Three Steps to a Sane Opioid Prescription/Pain Treatment Policy

Three Steps to a Sane Opioid Prescription/Pain Treatment Policy

By Cindy Perlin, LCSW.

Pain patients are suffering more than ever. After decades of pushing opioids as “the” answer to chronic pain, patient access to prescription opioids is being curtailed, often abruptly and with apparently no concern for the welfare of the patients. These cutbacks are justified as a response to an out of control opioid abuse and overdose epidemic.

Cindy Perlin, LCSW

Denial is rampant. Dr. Jane Ballantyne, president of Physicians for Responsible Opioid Prescribing (PROP) says patients should just learn to accept their pain and not continue to demand treatment with opioids or otherwise. Her stance is a denial of the toll severe chronic pain takes on the patient’s body, mind and spirit. Most medical professionals and all insurance companies deny the proof of effectiveness of other, non-pharmacological treatments for pain and deny the often-terrible side effects of other pharmacological approaches to pain. And chronic pain patients deny the escalating piles of bodies at morgues, dead from opioid abuse and overdoses that often started with a painkiller prescription.

There is a sane way out of this. Does anyone want to hear it?

Step #1: Get the DEA out of doctors’ offices.

The #1 reason that pain patients are being rapidly tapered off their opioid medications, abruptly discontinued or can’t find a doctor to treat them has nothing to do with their medical condition, success of treatment or drug use behavior. The main reason is that doctors are terrified of being prosecuted for writing opioid prescriptions. Prosecution can and often does result in loss of licensure, loss of assets and long prison terms.

Successful prosecutions have occurred even in cases where the physician’s only actions were prescribing opioids for legitimate pain patients. The Drug Enforcement Agency (DEA) deploys dozens of agents with guns drawn for these raids. They seize patient records and threaten arrests of all the practice employees. According to the website Doctors of Courage, run by a physician, Dr. Linda Cheek, who suffered this fate, more than 975 physicians have been victims. Doctors are particularly vulnerable if they are in independent practice without large institutions to back them up, and if they are members of a minority group. Doctors are prosecuted as drug dealers, their assets seized so that they have to rely on public defenders who don’t have the time or funds to mount an adequate defense.

These DEA arrests have been occurring for more than a decade but physician vulnerability has increased since the release of the “voluntary” CDC guidelines on opioid prescribing in March, 2016. Government guidelines are considered “standards of care” and when physicians don’t adhere to them they are at increased risk of having their medical judgements challenged, not only by the DEA, but also in malpractice suits and licensure challenges.

So, the #1 step in ending unwarranted termination of pain prescriptions is to bar the DEA from arresting doctors unless there is clear evidence of actual drug dealing, such as in pill mills. There would still be avenues for addressing poor medical decisions, if they exist. These include complaints to licensing boards, where other doctors would review whether decision were medically appropriate, and malpractice lawsuits, where expert testimony can be weighed in determining whether prescription practices are appropriate.

Step #2: Expand Access to Alternative Pain Treatments

While there may be many pain patients who can only obtain adequate pain relief with opioids, there are also millions of patients whose pain could be more safely and effectively managed with non-pharmacological treatments. Scientific knowledge and understanding of these alternative treatments has been growing for decades but is being blatantly ignored by the conventional medical community and health insurance companies.

Acupuncture, biofeedback, chiropractic, cognitive behavioral therapy, electrical stimulation therapies, energy healing, energy psychology, exercise, herbal therapies (including medical marijuana), homeopathy, low level laser therapy, meditation, nutritional therapies, physical therapy, stem cell therapy and many others are underfunded or completely ignored by insurance companies.

So, step #2 is to require insurance companies to adequately cover alternative pain therapies so all patients can have access to all of the treatments that have the potential to help them.

Step #3: Educate physicians and pain patients about all available pain treatment options

Currently, physicians receive, on average, less than two hours of education on pain diagnosis or treatment of any kind in medical school. This leaves them reliant for the most part on pharmaceutical representatives for their “education”. Little continuing education is available to physicians that is not sponsored by the drug companies. We need medical schools to present a required course in pain management that is comprehensive and unbiased in its presentation of pain treatment options and similar post-graduate educational opportunities.

We also need educational opportunities for pain patients in the form of courses and written material.

That’s it. Three steps to reducing suffering and the chance of addiction. It’s not rocket science.

Cindy Perlin is a Licensed Clinical Social Worker, certified biofeedback practitioner, chronic pain survivor, the author of The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free and the creator of the Alternative Pain Treatment Directory.

