlers Danlos Syndrome causes nonstop pain and suffering.
Until the scientific community harnesses complete DNA changes for both of these DNA distorting diseases, what does society due, turn a blind eye if their family and children are disease free? It is outrageous to think of the lack of knowledge of many afflictions that cause unending pain. Even dog and cat owners euthanize their animals when quality of life is gone. Is human euthanization going to be next as an answer when opiods are denied to chronic pain patients? Hope, love, and opportunity for life has been a founding block of this nation. No longer. To even mention the idea of taking a chronic pain patients meds away, causes these people extreme worry, anxiety, thus more pain. The mere discussion is inflicting more suffering. Sad and barbaric beyond belief. Truly.

Laura P Schulman, M.D.

Excellent question.

In my current N=1 study (the 1 patient being myself), having been branded with “Cannabis Use Disorder” because I have a medical cannabis card in my legal state and use it for pain control, and also because I have a “qualifying disorder” that makes me “high risk” for opioid use disorder (regardless of the fact that I have never had any kind of addiction whatsoever except the brilliant conclusion that since I use cannabis for pain control, I must be an “addict”), I’ve been literally laughed at by providers at the mere mention of tramadol. My high risk? I have a 25X higher risk of suicide from any method. I have a Serious Mental Illness: bipolar disease.

Please enlighten me: if my genetic disease (bipolar) makes me 25 times more likely to die by suicide, does it make sense to subject me to torture 24/7 from my other genetic disease (EDS)? I’ve been told I’m just supposed to “bear it.” Does my bipolar brain make me into a superhero, that I can bear unrelenting pain better than people with normal brains?

More likely, it’s a “not on my shift” phenomenon. “Oh no, we can’t give you anything addictive, because it will come back to haunt us (the prescriber).”

How about when I can’t stand this torture any longer and follow the script that says I must suicide? Then they’ll shake their heads and say, “see what happens with them? Good thing she didn’t have any pill bottles with our name on them.” Prescribers are being prosecuted for wrongful death in those cases.

While I have had some phenomenal results treating pain with acupuncture in my own practice, I attribute that to some highly specialized training that I pursued, specific training in treating neuromuscular pain, that is very rare among acupuncturists. You would have to travel to find one. And I personally can no longer afford to pay that kind of out of pocket cost, since I’m disabled.

I’m currently caring for my Service Dog as she is dying from chronic illness herself. When her life is over I will follow.