Why the Treatment of Pain Is Being Compromised

Why the Treatment of Pain Is Being Compromised

By Ed Coghlan.

One of the nation’s leading pain physicians has written a provocative article about the collateral damage that the opioid controversy is inflicting on pain patients.

Dr. Jay Joshi

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.

“This deeply misguided, if predictable, response threatens to deprive relief millions of Americans of relief from persistent, even debilitating pain. Instead of retreating from treating their pain altogether, we should focus on educating doctors on the multitude of safe, effective methods for treating pain in its various forms,” he writes.

Joshi sees the damage spreading. The American Medical Association is reversing its position on the designation of pain as the fifth vital sign, which many believe promoted the opioid epidemic.

However, no  educational guidance has been given toward increasing proper pain management awareness among physicians and other healthcare providers.

That reversal, he writes, “would abandon legitimate chronic-pain patients, who shouldn’t suffer because of an incoherent policy toward pain management.”

Joshi—one of the common sense pain physicians—has contributed to the National Pain Report in the past. 14 months ago he argued strongly that physicians and patients need to stand together—an article that generated significant response at the time.

Joshi provides a little history on pain management

“The medical profession elevated pain to the status of life-threatening conditions in the early 1990s, but never followed up with the education and rigorous controls necessary to treat it,” he writes. “Every other medical specialty has detailed guidelines on how to treat diseases, based on hard science and clinical data to determine the proper balance of risk and reward for a given pharmaceutical or course of treatment.”

Joshi has been critical of the opioid hawks who are trying to severely reduce if not eliminate the prescription of them.

“For example, opioids may be an option for a legitimate patient with chronic, debilitating pain that has failed to resolve with conservative or even aggressive treatment options. However, not all opioids are the same and they are certainly not a good idea for someone who has substance abuse issues.”

He decries that there are no residencies offered in pain management and estimates that 90% of the  “pain specialists” in America have no formal, accredited fellowship training in pain management.

We look forward to you comments, but before you comment we encourage to read the entire article by Dr. Joshi.

Here’s a link to his column.

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Authored by: Ed Coghlan

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How can we send these testimonials to President Trump or someone who can actually help us. I think the only way we can get our point across is to march on to Washington DC. and show the wonderful government what it looks like when people in pain don’t have the proper care. I am 60 years old and have worked since I was 11, the way I feel every day I might not make it to 61.I always pray for a miracle.

I have been in pain management for 23 years on and off, trying to break away from it but my health is getting worse and my doctors won’t increase my dose. I signed up for medical marijuana and started smoking a little each day along with my opioids, this has helped my pain levels. I was given an urine test and it showed the marijuana, I am sure the pain clinic is going to drop me and I will be in unbearable pain, do I have any recourse against the pain clinic for jeopardizing my health, the only thing they have said is my thc level has to come down and I know it hasn’t. I am 60 years old and have suffered multiple injuries, cancer, five hernias testicle amputated, a hematoma and that is only quarter of what I am dealing with. Any feedback would be appreciated.

Bill

Those of us who have to deal with chronic pain are made to feel like we are junkies if we tell our doctor the medication is no longer giving relief. We are forced to pise for every prescription and see the doctor monthly causing the costs to receive pain relief to skyrocket. If not for my family needs I would probably do what they really want us to do and check out. We are not only debilitated by the curse of illness, we are then humiliated and portrayed as junkies. THIS is BS!

I am a retired RN. I entered a well managed pain program in 1990. I had a birth defect w/ no left hip socket. I have a deformed left hip, had multiple surgeries- where a metal rod, screws and nails, are pounded into my femur bone. I can’t understand any of this, I have read of many pain patients like myself-who are Law abiding citizens, and have managed very well for 23 plus years on a certain Opioid formula which worked for me. It was above the CDC guidelines of 90 MMD’s Per day. So, why is it that chronic pain is still mis-understood today? I have written my Senator, signed petitions, and am trying to do the best I can, while still suffering from pain! At present, one of my screws broke in my hip socket. I am terrified of thinking of needing my 5th left total hip revision surgery. So, what is the solution?
I am not an MD. But, I feel that any Dr. Who is in a pain clinic-should speak up as to how these Opioids work for we patients who must live in horrible pain. I should have documented records showing how well I have done for 23 plus years. What also needs to be talked about- We Pain patients do NOT use our meds to get “ high”. We use them to give us a quality of life, and be able to get out of bed, socialize, etc! But, I am one voice. I can’t get my present pain Doctor to go above the 90 MMD number! All MD’s need to speak out, now and not later! I will be happy to be in a pain study. Nobody asked me! Common sense is rare today. I think chronic pain is a topic that nobody wants to speak out about! I feel that my RIGHTS have been ignored, is this fair? The 90 MMD’s first needs to be eliminated-so Pain Doctor’s do not fear losing their Medical licenses. This topic has gotten so out of hand, that we now are having shortages of Opioids in the Hospital setting. How outrageous is this? We are going backwards. It took me 10 years to find a qualified Chronic pain Doctor, and now for what? My health condition will not change-I suffer severe bone pain and muscle pain.I am now a guinea pig-I tried Gabapentin which gave me heart flutters, and a drop in BP.
I have NEVER overdosed on my pain meds. Pain should ALWAYS remain the 5th vital sign. Let’s get a study done now-with other Pain patients like myself-and if Dr. Jay Joshi would like input from me-I don’t mind helping out! Sincerely, Kathleen Clark,RN. ( retired).

