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

There are 116 comments for this article
  1. Robert Ivan at 5:49 pm

    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.

  2. Robert Ivan at 5:35 pm

    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.

  3. Alessio Ventura at 6:44 am

    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.

  4. Eric Johnson at 6:50 am

    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

  5. Teresa Sorrell at 1:24 pm

    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.

  6. Laurie Jackson-Bowman at 5:07 pm

    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.

  7. Larry again at 10:02 am

    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.

  8. Larry at 9:18 am

    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.

  9. Cynthia at 6:29 pm

    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.

  10. Holly at 9:37 am

    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?

  11. Jim Bob at 10:32 am

    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 in my journey to find relief, I sit here in pain and thank my lucky stars that I no longer use opioids to control my pain. It’s not like I wouldn’t take them if they were available, I don’t believe they worked for the type of pain that has disabled me! So, in my damaged brain from so called opioid use, I still have no voice.
    I honestly believe I have become what has now become a familiar word in our society, “narcissistic”! How dare me to go into my doctor’s office and know that I am way more educated on my disorder then he ever will be! It terribly upsets me that with 30 plus years of healthcare, and the doctors or medical professionals discount your education or what you may have to say! I can tell you from experience how quickly you fade away and become just another statistic and all the time energy and money spent on education are for not.
    I do believe the fourth leading cause of death in the US just happens to be, properly prescribed properly taken pharmaceutical medication. If we took a 747 and flew into the side of Pikes Peak on a daily basis killing everyone. Please tell me why we never hear about this?
    Today I’m opioid free. Cannabis does help some. The pain never goes away completely. Now, I’m a broken Grandpa with 3 grandkids who will never know who I was. How sad! With the holidays coming, I will be spending my first Christmas alone in 63 Years.
    I really would like to write a book someday. I’m not really sure how to go about it without using copious amounts of profanity to get my point across. I do believe the people in pain need a voice that can scream from the tops of Capitol Hill and get some of these gray-haired old Good Ole Boys to get off their ass and do something! Unfortunately, I don’t believe that day will ever come! Because once you take that first opioid, you lose your voice. I feel your pain people! I wish I had the answers for you! Today, I do not have the answers for you or me. If I knew if my brain was ever going to recover from opioid use, I would be interested in becoming involved in this crisis in America! Thank you

  12. Eric Johnson at 9:41 am

    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.

  13. Buffy Byrd at 3:29 pm

    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! 🌞

  14. Virginia at 1:07 pm

    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.

  15. Kelly Tanner at 12:51 pm

    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…..

  16. Buddy Hastings at 12:12 pm


  17. S at 9:53 am

    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.

  18. Ken Kephart at 9:34 am

    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.

  19. Lisa H at 8:47 am

    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!

  20. Heidi hyatt at 8:44 am

    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!

  21. Buddy Hastings at 7:36 am

    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.

  22. Amy Pollock at 6:00 am

    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.

  23. Pedro Lopez at 10:28 pm

    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.

  24. janice at 10:25 pm

    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.

  25. Ibin at 10:00 pm

    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.

  26. Kourtney Daubenspeck at 10:00 pm

    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

  27. Debbie Flippin at 9:58 pm

    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.

  28. Lori Townsend RN-C retired at 9:49 pm

    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 of some type of campaign or help compose a bill of rights for chronic pain sufferers. What say you all? Any help out there?

  29. andy lee smith at 9:47 pm

    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

  30. Mary Kujawa at 9:45 pm

    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!!!

  31. Patricia Howard at 9:25 pm

    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????!

  32. Michele Walck at 9:16 pm

    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 have been on 200mg of methadone for over 20 years!!! Yes 20 frikin years!! They are the ones who should have these rules not pain clinics! Drug addicts are supposed to be weaned off of methadone but they don’t do that because the state makes money from it. Also they don’t get kicked out if they fail a drug test!! If they fail a drug test, they are still given their methadone they just have to come in everyday instead of being able to take a couple days home!! So they can do all the drugs in the world and they aren’t kicked out or taken off of anything. How is this fair to chronic pain patients?? They are druggies and it’s ok for them to be on pain meds for a long time but now chronic pain patients are being denied anything!! This is just truely screwed up!! I am not going to stop fighting. I will be writing to all of the government officials and anybody who will listen. Chronic pain patients are now being treated worse then a drug addict that BROKE THE LAW by doing illegal drugs!! I have never broke the law or did illegal drugs so why am I being treated worse. I’m just sick of this government thinking they can control everything. This is not a communist country but it seems to be slowly turning into it.

  33. Steve janeway at 8:47 pm

    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.

  34. Kelly Tanner at 8:31 pm

    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?

  35. Karen Michelle at 8:28 pm

    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..

  36. Barbara Lawson at 8:23 pm

    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?

  37. Jenny Picciotto at 8:17 pm

    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.

  38. Karen Michelle at 8:10 pm

    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.

  39. Siddha at 7:46 pm

    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?!

  40. Shane Beals at 7:31 pm

    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.

  41. Rita KIMBEL at 7:28 pm

    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.

  42. Martie Staten at 7:17 pm

    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…😓

  43. Patricia C Seawright at 7:13 pm

    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!!

  44. Mike Iapicca at 6:56 pm

    I just got discharged from pm I also have hepc so my liver isn’t functioning properly it’s not breaking dwn meds all the way so my pm dr sez my urine results came back false as if I was faking it I have 5 FIVE DEGENERATED DISKS N A TORN ROTATOR CUFF IM IN CONSTANT PAIN BEEN ON MEDS FOR FOURS YEARS CUZ OF MY LIVER I CANT HAVE SURGERY YET SO I WAS GIVEN MY LAST SCRIPT I ALSO PAY CASH MY INSURANCE DOESNT COVER IT SO I HAVE A MONTH TO FIND A NEW PM DR THAT MEANS I HAVE TO SPEND 250 for office visit if they accept cash if so I then have to hope I get my 120/month of pills, it took me nine months to find this dr, they don’t understand they just wash thier hands while I’m in a state of panic going to drs twice a week n worrying bout withdrawals sumthin has to change then there’s a 150$ urine chrge n they [edit] that up as well!!!!! I’m lost in pain n goîn through withdrawal cuz I’m cuttin my dose from four a day to one so I can make them last till I find a new pm, once they decide to cut you off they’re so cold as if they NVR met you before suicide is better than playing the frigin game they play, is what it is to them I was hit by a bus I’d like to put them in my position for6 months n cut em off n see how/what they would do I’m sure they’d beg n be as dumbfounded as I SO not fair in the beginning they’re so nice, I’m here to help ease your pain wen the lab [edit] up, cuz they do trust me you can swear up n down I had one lab tell me I had morphine n oxy in my system I told em retest me nope they’re like god to pm I’m just tired of playing thier frigin game it seems no matter what eventually I always lose. Like now cuz of my liver I’m fighting two battles so far I’m 0-1-4 PAIN IS NO JOKE WEN YOU CANT SHOWER CUZ YOU NEED HELP OR CANT GET OUTTA BED WITHOUT A PILL
    If I had money like a star or CEO of corp. I’m sure I’d have np getting my medication
    I’m sick n disgraced at the hipocratic oath fitting name for what they swear to [edit] HIPOCRATES!!!!!

