The Opioid Story Needs a New Chapter Written

The Opioid Story Needs a New Chapter Written

By Ed Coghlan

The government’s crackdown on opioids has “boomeranged” on the pain patient.

That’s the assessment of Jerry Henderson, a Physical Therapist who helps run Clinicient, Inc, a Portland, Oregon firm that helps physical therapist manage their practices.

“It doesn’t make any sense to crack down on opioid prescriptions and not have other therapies ready to replace them,” said Henderson, who obviously believes that physical therapy should be among them.

Stanford psychologist Beth Darnall PhD was saying the same thing in a recent poweerful Huffington Post op-ed entitled “Limiting Opioids Alone Is Not a Sustainable Pain Care Plan.”

It’s interesting because both Henderson and Darnall would tell you that opioids are over-prescribed but often are necessary to help responsible pain patients manage their pain. It doesn’t make sense just to say less opioids without an alternative.

For Henderson and his physical therapists, they feel that some of the crisis has been brought on by insurance companies and managed health care companies.

“Many payers resist the idea of physical therapy because of the expense,” he said. “But the idea of helping someone early in the treatment process through physical therapy can help remedy the actual cause of the pain.”

Henderson had an interesting idea.

“If you could put a family practice doctor, a physical therapist and someone from the insurance company in the same room, you could quickly show the value of what integrated treatment can mean for the patient and for the payer.”

Interestingly enough, in most states a patient can directly go to a physical therapist. But if the insurance company or managed care company doesn’t approve it—the patient is forced to pay out of pocket which most people don’t want to do.

“It’s another example of the health care system not being a system at a when it comes to treat pain patients,” he said.

Darnall pushed the same point in her Huffington op-ed:

“The problem is,” she wrote, “we do not have national systems in place to treat chronic pain otherwise. This is the larger Catch-22 that simply must be addressed. It’s time for national governments to put their money where their mouth is and to focus on major pain research initiatives and comprehensive treatment programs that will allow us to treat pain better.”

So while some pain patients worry about being denied access to medication without any substitute they are left to ponder the question that patients, provider and public health officials should be asking.

“How can all healthcare stakeholders work together to ensure the ‘ideal’ treatment path for chronic pain patients?”

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Authored by: Ed Coghlan

There are 32 comments for this article
  1. Marty at 11:48 am

    I see my other replies were not allowed. I guess some personal attacks like this one below are allowed to remain……

    Marty- youve committed the naturalistic fallacy that makes no way for people in pain. Worse then that you justify immobolism and silence.

    This was a reply to this comment…..

    Well when people who are suffering that depend on others for relief or empathy are demonized and are labeled as drug seekers and such if they speak up they tend to keep quiet. Just human nature my friend.

    I don’t see where I justified anything, if anything that is what is happening in the real world. It’s called empathy not justification ……………….

  2. Dave at 6:43 pm

    @ Jean- youre an extremely articulate and perspicacious individual and i admire your writing skills.
    Perhaps I was blessed at a young age with a strong belief that disease is curable and an openness to experience- for this is what got me thru 4 years of pain and what, in part, drives me today. Theres a theory called 6Ps- optimism, emotional stability agreeableness, openness to experience, extraversion and conscientiousness that is used to explain adaptation to illness. I had 3 of the six qualities- perhaps thru the grace of God.
    But as Ghandi said thedifference between what we are doing and what we are capable of doing wouold solve the worlds problems. And this is why pain care in America is such stuff as Greek Tragedies are made of- for our institutions and individuals in pain and their family could be doing better- but are not. Explaining it away to depression, treatment burden, learned helplessness, etc- may satisfy some- but not me. Certainly Blacks could have explained away immobolism regarding the civil rights movement- that they feared being arrested or that there was no hope for them- but the like those in the Womens movement succeeded. And where does hopelessness and excuses get anyone? I know about being hopeless as i wanted to kill myself when i had pain- but i kept on going. I could excuse away being immobile- that i have spent quite a lot of my time and money to improve pain care- and am not in pain- i could be using that money for vacations or other things. And learning about pain care and trying to improve it is no walk in the park so I too could excuse away being immobile. But i wont And I hope i can keep on trying to help people in pain until my dying breath- and then i know i can die with a sh*t eating grin on my face.
    You know just today I got an email from an animal rights group that informed me they reached 200,000 signatures for a petition in Florida for reoving crates for calves. I dont think all petitons in pain care total 200,000 in the past year. The ASPCA last year received $40 million in donations- collectively all the donations for pain care dont come close to that.
    So I am disappointed in the 1110 million Americans in pain who could donate $5 each a year so that there would be $550 million for improving pain care. This year- I gave $150 so far to improve pain care- not to mention the many books on pain care and healing i have bought. So yeah, there is no doubt in my mind people in pain could be and should be doing a lot more. And it would not surprise me if we found out that those 110 million Americans in pain spend more on animal welfare then pain care organizations. Imagine that.
    The real issues in pain care are not technical- they are moral issues. And pain care reflects the poor morals of our Nation.