Ml Reazor

I totally understand what everyone is going through. I moved almost a year ago from Tennessee 2 Northwest Florida. As soon as I arrived I made an appointment with pain management and found a primary. I’ve been through two primary cares and have seen a pain specialist the only thing they want to do is shove those damn needles in my spine. I also have spinal stenosis degenerative disc disease, rheumatoid arthritis and fibromyalgia I went to see these new doctors thinking all will be fine. Not one would give me pain meds I’ve been on the meds for about 10 years. Well a few weeks after the move I ran out of my pain medicine and had to go cold turkey off of fentanyl patch and onoxycodone. I was so sick I had to be hospitalized. I was also on Xanax for anxiety. I could have died. This is going too far and they’re not even finished yet. I believe we must stand up for human rights. This will cause many unnecessary suicides and Street addiction. Is this what the New World Order is all about? [edit] Good luck to all in this fight for our lives.

PippisMa

Pain patients are treated so wrong. It appears as if those with the dollars and the power are trying to kill off the entire segment of society that needs pain medications for very real conditions.

Jayg

I wish I knew how to Dr shop! In WI I don’t think you can! I’m a documented chronic pain pt with short bowel/mal absorption due to chrohns/mult resections for 40+ yrs. Put on Fentanyl 75 patch/Ativan 10yrs ago for spinal stenosis/spinal fxs./RA/Kidney CA from Biologics muli. System fail. Lived semi normal productive life! Opioid crisis hits sent to pain mgt.weaned off fentanyl/Ativan cold turkey with Vicodin! Hypertensive crisis along
with massive pain/chrohns flare return!
Treated with Metroprolol!
Plan of care, Wean off Vicodin/use wheel chair!!! I will not live this way!!! I’m ready to give up no one will help! Pain management lies! Primary md says see me in a year??? No where to turn!!!

Robert Ivan

After reading through all the comments for this article, it’s staggering to feel the collective suffering and hopelessness by all.

I wonder how many people having lost all hope have decided to take their own lives instead of suffering one more day.

There is one thing that differentiates someone who suffers from intractable, continuous pain and the drug addict junkie shooting up Heroin into their veins…

Besides overdosing from too much Heroin or Fentanyl, how many times do you hear of a junkie committing suicide because they couldn’t get their next fix?

May The Lord protect us all from this well contrived genocide. America’s Final Solution to pain management.

Robert Ivan

To: Laurie Jackson-Bowman

“I pray that our scientists look closely at the natural plants and find a cure for chronic pain.”

Not to sound gib, but they already have. It’s called the Poppy Plant. You cannot reinvent the wheel expecting a more efficacious result and for our collective conditions, there simply is nothing else that duplicates our own bodies endorphins so precisely with minimal side effects. As we suffer, the healthy citizens of California are lighting up their bongs to get wasted. Something is wrong here.

To: Alessio Ventura

After reading your comments, I immediately watched the episode of Blue Bloods which used to be one of my favorite television shows. The way they made the almost seamless transition from Fentanyl with a few grains being absorbed by Detective Biaz putting her into a week long coma to high grade pharmaceutical opioids being essentially identical was insulting.
The interaction with the ER Doctor defending her way of dealing with trauma patients and the DEA agent ultimately dismissing her by throwing the full weight of Nazi America’s authority to shut down the largest trauma hospital with a stoke of her pen shot shivers up my broken spine.
The ending was really interesting. They offered more sympathy to a child rapist on a sex offenders list than the shows producers completely negating chronic pain patients existence.

Alessio Ventura

I have chronic intractable pain.

Every month, I drive to 30-40 pharmacies before I either find the medication I need or I give up. It is not unusual for me to be in withdrawal on the months where I cannot find the medicine. Eventually, I find it, but it is an exhausting and painful endeavor.

Why is this happening?

Because doctors and pharmacies have been intimidated into not providing the opioid based medicine that we have found to be the only medicine that works.

When you have a constant drumbeat from government officials, media, and TV shows, blaming doctors and pharmacies, then it is no wonder that they cowar.

In December, 2017, the CBS show “Blue Bloods” had an episode called “Pain Kilkers”. The point of the show was that the opioid epedemic is being caused by physicians, who overoerscribe opioids. The patient doesn’t use allmof them, and the remaining pills wind upmin the hands of kids. One of the last scenes in the show is whete two detectives, one with the DEA, threaten an ER doctor with arrest and shutdown of the ER because they prescribe opioids for trauma. That scene alone was so irresponsible that it was funny if not dangerous. Do the producers and actors on this show believe that trauma victims, like gun shots, car accident victims, severely broken bones, etc, can be treated with aspirin, tylonol?

It is time to speak en masse or we will lose our right to pain relief. I have been writing to all of my reps at the local, state, and fed level, but it falls on deaf ears becausr I am one of only a few. Everyone who needs pain relief MUST SPEAK UP NOW before it is too late.

What is the alternative if they take away our right to pain relief? Suicide.