  45. Paula Howerton at 6:54 pm

    I have been under pain management for over five years due to chronic pain. I have undergone 5 sympathetic nerve blocks, two popliteal nerve blocks, two bier blocks, insertion of spinal stimulator, been prescribed every type of medicine both oral and topical. In the last three years, I have had to change doctors three times because my pain doctors quit due to the increasing regulations. The pain meds I use are the only thing that allows me to function to some degree. If I can’t get my meds, I wouldn’t be able to have any semblance of a life.

  46. John at 6:27 pm

    I have herniated disc at c6-7 herniated disc at t12 I have had a duaion at l4-5 and l5-s1 I have chronic pain due to narrowing of the spine due to scar tissue been removed came back 3x worse according to my pain management doctor so he treats me but he is even getting spooked we are in real trouble when they take all the meds away from ppl like us who just want to live as normal as we can you only live once why they messing with us here is what I said. Should be done if it comes down to it which it should never but if so let the DEA sit in doctor office go through x-rays MRIs CT scans records see the kind of problems we have then ask would you want a loved one to live with the pain you already know the answer any if they want have a dea hold the script till you take a urine test he can stand and watch if you have nothing to hide you won’t care once it’s done they hand the script over and away you go I would even sign a contract if I die or get other problem from the meds I won’t hold anyone responsible but me I don’t know what it’s going to take but someone this is still America I think anyhow if you get down to the nuts and bolts here it is in a nutshell it was reported less than 1percent or people who are prescribed these opioid medicines over dose but maybe that is their intentions I don’t know but habitual street drug users I e heroin users cocaine users acholics ect account for the most deaths how about how many soldiers come home can’t cope for one reason or another kill themselves because pain is to much to live with that is the hero’s if our country the defenders of our freedom fall through the cracks my brother almost did but I don’t know exact percentage if each death toll but I know this of course it’s easy to put the blame where it looks the best ok I am done
    THere HAs to be some kind of compromise or things are gonna get bad all I ask is people please please remember we are human to just live a harder life then the average Joe without the pain meds there will be so many suicides how will they handle things then I can’t see living without meds it would be cruel and he’ll if a lot of torture and you can handle somuch everyone has their breaking point please don’t push us to that limit

  47. Cyn at 5:41 pm

    My pain medication has been cut in half. I feel terrible for those who have been cut off completely.

    I’m sorry for myself that I can’t get a dose of medication to help me live through just through the day.

    Someone. No, many doctors need to stand up and speak their minds. They have too or all of us will die by our own hand. I don’t want too but I can’t wait to find out in a year or more the great break through.

    Help us.

  48. Kenneth Frank De Cesare at 5:41 pm

    Man this is a total debacle the magnitude of dignified chronic pain patients designed adequate pain control is growing and medical attitude is oh just another day with the DEA ruining lives and frightening American doctors and patients down the rat hole. Where they now can work all 4 angles of totalitarianism.

  49. Eric Johnson at 5:30 pm

    another Dr dropped my case cos he’s done “all he can” so I had no meds methadone list 35 pounds, immune system weakened,”: got flu, wound up in hospital then nursing,g home- — lost ability to walk- -ALL BECAUSE I AM DENIED THE 90MGS METHADONE that keeps me alive- – I HAVE TRAUMATIC BRACHIAL PLEXUS AVULSIONS from c-5 to c-8 with AVULSIONS to t-12–Spinal cord “cauterized”at John’s Hopkins 120 lesions burned. help, . I made it to TOILET today- -(had extra methadone – I save some back so I cab eat couple times a week, and have a bmp every 10 days or so) MY LIFE SUCKS

  50. Melissa at 5:13 pm

    I am 38 years old .i have been on my current pain meds for 20 years .i can not function with out them .i cant walk with out them .i have been put through every hoop just to keep them and now they have cut me back so much thats the pain is unbearable .this is not fare to us chronic pain suffers at all. I have always took my meds the way i am suppose to .never been to jail for nothing .passed every pea test i was giving .every pill count but there still taking them away .i have ra bad gout and 3 herniated disc in my lower back .i have endometriosis which is very painful .i also have a blood clot disorder and i have had a major heart surgery and heart attack at the age of 35 ..thank u to dr like you who trys to help .but truth is no one is going to listen .no one cares about us .they say we are junkie s … Truth be told its the st drugs that are killing people not pain meds

  51. Larry at 4:51 pm

    I have MS with lesion’s on my brain and spinal cord and I face pain every day and most of the day. Sometimes it wakes me up at night. So if anyone takes my meds. away I’m SOL.

  52. Leslie K Annonio at 4:42 pm

    We are going to a funeral Sunday. Our friend had chronic pain due to surgeries resulting from a tractor trailer accident years ago. For a while he was on narcotic painkillers and after he could no longer get them he turned to heroin for pain relief. He overdosed last week and we are heartbroken; this happens so many times and I do not know what the answer is but somebody needs to address it.
    He leaves behind a wife and four children who adored him.

  53. Laura at 4:32 pm

    My life is over. Pain rules. I am isolated and alone in my bed. I just moved I have no friends. I feel I did something wrong. I was physically abused by my father and other men in my life that has desrltroyed my spine and lots of otblher issues. I feel like I am being abused by the health system. I am alone in this. I have been crying for three days straight now. I have been thrown off a cliff by the medical community. The medical community better smarten up before they have suicides not from iPods from the lack of them and unrelenting viscious pain.t

  54. Roxanne Kitchens Davis at 4:18 pm

    I hope things DON’T get that BAD where I am,it’s bad enough when U have to go from pharmacy to pharmacy for my meds because they don’t have them at my regular pharmacy even though I come
    In there EVERY month on the same day.I miss the days when I could call my pharmacy a week before to remind them. It really helped.I totally understand why people turn to herion.Not for me but SUCIDE HAS CROSSED MY MIND A FEW TIMES,BECAUSE THE PAIN GETS SO UNBEARABLE AT TIMES ALL I DO AS CRY AND WONDER HOW I CAN MAKE MY PAIN BEARABLE.

  55. F.S.T. at 4:09 pm

    Comment duly noted, Bunny Wynne. Though I don’t curse, today’s idiotic, insane rush to pull chronic pain patients’ pain relief makes me want to. I am hurting, she is hurting, like hundreds of thousands of us chronic pain patients are also. No one cares. If they did, this wouldn’t be happening. My meds are being titrated DOWN, what nonsense is that, when pain and years suffered are going UP. Are doctor’s really nincompoops, and just now being exposed for who they are? This ridiculous War on Pain Relief tells me they are.

  56. Jim Bob at 3:34 pm

    Greetings, I have been a chronic pain patient for the last 10 years. Opioids are now out of my life for almost 18 months. I have 30 plus years in the medical profession. The day I took the first opioid, I had no voice in my health care. How sad, that we as chronic pain patient due to the negligence of another who we put our trust in and now we have to deal with the unrelenting pain without appropriate means of managing the pain. Yes, I’m proud to be off the [edit] Oxycontin and would be happy to testify against Merck Pharmaceuticals at any time! I have been off the medications as indicated above, my question is what the hell have the drugs done to my brain! There are no studies of post oxy use! What the hell is going on Merck!? And as far as your claim that these medications last 12 hours you can shove a couple up your [edit] cuz I guarantee you it’s 4 to 6 if you’re lucky!! How these people get away with this type of marketing I will never understand! Am I angry the opioids? Hell no, they help it times. Fortunately, I became such a pain in the ass that I finally found someone that to believe me that something was going on in my back. The surgeon that I chose, scheduled 40 minutes for the procedure. I was told it would be 20 minutes 40 minutes tops to remove a small cyst to give me room before my stenosis. Six and a half hours later when I woke up, I was told they did a 4 level laminectomy along 3 hours of scraping dead tissue from the infection that occurred from the first surgery. This is what I had complained of for 5 years! When you take an MRI and you’re always laying down stuff doesn’t show up!! I have lobbied if you will for a functional MRI in my city for years and it’s still not here! Due to damage caused by my first surgery I now suffer from debilitating chronic neuropathy bilaterally. My life has become one of the types of Life I never dreamed I would be living on this day! The people who are unfortunately being denied these life-saving drugs at times are being abused and tortured by our so-called government! Are freaking medical society and the insurance industry need to get there fist out of their [edit] and do something to help all of us the deal with this disease on a daily basis 24/7!! I seriously doubt your publish this I hope you do! I want to write a book if you like what I have to say let me know because I have a lot to say!! Thank you have a great day