  3. Tim Mason at 4:49 pm

    Thanks for responding Loura. I figured I was not the only one looking at “patient advocates”.
    I am getting a new GP in August and perhaps he can do some leg work for me. I have had a couple of back surgeries and now and extruded disk (bilateral) which other than pain is causing leg weakness and numbness. The fusion is complete on my L5-L1 but L4-L5 is extruded. My pain is well managed but the neurosurgeon told me there is nothing else he can do. Nerve roots encased in scar tissue. I just would like for the pain management, surgeon and someone else get on the same wavelength. I am going to take my Pain-Wise book in and let my doc look at the treatments I found other than a Spinal stimulator. These must be big money makers for them. Thanks again.

  4. Jean Price at 12:06 pm

    It’s not hard to see Dave’s point, (if you look past the wording of being called sheeple!!) He has worked long and hard to bring changes and knows pain personally. And he knows the power which UNITY could give us, and how fractured our advocacy efforts really are. I relate to his frustration myself…but I already feel bad I’m not DOING more…because I CAN’T right now…so feeling shamed isn’t going to motivate me or most people into action. It rarely ever helps motivate change!! It can instead change the focus from rallying to feeling put down…and no one in pain needs any more of that! Life with pain doesn’t exactly breed upbeat, assertive motivation and the drive and energy to speak out constructively….we are too consumed with how to meet our own basic needs and our own lack of good care. It becomes easier for us in pain to be passive aggressive…especially when we feel overwhelmed and inadequate to make a difference with the little we are ABLE to do. And there’s also the issue of follow up and follow through when we speak out…since one day we could write a letter and the next day be unable to get out of bed for a week or more. And then our efforts get lost…we struggle with everyday chores and the stacks of EOBs and medical papers laying around that have taken over our living space…plus trying to keep our mental health intact! By the time we have another day with more energy…we chose to spend it on our families or things we enjoy, to boost our coping for the harder days ahead that always seem to come! It becomes easier to be passive and not really confront our doctors for fear of being labeled and punished with worse care…and then be aggressive HERE as we lament our own pain issues of poor care and discrimination. This being said…perhaps we all COULD do a little better, using our limited energy for speaking out to others who don’t know about pain and the sad situation…instead of speaking out to our peers here who know all too well about the status of pain care or the lack thereof! ANY EFFORT TO INFORM THE PUBLIC WOULD HELP. I think many of us have fallen into survival mode, which blocks us from being more active in speaking out…yet to be told WE are the problem is part of what I thought we are fighting against! It is kind of Catch 22, isn’t it, Dave?! If we could do better, we would, but we can’t because our pain prevents it…..so we become THE reason things aren’t better for us and all those with pain!?! It’s hard to fight greed and power and nonsense on any issue…able bodied people struggle with this. Please don’t discredit us due to our inabilities and then chalk it up to US being the problem. I believe you want better for all those with life limiting pain….and the frustration you feel is justified. But it still hurts when the first impulse is to defend ourselves instead of to join you in the fight in any way we can. Lead us gently…we’re all fragile! And thanks for caring enough to participate in this fight. We need caring people who can and will be advocates.

  5. Loura Shares A Story at 9:44 am

    I actually looked into patient advocates last week. I don’t know if it’s the same everywhere, but in my area at least, they only dealt with specific diseases/conditions, and marketed themselves to the elderly and/or severely disabled. I called one place, but they had no answers or direction for a chronic pain patient/post surgery patient.