Eric Johnson

ditto. I been in a nursing home last 2 months. meds cut off- became malnourished, flu, septic– in wheelchair for first time in 25 years. I have BAD traumatic brachial plexus avulsions. I wish i’d died 25 years ago

Teresa Sorrell

Please Dear Lord let the minds, ears and hearts be opened and let US find relief. Let someone stand up and say “I will lead you, I will be your voice”. We have to come together and fight as a force of the millions we are. We can not March because we hurt to much so we need to use whatever means we can to be heard. Somehow we must gather our voices in a loud shout that will be heard.
Someone somewhere needs to lead us.
I too have said that I could not, would not, did not live in this pain. Two years ago I walked into traffic when my last pain medication was stopped. Since then I have agreed to try anything. Believe me it’s been everything. Pain management has injected, burned, and poked needles into every square inch from my neck to my tailbone. Still in pain. Still think about ending the pain once a week at least. If you are intelligent and know how to write letters and know the Hell of Chronic Pain please be our voice. Lives depend on you.

I pray that our scientists look closely at the natural plants and find a cure for chronic pain. I have fibromyalgia etc. and it is very cruel and chronic. I have anxiety and mental illnesses due to chronic pain. I hurt so bad that I contemplate suicide ESPECIALLY when I flare up, the pain is so out of control. I can’t even imagine life without being able to control the pain. There is no quality of life with chronic pain everyday of your life. I pray for everyone because I understand. If God would be willing to allow those that stand on the other side of these chronic situations to experience what we feel, I believe their insite would leave all of those making decisions, to advocate for people like us with their very own lives. May God have mercy on us all.

Hi , Larry again I just wanted to add to my last comment that I take a med. for MS and it cost 17,500.00 for a 90 day supply , that’s right look it up if I didn’t have patient ass. Program I would be SOL.

I have MS and I’m in pain every dam day so DEA get off our sick backs. What if you all wore my shoes for a day . yes you would plead for some meds. Bet you would.

Cynthia

I won’t go into the details of my chronic pain issues, but reading these posts left me in tears.
I am fortunate to still have my compassionate doctor and my pain medications…for now. I urge all of you to contact your state medical board, your government representatives at state and federal levels, governors, federal agencies such as the CDC, DEA, even the Whitehouse with your stories. If your writing abilities aren’t that good, have someone who can draft an intelligent letter about your experience do so for you. I suggest copying it and mailing it to anyone you can find that has involvement and the power to help make a change. Having a somewhat professional sounding letter goes a long way to helping
change the perception of chronic pain patients. I know it is difficult but some of the posts
I’ve read are borderline jibberish and do nothing to help our cause. Don’t let the doctors bully you if you can. If they cut you off file a complaint with the medical board in your state.
Tell them your doing so. This is all we can do for now. Good luck.

Holly

I am sooo very tired………I sometimes wonder which is worse? The slow weaning or just go for it all at once cold turkey. I just cant do this again…..Just too many surgeries and so much pain…Are we in hell?

Dr. Mike, I appreciate you taking the time to add your 2 cents worth. A couple of years ago, 30+, I gladly and eagerly became an RN. Over this period of time I had become an information sponge seeking to become the respected health care professional an RN used to be treated as such. What a disappointing time in my life when god forbid, I injured myself. The day I chose to take that first opioid basically became the end of what I called, my calling. During my time enjoyed by being an RN and a respected member of my community, I had the opportunity to wear several hats in the hospital that I worked in. My favorite, being an ER nurse and dealing with trauma, that’s right I’m a self-proclaimed adrenaline junkie! But that was many moons ago. Once I took that first opioid, my voice in the medical community became silent. And if by chance I did question my doctors and the handling of my painful disorder, I was labeled as a problem patient. I have to admit, I am absolutely guilty of discrimination when I would form an opinion on a patient who presented themselves to be in pain. For this, I apologise profusely for the way I may have treated you. You would think after 12 plus years in an ER setting, that one so called educated health care professional would have some understanding about what real chronic pain is all about! I could not have been more wrong about pain! Please, if you are reading this and you happen to be in healthcare, I encourage you to demand more education about a disease that steels the life out of people who you may know. Then once you become educated about chronic pain and this opioid crisis, then think again and thank your lucky stars that you have not been or had the pleasure of experiencing chronic pain 24/7! Now back to the time when I took the first opioid. You lose your voice and your health care! My PCP was very supportive in the beginning. But it wasn’t long until I receive the letter in the mail stating that I had 30 days to find another physician to treat me as a patient. I have to say that my primary care physician developed a a terrible disorder of ”testicle shrinkage”! After taking that first opoid, I am now considered a drug addict. If I were to complain or bring up this travesty of abandoning patients, I may have been blackballed sooner. In hindsight, I wish I would have said something! Whether I’m a drug addict or not, you just don’t abandon your patience because they have a disorder that you as a physician do not have the Magic Bullet for the relief of pain! In fact this is when your primary care physician should really start listening to you! They might actually learn something!! Now after 10 years and just over a million dollars spent… Read more »

Eric Johnson

pretty much exactly what you said. I am currently in a physical therapy hospital after waking up UNABLE to WALK again.(it happens every time they cut off my methadone. I lost 35 lbs in 4 weeks this time). I feel so bad for us. I’m sorry to say- we’re damned.