  57. Tim Mason at 3:14 pm

    If you remember “hand written” prescriptions from a pad that was always kept in the exam room raise your hand. (at least you know how old I am)
    This is where it all began. “thieves would still the pad and write their own prescriptions”
    We have moved way past that now with electronic scrips and even the paper used to print them is counted out, even in hospitals.
    Denying medicine is not far removed from denying health care for “pre-existing conditions” or the AMA allowing “Cherry Pick and Lemon Drop” with preferred providers. (AMA Annual Meeting 2016-March) Not unethical to deny services if sufficient revenue can be obtained by the provider-even if he/she/it is in a network. Obama Care workaround PEC.
    Fast forward two years-Now even veteran patients of long histories of chronic pain and well documented imaging and sound diagnosis’ of organic pain causing conditions are being left to curl up in the corner or die in bed at home.
    Medical Empathy and Compassion now have a price tag. Doctors that provide such empathy are now called criminals

    It would be nice for law enforcement, government legislators, and all CDC, FDA personnel to understand WHAT WE are dealing with-You can never truly understand it until you live it. I would like to see them make an effort.
    Daily pain is a frightening experience. We are treated like the neglected pet, a Dog, left outside in the winter while the bureaucrats set by the fireplace sipping brandy and smoking fine cigars. Resting from a days work of crucifying the sick and elderly. Shame on them.

  58. Sharon Herman at 3:13 pm

    Kelli I have also thought of the civil rights route. Need to fight back. Not too computer saavy
    but if you can contact me thru this link I would like to talk.

  59. Sharon Herman at 3:09 pm

    I have rheumatoid arthritis and am still suffering. I used many different types of pain management over the years some helped some didn’t. However my condition will not improve as I age. When I was ready to increase to a longer acting form I was refused and now Go between rheumatologist, pain doctor and orthopaedic. It’s a nightmare. I even requested an appt with my senator on how to fight back. How many people who needed these to just wash clothes or take care of their families are just ignored now. It’s always the people who abuse who ruin for real people in pain. Is there a way to organize and fight back you let me know and I am in.

  60. FED UP at 2:53 pm

    It SICKENS me to NO end that people who have been diagnosed with chronic pain, and has tried every option, besides being cut open, only for a 50/50 chance that it will help, can’t get relief from their Drs all because of the opioid epidemic. If a drug addict wants drugs, their going to find them, with or without a Dr giving them a script….let’s be real here. But, for those of us who suffers in silence day after day after day, because Drs are just being completely judgemental, because of a tattoo for instance, or for just a so called VIBE, it’s very sad, and so very unprofessional. Use your training, you went to school for years, so it’s up to you to help your patients, help them have quality life, whether it be with surgery, meds, injections, therapy….but please don’t judge a book buy the cover!!!!! Do your job, help people.1

  61. Butch at 2:52 pm

    The government is turning good people to the streets, to try and find relief, they are hurting a lot of good people. .
    God help us…

  62. Andrea Breau at 2:40 pm

    I agree with Kelli , it certainly is a violation of our rights.. there are legislation groups on Facebook , you can join , that addresses that exact subject. I myself think the public should be educated more. It’s like a dirty secret being swept under the rug. People just love to judge subjects , or people ; when they know next to nothing about it.True Chronics can not become addicts ; but try and explain that to them . It’s ignorance that’s the issue here. What did those idiots in politics think would happen when they stopped the access to the ones that do have addictive behaviors ?!.. Then torture the ones that never did anything wrong ??.. They should educate doctors , and patients of every alternative form of treatment also , before opioid treatment is introduced ; because as we all know , it’s a lifelong desicion, not to be taken lightly. I tried a new treatment recently called Structured energy; and not that it will get me to stop medications , but it’s certainly helping ; maybe it help someone that isn’t Chronic yet. I for one , have never stopped looking for other alternative treatment ; because I knew someday this would happen. The Bad apples would mess it up ; because they always do. I suggest to the ones talking suicide.. try finding out from Doctors , pharmacist, patients , whoever , what laws are stopping you first , before giving up , because it may be something like here in Florida , where you need to designate one pharmacy within 5 miles of your Doctor… they do not like giving that info out , but if you have ” never ” done anything wrong , it should not be a secret either..If you did do something wrong before the nightmare started , than God bless you , and good luck ; because the DEA has formed an entire profile around you…and you are just #₩¥£

  63. Hollie at 2:24 pm

    I’ve had chronic pain for 20+ yrs. 7 yrs ago I was placed on a pain medicine that FINALLY helps my pain. I’ve been on the same drug, same dosage for 7 yrs and surprisingly the doctor asked me to try to decrease my daily amt. I thought, why?! This medicine has given me back my life. I can FINALLY sleep. I no longer miss work. No longer cry, saying I hurt all of the time. For a while I thought my husband is going to divorce me. I couldn’t have sex without horrible pain. Now that people are abusing pain meds, dying from pain meds and it has become a public problem my doctor wants to decrease my daily amt. I’m guessing this is a start to what is about to come. I hate that people living with chronic pain have to experience this but pain is looked upon negatively. I hate telling others that I even take pain meds but unfortunately I do. I pray I don’t go through horrible withdraws like so many do but unfortunately the day will one day be here. Hopefully later rather than sooner.

  64. Debbie at 2:19 pm

    It’s a terrible situation. If we live in the greatest nation in the world why is this happening?

  65. Virgil Phillips at 2:09 pm

    I’m peed of been on pm for 20y no problems now cut off never been to streets until now bought my first pills today I feel guilty but outta pain is this my future

  66. Mark Schmidt at 1:58 pm

    I have a severe nerve disorder called Small Fiber Neuropathy. It is considered a disease that is the highest pain level that a human has to endure!
    I live with the disease every day and I am told that if they don’t find a cause, I could be in for the fight of my life! I already am!
    I am not an addict in any way as I only take 2to 3 hydrocodone a day..My doctor thinks I should be on more than that.
    I should not be in a position to have to worry about the future of my pain meds when I have a legitimate physical problem! Pain meds in the wrong hands is bad, we know that….but for those of us who live in enormous pain 24/7 it is a little bit of relief in an otherwise dismal life!
    I will continue to fight this horrible disease until I can fight no more!! The meds help to even the playing field! Without them my disease can push you over the edge!
    People who are healthy REALLY don’t understand what someone like me goes thru just to get thru the day! If they did understand they would never complain about pain meds for even a single day ever again!