    On another note: I was noticing some disturbing comments on a chronic pain advocacy article by the Boston Globe. I couldn’t comment b/c I didn’t have an account there, but many folks refused to believe the “100 million” stat, didn’t seem to understand that statistically, that number mostly reflects people 45 and older, or that our current pain management treatment “system” needs a holistic approach (transportation, counseling/psychological evaluations, help around the house, etc.) and overhaul.

    How can 100 million people really suffer so quietly? But I suppose we have been!

  6. Marty at 7:56 am

    Dave I am just expressing what people go through since I myself have been fighting since 1991. As you know pain leads to depression and when one is rejected time after time after time after time depression rises and at times one tends to give up. I myself have to take breaks from the fight to regroup mentally but I do bounce back or I would of ended my pain long ago as many do. Please don’t act like I have no fight or clue as to what someone who suffers from never ending pain must do to survive. Thanks for your reply.

  7. Tim Mason at 8:04 pm

    I have been reading this blog for a few months now and have drilled down thru several of the archives. Perhaps I missed it somewhere. It would be an article about “Patient Advocate”. They are out there and work for the patient for a small fee. I did a little research on this and what I have put together sounds like this:
    A patient that has several specialists like orthopedic, neurosurgeon, urologist, etc. Things really start to get complicated. The “Advocate” steps in for the patient and looks over all the medical documentation from each and assembles a plan of action. In most cases, he/she will approaches the physicians with the patients concerns and issues. Basically, the “advocate” does a lot of leg work and gets the answers and course of action for the patient. I read that the price varies by geographical are and experience needed by the advocate. The advocate would need to be knowledgeable to some degree for each disease or condition noted.
    In a like manner this blog is serving the needs of the pain patient by gather the experiences and pitfalls of others.

  8. Dave at 9:27 am

    Marty- youve committed the naturalistic fallacy that makes no way for people in pain. Worse then that you justify immobolism and silence. Your approach makes no way for people in pain. Big Brother wont fix pain care because they dont see it as broken Silence equals death. As David Biro wrote- as long as the conversation lasts there is hope for people in pain. People in pain need to inititate the conversation with Big Brother- and keep it going until pain care is put on the right track.
    Impotent immobolism, excuses, rationalizations, whether from our institutions or from people in pain- are very much part of the problem in pain care-and they are certainly not part of the solution. Lets get out of the darkness of our own shadows and the shadows of others and into the light. Lets move forward mentally, morally, spiritually to much different ad better pain care.

  9. Marty at 12:51 pm

    Well when people who are suffering that depend on others for relief or empathy are demonized and are labeled as drug seekers and such if they speak up they tend to keep quiet. Just human nature my friend.

  10. Dave at 6:15 am

    My goodness- Lions Tigers and Bears- Insurers, Doctors and the DEA- if only…..
    People in pain who are dont have a vision and are unwilling to do more then point a finger- you are part of the problem. Youre passivity allows the Lions Tigers and BEars to scare you.
    Its time you stopped being sheeple- not just for your own sake- but for others suffering from poor pain care. Get off your self justifying …. and start mobilizing- o more then write our lazy minded Congressman. Cursing the arkness instead of lighting a candle- get real. Its going to take hard work-bloo sweat and tears to get pain care turned around in this country.
    People in pain- your passivity is part of the problem an complaints are not enough to transform pain care- get real.

  11. Jean Price at 7:41 pm

    I was just struck with a thought here…..Instead of us all writing letters, it would be great if Ed could print out multiple stories and comments and send packets of them to all the senators and house members and all the radio and newspapers and television stations!! It would give them a clear idea of the devastation these crazy policies are causing and that would tell our stories pretty well! How about it, Ed?! If you needed help doing this, I bet some of us could help or chip in postage!!

  12. Loura Shares A Story at 12:53 pm

    I want to know how to find out if the politicians behind these new laws are getting paid/funded by drug companies. I am sure they are, but I need evidence to prove it.