Ditto to All the above 😓
Was prescribed opioids for 10 years.
My pain medication was stripped away in November of 2016.
I had surgery for cervical spinal stenosis in January. I have also been diagnosed with Fibromyalgia. I am a survivor of MDD, Anxiety, and PTSD. I am barely functioning enough to get through each day. I have thought about suicide, but I feel like that isn’t my decision to make 😇. I feel there is an argument for Chronic Pain to be deemed a terminal illness. How many of us have so little quality of life? How many of us are Slowly Dying? I believe there are intelligent, courageous people out there. PLEASE Please Advocate for Us. We want to Live too! 🌞

Virginia

Responding to one had stroke 35 years ago and now on Norco finally.
I know how hard it is to get any doctor to hear your pain. And that’s what it is really, a doctor to read and hear your pain.
Here’s what I did. Started a pain management program referred by my PCP, let the Dr there really touch and know where my pain is, then let him know I’m willing to do anything to get relief. Ok, it took almost a year of 2-3 visits with pt Dr.,2 complete rounds of radio-ablations including several nerve blocks of facet joint and medial nerves of C2-C5, many visits to chiropractor, and, also, as you, went to many specialists: neurology, rheumatology, neuromuscular, neurosurgery, etc. After all that we learned my nerves were working fine.
They also came up with the diagnosis of Fibromyalgia, Osteoarthritis (moderate to severe), degenerated disc disease, spondylolisthesis, and there is something else going on that is far too high above their pay grade.
After you go through a miriad of other pain remedies, and go through all the other things they recommend for you to do; and they all fail to give you any relief, then you have power to request whatever you want.
Go with these quacks a few miles first, then you can fly the coup when your wings grow stronger. Find a doctor who will listen to you and look you in the eye when they talk to you and not their computer screen.
Put yourself in their shoes too. They could be writing a death certificate for someone who has a plan on how they can take their life, not a prescription for an opioid pain medicine.

Soo sorry and most of us with the REAL DEAL can relate. My Dr handed me a pamphlet for output drug treatment! I wanted to throw it in his face! WHAT does THAT have to do with the suffering I have to endure? Are they going to help me learn to live every day not being able to leave my house because the pain will simply be unbearable when I get back and my only hope is to cry myself into exhaustion so I might be able to grab 2 hrs of sleep where I can DREAM of being pain free! If our bodies could hold up (which they can’t , THAT THEY know) we could go to Washington and spend time showing them WHO we are! Its frustrating and sad,sad, sad…..

I THINK THIS A BUNCH OF [edit],I WISH THE DEA COULD WALK IN MY SHOES FOR ONE DAY,I DONT THINK THEY COULD DO IT,I HAVE HAD 11 BACK SURGERIES 2 SPINAL FUSIONS,I USED TO BE ON A DOSE THAT CONTROLLED MY PAIN PRETTY GOOD,2 OF MY PAIN DRS ENDED UP CLOSING THERE DOORS DUE TO THE FACT THEY WAS AFRAID THAT THE DEA WOULD SHUT THEM DOWN,AND ONE OF THEM IS A PROFESSOR IN PAIN MANAGEMENT, I CAN UNDERSTAND NOT GIVING PEOPLE OPIOIDS THAT HAS NEVER HAD ANY KIND OF DISABILITY SURGERIES, WHAT STARTED ALL THIS WAS THE PILL MILLS,PEAPLE GO THERE BECAUSE THEY ARE ADDICTED OR SELL IT,THAT IS WHAT HURTS REAL CHRONIC PAIN PATIENTS, I HAD TO GO TO A DIFFERENT PAIN DR AND HE CUT ME IN HALF OF WHAT I USED TO TAKE,NOW IM SO MISERABLE I DONT EVEN WANT TO LIVE ANYMORE, IVE CONTEMPLATED SUICIDE SO MANY TIMES,I TRIED TO ONE TIME AND ENDED UP ON LIFE SUPPORT, IF MY WIFE HAD NOT FOUND ME THAT WOULD HAVE BEEN IT,IM TIRED OF LIVING IN SO MUCH DAMN PAIN,I CANT SLEEP IN MY OWN BED, I HAVE TO SLEEP IN MY RECLINER WHEN I DO GET TO SLEEP, IVE KNOWN SEVERAL CHRONIC PAIN PATIENTS THAT HAVE KILLED THERE SELF DO TO THIS DEA [edit],THERE NOT DRS,LET THE DRS DO THERE JOB,SOMETHING HAS TO BE DONE OR THEY WILL SEE ALOT MORE SUICIDES OVER THIS,AND THEY PROBABLY DONT CARE.

S

I see no hope for sufferers of chronic pain. I have had CRPS for three years. Some days are better than others, but without hydrocodone 7.5, this condition would be impossible to survive. So, now I have a plan. My plan can be summed up in two words: I quit. I do not believe anyone will rescue me from my pain. Compassion and common sense and decency are dead.

Ken Kephart

I am a 50yo male who was on pain meds for approx 15yrs. I took them as prescribed and never sold them or abused them, I even had to sign a contract with my doctor and have regular drug screens (which makes you feel like your doing something wrong and like a junkie on the street)I am a husband and a father and got up and went to work every day and by the way it was the doctors who told me i would have to be on meds forever.My Dr leaves the practice and now I have to find a new one, well guess what the new Dr doesn’t believe in pain meds regardless of diagnosis and said maybe i need to go to a treatment facility, needless to say I don’t have a Dr now. It’s been about 5 months since I had any pain meds and I am not the same husband or dad anymore,I can’t play with my kids I miss work now and I am a constant jerk. I have severe back and joint pain that runs down my legs and hips constantly, i don’t sleep and have had surgery, facet injections,trigger point injections countless PT appts and just about everything else and nothing works except the measly 20mg of oxycodone I was on daily(which didn’t take the pain away but allowed me to function as a human being) I understand there is a epidemic of opioid abuse but not everyone is an abuser. It just amazes me that the Drs can say sorry there is nothing we can do to fix the pain and oh by the way we are not going to prescribe any pain meds because some people are abusing it, sometimes i really can’t believe it because it makes no sense at all. So I am also looking for any attorney who is brave enough to stand up for what’s right and fight this inhumane treatment.