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Authored by: Cindy Perlin

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HAZZY

YOU ARE VERY CORRECT, IVE BEEN SUFFERING WITH CHRONIC-PAIN FOR 20 YRS. GET THE PUSHERS, LIKE YOUR COMMENT SAID

I totally agree with you, if it wasn’t for the street pushers the real people who suffer wouldn’t be without the meds just to survive daily life. What their not letting others know that most OD’s are from heroin or that fentnyal. The laws are making pain suffers think about death so in that case when are in line with the real OD’ers so I sit here in pain that makes me hardly walk and they just keep dropping my meds. I can go on and on but what use is it until they get the street junkies out of the pictures the true pain suffers will suffer.

HAZZY

YOU DON’T WANT TO COMMIT SUICIDE, YOU WILL PUT YOUR FAMILY THROUGH PAIN, MY MEDS WERE CUT ALSO AND I TAKE 3 TIMES AS MUCH AS YOU. I, DONT THINK ABOUT KILLING MY SELF OVER IT. HANG IN THERE THINGS WILL GET BETTER.

First we all need to stop playing doctor,what works for a few patients will not work for all,their a lot of patients dieing out here,I ‘M one who’s had almost all treatment in not work,do very little or nothing,or just not work at all,I’ve been in severe chronic pain since late 2003 my pain gotten greater due to their no cure,i’ve never had an doctor start me off with strong opioids,but since having 4 major operation,2 neck fusion’s,and doctors won’t tell you that in a fusion it makes it harder on the rest of the spine,not blaming doctor it the way it is,i’m not going to write down all that been done to me medically in operation’s,pain doctors,medical testing,mri’s,cat scans,doctor statement that i’d be in severe great pain the rest of my life,for i’d be here all-night,but in 2015 finally doctors pain-doctors said there nothing more we can do but put you on an strong opioid,he put me on oxycontin 30mg’s 3-times aday,and it gave me back my life as an disabled person reduced my pain in half,then at the end of that year my doctor was stopped from treating pain patients,those in power said he was over medicating his patients,didn’t found this out till last year,i was told by his nurse his wife had an baby and they were moving,but it became clear after seeing,talking to another of his patient at the store he said they made it sound like he was a drug dealer,anbd his patients were drug addicts,guess that why i never got back the medicine that had finally worked for me after 12 years of pain hell one year of almost back to normal,then reducing my medicine back down to where it is pain hell again,and there where i’m at now,if i was not so afraid,i’d just kill myself,and they have reduce my low down to where i’m in so much pain,i cn’t even fuction as an disabled person,there not just killing people there torturing them to death,hell is having hitler move to put these pain nazi’s where he is.

Why all the new laws on prescribing, while at the same time ordering all those studies on, basically the reasoning on why they’re making the new laws?

Doesn’t make sense to me. Enact stuff before you know anything about what you’re enacting.

Not to mention the absurdity of what’s in the bill to start with. They can have most if not all of their questions answered if they would do one thing – talk to the National Pain Report. The research has already been done for them and the multitude of studies they want to do that’s already been done!

CHERYL MASSEY

Prescribe them a week at a time. That way people will be FORCED to stretch out their intake per week, forcing them to not over-take (even tho they may need/want to take more), resulting in less of a chance to inadvertently become addicted or sell have their Rx.

Byron

As I have posted elsewhere:

Every chronic pain patient needs to be VERY concerned about HR 4482, the Meadows-Renacci “Opioid Abuse Deterrence, Research, and Recovery Act of 2017” https://www.congress.gov/bill/115th-congress/house-bill/4482/committees?r=6 .

Contact your US Representatives, especially members of the Energy & Commerce Committee https://energycommerce.house.gov/about/ and Judiciary Committee https://judiciary.house.gov/wp-content/uploads/2017/12/115th-House-Judiciary-Committee-Updated-120517.pdf .

Notasheep

Dr. Lawhern,

I hearby posit that the CCP’s on this site and the other sites we have all at least read, elect you to face the Senate in a televised debate concerning the manufactured opioid crisis. The debator for, will be CDC’s choice.

All in favor?

AYE

Will donate funds and lobby for placement in schedule of senators. I don’t have much, but $1.00 from 20,000 people is $20,000.

Nancy Wilson

We all have gone through this at one time or another. Don’t stop your pain meds because of her ignorance. I know it is hard to do, but stay calm, and continue to treat her with kindness, you know who you are and that is all that matters. People will truly never understand what we go through unless they or their loved one goes walks in our shoes. I kindly bring to peoples attention that this could happen to them one day. How would they feel? What would they do?

Nancy Wilson

CC, I am so sorry for all that you are going through with the VA. Thank you for your bravery and unselfish service to our country.

Brian Kwasny

I am now being treated like a drug addict by my doctors nurse who manages my pain meds. I think of other possible treatments but I’m afraid if they don’t work I’ll never get my pain meds restored.