  67. Kimberly at 1:54 pm

    I’ve read both articles and I am a bit confused if Dr. Joshi is for pain medication for chronic suffers or against it? I have been suffering chronic debilitating pain for over 20 yrs now from multiple conditions… I consider myself blessed and thankful that I have a Dr who seems to understand my pain and has helped me physically and mentally to deal with this excruciating pain with medication and physical therapy. I don’t know how I could function without my pain medication it’s the only thing that’s given me any relief and allowed me to be able to have any quality of life…It scares me to think that I could possibly lose this because of people who choose to misuse these drugs …There are lots of us who don’t abuse medication and it works and it gives us some quality of life….I hope that these bad apples, so to speak, don’t turn over the whole apple cart for us who need these medications and know how to be responsible with them.

  68. Renee E Mace at 1:47 pm

    My NP has had to lower my pain medications so low that my type 2 Diabetes will come back and my pain is so bad, that I stay in bed all day and cry most of it. How cruel it is to know that here are drugs that can ease our pain as to not suffer, but to have them lowered so low or even worse, taken away. I just got back from a very long doctor’s appointment, I wanted to see a pain doctor to see what other treatments he could offer me with my pain medications so low. After 2 and 1/2 hours, I was told nothing he could do for me other than lower my medications even lower. He does all kinds of new treatments but as long as I take any pain medications, NO HELP!

  69. Bryan at 1:45 pm

    Our lives are being irreparably harmed by legislators. These lawmakers for the most part have no medical training or background in the medical community, yet they are trying to over control our pain meds and eventually take them away. I know I speak for so many like myself that deal with chronic, irretractable pain on a daily basis. When they finally take away the very medications that make my life bearable, I will be forced to go to the streets, or just not go on at all.

  70. Queenie at 1:23 pm

    It’s turning more people to street drugs and heroin is the worse, but the government owns all of that so they don’t care.

  71. Cindy at 1:21 pm

    I had a wonderful doctor who worked with me and knew me well. I had to move to another state and now I can not get a doctor to even take me on because I take meloxicam for pain in my legs. I refuse to take any controlled drugs because of the stupid paperwork envolved and my work will not allow me to call around and run to a doctor for a script, thus I refuse to take a controlled drug, but for heaven sake, I can’t get a doctor because of meloxicam? Really? It’s not a great pain relief but it works the best for me with a hassel but now no one wants to take me on when they hear I am on meloxicam and I get that stupid same speech from every office, “I have to let you know, if we decide to take you on as a patient, our office does not treat pain management….blah blah blah……
    It’s always the few who abuse stuff that makes it harder for those who really need the help and don’t abuse the system. So what can we do about this???????

  72. Fedup at 1:18 pm

    Sounds like Dr.Joshi is just a closet opioid basher,using the word dangerous to describe opioid medication? Highly recommending procedures for pain that even a novice of the situation knows insurance companies will not pay for! I can hear the ppl at Blue Cross laughing now.If they did pay for crazy therapy and the patients got no relief,and in the end opioids relived their pain isn’t that called step therapy?a strategy used by insurance companies to save money? A car is dangerous.My meds are not dangerous! NOT WHEN USED AS DIRECTED!

  73. Lisa Melasecca at 1:16 pm

    My daughter had an aortic dissection and a stroke 10 years ago which left her paralyzed and is in constant pain her pain Dr. Closed his office a month ago he would not prescribe any meds to hold her over till I found a new Dr. I can not find a new Dr. That will prescribe the meds that she is on I control her drugs and she is not an addict something has to be done to help people like her she begs me everyday now to take her out of her misery it is heart breaking

  74. Eileen at 1:13 pm

    Josh I, Tx the Good Lord 4 the very few DRS as of you, who see the truth opposed to $ signs! I can’t Tx u enough 4 speaking yur truth. Both CPP & addicts need help but on 2 seperate podiems! 💜

  75. Nancy at 1:08 pm

    My husband had a accident when he was 14 years old. His leg was cut off by a bush hog and was reattached in 1971 with experimental surgery at that time and he is having a hard time with Drs not wanting to prescribe any medication. You can see his injury and he is still having trouble with the Drs.

  76. Brittne at 1:03 pm

    My husband is dealing with his doctors saying he is almost 37 and should not have this pain. Well guess what he does and it’s written all over his MRIs. He has been withdrawing from all of his medications at one time with no help from anyone. No wonder most people turn to heroine, I would. It’s sad when a pain specialist comes into the office and is more concerned with clearly stating that he is not a pill Mill and no one this age should have pain. Pathetic they don’t require classes to show empathy for a patient who suffers from chroic pain and their families and what they have to endure on an everyday basis.

  77. Clifford Campbell at 12:48 pm

    I have been under the care of a wonderful pain management Dr. for over the last 15yrs. I have tried everything from trying to deal with the pain that draws me up into a fetal position to spinal shots or blockers that just don’t work. My MRI shows anyone that I’m screwed together with 7 plates, 8 screws and 2 rods. Yes 7 plates as I have 3 each side of my spine and the 7th lateral because after so-called spinal fusion my L5 lumbar crumbled into pieces. I have to take electro nerve induction tests at least 2 times per year for the DEA rules and fail every time. I was taking 1 80mg oxycontin in the am followed up with 4 more percocet 10’s per day, which was working fine for me but insurance decided not to cover the 80mg any longer so now just for instance purposes I have to take 8 percocet 10’s daily. It does the job for now but every day I keep waiting for BS politics to reduce or eliminate all together what I’m taking now. The government should get out of the doctor’s office and learn that all of us aren’t junkies. I’m disabled and a full-time father of 3 grate kids just trying my best to teach and covet them into adulthood, this is my only wish then I’m ok with whatever future I may have. People need to realize that there are real people out here like me that don’t choose drugs but NEED them. I love life and my children as everything else has been taken from me but with the help of my pain management Dr I’m able to deal. Should anyone who reads this think there is a better solution, I have tried them all. To my fellow pain sufferers I wish you luck and an afterlife free from chronic pain. Clifford Campbell

  78. Dr. Darryl George at 12:37 pm

    Multiple “pain specialists” across the state of Oregon have been investigated and disciplined for inept and incompetent pain management of their patients; some have lost their licenses. Some were specialists and board-certified in other fields, but quit to provide pain management services because it became the lucrative field, especially by setting up in-office labs to do urine drug testing. Some have faced insurance and Medicare fraud investigations for their billing practices; many others should but fraud is of little concern to some insurance companies due to the billions they already rake in from patients and then deny them appropriate care, all for the sake of keeping their financial bottom line positive and paying big dividends to their stockholders. It’s time to get glaring financial profits out of health care services and the insurance industry. CEO’s who make tens of millions of dollars to sit on their asses and make a few decisions at the office and then run off to lunch at the country club and then play gold, racquetball, etc. before jetting off to their yachts and four-day weekends in the country. I review records from all across Oregon and have seen providers who fail to do pill counts, review state prescription monitoring websites, perform ANY urine drug testing, get records or imaging to confirm diagnoses, etc. The Oregon Medical Board often fails to hold them accountable for breaches in standards of care because of personal connections. If you become an “enemy” or “disfavored” physician to the medical board, you become a target and they will “take you out.” Administrative law gives them the power of the Gestapo. You are “guilty, until they decide you’re innocent.” Even if you appeal a guilty finding to an impartial administrative law judge (ALJ) who rules in the physician’s favor, the medical board refuses to accept the appeal verdict and still revokes your license. The governor of Oregon is in collusion with the Executive Director of the Oregon Medical Board by refusing to follow state law: The chair of the medical board has been serving illegally since his term officially ended on 2-28-17. State law says he can only serve two terms at the pleasure of the governor. It does not allow him to stay beyond that despite the desire of the governor or the board director because they choose to use him and the board as a tool to destroy the lives of physicians actually choosing to help chronic pain patients. While their physician friends make the same mistakes or even worse, they are protected from disciplinary action. The “who-you-know-buddy system” at its’ finest. The medical board refuses to address fraud as an ethical issue in professional medical practice. They know it’s going on and fail to investigate. I once asked a board member, “If I know of medical fraud, would the board want to know about it?” His response was, “It would be better for you NOT to report it.” Almost a threat?