Lisa H

I am a chronic pain patient with a herniated disk, and severe lumbar arthritis. I get injections, I use heat and topical agents, and yes I use opioids. Using opioids responsibly has allowed me to keep working full time. It has also allowed me to do more than go to work and lay down when I got home. By having my pain controlled, I have been able to be more active and even start exercising, which has decreased my pain even more. It is very disappointing that the medical community, government, and others have had such a knee jerk reaction to the opioid crisis. I am thankful for the few pain advocates that are fighting for the millions of chronic pain patients who have become collateral damage. Recently my insurance company started requiring a 5 page pre-auth for 14 days of short acting opioids. You can get a second fourteen day supply with a second pre-auth. They will only authorize 28 days in a 3 month period. Therefore the pain clinic will not complete the pre-auth since it is a lot of work and still leaves the patient without coverage for two months. I am a nurse and know about GoodRx and so I am still able to get my pain meds without insurance at an affordable price. However, many patients are either paying a fortune for their meds or are sadly no longer getting them. I am willing to fight for our right to be treated effectively for our pain. I’m just not sure where to begin. A list of where pain warriors can begin to start advocating would be fabulous!

Heidi hyatt

We MUST STOP killing the life of the people that DO NOT want addiction but have legitimate pain issues! So to stop the bad behavior in SOME the government carpet bombs the whole dam country! Killing all! I don’t know about everyone else but MY broken body CAN NOT bare the burden of addicts which IS A CHOICE because the illness in my body (which I didn’t choose) is heavier than I can bare! We do EVERYTHING to constantly prove we are NOT DRUG ADDICTS and then the government once again causes MASS COLLATERAL damage and death because LAWYERS are making MEDICAL laws and making a whole new group of VICTIMS with hell to pay and their families suffer without them! So we and our families suffer because others CHOOSE to abuse prescriptions, which by the way WILL NEVER STOP..ITS NOT A NiRVANA it’s REAL LIFE. I can only hope and pray that doctors will form together to DEFEND chronic pain patients or else there may be another epidemic on their hands!

Buddy Hastings

I have had multiple and i mean multiple Back surgeries, ive had 2 spinal fusions, ive had all the nerve blocks and many more of the same thing,the only relief i get is from opioids, at first it was fine,they was giving me the right dose, now that the Dea has gotten involved in this my dose has drastically been lowered to the point i dont get any relief any more, two of my best pain doctors have completely closed there doors for feer of the Dea,i cant sleep in my own bed do to the major pain i have,i have to sleep in my recliner when i do sleep,ive even thought about suicide because the pain is unbearable, i take my meds exactly how they are prescribed, i dont know what’s going to happen, why cant the government let the drs do there job especially when patients have real proof that they are in chronic pain,i know some people that have as much pain as i do who cant live like this the rest of there life,who has committed suicide and others who think about it like i do at times, something has to be done about this soon.

Amy Pollock

I went off meds for 3 months because every doctor I saw blamed every other issue on opioids. I got to the end of that 3 months of sitting on the couch wanting to die. I thought there’s no way I’m going to live my life in such pain that I vomit sometimes. I tried everything available to me, marijuana, vitamins, supplements, I was taking so many Tylenol and Advil I was getting sick from it. I planned my death over and over because part of me felt that there would be an end at last. They put me in a mental hospital and pushed drugs on me that even today I don’t know what they gave me. They did, however put me back on Norco. I immediately started to feel better and I was able to walk for longer then 10 seconds. Now I’m labeled as insane because I wanted to die and no one wants to listen to a crazy person making up pain problems. They all missed the whole point, I still have a plan to die with dignity but I’m far from suicidal. I have so many diagnoses I have to write them down to remember. I had a stroke when I was born and now 35 years later they don’t think I should be in pain. I had one doctor tell me I had MS and another tell me I don’t. I had a doctor tell me I have “Central Pain Syndrome” but no one even knows what that is. I had a pain doctor tell me I was so far out of his league it would be a disservice to treat me and another tell me I’m drug seeking. I’ve seen more the 30 doctors and no one will help me. I wanted a pain pump or brain stimulation but I keep getting shut down not one wants to take a chance. If I had just had a stroke last week and complained about pain every neurologist would treat that pain without question but I had it 35 years ago and because of that I have so much damage to my body since my left side hardly works it’s in such a bad state of dystonia. I have disc degeneration so bad doctors say I’m “way to young” for these kids of issues but again will not treat. I got disability one my first try immediately without any more documentation other then my medical records and my pain doctor now is “shocked” Why is it so hard to believe patients even with proof. I’m taking pain meds now that barely let me take care of my children but it can’t be increased at all! It’s so incredibly sad I have to suffer and want to die because no one will help me.

Pedro Lopez

I am a chronic pain and arthritis sufferer. It is terrible I always been independent and now I can’t even do basic life task to tend to me. rhis is a real burden my Dr. Resigned and now on my first visit without checking my MRI or exam next she cut my pain meds. I need serious help she is descriminative and doesn’t care for my well being I am alone and have no one to help me can’t bear the pain. She thinks that everyone is a junkie and that is how she talks to you and treats you. The Pain is unbearable.

janice

is there any doctor that still has common sense about pain management, could you please please step up to the plate. Is their any lawyer out there who can assist those of us suffering from day to day? To take those who are performing actions that take away quality of life for us? Please step up to the plate. I can’t believe the Dea and others have been slowed to go this far it’s too far already. Please I want to join in on any lawsuit that stops those who are harming cronic pain patients, not for the financial gain for finding relief. I firmly believe our govt is weeding out the strong from the weak.