Nancy Wilson

So true! Great comment!

While we review all comments, which can take some time, we are very liberal with our policy on posting reader comments. Your comments have not been “cherry-picked” nor do we have any comments pending from you. I’m not sure what happened, but please resubmit, and barring any vulgarities or attacks on the author, it will be reviewed and posted. Thank you for your readership and your comments!

Robert

“And chronic pain patients deny the escalating piles of bodies at morgues, dead from opioid abuse and overdoses that often started with a painkiller prescription.” Please note that the vast majority of people who use pain relievers non-medically never progress to illicit opioids. And that is NON-MEDICAL use, not MEDICAL. Medical opioids are not the bogeyman we’re allowing PROP, and others, to portray them as. It does not serve our cause to accept an inaccurate narrative that has no data to support it. We should not be conceding that PROP talking point.

Here it is from the horses mouth . . . “Four out of five recent heroin initiates (79.5 percent) previously used NMPR . . . . However, the vast majority of NMPR users have not progressed to heroin use. Only 3.6 percent of NMPR initiates had initiated heroin use within the 5-year period following first NMPR use. The study contributes important new data to improve understanding of the role of prior NMPR use in initiation of heroin use in the U.S. general population.

https://www.samhsa.gov/data/sites/default/files/DR006/DR006/nonmedical-pain-reliever-use-2013.htm

Tammy Glover

This lady had no idea what she is talking about. My mother suffered with pain so much. I’m tired of suffering. This is not even funny. I can’t play with my grandchildren bc of my pain. I would love to sue all who are causing me and others suffer with pain.

CC Visnesky

I think the author went for a bit of alliteration in the ‘deny deny deny’…this time it backfired and is offending many CPP.

My concern is the VA. And what feels absolutely insulting to me as a mature, independent veteran is the VA does have harsher ‘rules’ than the CDC since 2010… and that information is hidden online. The little-known VA Clinician summary which also states (pg 24)
#5. IMPROVED FUNCTION, not pain relief, is the primary clinical goal.
a. Opioids should only be continued when patients demonstrate functional benefit and are actively engaged in self-management of pain.
b. Opioid prescribing should be conducted as an ongoing trial documenting high benefit and low risk.

By THESE standards we should receive opiod medications. The VA tracks our every scrip, every word we say with a therapist is logged, so they can follow pain patients forever.

Many of us were reduced off meds significantly through their ‘Integrated pain team’ program. The GOAL to save all the vets under age 30 from a lifetime of pain meds, future addiction has been stated in reports, but this goal has also swept in the rest of the seriously ill, and aging veterans. Reduced by 90% I am no longer able to maintain my home, no bending, stooping, raking, lift, move anything heavy, do no yard work… it’s depressing. I will soon be forced to sell, and live in some beige apt. that will absorb my entire SS, and parse out the rest of my savings for food and heat, or live in squalor if I don’t pay endlessly for every service needed. “Aging in place,” keeping financially secure and independent was a goal I planned for all my life.. This biased NATIONAL HYSTERIA over opioids will be the SHAME of the next decade when the real harm done to CPP is seen. https://www.healthquality.va.gov/guidelines/ look for OT Provider Summary 2017-a 30 pg. pdf

Barbara R McCann

I have been in pain since the earliest childhood memories. I have brittle bone disease. I have had over 50 broken bones..low estimate. I have several metal plates through out my body. Many of the plates were fastened hap hazzardly..due to no bone mass to affix the screws to! I have had four back surgeries. I was in a t bone mva..again more fractures..and a brain injury..that has caused me headaches every day since.
Every time I have went to physical therapy I break something!! I have had all the alternative options that pain management could offer. I have been been discharged by four pain management programs. I was fired last month by my primary care physician. Why you ask?? Because I asked the following- Could I please have some other drug for a while. Because I had been on norco for a while,and was building a tolerance to it. At that point I was called a drug addict..and was told I was being sent to drug rehabilitation services. Really?? Seriously? So here I am off the norco cold turkey..and he wouldn’t even refill my other meds for my head injury..so far no seizures.. I went to a clinic for possibly an injection for my back..where i was told that the doctor had went as far as to place me on the state of Michigan drug seeker/addict list. I am in such pain and so depressed.. I cannot afford trying a cbd oil
I am 60..not much quality of life here…Something has to change

Dear Dena Meeks:

When I read your letter, it could of been from me of what you wrote. I am is horrible pain and I am currently having panic attacks because of my ant-anxiety medications being tapered down to none. As all of us know, stress can make our pain levels soar and mine is so high that it is out of sight!!!! I haven;t as of yet had my ER’s taken away yet, but every month that I go to my pain management NP, I am lowered again even when I am told I am not getting lowered. My pain is so bad that I am in isolation once again trying to hang on but I wonder for what? I know my family needs me but I do not want to be a burden to them, when I have enough pain medications I can function somewhat and be apart of the living. Today I have to put all of this (MADNESS) in Jesus’s Saving Hands. I keep on looking for anything that can lower my pain and anxiety but I have found nothing that works for me other than pain medications and anti-anxiety. Like you, my spouse and I are living paycheck to paycheck, we have no extra money and if my er’s get cut off by my RX or Doctor, I will be in the same boat as you. I am praying for you, myself and all the people who use their pain medications for PAIN, and to get help right now, because tomorrow might be to late for some of us. I live in WA State, I pray that my state won’t do what your state is doing to you. GOD BLESS US ALL!

HAZZY

IAM ALSO BEING CUT IN MY MEDS AT EVERY MONTHLY VISIT TO PAIN MGMT, THIS IS TOTAL BS, I CAN’T WORK AT ALL THE ONLY THING THAT HAS REALLY HELPED ME, IS MY PAIN MEDS WITH THOSE I CAN DEAL WITH THIS PAIN 24/7. I MIGHT HAVE TO POP A DOCTOR IN THE FACE.

HAZZY

IAM ALSO BEING CUT IN MY MEDS AT EVERY MONTHLY VISIT TO PAIN MGMT, THIS IS TOTAL BS, I CAN’T WORK AT ALL THE ONLY THING THAT HAS REALLY HELPED ME, IS MY PAIN MEDS WITH THOSE I CAN DEAL WITH THIS PAIN 24/7.

Why was my post on the subject concerning the biggest lie of them all not posted? The lie that 80% of junkies get started on heroin because of RX drugs.Are you any different from the DEA if you don’t post what you disagree with?This statistic is the starting point for all the actions taken against CPPs.Do you agree that the HEROIN PROBLEM is because someone takes a opioid for a pulled tooth and six months later they have a needle hanging out of their arm?Don’t cherry pick post to be posted on weather or not you agree with them or not.The idea that most junkies start on pain meds is their biggest lie,the lie that made all they have done since possible.

I think that someone that had the opioid police (the feds) interfere with there medical treatment sue them for millions of dollars for violating thier hipa rights what give them the right to go through my medical file i thought this was against the law if someone wants to sign there rights away so be it but if this were ever to happen to me i will challange there authority to violate my rights isnt this the land of the free??

Nancy Wilson

Charlene, I am so sorry you are going through such agony. I have the same conditions you do along with fibromyalgia and RSD. They have no idea what it is like to be in so much pain. No one can take this amount of high pain levels 10 + , 24/7, we can’t eat or sleep. It will wear down anyone! I don’t care how strong they are, or what background you come from, it begins to take a toll on your mind! If something is not done to get the opioid medication guidelines changed back so to keep the government agencies off the doctors backs, they will see way more suicide deaths along with lawsuits, than they ever seen with overdose deaths, because we have open and honest, and have poured our hearts out. We are crying out for mercy before another one of us takes our own lives because we could not handle the pain that pushed us over the edge.

I agree with SO nany of the letters from pain patients above. I have had 4 lumbar back surgeries, and need a 5th. I also suffer from severe arthritis and fibromyalgia. I am on oxycontin, with breakthrough oxycodone, valium, lyrica, and muscle realxers. There’s seldom a comfortable day. This is going on 20 years. When i hear about all this DEA stuff going on, i cringe. I truly believe that there’s a big difference in those ‘overdoses’ and most of the true, chronic pain patients that sincerly need these opiates to live some kind of a normal daily existance. I would LOVE to not need these meds……but i and my doctors, feel that i would not be able to WALK if not for them. It’s not our fault that opiates are sold on the streets and “users” OD on them. Let’s start using our heads and not lumping all opiate patients into one category…..that of “drug addicts wanting a HIGH”. It’s not true. If ‘they’ take away the legitimate use of prescribed pain meds, there will be a huge increase in the use of ‘street drugs’ for people to live with their pain. The government needs to butt out of the doctor -patient relationship and concentrate on illegally gotten drugs.