  13. Sherrie Harris at 11:22 am

    This is getting rediculious. I wish you could get the treatment you need. They are wanting to take our meds away and I don’t understand. True chronic pain suffers do not run out of their meds bc we know what will happen horrific pain. We already fight it 24/7 control it thru meds. They are wanting to just take them away with nothing to replace or help us. They keep talking about Medical Marijuana but that’s not good to work bc it’s not available in all states just a handful. Our insurance company are not willing to pay for some of the things that they have suggested ie massages insurance definitely doesn’t cover them and they are not cheap by no means. What you are dealing with its not fair. The LGBT community has more rights than we do. I am all for the LGBT community bless them bc they deal with being labeled as we do but our label is not a pain patient it’s has come to be we are drug addicts. Even though we don’t abuse our meds nor go on the streets to get our meds. I wish you the best for you I hope that you are able to get the help you need. God speed to you and God bless you.

  14. Cindy at 9:57 am

    Hello all,
    I live in central oregon. I work less than part-time. Therefore i am on medicaid. So i have a major issue with the media government bull cr*p about opiate addiction. I can not get proper pain management for my bad back / hip. Im getting such cr*ppie care its shameful. As a pain patient i am allowed 4 visits a year to pain management. Physical therapy is not covered even tho they say it is. I had a eval and w my nerve imping, severe ddd, herniated disc and stenosis, and other medical terms…i got two visits w a chiropractor. Ive been told i need hip surgery but my ins wont cover it. So here is my frustration! IF I WAS ADDICTED TO HEROIN OR OPPIATES I WOULD GET CARE 6DAYS A WEEK FREE!!!A RIDE TO THE CLINIC FREE! I WANT TO KNOW WHY NO ONE DOES A NEWS STORY ON THIS. THEY HAVE DRS FEARING THEIR LICENSE. IM SO ANGRY!! ALSO IF I GOT A DUII I WOULD GET MY TREATMENT FREE AND ALSO A FREE RIDE! ALL PAID BY MEDICAID…BUT I WHO TRY TO WORK GET NOTHING!!! ZIP..NADA..PAIN MANAGMENT WONT SEE ME CUZ THEY CANT MONITOR ME ..UGH IM SO BEYOND FRUSTRATED. GREG WALDEN OUR STATE REP WAS ON THE NEWS NOT TOO LONG AGO ..HE IS WRITING BILLS TO PREVENT DRS PRESC OPIATES..NOTHING MENTIONED HOW SUCCESSFUL BEND TREATMENT CENTER IS!! ANGRY IN OR

  15. Tim Mason at 8:41 am

    I love the photo you used for this thread. I remember taking typing in high school and actually got thru college without the internet and a computer. I still have an Underwood.
    Excellent Photo.

  16. Angel at 8:17 am

    Again the failings of this campaign deny the realities of chronic pain and common sense. My leukemia is not well served by acupuncture antidepressants and physical therapy yet this treatments should be available to all pain patients. The crusade against the disabled accessing their medication is anti American and anti science

  17. Doug at 2:59 am

    Next Tuesday June 21st at 3pm EST, the Chronic Pain Community is calling all our peers to action. We want all capable to call thier US Senators office and express concerns about the Bills being voted on about opiate addiction and treatment. Our concerns are the fact that the US Senate will be deciding the future of prescribing opiates with considering the impact these Bills will have on the Chronic Pain Community. These Bills are for allocating funds for treatment of addiction with absolutely no funding going to the research of safer drugs for treating chronic and intractable pain. Please call the offices of your Senators and express your concerns on this date at 3pm eastern standard time. Please join in and let’s make a difference. Thank you all and I truly hope that you are having a minimal pain morning.