I could not agree more with Dr. Joshi that patients and…….physicians should “stand together” but, the method that the DEA has incorprorated in the enforced compliance of prescribing 90 mme, daily, maximum REALLY handcuffs our providers as they can be targeted on an indivdual basis whicht terrifies our doctors who have a two fold mission, profession. Which is to treat the patient with the best, most effective treament at their disposal AND earn a living for themselves, and their families. NO patient is “worth” license suspension or surrende when it comes to the geastapo, I mean DEA attacking personally, an individual practioner and the unfortunate vicitm. The practioner has very little resource to “justify:” exceeding 90 mme daily, maximum even with documentation, drug screening, amd their personal examination and evaluation of the patient on a regular appointment basis. The “system” to reform society to “avoid” drug use, abuse is unfoirtunatley quite an effective means to bring our providers “in line” thus. further harming their patients. I would NEVER have believed that such a treatnmnet “policy” for opioid prescribing physicians would EVER exist. Let’s give em………h, I mean facts.

I know someone very dear to me in CHRONIC PAIN. Very miserable every day and not FAIR to have to.live like that goes thru hell daily. COME. ON WOULD YOU WANT TO BE LIKE THAT 24 7. WAKE UP THEY HAVE DR. NOT THE STREETS HELP GOD THESE HURTING SOULS. ALWAYS REMEMBER IT COULD BE YOU

Debbie Flippin

It’s so hard on the people who have legit reasons for needing pain meds. Because of the idiots who abuse narcotics the pain meds that we need just to be able to make it through the day are denied to us. Something needs to change. We have the right to get our meds so we can have the opportunity to try to live a somewhat normal life.

Lori Townsend RN-C retired

I too have been on pain meds for over 20 years now. I don’t abuse them. I don’t sell them and I don’t drive if I have taken any. I am under the strict care of a prominent PM physician who checks me monthly with examinations and random drug screenings. I have Crohn’s disease which is an autoimmune disease that causes extreme abdominal pain, ulcerations from my mouth to my anus, sore joints, fevers, terrible bouts of sudden and prolific diarrhea, etc. I have to use an opiod medication to not only reduce the pain but it also reduces the diarrhea. Tylenol doesn’t even touch the symptoms and non-steroidal meds like Motrin and Aleve can actually cause flare ups. My Medicare advantage plan has been lowering the limits subscribers can get without a long and arduous approval process that takes time, effort with paperwork from myself and my doctor, lots of stress and oh…there is the expense. This year the insurance company increased the tier level on the drug and decreased the limit I can get without prior approval. If I try to purchase the medication out of pocket the drug cost is over 1000.00 per month. I am a retired RN, on a fixed income. I can’t pay 1000.00 a month for a drug. The money is just not there. I am keeping my fingers crossed that they will approve 2018 payment for the medication. Even if they do, what about the following years? All the crazy that is going on about opiods is frightening to those of us who are chronic users of the drugs. All the nonsensical laws being made by people who know nothing about the subject that takes a very private matter, our health, out of our control and ties the doctors hands behind their backs. In some states even pharmacists can refuse to fill the script. And what is causing this epidemic is not so much what responsible doctors prescribe but what is flowing over from China on the black market. Herion, fentanyl tainted with elephant tranquilizers and other adulterated drugs. Young people looking for a thrill take one dose of that stuff and it kills them. That is what the real cause of this so called epidemic is from. Yes, there will be pill junkies that will be in the mix but those can be rooted out through careful screening and education of doctors. What is going on now is a national witch hunt for anybody that has to take opiods. Including people like me whose quality of life would sink to an all time low of endless pain and suffering, having 30-40 liquid fire diarrhea bouts a day. Right now I have semblance of life, without these meds, well let’s just put it bluntly, I would probably commit suicide. Like the commentor prior to mine, I feel like my rights are being violated as well. If I had the energy to do it I would like to start or be a part… Read more »

the CDC AND DEAL ARE murdering hundreds of dsabled cchronic pain patients every day-to-day with their reckless natzi ispired ideaoloy by taking away our lifesaving medicine making war on the weakest mot helpless section of our population how can we as americans clamly sit by and let this massive genocie mass proportions happen disabled veterns who have fought for all of our freedom cut off form their live saving medicne with n alturnative for relief but forced SUCDE its appauling and sickns me to the core when there no reason for this to happen we are not additics we have medical issues that cause such horrible intence pain no human can stand for eve short periods of time the medical comunity knows this as does the rest sociaty thay are picking to ignore this and let disabed pain patients die and suffer at alarming rates pure neglect the CDC AND DEA dont care if we die and suffer beyond s humanly possible wake up doctors-people of amercia your dads-moms-sisters-brothers-and children are dieing-suffering because the CDC AND DEA are causing it:::::::: christ we trust disabled chronic pain patient andy smith

Mary Kujawa

I have gone to a pain management clinic for close to 15 years now, I have had every test & procedure there is for my condition… there is nothing any Dr or surgeon can do for me… the only reason I am still able to walk & function is strictly do to the pain meds I take. How dare the non educated government take our only hope of managing our pain away from us!!! Patients who have a history of true legitimate chronic debilitating pain cannot go without the meds!!!