Charlene

Hi I’ve just started pain medication because the shots and physical therapy was not working. My pain level caused my blood pressure to rise and the shots caused irregular heart beats. My Dr. Switched me from. Narco, from Tylenol oxycoton, from plain oxycoton to dilated now waiting for a patch in between the dilated treatment because of chronic pain, nerve pain, numbness, pins and needles, sharp stabbing pains in my back , lower legs and feet, on top of fybromyalgia all through my body and osteoarthritis. I also suffer from depression and anxiety for several years taking medications. Now I have these body elements my anxiety attacks are higher. I take Valium as well for 25 years because of abnormal panic disorder something like seizures. I’m on a few medications for seazures, effexor for bipolar, lamotregene, neurotin for nerve pain that does not work. Baclowphen, which my Dr. Is switching to a more skeleton and pain muscle relaxer. I tried several different pain meds and none seem to work. I have several disc that deteriated and buldging a pain level of 8-10. So I’m taking 2mg of dilated 4×per day, a 5mg patch that laSt 7 days per seek. I think I need surgery. So please DEA and CDC. You can’t judge peoples pain and say they don’t need opioid. Your not the one crying at night with warm pads at night going to ER because the pain feel like your dying. Not everyone is abusing the opioid pain management system. My Dr. Is not afraid of the DEA she afraid I’m gone dye of pain. I don’t want surgery but bit gearing that way but I’m scared of that more than the pain meds because its not promised. I’m under pressure. I thank the press for caring but sometime caring causes more harm. Non opioid medications laugh at my pain. I tried getting Ssi and I was decided. Horrible I feel like they want people to die of pain because its not them. They don’t know how it feels to be in peoples body with pain. The shots last from 2-7 days for me and steroids causes my heart to race now I’m on 2 more high blood pressure medications ..Now my blood pressure is under control. People overdose because they start out wanting to get high or do street drugs. If you don’t prescribe pain meds people turn to street drugs which will never end. Stop picking on the doctors for treating pain thats what they spealize in. Shots and other therapy don’t work for everyone with a pain level over 10. Just stop staying deal with it. Thats like saying you have sickel cell or lupus deal with it with no pain meds. Pain is serious. Immune pain is serious and not to be played with. I just wanted to tell you how I feel because the FEA option is not working. I take my medication the way the Dr. Tells me to and I’m fine. Let… Read more »

Nancy Wilson

The overdoses ARE NOT FROM chronic pain patients misusing their medications. I am dependant on my medications, but not addicted! I was bedridden after being the victim of a four car accident, and had no quality of life without the use of opioid medications. These medications gave me back my life. I am no longer bedridden and am able to help care for my 78 year old father, be a wife, mother, and spend quality time with my grandchildren. Anyone can be a victim to a tragic accident or illness, that may leave you in severe chronic pain , so I would be careful and think before demonizing these medications. Instead, deal with the true issue, why are people taking medications that aren’t prescribed to them to get high. That is the real issue to address.

Susan Bingham

I also have a very lot to say im a 75 year old lady and ive been on my pain meds for 15 years but my doctor retired and now im reduced to taking Subutex does not help with pain at all. Will someone please help us who are legitimately in pain we feel awful for the families of t hose who have overdosed but someone needs to see there sre dome of us in real pain. My suggestion if pain doctors would randomly call patients who are on pain meds to come in pill count and drug screen in all these years ive only been asked to do a pill count with drug screen once. Drs do this every month with as many patients as possible they never know when its gonna happen and boom they are caught. Please help us in pain i agree we should stand together
Susan
Indiana

Nancy Wilson

Why aren’t they addressing the real problem! As a chronic pain patient since 2005 due to a four car accident that wasn’t my fault, a mother of two and grandmother of six, I am tired of seeing the commercials on TV about someone’s loved one died because of a overdose. Why did they want to use drugs in the first place? That’s what needs to be addressed! Where are the commercials of people like me who had to give up their 20 year career, was bedridden, and suicidal until I received help from pain management doctor, who carefully monitors me on opioid medication. I have quality of life now and I am able to have a somewhat normal life and spend time with my family. No one wants to live like this! AN ACCIDENT OR ILLNESS CAN HAPPEN TO ANYONE AT ANYTIME AND THEN THEY WILL NEED THE SAME MEDICATION WE NEED, BUT WON’T BE ABLE TO GET IT BECAUSE THEY HELPED MAKE THESE HORRIBLE GUIDELINES!

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Ron

More of us will be going to suicide!