  18. Sherrie Harris at 6:19 pm

    Heather you and I have alot in common. I had a compassionate dr and he wrote meds he talked to me about everything that I have done to try to get relief to live a somewhat normal life. Well that’s not the case any longer. They kept harassing my Dr to the point of he closed. So now I thought that I had found a MD till he would retire i thought only to find out that he’s only getting me into pain management (which I am thankful ) to push me off and left to find another MD in three months. I have alot of the same problems as you do not all that you have but my fair share. I have irreversible chronic carpel tunel both arms and hands.Congenital spinal stenosis cervical. Bulging hern discs in thoraic and disc degenerative disease in thoracic and lumbar four disc in lumbar that they are wanting to do a spinal fusion surgery on and osteoarthritis in spine hands knees feet neck. I also have Fibromiligia and spondylitis to, I have done physical therapy . It would put me in the bed from all the pai. To only have to go right back the next day. Physical therapy one day bed next day then PT again to only end right back into bed next day then back to PT again. I have had many cortisone shots and epidural to. But still the pain is so bad that I have to take my pain medication. I am scared to have the surgery bc of all the failed back surgery I have heard about and they take more pain medication than I do now. Trying to get disability is hard. They deny you for the craziest reasons that make no since. I am as frustrated as you are bc I feel like this, if they take our meds away when we have done everything else possible to get relief to no avail. It’s very frustrating. The doctor that’s getting me into pain management did write my pain meds but not my Valium for nerve damage and horrible Aniexty nor my sleep medication. Well no he did give me 15 days of nerve meds when I had two left called office to see about getting more to only be told no. I have been on this medication for 15 years now all of the sudden running out is dangerous as a nurse you know this. I have not been able to sleep no more than 4 hours since this has happened. I don’t understand what they are doing. What are we supposed to do. Medical Marijuana is not a option where I live. I am a 51 years old and have a desire to keep living but scared of what this new war on opioids is coming to. They have lost the war on drugs that’s clear so I guess it’s a new war on opioids that chronic pain patients need just to do the daily things a normal healthy person takes for granted. I am going to do what you suggested by writing all you mentioned. But it’s not fair to us. We would not be treated like this I believe if all the “Famous ” actor’s and musicians have died from overdose most of whom got these medications illegally. That is my opinion. Who else thinks like I do? Because that’s when the war on opioids began. Whitney Houston. Phillip Seymour Hoffmann Health Ledger and now Prince. That’s is why I believe this is starting. Sorry for ranting. But sometimes you have to let it out.

  19. Sandra Carmel at 4:59 pm

    Going to physical therapy will not help me now at this point in my life. I have been for different injuries in the past. I have CMT1A and scoliosis osteogenises imperfecta osteo arthritis sciatica hip dysplasia in both hips degenerative disk disease painful caluses on my feet and to complete the list I have had all my toes amputated on my left foot been through surgery 12 times two triple orthodesises on both feet at the same time. I don’t know if you are familiar with all my medical problems I have listed but if you know about any of them physical therapy doesn’t help anymore I am 58 years old with a current pain management Dr who gives me 7.5 mg of oxycodone with Tylenol 1 every 8 hours for severe pain he doesn’t have a clue what it’s like to live in so much pain and refuses to do anything more. I don’t sleep at night and suffer all day long and now the chronic pain patients are going to be given less because those who decided to abuse and get high from these medications among other things we now have to pay for their mistakes. If this is the way to solve this problem we should go ahead and punish the criminal and everyone that knows him or her with the same punishment of course that wouldn’t be done because all these people that knows the criminal is not guilty or to blame but the chronic pain community is being punished for the abuse of others what makes that right I realize this is not the way others might compare what is happening to the pain community but it should be because it doesn’t solve the problem and why punish the innocent (chronic pain patients )

  20. Gabriela McCusket at 4:53 pm

    I receive my care at the VA & am being told I have a year to get off my pain medication which I have been for at least 12 yrs so I can work, take walks, walk my dogs etc. He has reduced the amount of pills I can & increased my Gabapentin which does not work that well & told to take tyneol but nothing for the side affects for removing the medication. I have no problem coming off of my pain meds if you can give me something that works.