Well lucky you who have been blessed with pain management!!!! Me 9 yrs December 30th ! Severe reaction from antibiotic (Leviquine) 20++++ outpatient spinal injections with steroids!!! Joy been speeding ! No Sleep! take 6 Advil pm! === abdominal bleeding! Torn ligaments,, ( relocation of ulnar nerve) 1 month later (Rotator Cuff)!!! I can’t walk or bend! But I do move but in much Pain!!!! Radiofrequency lesion lower lumbar! Nov 6th! 2017! I’m worst! I only asked for some Vicodin! I’ll break in half just to relieve this God forsakin Pain! Which i didn’t ask for! I’m 66, lost 9 years of my life!!! An new Doctor’s need a shrink!! Ya i thoughtful out find some pain meds! Several times!!!! But, scary world out there now!! So I go on, walk two aisles in store an Freaking Pain! Well don’t need a prescription for some Jack Daniels!!!!! But I don’t want to go that route!!! I check overseas for Vicodin, an never lived in a home that I can’t clean! Sick, I look I try I stop, I try! May I save just 1 pill????!

I am only 40 and have had to be in pain meds since my twenties.at 16 I was in a dirt bike accident which dislocated my right hip. The doctor punched it in so hard they rotated my hips. 9 years after and the birth of my son made my back hurt beyond belief. My back had to compensate for my hips being so out of place. I have had degenerative disc disease since my mid twenties. I need 3 fusions, have 4 herniated disc and fractured endplates. The pain clinic I went to put me on pain med and sent me to a surgeon. They surgeon says I was absolutely to young to be having fusions and surgery. He says to keep away from surgery as long as possible. 13 years at my doctors and he retired. I found a new Dr. That right away said I don’t just hand out pain meds and your on your way. I have told of other things to try. Which u had already done every kind of injections before. I said I’m not afraid to try anything. If it works that’s all that matters.he said he was going to slowly take me off my pain med and try things. Last week he let it slip that once he got me off my pain med, I was no longer going to be seen by him. I said excuse me! He said to me that they is nothing wrong with my back and he had patients with worse backs that aren’t on pain meds. I said yea and I bet you they are all old too aren’t they. I am only 40 years old and have a son to raise! He then told me that because if the new rules, there is no longer a long term plan for chronic pain. He told me to just take a bunch if ibuprofen and Tylenol!! He must not of looked at my file at all because I had bad ulcers from taking so much ibuprofen in the beginning of this. So because I am young and will need long term care, I am not aloud any kind of meds!! Because of my age I’m being told I have to suffer! To me that is nothing but discrimination!! Why should I be told I have to suffer only because old my age. So now at 40 years old, my life is over. I will not be able to function. He didn’t even look and see that besides my back and hips ( which I was told by the surgeon I will eventually have to have both hips replaced ) I have suffered from severe arthritis. I also have a inflamitory disease. The ass kicker too is that state drug rehab facilities do not have to go by the new rules. It’s ok if your a drug addict. You can get all the m ethadone toy want. I have 2 family members that were herion addicts and they… Read more »

Steve janeway

Had severe tooth pain. Dentist examined m e and determined that I needed a root canal. The first available appointment was two weeks away. He refused to give me any pain meds. In addition he made me feel like a street junkie for even asking for meds.

Every month I get threatened with losing what little meds I do get for chronic severe pain following 8 back surgeries to try and correct it. It is terrifying to say the least that I may have to go without. In that case, I fear street drugs or suicide will be my only 2 options. Please! Does anybody hear me?

Doctors don’t care about their patients, they just want to give them a pain pill and send them out the door. My pcp did this for 5 years then sent me to pain management, after going there for a year they try to tell me suboxone shows up in my drug screen which I had never taken in my life. The Dr goes ahead and gives me my meds with 2 refills and when I go back says suboxone shows up again and that there was not enough urine for the last test to be verified and I had already left before they discovered their was not enough but they could have called me to come back come in for another test. On this visit I was cut off until it was verified which was to take 7 to 10 days but I never heard anything back from them regarding my verification so I called and the nurse said the verification came back that sub was in my system. How this happened I do not know I think they screwed up the first time and had to fix there mess by getting rid of me..

I was on pain meds because of 17 surgerys starting with back and cervical fusion from age 32 and recovering now from fusion and pins and fusions in my hand i am a rare person that.does not Jones I thank the Lord for that! I would like to be out of pain! What do I do?

Jenny Picciotto

Dr. Joshi’s point that education and a framework for proactive pain management are missing is important. “Just say no” and negative-facing “solutions” to drug problems favor the stick over the carrot. We must educate doctors so they understand pain and pain management options. Doctors must take continuing education so they can keep up with this developing field. Research into plasticity of the brain is a recent development, yielding new treatment options and a better understanding of how pain affects the brain.

We are currently punishing legitimate patients (and physicians who treat pain patients) for the opioid crisis. Fines, delicensing, and refusing to provide critical care will not make the problem go away. We need to address the roots of the problem and take positive steps to eliminate the factors that lead people to seek out dangerous street drugs and factors that lead people to overdose on legitimate pain medications. This is a social crisis that will not disappear through law enforcement.

What are the reasons for this social crisis? Is it despair, financial inequality, lack of medical care, loss of hope? People who live in an environment where they feel safe, have financial security, and are intellectually and artistically stimulated have reasons to live productive lives. They are engaged and want to contribute to society, to give back. Why are people taking their lives and what can we do to help them thrive? The answer to that question is not to throw them in jail or take away medical care, leaving them to suffer debilitating pain.