Ron

Ok this is the typical response we hear .. that pain Meds are causing all of or he majority of ods and we visits for same . But in reality the numbers aare so askewed an assbackward that it could not be any further from the truth . Like saying the earth is flat ..’ no offense to flat earthers but this is unacceptable and needs to be reversed ASAP as suicides clime for people that are legit pain patients do not sell there Meds An have been on hen for years with no significant problems , as I’ve been working with a pain management specialist who is he greatest An I would be heartbroken if he was shit down or areas Ted because he cares enough to do the right thing versus what he government says he should do! Why are the Feds sticking their noses in something that they have no business or right to do .!? These are questions not being answers and only more put out about he horrors of using opiates . Well to be clear the % of ODs for just pain Meds was only about 3-4 % of the total .? So do the math with all of the fentyal An carfentyal Being poured in thru our open borders is just pushing more and more herion addicts ad other REC users of drugs to go to this albeit the rise in ods , and I find it offensive to hear that legit pain patients are oblivious to the deaths piling up from his fentyal crisis .. which would be more accurate to call then this witch hunt that had been labeled CdC operate prescribing guidelines. More like I’ll lock your doctor up for keeping his patients out of unbearable pain and a quality of life that was unable to be had with no way to control their pain. Then comes the facts that these numbers were deliberately manipulated to go after these Drs and thereby hurting and raising the suicide rate for pain patients who’ve been reduced or cut off from the very Meds that have made them a productive member of society . If you want to stop this crisis label it for what it is . Street drugs An alcohol are responsible for the majority of these cases with the person that has overdosed on street drugs mixed with other substances that u can walk in an buy as much as you can .. if they are this worried about our not dying which I believe it to be the opposite they want to exterminate what they see as people that are not working or in school and generally great people . We are not addicts nor druggies we take the Meds as prescribed and never sell them ,you’d have to rib or shoot me to give my Meds up . I need as many mgs as I can get especially now with this new redder madness type approx which is… Read more »

Ibin

I HAVE and can prove through my providers careful, documentation 0f prescribing opioid medication that I have gained, 23 years plus of self preservation by remaining employed after two back surgeries nearly ruint….my life. This documentatiom of benefit, from prescribed opiiod medication as the last, effetive treatment for continuous over the top pain after surgical correction did in fact accomplish all, that can be done for my lower back issue. The beneficial use of medication is totally being disregareded, With an 80 percent reduction in medication after 2. 5 decades. I have lost my home, I can NOT work but about 20 to 22 days per month and If I were not self employed, I would be homeless. Pill counted, drug screened every eight weeks for 2.5 decades is not enough “proof” that long term opiod medication has been ONLY beneficial to my self reliance. Rerduced medication is in fact causing disability but, this fact is overshadowed by the opiod, illicit, aclcohol comingling of people that have overdosed. I lost a brother to overdose but, I do not blame a treament pian, an opioid medication, for his demise. I also know of a patient that took his own life almost one year ago after seeking pain management, every way “legally” hat he could. What about the feelings of his family? They and their unneccessary grief….don’t count in the declared “opiod crisis”? There IS help for those thst need opioid medication treatment AND those with substance abuse disorders but, dot/gov refuses to recognize that these are two differnet issues.

Holly Davidson

I am curious why some patients are allowed to pay cash and others like me cannot?

Maureen

With all due respect Cindy…I disagree wholeheartedly with your post.
To my surprise, you sound naive. And, I must add, by no means are we in denial of the
abusers deaths. I find that line offensive. We are an empathetic community.
We strongly deserve the empathy returned.
@Dr. Lawhern, once again and with great gratitude…you have hit all of the nails on the head.
Thank you for your expert comment.

Troy

I so agree I have been on painmangment for 27 yrs . An with out my meds I couldn’t function. Keep speaking out it’s time to stand together

Michael G Langley, MD

Well said, Dr Lawhern!

Jim

they need to get this straightened out about the medical marijuana here in Florida the cannabist marijuana weed whatever they think they want to call it but it does work heals cancer heals seizures they trying not to make it Lulu’s legal as possible down here cuz all these Crooks is got their hands in the cookie jar have they make it legal they lose a lot of money but it’s already been passed so they’re breaking the law and I hope the guy soon as the piss out of them the attorney up there in Tallahassee that’s behind this medical marijuana Nan surance companies got to do something there’s too much of this opioids and the only way you’re coming off of it is by using marijuana because they can’t take you off of it and give you methadone cuz it’s worse on you then the morphine addictive was so the FDA needs to wake up and the DEA needs to be closed down because that was never meant to be what it is now rating doctors offices and Runnin on people here in the United States when Reagan was in office he made the DEA to be in Mexico to stop it from being coming across the border but their asses got run out of Mexico by the cartel so then they make it to where they’re just license to do whatever they want to do harass black people harass everybody and it’s a waste of our money because it ain’t did nothing but clogged up the court system what nonsense

I agree it’s not the real people that suffer from chronic pain which was caused by Drs. with 2 failed back surgeries, neck, ankle well let’s just say I’m metal from head to toe. The ones that OD have or had a drug problem before even going to a Dr. that’s what their missing they had no pain they had an addiction problem so the ones that follow all the rules and suffer because of the lowing or high prices for our medicine. It’s the DEA that’s making it worse and if I wanted to go for other treatment that I know would lower my pill intake is illegal in the state I live in and yes I’m talking about medical weed so if I test dirty there goes my Dr. and she is for it but the rules screw everyone. I’m 62 and I could not function if it weren’t to the small amount they lowered me to. This just all depressing more and making my life even more miserable. Thanks for listening Suzanne

Most tests on so-called “alternative therapies” reveal results about like a placebo.