  79. Angela Harvey at 12:35 pm

    I have lost pain management because the place I was out dumped all their Medicaid patients a year ago. I still have no luck and have to get by on a tiny amount that my Pcp gives me. I have been I’ll for almost 20 years and this so called opioid crisis is turning into a suicide crisis by legit patients who can’t go on with the pain. I can no longer walk and need back surgery on top of my other health problems. I can not find any one to do pain management so I can have surgery. I know many others in severe pain reaching the end of their ropes. Something has to be done. We are human beings and should not have to suffer this way.

  80. Judie T Plumley at 12:27 pm

    I am a chronic pain patient after a hospital gave me MRSA in my spine and destroyed my back. Two years ago, due to the regulations surrounding narcotics and pain clinics I had no choice but to come off my meds. No insurance, no pain meds. That is when I found kratom.
    It does make me sad that I will never get the help I need. It makes me sad people die everyday due to pain, sometimes caused by the Medical profession, and our government doesn’t care.
    I will never go back to a hospital, no matter what happens to me, for fear of them hurting me and leaving me to suffer in agony. I know what agony is. I would rather die than what I went through with that infection, and I feel totally betrayed by the way I was treated because I had the audacity to be in pain.
    Nope, never again.

  81. Michael G Langley, MD at 12:21 pm

    Funny thing, the two year course that I took for a certificate in pain studies, and my fellowship with the American Academy of Pain Management (the first one) were both determined “invalid” by the “medical community” (the competition). More education, in my case, just proved to be my downfall. Don’t get educated more than your fellow physicians. They either don’t understand what you might be doing as a physician. They seem to be afraid when they are saying, “You act like you are smarter than us”. I find it discouraging that my education caused a form of discrimination. My education included a minor in Neuroanatomy and endocrinology in graduate school. It gave me a more rounded education that just might have appeared to make me appear “smarter”! Add to that the majors in anatomy and zoology left me with a great education to draw upon. Sadly, it caused me trouble!

  82. Rosalie Matthews at 12:09 pm

    I am a 54 year old disabled (13 years now) RN who has been on pain management since my disability. I have had 3 cervical unsuccessful fusions, with a metal plate and 6 screw fixtures. My lumbar spine is so screwed up, surgery isn’t even an option. I have DDD, (degenerative disc disease) and more recently diagnosed with osteoporosis in the lower part of my spine and both hips.
    I have had physical therapy, steroid injections, and nerves burned to attempt to manage my pain. I’ve tried everything that was suggested by my pain management doctors.
    In September, my pain management doctor states, “The CDC is coming down hard on doctors writing opiode prescriptions so I have to wean you down to under 100 mg of opiates daily. “ At this time I was taking 270 mg total of long/ short acting Morphine, Fentynel 50 mcg patch. So, he takes away the Fentynel patch, and cuts the Morphine dose in half! And he says, “Next month we’ll try to cut back again.” Of course I was devastated and went through withdrawals, but I thought he had to do that to stay out of ‘trouble’, so I didn’t question him.
    In October, I was scheduled for a meniscus tear repair on my left knee. The surgeon stated I was under contract with pain management so he could not write pain medicine for after surgery. But he recommended my pain management doctor write a prescription for double the current pain medicine I was currently taking for a period of 1 week post-op. My pain management doctor refused!!! He said I was taking enough pain medicine to get by after surgery. Okay, now I’m pissed-off! The amount of pain medicine I take daily isn’t enough to manage my daily pain anymore and now I’m supposed to have knee surgery with NO additional pain medicine? That just seemed barbaric to me! Surgery is a whole other level of pain, not to mention it’s KNEE surgery!
    I agree that the government needs to stay OUT of the doctors office. People are not even being treated ‘humane’ anymore! A dog even gets pain medicine after surgery!!!
    And for anyone who wants to question this, I will provide Dr’s names, phone numbers and addresses! Because I know just how unbelievable this sounds!
    I did go through with the knee surgery without any other pain medicine. I did live through it and the surgery was a success. However, it forever changes the way I think and feel about our government and doctors. And I have requested that my pain medicine be cut down until I wean myself completely off opiates. I may not be able to walk and do the things I could before, but I’ll be Damned if I rely on a prescription to keep me from going through withdrawals again! And be treated like some street junky! This has been a very emotion and hurtful experience.
    I only hope that this situation gets fixed before there is more suicide from people who suffer in pain! I have never abused drugs or my pain prescriptions but I sure as hell feel that I am.
    December 15, 2017

  83. Malynda at 12:04 pm

    What happened to the DNA testing that was approved by the FDA back in 2013 ?
    This test was to be able to match up the individuals DNA to match up the medication that is specifically for that individual. From a cold to cancer, it’s exactly what people need especially now. It would solve the problem, so we are not going through trial and error. Medicade insurance excepts this plan, so why aren’t the professional’s doing this.? It would solve the problem of self medicating and over dosing, or going to street drugs like heroin.
    This would make people to be more responsible and stable, and people wouldn’t have to worry about if it’s going to work or not. The doctor’s wouldn’t be on guard and hopefully wouldn’t treat everyone who needs opiates to handle certain pain, like a junkie when they walk in the door. Innocent people are turning to heroin and other drugs to self medicate and are over dosing because the doctor’s won’t give them the right medication or it’s not strong enough, or not the medication that doesn’t work with the chemistry to fit their DNA . What do we need to know and do. Too many people are dying and committing suicide because they are not getting the appropriate medications for their ailments.

  84. David Charles Dax at 11:47 am

    I had to quit (retire)my job with 7 years to go. Worked the last 8 years because of pain meds. Now since politicians think they are doctors too I had to take a steep pay cut. Hope they nor their family members are stricken with pain every day and night knowing we have the meds to help them.

  85. Susie Nickoli at 11:36 am

    Thank you! For the comments.. I’ve been living with some sort of pain since age 8. I can’t seem to find anyone that will hear my cries.

  86. Tonya West at 11:31 am

    The pain diaries,records, files etc.. that were documented by specialty doctors obviously have not been looked at. Now I have been tossed around since my primary care physician retired two years ago. With the pain I suffer from causes my independence to deteriorate. Walking is next to impossible and bottom line is they just don’t care! My doctor knew I needed help. I don’t enjoy the health problems, I no longer have a real doctor. We have temp doctors every three months beginning two years ago. I am very concerned for all of us. I agree with a post I read. The doctors and patients must get together. The people that truly need pain management must work with the doctors. My doctor that retired would not have a choice in this matter. The DEA is forcing the doctor to stop. I really worry about the truth. The real reason behind this. If it truly is happening because of people overdosing those are the patients that need weeded out. This medication causes terrible withdrawal symptoms. Why would a doctor you know and trust to help you turn on us? Why were doctors allowed to treat if it is truly this serious. Who do we talk to, ask questions? No answers! Time for attorneys and class action suit! People are hitting the streets in search of heroin. This makes no sense to me. It doesn’t take a professor to know this is going to cause MORE PROBLEMS, ILLEGAL ones.
    Please guide us in the right direction.