  21. Heather at 2:52 pm

    This is so true. Before I lost my job as a nurse and was our families carrier for ins on bad met my deductible and had been ordered PT and OT again and this time it was free and covered due to my deductible being met. Then after my surgery and extended leave of absent and exhausted FMLA from work left me unable to return as my body has been in constant agony even worse since my hysterectomy and 24/7 pain is my daily routine and sometimes can’t even get out of bed. Well I was doing water therapy as I have AS or Ankylosing Spondylitis, Severe Fibromyalgia, Osteoarthritis all over my body, DDD, multiple bulging disk in my cervical and lumbar spine, neurapathy, sciatica, IBS, Gerd, esoohogitis, Carpal tunnel which left my hands contracted and stuck until I received an injection for it, and much more. My physical therapist did his initial eval this last time and noted my co dition has gotten much worse and I have hypermobility although I can’t do all ask on veal but still have some strength but get stuck and can’t get back up or it hurts to bad and I failed the machine trials as the little ole lady with the walker zoomed thru the bike it Keep alarming on me multiple times because of my knees and hips, back, and hands so he decided I was not allowed any land machines due to safety and fragility of my body. Well I did water therapy a few weeks on my old ins and it really seemed to help me and felt good although I still had 5-7 or 8 pain at times but still felt good. Good enough my husband went and bought an above ground pool fore to do exercises at home I felt it was Doing that good. Well poof. Ins gone and had to pick up on husbands and now I have no income and still don’t over a year later and on my 1st appeal with disability as they said, get this, they are I am unable to work and therapy stated sedentary work only no greater than 5 lbs and Dr says no more than 5 lbs and no sitting walking bending stooping lifting and no walk I g sitting or standing more than 15 to 30 min at a time. Ok seriously. I’m a nurse who is going to hire me with these restrictions or anywhere for that matter. Anyway months passed and I asked for another referral to therapy as I had been to the Dr multiple times and lots of test and out of pocket layed so thought my copays would be less. Nope no therapy for me as it is gonna cost me $50 per visit 3 x week up front and then get billed the additional $150 for each visit until my deductible is met. I do not work. This is what is wrong. Y’all are right they have no plan on place to help us when they want to reduce or take away our opioids and therapy alot of times ask you to take them 30 min prior to a session so you will be able to tolerate it. Well if they would think these things thru instead of jumping the gun and have the alternative more affordable them patients may be able to do more. I would but I have my pool and do what I can on my good days which are not always good. Not only this problem now the pharmacies are wanting to call my Dr on this month’s refill which I advised my Dr to do a med review as they want to try to do dose reductions as well ask talk drs into it. My Dr said he is sick of Walgreens who seems to be the only ones Doing it and he is not changing anything. He is the Dr not them. And the insurance company has now changed their formulated as well this past month and changed the tiers where some of my meds I have been paying $6 for years are now $75. Needless to say I called and told them they are causing info stress on patients and I’m not paying it and my Dr sent that I needed that ed and they said oh well it is what it is that doesn’t count anymore. So medically necessary notes from Dr count for Aetna anymore. T
    So have to make appt with pcp and get sleeping med changed which I’ve been out of for 2 weeks now and not sleeping just on and on. Someone needs to get control of ins companies to help patients if they are gonna make our life’s hell by trying to take away meds that help those of us who are responsible adults and sign contracts do drug tests and are real pain patients not ADDICTS. Sorry for the rant but I’m a big advocate for many organizations to help EDUCATE and advocate others. And remember the most important thing of all NE YOUR OWN ADVOCATE AND KNOW YOUR DISEASES AND DISORDERS…….THIS IS SO CRUCIAL AS I AM ASHAMED OF WHAT THE MEDICAL PROFESSION HAS AND IS BECOMING…. PLEASE HELP!!!!! WRITE TO INS COMP, CDC, FDA, DEA, WHITE HOUSE, YOUR LOCAL REPRESENTATIVES, as I have done it all and ask what their plan is for the increase in suicide that is occurring and going to skyrocket due to this unneccesary political nonsense. Someone or alot of people are secretly getting rich.