Danny Elliott

Also in reference to the author’s statement that “… chronic pain patients deny the escalating piles of bodies at morgues, dead from opioid abuse and overdoses that often started with a painkiller prescription”, I wonder what Ms. Perlin has to say about the CDC’s September 1, 2017 “Morbidity and Mortality Weekly Report” (MMWR)? (I even wonder how many National Pain Report readers are aware of this report. The link is below.) This MMWR states the following:
“Approximately 90% of unintentional overdose deaths examined in 24 Ohio counties that occurred during January–February 2017 involved (Illicitly Manufactured) Fentanyl (IMF), fentanyl analogs, or both”. 90%! It also states that “IMF… and the co-occurence of other drugs is common”. As aaron clearly points out, Ms. Perlin doesn’t provide any commonly accepted statistics to support her assertion that “…drug abuse and overdoses often started with a painkiller prescription”, but the CDC’s own study states very clearly that it is the drug abusers, who commonly abuse several drugs/alcohol at the same time, who are dying. And it’s become far more likely that Illicitly Manufactured Fentanyl is the overwhelming substance that is the cause of death by overdose, not pharmaceutical-grade “painkillers”.

https://www.cdc.gov/mmwr/volumes/66/wr/mm6634a3.htm

HAZZY

WELL, I HAD MY MONTHLY PAIN MGMT VISIT TODAY AND MY PAIN MEDS WERE CUT BY 30MG, MY BP IS SKY HIGH FROM PAIN, I GUESS THEY WANT ME TO HAVE A STROKE.

Ann

It was a relief if not a surprise to see this article regarding opioid pain medication, the government, and the ongoing misinformation that is being tossed around without any concideration for those that do not abuse but truly have a quality of life issue without pain medication. Thank you Dr. Lawhern and the others that have commented on the original article. I have the deepest sympathy for the families that have lost loved ones due to abuse. However the media and other sources are punishing the wrong people. My husband has taken prescription pain medication for over fifteen years. Without it his quality of life would be miserable. We have switched to mail order which has been a great relief from the uncertainty and scrutiny experienced each month trying to get his prescription filled. We have also been “cut back” by my prescription plan to limit the amount of pills prescribed monthly without regard for the strength of the medication and frequency prescribed by his pain management doctor. We have a mantra “ we have done nothing wrong” to reassure each other when feeling the stress and pressures from we feel from watching the news and seeing the reports of death due to overdose and abuse. Where will all this go? We need people to speak out for patient rights and buck up against the current trend.

I too, received a “Medication transfer” from my neurologist over to my GP. My GP is confused as to why they are now handling my TRAMADOL. I have “The most painful condition known in the medical field”…Trigeminal neuralgia. It is treated mainly with anti-seizure medications. The tramadol is for days when I’m about to have breakthrough pain, which will leave me going in an out of the emergency room, (SUPER EXPENSIVE), hooked up to an I.V. flow of very toxic medications. I literally can’t communicate at all when I am at that level of pain. My blood pressure, my anxiety, and my spirit of teamwork between my Dr has flown out the window. I found my neurologist office to ask if it was just me, or everyone else included in the practice? She said everyone in the practice will no longer be receiving opioids from my neurologist. Seriously folks, this is serious.