  87. John Jansen at 11:30 am

    I was on a low dose (5mg) generic percocet for 4 years following a leg amputation. Additionally, I have peripheral neuropathy which gabapentin only partially relieves. The oxyc brought my relief to 90%. I’ve moved to Gainsville fl and each Doctor’s office I’ve entered here have signs posted saying, “NO NARCOTICS PRESCRIBED REGARDLESS OF DIAGNOSIS.” I’ve not been able to get a referral to a pain management clinic due to an insurance snafu. So I went cold turkey off the opiod and now hurt 24/7. How is this good medicine. As Virginia said, “this is only practicing medicine,.” Responsible medicine wouldn’t give in to social hysteria and burocratic pressure. This has left me and others hurting and feeling like junkies looking for a fix. How can I help advance this discussion?

  88. Valorie Hawk at 11:22 am

    New state laws are being passed nationwide without considerations to pain patients. Both WA State and Maine have exemptions either for legacy patients or Palliative Care, but doctors are still afraid of the DEA to prescribe for the chronically ill. Join your state pain advocacy group – mine is Washington Pain Advocacy Group. At this point, I think we are going to be forced into creating a federal solution, as the some of the states have gone so far that it could take years to turn back.

  89. Sandy M. at 11:16 am

    My neurologist who retired, had taken care of me for years before my Central Pain from a Hemorrhagic Right Thalamic Stroke almost 18 years ago. Now my Primary Care Dr., who took over my medications, has cut me back to the point, I want to cry and scream, I hurt so bad, it’s Christmas and I can’t even get out and shop for my grandchildren. I have gone to her for over 25 years and I go every 3 months. Last appointment she told me she didn’t want them (DEA) come busting in her office. I told her I don’t want that either, but I’ve tried every medication, it took me years to find the right combination and I never abused them at all. She knows that and she knows me well. I certainly don’t want anything to happen to her that would hurt her career. So many doctors are running scared. I also had Scoliosis surgery 4 years ago and my entire back was/is deformed, so more than a fusion was done at that time. My back from T3 to below L5-S1 into my hips are metal. Therefore, I can’t do much exercising (I think going up and 13 steps in my house several times a day and doing a load of laundry is enough exercise, almost same as physical therapy was and then hurting even more is exercise enough) and PT doesn’t help. I went to PT after my stroke and Scoliosis surgery. I don’t know what to do, but I’m 70 years old and certainly don’t plan to be an abuser or junkie. I just want a little relief. Thank you Dr. Joshi, I appreciate your article. God Bless All of You who are in the same situation. I’m really glad to be my age so I don’t have to suffer like you who are young, I just feel so bad for you.

  90. phyllis bouley at 10:55 am

    I’ve been a nurse for 38 yrs and now on disability as my pain is excruciating when I sit, stand, or walk. I’m fortunate to get minimum pain meds but have taken away my tramadol I used for breakthrough pain. We are suffering I’m only 56 and bedridden 99% day. Three herniated discs with nerve root compression, scoliosis, sciatica, you want to shoot yourself you hurt so bad. Year ago went into vtach due to pain out of control. YES THE LEGITIMATE CHRONIC PAIN SUFFERERS WHO’VE DONE ALL CONSERVATIVE TX. WHY CAN’T WE SUE???? GOVERNMENT IS THREATENING DR’S WITH LOSS OF LICENSE FOR PRESCRIBING TO MANY OPIOIDS I AGREE WE HAVE RIGHTS AND NEED TO FIND SOMEONE TO REPRESENT OUR RIGHTS TO HAVE A QUALITY LIFE

  91. Denise Williams at 10:53 am

    Just like me, I have several bulging discs, sciatic pain in my right leg, right shoulder pain and not to mention degenerative bone disease. I’ve been without my pm meds for 4mos. My pain dr has been given me these injections which doesn’t last that long before I have to get another one. These addicts has really made it hard for us that suffers with severe pain on a daily basis. I cant understand why those that has less issues than I have can get more meds quantity and stronger doses than those like us. Good ideas sometimes turn out to be plain jokes, no I dont care to deal with your method.

  92. Terry at 10:53 am

    Voices that group together seem to be heard. Those of us that have chronic pain and think about how to end our suffering should band together and make ourselves be heard!

  93. Kahty C at 10:53 am

    The Industries benefiting from this have created a compelling and well repeated False Narrative. They leave the word pain our of all of the misleading “News” about the “Opiate Epidemic. As people die from street drugs they are still blaming the Pain Physicians and Patients. Every day there is another “Advertorial” an Article that appears to be “News” but it is really Advertising a Product, Treatment or New Age Therapy, deliberately deceiving the Public. Physician who write Articles denouncing Opiates or presenting Alternative Treatments as if they are Scientifically proven to work, are the ones who have their Articles republished by Major Media. An Article like this runs counter to the current False Narrative.
    People want to hear about Magical Solutions, like “Mindfulness” or Herbs. The average person cannot conceive of Intractable Chronic Pain. A lot of people would quit their jobs if they knew what they too could end up with Intractable Chronic Pain. The workers who now, “work through the pain.” The people in the Gig Economy, have to believe they won’t suffer any long term consequences. Instead of being able to take a few days off and recover from an injury, they keep working, until they drop. When their bodies give out, they will be told to see a Psychologist, instead of a Diagnosis as to what is causing the pain. The Industry decided that this sequence of events was not Profitable.
    They ran “News Articles” about “Hillbilly Heroin” where they maligned the Blue Collar Workers. The people who used to work for a living, and were injured or their bodies just gave out, were all described as “Addicts.” Many of them have given up and turned to drugs as an out of the Economic Despair, and lack of meaningful work. A similar number are drinking themselves to death, but they do not fit the narrative.
    Most of us do not have accesses to Stem Cell Treatments. The New Age Community and Quacks latched on to that profitable business. This led to a lot of Misinformation regarding the effectiveness. Even the Radio Frequency Nerve Ablation has it’s limitations. It is not a Cure All. In Fact some people have to undergo repeated attempts to identify the pain generating nerves. The way a lot of our Insurance is structured , this requires multiple Office Visits. In Countries with Socialized Medicine they can identify the nerve and apply RFA on the same day. Here in the US, they have to do one procedure to identify the nerve, then they require a separate appointment to do the Ablation. Due to the lack of Pain Management Physicians these appointment can be months apart.
    Even the Marijuana Industry has overstated and misled the public about their Products. They peddled a False Narrative about “Curing Pain.” At best their product can make pain less unmanageable and promote sleep. They jumped on the Opiate Epidemic narrative too. Chiropractors, Acupuncturists and Psychologists all found a new way to Market their Industries. The Horrors of opiate Addiction are front Page News, so any of this Pseudo Science, is better than the Horrors of Addiction. They even found various limited “Studies” to mislead a gullible public.
    They had to find a narrative that allows people to be disposable. The Death Rates are climbing, so they had to hide the reasons. The “News” keeps referring to this “Epidemic” in two approved ways. While they run the narrative of the addict that got hooked by Prescription Drugs, they also run a Crime Narrative. A lot of crimes can be attributed to “Drugs.” This is not accidental either. The Public has been led to blame addicts for our social problems, instead of the other way around. They have also been presented with a “Both Sides” argument when it comes to treatment. Willpower and Prayer have been presented as “Treatments.” This way we can all ignore the deaths, despair and hopelessness. People with money have access to treatment at luxury spa like, facilities, while the rest have to go to various Community Non Profits. Many have been using the 12 Step Programs for decades with few success stories.