  22. Pam at 2:36 pm

    “While some pain patients worry about being denied access”. Some is lightly putting it. There. are tens of thousands of legit pain pts just on one of the petitions ive signed,mclose to 30,000 in regard to this hell we have been dumped into, a very painful hell. Whike physical therapy is another treatment option, it did not help me and I went to physical therapy a little over two years, It got to the point it was doing more ham, intensifying my pain and my dr stopped it, thousands and thousands of dollars in debt to just the physical therapy place that I could not afford. Many many pain pts who have had their meds abruptly stopped have been thrown into severe withdrawal, seizures, shock, and death. We are being left with zero options here and what I don’t get is, when a person is suffering from chronic pain, chances are they have been suffering for a very long time, and have already been thru the therapies, otc, nsaids, injections, surgeries, etc and opiods are the last resort. As with me, I tried it all before I could no longer take it, I was finally put on opiod therapy and had to have back surgeries that FAILED. I just don’t get it, none of this hell. When a person has years and years of medical records, mris, xrays, labwork, scans, and documented diagnosises that are DEBILITATING AND INCURABLE, there ahould be absolutely NO reason to deny that patient pain medication/relief. My Lord, how many medical conditions out there require a pt to be dependent on medication for QUALITY OF LIFE!?! People who suffer from heart disease, asthma, diabetes, lung disease and so on. These patients require a life filled with medication if they want to live. It’s no different for CPP’s, if we want to live and have some quality of life and have tried everything that each of our bodies could take, hey what works for you may not work for someone else, and if having to take pain medication to have that quality of life is necessary, then so be it. We should not be shamed, degraded, treated like junkies and turned away b/c we are chronically ill and yet our government, cdc, fda dea, and society do exactly that to the suffering, SHAMEFUL!

  23. Paula at 12:05 pm

    I have been through several rounds of physical therapy. They have helped and I really wish that I was able to consult with my physical therapist on an as needed basis, but insurance does not permit it. And my insurance copay is now $45 a visit! $90 a week! Oh and insurance has also refused to pay for pt because I was not making enough progress. My health conditions will never improve, I’m just trying to maintain the flexibility and mobility that I have. My physical therapist did help me develop an exercise program trailered to my health issues. I try to go to the gym twice a week and I also take a gentle yoga class twice a week too. In addition to that I do use opioid pain medications along with supplements. Am I pain free? No, but my regime helps make it a little more manageable. I just worry that in time the government will make it next to impossible for intractable pain patients like me to get the medications we need to help maintain some quality of life.

  24. Tracy at 11:35 am

    Sorry to hear you had to pay $1000 to be taught to squat to pick something up, or turn your whole body instead of twisting at the waist. A little research would have provided the same information.

  25. Tina at 11:14 am

    Thanks Ed for this great article!!

  26. Diane Gracely at 11:06 am

    First off it is NOT that patients don’t WANT to pay out of pocket for PT it’s that MOST patients CANNOT AFFORD too.

    Secondly, patients like myself who have suffered with chronic pain for many many years are at the END of their rope. NOTHING helps me to have a quality of life with a little less pain than OPIATES do. I’ve been through every other alternative out there available to me. OPIATES is the LAST RESORT, the ONLY thing at this time that gives me ANY RELIEF from chronic pain.

    There are also other chronic pain patients like myself who cannot make use of SOME of the alternatives for other health reasons. For example, I had gastric bypass surgery, I cannot take NSAIDS. Doctors orders. It is also recommended that I do NOT use a spinal cord stimulator because I have Charcot Marie Tooth disease which caused peripheral neuropathy. I already have LOTS of nerve damage so this type of therapy is NOT recommended for me, it COULD do MORE damage than good and put me back in a wheelchair.

    NO ONE knows more about our bodies and ALL of our health problems more than we ourselves do about our own bodies and what we have been through over the years.

    The ONLY alternative therapy that is recommended for me through ALL of my doctors and believe me I have MANY, is swimming and hot tubs. It helps but still NOT near as well as OPIATES. I use opiates in combination with my swimming and hot tub therapy. This is what allows me to have a quality of life.

    I like many others have many illnesses and health problems. My list is a long one. I have suffered with chronic pain since I was 5 years old. I am now 52. I’ve been through every alternative therapy. WE chronic pain patients have a HUMAN RIGHT to use WHAT works for us. And IF opiates work for us it is against our HUMAN RIGHTS to take them away from us.

    It is OUR LIFE, WE are the one who suffers daily. Not my doctors, not my brother or sister, not the CDC staff, not the DEA staff, not even president Obama. It’s ME who suffers. I have the RIGHT to use what works for me and allows me to have a quality of life. Without a quality of life we cannot and will not survive. Those who do NOT suffer with the pain that we do have NO IDEA what it’s like. PERIOD

    Some day many will know because we all get old, we all end up with an illness or hit by a drunk driver (like me), or end up with cancer, etc… Each individual that reaches this time period will then KNOW WHY we are fighting for our HUMAN RIGHTS.