Bob Schubring

Opioid use disorder is viewed by too many Americans as a sort of medical mystery that randomly emerges after taking medicine for real pain. It is not an accident that the counties in which escalating numbers of corpses in morgues, are the very counties in which methamphetamine use is most rampant. Stimulant abuse results in sleep disorders. Since sleep is a biological necessity like breathing, eating, and defecating, people respond to their sleep disorder by asking their dope dealer for a drug to help them sleep. Very often that used to be some pain medication stolen from a senior citizen with chronic pain. Nowadays, it’s more likely to be illegally-made fentanyl, created on the very same distilling columns and cookers, where the dope dealer made the methamphetamine that he sold his customers. Since dope dealers overcharge for stolen opioids and the fentanyl they sell, customers often mix the expensive drugs with whiskey, acetaminophen, and diphenhydramine (an over-the-counter sleeping pill). Some die quickly of respiratory arrest. Others die slowly of liver failure. Our denial of the stimulant-abuse problem begins in grade school. Children with attention deficit/hyperactivity disorder (ADHD) have a brain disease, in which some brain circuits run too fast, causing impulsivity. One can medicate the brain to slow the impulsivity, or one can medicate the brain to force all the other circuits to race to keep up with the impulsive circuits that are firing too fast. Another brain disease that’s got impulsive characteristics, Epilepsy, responds very well to cannabis therapy. Sudden impulses that result in uncontrolled epileptic seizures, can be prevented with cannabis. Last year 6 scientists at King’s College London decided to try cannabis therapy on controlling the impulsivity of ADHD. Their findings: Just as many ADHD patients who self-medicate with cannabis report, cannabis controlled the impulsivity and helped the people to focus. And cannabis did that, without the side effects of sleeplessness and anxiety that occur when stimulants are used to treat ADHD. (Cooper, Ruth E., Williams, E., Seegobin, S., Tye, C., Kuntsi, J., Asherson, P., “Cannabinoids in attention-deficit/hyperactivity disorder: A randomised-controlled trial”, European Neuro-psychopharmacology 2017; 27(8):795-808. http://dx.doi.org/10.1016/j.euroneuro.2017.05.005 ). Yet the evidence that slowing down the mis-firing nerve circuits was ignored. Institutionally, too many people at DEA and elsewhere, risked too much political capital on arguing that cannabis was dangerous, leaving the dangerous stimulant drugs as the only alternative. In the case of the late singer Michael Jackson, trial testimony revealed that for the last decade of his life he was unable to fall asleep normally, and hired a physician to inject him with the surgical anesthetic Propofol, knocking him unconscious, so that he could sleep. Stimulant overuse is dangerous, but children and teens and parents, who have become accustomed to thinking of their Ritalin and similar stimulants as healthful, simply aren’t connecting the dots and recognizing that a sleeping disorder is a sign of serious trouble. Kids who take sleeping pills that don’t get the job done, try mixing the sleeping pills with alcohol. When that doesn’t… Read more »

Sher

I wonder how Ms Perrin would feel about her medical decisions being made by someone who has never seen her. That is what we chronic pain patients are dealing with & a lot more. Can you imagine how we feel? How do the insurance company, the CDC, the pharmacy, know what is in my best interest? That should be between my physician & myself. It’s like a nightmare with such judgmental, so called experts making our healthcare decisions. I have lost my job, my independence, my trust in government & my ability to manage my pain. All concern is for the addict, never have I heard any concern for the welfare of the chronic pain patients. Where is the outcry? The lawsuits? Doctors voices? It’s like we don’t matter, what a terrible feeling.

Christine Sparks

Does anyone have any insight on how we might advance a class action lawsuit against any of a number of entities, like CVS, insurance companies, CDC, etc.? I’m sure there are many obstacles and that it’s expensive and energy intensive, but is it worth a try? I truly don’t know.

Kahty C

As long as the Industry is controlling the discussion, and our News Media deceives the public, we are not going to get anywhere.

Denise

Like I’ve been saying and i agree with everything being said but that still does nothing, and if we want to stop this we need to come together, and demand an audience with the top man, and yes President Trump as he is being fed these lies by the man that has been put in charge of the Commission on the Opiate epidemic. Chris Christie is has been leading this nightmare! I truly believe his movetives are in no way what he claims. The facts speak for themselves and as of the 20th I have no idea whats going to my out come..this is my final pain prescription, and it has been slashed with out regard to any tapering. I have mulitable pain issues that have only gotten relief from morphine I have never abused these drugs. Now my pain has intensified to a level that I’m not sure what will happen! I’m trying to hold it together to be of use in this fight. To those that are with pharmacies that are cutting you are flat refusing to fill, establish with a Walmart I have been blessed to be with wonderful pharmacists. So if anyone wants, we need to band together. Be HEARD AND HAVE A VOICE. I live in Las Vegas and there is a News outlet that has in Nov. Ran a series showing what is happening to us. #ourpain..we need a part two. There are millions of us, we can make a stand for what is our God given right to life. The time to be silence is no more.

Janice

I am an opiods user, not a user. I actually fear for my doctor because he does write my scripts for opiods.

Although I am a law abiding, grandmother, I would seriously consider medical Marijuana if it were available.

Red ,your always right on the money with your look on this issue.What I think on the subject you are always able to put it in order to be read.Your the one we need to send to Washington DC to straighten this all out.Iam going to start including you in my daily prayers. So if you find yourself on a plane bound for DC and you don’t know how it happened,know that you are on a mission from GOD.LOL.
ALSO to Dena Meeks maybe you shouldn’t stir the bees nest,it might make things worse.Iam almost certain it is their policy to give trouble makers,being anybody who doesn’t do what they are supposed to and keep their mouths shut,a lesson in questioning the insurance company.

Steven Smith

A person can sure tell who suffers from pain big time and who doesn’t. If you did suffer pain you would know that option 2 it’s just a bunch of stuff that sounds good but in reality does nothing. If a patient with a degenerative disease could make their pain go away by accepting it or pretending it is not there or making it their friend they would already be cured!