Thank you for sharing this article, which helps us learn about therapies our doctors may not be aware of. We have to educate ourselves about emerging, alternative, and complimentary methods of reducing pain, managing stress, and staying as healthy as we can. Feeling disempowered can lead to feeling defeated, which perpetuates the crisis. There is rarely a silver bullet solution to managing chronic pain, which affects us physically, socially, and psychologically. Too often, doctors focus solely on the physical aspects of pain, ignoring the benefit of an integrated, holistic approach to pain management. We need take the lead in developing a treatment plan that treats all of the ways pain affects us.

The current crisis needs to be addressed on many levels. We need to educate our doctors about pain and advances in pain management. We need to investigate the causes of and find solutions to the social problems that have lead to the “opioid epidemic.” We need to educate ourselves as pain patients and take an active role in our own health care.

I hope that the national attention to this problem will lead to a productive conversation among all stakeholders, doctors, patients, pharmaceutical industry, drug abusers, DEA, and people at risk of being taken advantage of by illicit drug cartels. It won’t be easy, but it is necessary.

I was on opioid pain medicine for 5 years then my pcp had to refer me to a pain management clinic which I went to for a year. At my Sept appt I went thru the usual routine of lab work the Dr came in and told me suboxone showed up in my urine screen and he would send it off for verification he gave me my prescription with 2 refills. I never heard anything back from them regarding my urine screen so I go to my Dec appt and the same thing happened my urine screen tested positive for suboxone and I wouldn’t be able to get a refil until the verification came back, I asked her about the previous visit and she stated that there was not enough urine for a verification and I had already left before they discovered it. If this were correct why didn’t they call me to come back in instead they let me get pain medicine for 2 more months then on my Dec visit cut me off cold turkey until the verification came back she said it would take 7 to 10 days. A month went by and I still hadn’t heard anything from them so I called and the nurse said the further testing was positive for suboxone.. I have never taken suboxone so I don’t know how this happened. I believe they screwed up Sept by not calling me to come back in for a retest so they had to fix their mess and the only way they could do that was to kick me out.. I know ppl will say that I had to have taken suboxone if it showed up in my system but I swear I had not. I believe they do this to patients to get rid of them because of all the controversy about pain medication. I have not seeked another pain Dr because it’s just so much of a hassle, I’ve learned how to deal with my pain but it’s just not fair for the ones who live with chronic pain.. doctors need to listen to their patients and try to help them but we are just a number to them.

Siddha

What REALLY needs to happen immediately is the establishment of Chronic Pain as a TRUE medical condition!!!
Then second, we need to establish that Chronic Pain Patient suicides as a mark AGAINST ALL treating physicians of that patient!
As well as the choice to NOT treat that patient’s chronic pain.
Because I can assure you that if the pain, as well as the non-treatment of it leading to suicides, becomes a legitimate concern for the physicians then they would both care AND stand up & fight for both the patient and the medicine to treat them!
Yes there are other methods of treatment for the myriad forms and causes of pain…but no ONE method works alone! At least that’s what they tell us!
So why are we now seeing cowardice as such a strong & obvious personality trait with so many doctors?!

Shane Beals

I have severe disc degenerative disease herniated disc a fractured foot and I’m obese. I’m in constant pain. And I cannot get the pain management I need so that I can work through it to lose 150 lb so that I wouldn’t need the medication I’m on now. Because doctors are afraid of the dose. Therefore I have to suffer even though I begged the doctors with them monitoring my progress if I try to work through the pain to lose the weight. But they won’t do it because they’re afraid of the government. Therefore I have to suffer and it’s wrong.

All we can do is pray for each other, my intractable pain has taken over my life again this year. My one oxycontin pill was taken away in January and by March my PM doctor presented me as a new patient, step fail first, or what ever it was called. We already did this 14 years ago, already implanted the neuro-stimulator 10 years ago but we must prove again that the Opiate is needed. PM keeps me under the CDC LIMIT of milligrams so the DEA doesn’t shut him down. He gives me 27mg. Extampza and recently added 50 mg nucynta to control breakthrough spats. I guess the medical marijuana is what my PM wants me to use instead of opiates, so that’s my next try. I can’t see it working. I just want to be pain free with no strings, 1 oxycontin compared to all of this, give me my pill back so I can continue on with my Petty little injured spinal cord. Life is hard as hell, as it is, for me, now let’s see if I can take some more suffering, all to save a few heroin addicts from killing them selves. I’m not interested in killing myself, I’m 57 years old and not ready to die, just to live pain free please.

Martie Staten

I have DDD, neuropathy Psoriatic arthritis, fibromyalgia and as a chronic pain suffer and someone who does not abuse the medications, I would suffer a great deal and wish not to be punished by those whom abuse them, please…😓

Patricia C Seawright

I have chronic and debilitating pain from an on the job injury from January 2007. And this Witch Hunt that has been going on due to all these celebrities overdosing is shameful!! Most normal people that have pain like I do don’t take pain medication to get high!! They take it to relieve the pain! If celebrities want drugs, they have the money and connections to get them. Their overdosing should be looked at in an entirely different view. We, the people in the U. S. that live with chronic pain on a daily basis, should not be lumped together with the rich and famous that take the opiates just to get high. We take them because without pain medication, we cannot live any kind of a normal life!!