  94. Dwight Reed at 10:50 am

    This topic hits me hard. I’m dealing with severe problems, and have lost access to pain meds because of this so called crisis. Besides that I’ll write about the lies we’re being told. Doctors are now quick to say that they are at fault for the opiate epidemic. Let’s take a look at that, and see the lies unfold. The FDA, and the DEA, along with other agencies dictate what is safe to prescribe, and give a general idea of what drugs a doctor should prescribe. As long as the doctor kept the prescribed amount of opiates at , or below the maximum per patient, per month there was no trouble for said doctor. Doctors were doing what they were told was the right thing to do, and so they prescribed opiates. Now either every doctor in America is a gullible idiot with no brain, or they simply are scared of jail, or other consequences for prescribed opiates that end up being abused. It’s ludicrous to think that all of us are stupid enough to believe our doctors are at fault, it is that the government is the cause of the drug epidemic. The CIA supplies our streets with tons of cocaine, and heroin, and then taints the heroin around the same time they wanted to push this epidemic narrative that doctors are pushing on us all. They also are trying to ban kratom, and have been lying out their teeth trying to get the public to believe their lies about this plant being deadly. The last time I checked 36 death from one substance, is far less than the 10’s of thousands of deaths caused by prescribed opiates. So are they mad that they didn’t get to kill us themselves, and hate when we don’t die on their drugs? This whole thing is backwards, reckless, and has damaged millions of us chronic pain suffers mentally to a severe point. Please contact your servants in Congress, and help fix this. We need all of us to get this turned around!

  95. Christopher Bucci at 10:46 am

    Instead of this knee jerk idiocy, they should do blood work to check patients levels of pain medicine. This should be mandatory for pain management doctors because there is a problem. There’s no way I should be able to go on the street and purchase any pill I want. I can because there are people who have nothing wrong with them going to quack doctors who will prescribe an unruly amount of meds. The patient then sells them. So yes, there needs to be changes, but not this. Heck, a doctor in Florida moved here to the panhandle part of the state after getting his pill mills shut down. Under federal indictment already, my family doctor hired him. I was getting 90 Loritab 10 mg. per month. This guy changed it to 180 Roxicodone 30 mg. and 60 Xanax bars per month. I couldn’t even take all that crap and went to another doctor. Although to do what their doing, ostracizing doctors for prescribing meds is negative on many levels. As I said, random blood work 4 times a year for levels, not just presence would do it. Anyone can sell pills and keep two for a urine test.

  96. amber at 10:46 am

    When I read these comments, it terrifies me. I typically say that suicide is a permanent solution to a temporary problem. Only chronic pain is not a temporary problem. Kelli, I think you’re on the right track. A lawsuit may open their eyes. Something has to be done. I’m so sick of hearing “opioid epidemic” on the news everyday. The people that have caused all these problems are the ones using “opioids” to get high; the media uses the term opioid to define heroine, or fentanyl that’s being made in china or Mexico and sold on the streets. It’s not real medication! The people who are legit pain patients are paying for all the bad apples out there who have ruined the lives of those who suffer from chronic pain issues. It’s terrifying all the laws that have been made by people who haven’t a clue what their doing to people who need opioids just to function, to have some semblance of a normal life. Something has to open the eyes of lawmakers and make them see the truth of all this!

  97. Deborah schank at 10:40 am

    I have been on pain management my doctor was 84 years old for 7 years years he is now retiring on December 20th 2017 he told me I have to be referred to Montefiore or Albert Einstein pain management is in the hospital now you have to go through drug testing which is no problem for me I recently went through 8 days of opioid withdrawal suffered I’m currently a survivor of domestic violence many beatings post-traumatic stress disorder breast cancer survivor I have arthritis both knees right foot lumpectomy side effects from that pain in my breast and I have an L1 S5 lumbar arteriosclerosis with a bulging disc what am I going to do get a referral for my medical doctor for pain management in Montefiore is that an option for me ? I’m going to discuss it with my medical doctor on Monday it has to be done as soon as possible I have a month’s worth of the last prescription of the pain medication I’ve dependent on for relief without it I’m debilitated can you help me dr. Joshi and had to get support and doing this process so that I don’t suffer from fibromyalgia and all the other things I discussed with you on this email thank you so much I’m so impressed by your comments please respond to my email God bless you there’s not many supportive doctors in your area I guess the government thinks they have control over everything but they can’t control physical pain management it’s against my civil rights and I plan on advocating in that area God bless you

  98. Matt at 9:52 am

    In 2003 I was in an accident that resulted in the end of my life plans. It was three days before I left for boot camp and I was taking my wife to lunch. A young woman who was late for school ran a red light, the rest is a little blurry, but the trip to the hospital is very clear. I was immediately disqualified from military service due to medical issues that where “not likely to resolve in a satisfactory medical entry status.” Seven months and eight surgeries later my injuries where declared permanent by my doctors as well as the insurance required doctors. I could not work, I could not go to college, and mental health issues started to take over my thought processes. I entered pain management and proceeded to get countless injections, PT, and a host of “alternative treatment” options such as chiropractic and acupuncture. After two years I finally caved in and started taking narcotic pain medication. Suddenly I had a little life given back to me. I couldn’t do cartwheels, but I could work and spend time with my daughter doing something other than sitting on the couch. Opioid medicine literally saved my life. I was on opioid therapy for nearly ten years. I still had excellent results from the medicine when I decided to go back to school for what I always intended, nursing. To reduce issues around practicing medicine I transitioned to Kratom for pain management. It reduces the pain to a level that I can continue in school, but I have breakthrough opioids for the days that the pain would cripple me. Without these medicines I would not be a member of society. If I was still alive, I would be on disability and be a burden to the tax system and my family. Now they want to take away my Kratom and opioid medications because people can abuse them. When you make restriction laws and threaten medical providers you don’t hurt the illegal acts, you only hurt those that are in real pain and have no option. We’ve stopped water boarding, but we still practice torture in America.

  99. Mike at 9:45 am

    I hurt my back at work a little over a year ago, have had two surgeries, and still have severe pain of which is destroying my life. This is under wc. The Dr in charge refuses to prescribe opiods except for one week following surgery. He explained to me that all pain after inflammation goes down is in your head and that all opiods are highly addictive. Since it’s a wc case I tried but am not able to switch Drs. The obstruction of the truth about chronic pain and the paranoid opinions of the uneducated are the reason I have gone from a happy go lucky guy to on the verge of being suicidal. The truth about these studies needs to highlighted and why these drugs are so effective for severe chronic pain patients. I appreciate seeing articles like this so that hopefully not everyone has to suffer like I do.

  100. MaryLou Gallagher at 9:44 am

    The government has opened up a new can of worms buy denieing people in cronic pain relief.peeps will do what they must to get relief.if that means street drugs, so be it.why does the government have to make my disions??? I will make my own disions…

  101. MaryLou Gallagher at 9:37 am

    I also Have been on pain meds For over 10 years. I have degenerative disc disease, bulging disks, bone on bone.my spine and hips are effected as I have RH Arthritis.i do not abuse any meds but I have been cut off from my pain meds.Now I cant do anything, no life.and now very depressed because of my cronic pain.now I understand why peeps turn to street heroin and suicide. No one can live like this. Please help , you will prevent another tragedy.