  27. Tim Mason at 9:31 am

    Marty, actually agreeing to and going to PT proved that you were willing to add to your prescription drug program. You will willing to do something else. Even if it did not help you proved that you were willing and that goes a long way and on your medical record.

  28. Tim Mason at 9:13 am

    ” But if the insurance company or managed care company doesn’t approve it—the patient is forced to pay out of pocket which most people don’t want to do.”
    I don’t think it is that they don’t want to pay out of pocket it is just that they can’t afford physical therapy. Even the copay’s are expensive.
    I just completed 33 visits or 15 weeks of physical therapy at I year post ALIF 360 on my lumbar. I have great insurance and have no immediate copay. However, the copays do come due and for those 15 visits my copays came to approx. $1000. That is a lot of money these days.
    What I learned from my PT was limited but very helpful:
    Learned to squat to pick small objects up. Learned a better way to get out of bed, learned to turn my whole body and not at the waist. Learned how to stretch my hamstrings, go hot tub therapy and massages. The clinical massage is affordable and anyone can get these w/o Rx or any referral. The clinical massage can be painful but they are great.
    Let me suggest what is lacking:
    In all my researching this opioid fiasco is there has not be any “peer reviewed” study by Pain Specialists. When I say Pain Specialist, I am taking about the credentials one would hold as mentioned in the “Pain-Wise” Book.
    Unless many of these Pain professionals weighs in on the problem everyone will still be left wondering.
    If you have chronic pain you need to get on board with one of these professionals soon. There are few of these doctors around and space is limited. Act Now.
    If you do not have imaging, previous surgeries and other respected testing reports available you have a lot of work to do and ground to cover.

  29. kris at 8:43 am

    my insurance covers physical therapy and I have gone twice for 2 separate issues and it did not help at all with either one…

    so good luck with that.,

  30. Kurt WG Matthies at 8:35 am

    Ed, it doesn’t make sense to limit opioids in many pain populations, period.

    Our buddy Jack Reilly at the DEA has a new video for law enforcement — counterfeit fentanyl (or fentanyl analogs), imported from Asia in China White heroin since the Vietnam war, and from Mexico and Canada over the past 10 years, is now being manufactured in California and soon, every state in the union.

    Here’s Jack …

    http://1.usa.gov/1tujvEg

    Many of these pills are being manufactured to appear as popular pharmaceutical drugs — like OxyContin — but actually contain unknown amounts of fentanyl, which is 50-100 times stronger than morphine.

    Some chronic pain patients are now buying this stuff, because safe physician supplied medication is being greatly reduced or denied. It’s a recipe for death.

    Second point — untreated pain causes disease — a reason ignored by the cheif nanny state monitor at CDC, Dr. Thomas Friedman (the man who saved New York City from the Big Gulp). A recent article in the Journal of Pain Research out of Japan linking the severity of low back pain (LBP) to other diseases:

    This is only one in dozens of studies liinking untreated pain to disease — studies ignored by the CDC’s recent conclusions about the use of opioids in chronic pain.

    The title of this paper is: The relationship between pain severity and patient-reported outcomes among patients with chronic low back pain in Japan.

    The paper appears in abstract at the link below, and it’s an easy read for most pain patients, fluent in English.

    Here’s the conclusion:

    “The impact of chronic low back pain on health-related quality of life, depression and anxiety symptoms, impairment to work and daily activities, and health care use increases with the severity of pain. Interventions reducing the severity of pain may improve numerous health outcomes even if the pain cannot be eliminated.”

    https://www.dovepress.com/the-relationship-between-pain-severity-and-patient-reported-outcomes-a-peer-reviewed-article-JPR

  31. Marty at 7:52 am

    In my case the trouble with physical therapy it does not help with my neuropathic pain and actually causes me more pain. Never mind the fact even with insurance the 40 dollar co-pays three times a week is a tremendous burden since I am disabled and have not worked for many years and do not collect SS due to my wife’s income. I would love to go to massage or acupuncture but I would need to go every day and there is no way I could afford to do so. This is one of the many reasons we need single payer.