  102. Randy Brown at 9:34 am

    I have suffered from chronic pain since2006 work accident falling 3 stories about 30ft. I wont go into the detail of injury it would be very lengthy. I will say i received 100 percent dissability after maximum medical improvement in 8 different injuries of my body. I have exhausted every treatment in pain management possible and nothing has provided any relief. Pain manage management started me on low dose treatment after 2 years with great education on opoid treatment in 2008. I respected these drugs and abided by all rules. Did they relieve my pain? No, but they brought my pain levels down to a 4 to 5 and made me funtional. I have been treated with these drugs for nine years with absolutely any problems. In 2016 pain management and my primary care physcian said they would have to taper me off slowly in 12 months because of the opoid controversy even though i was having good results with them. From jan. 2017 to present i never had any withdrawls the way they tapered me off. In the 9 years my doses were increased slowly from tolerance. The last 2 years i was taking 120mg oxycontin and 120mg oxycodone for breakthrough pain. I never once had any problems with them because i was educated by management and knowledgement by my self through research. The last 11 months my pain levels are back to 8 to nine again and now i am taking 6 blood pressure tablets a day and it still 165 over 110 because of chronic pain. I get what is going with this crisis and it is great that it is finally being addressed, but at the same time it is not fair to punish chronic pain patients for this who use their medications properly. A lot of us are literally dying in torture of pain and for some it is so excruciating they are committing suicide. It is sad that our government is letting this happen to us without even reporting on our side. We (CPP) are all fearing are lives now and opoid overdoses will rise in illigitament people using strèet drugs fentanyl and heroin over these new prop and cdc guidelines. There is no easy cure to the crisis, but the guidelines have already made more people die, and just watch in the next couple years the deaths will 3fold of what they are now.

  103. Gary Miller at 9:31 am

    I can’t stand it when people that have NO CLUE what they’re talking about chimes in and says that pain sufferers can’t take opiods anymore! Just ticks me off like no other. I have Multiple Sclerosis and I’ve been taking Hydromorphone for 17 years and have never had any negative issues with it. I won’t get into all of them but 3 of them didn’t do anything for me until this one. I couldn’t even take straight morphine, swallowed it, came right back up, horribly! It’s not even close to get addicted to them. Supposed to take 2 a day plus as needed. Eleven years ago, my pain was off the charts and I couldn’t shake the pain no matter what as I ended up taking 16 that night. I wasnt high or addicted! Probably because my other pills I take due to this disease have changed and I’m doing better at managing my MS and the pain. My brain could not comprehend in the beginning that if I have pain, take the pill, even if it was right in front of me. I’m better at taking them now and my wife reminds me to take one. Does that say addicted? I used to drink a lot in Jr. high, high school and college because I loved having a good time, not because I was an alcoholic. Now, a 6 pack may last a year. Point is, everyone handles everything different. Yes, some people abuse because they want to get High but don’t label everyone
    due to that! There are many forms of MS but we are not all in the same box. Some may look like and act like everyone else and some are wheelchair bound or bed ridden. Person one all the way to the last two I said and everyone in between may need a narcotic occasionally and the no nothing individuals want to end that? Think there’s a problem now? Do that and a problem never seen before will erupt immediately, I CAN PROMISE YOU THAT! I heard people are abusing Gabapentin which is used for seizures and nerve pain with no euphoria results. Is that the next crisis for no reason or is sugar next? STOP trying to ruin peoples lives when you have no clue about the non abusers! Funny how there isn’t a big roar about alcohol and tobacco deaths coming from the government like they are about opiods. $$$$$?

  104. Bob Schubring at 9:24 am

    In a recent off-the-record discussion with the Medical Director of a Detroit-area inpatient psychiatric hospital, that doctor told me quite frankly that “putting substances in your body that you don’t need, puts you out of balance”. He discussed the Endogenous Morphine/Dopamine system, and the Catecholamine System (which includes the neurotransmitter serotonin). He squarely blames the “opioid epidemic” on methamphetamine abuse, having admitted significant numbers of patients for in-patient recovery after they become alarmed at being unable to sleep, and then experiment with mixtures of opioids, alcohol and sleeping pills, trying to force themselves to sleep. Often the experiment ends in a medical emergency and the patient is hospitalized.

    What actually works for these patients is to spend several weeks as an inpatient, where no methamphetamine is allowed in the hospital because visitors who bring things there are searched. All of one’s endogenous neurotransmitters and neuro-regulatory substances will eventually stabilize, said the doctor, but getting off the meth is the key to starting that process. Symptomatic treatment is given as necessary and any co-morbid psych issues are sought out and found. Frequently the meth habit begins as an effort to self-treat some psych problems, for example, a depressed person may try to pep himself up by taking stimulants, But major depression is an ailment in which the person is too uncomfortable to sleep well, and taking stimulants simply masks the bad feelings of depression while making the sleeplessness worse.

    Why, then, are so many people blaming the wrong chemical for these deaths? If the meth addiction is what’s driving people in desperation to mix opioids, sleeping pills, and alcohol to force themselves to sleep, why aren’t public officials doing more to warn us against taking meth, I asked.

    The doctor’s answer: Politics. Right now it’s politically desirable to attack the opioids, because politicians believe they can win public favor by doing that. Actually solving the problem is the least of their concerns.

    After learning that, it is now very disturbing that the most-prominent campaigner against opioid treatment of Disabling Intractable Pain, Dr Andrew Kolodny, actually wrote a book, “Crystal Meth and Men Who Have Sex With Men: What Mental Health Professionals Need to Know”. Dr Kolodny is not ignorant of the methamphetamine problem, He’s not ignorant of the fact that meth addicts become desperate for any possible means of restoring normal sleep. He’s not ignorant of that fact that in their desperation, people might mix sleeping pills with opioids with alcohol, desperately trying to force themselves to get some sleep. And he’s certainly not ignorant of the fact, that significant numbers of people are dying of mixing sleeping pills with opioids with alcohol, often in the very same communities that recently had an upswing in methamphetamine use. Why is it that Dr Kolodny influenced the Centers for
    Disease Control to issue “guidelines” on opioid prescribing, that completely ignore the role that methamphetamine addiction has played in driving young people to risk death, just in order to restore their normal sleep cycle?

    Morbidity/mortality data bear this out. The typical patient with Disabling Intractable Pain, begins using prescribed opioids for pain control, sometime in his 50’s or 60’s. The typical addict becomes addicted to illegal drugs like methamphetamine, sometime in their teens or early 20’s. The Hollywood model of opioid-related death, where some healthy young person gets an injury, takes pain medication, then develops a craving for more pain medication and when doctors don’t provide it, switches to heroin, simply does not explain what’s actually happening. If heroin makes people feel pleasure, why are they taking sleeping pills and alcohol with it to force themselves to sleep?

    Is it possible that Hollywood has created this mythology surrounding opioid pain medication, because the entertainment industry refuses to come to grips with how methamphetamine is being used by entertainers, to cope with their demanding schedules? That, to me, is a question worth asking.

    The late singer Michael Jackson’s family refuse to discuss what sorts of substances he might have consumed, but testimony at his doctor’s homicide trial, revealed that for Mr Jackson’s last decade of life, he was unable to fall asleep, and paid the doctor to knock him unconscious every night, with a surgical anesthetic called Propofol. Were Mr Jackson’s handlers keeping him on stimulants of one sort or another, so that he could perform and make them millions of dollars?

    Taking Propofol to get to sleep, is not someone’s effort to get high. It was the desperate act of a man who couldn’t sleep normally. Just like the poorer people who mix sleeping pills with opioids with alcohol, after meth use has made them unable to sleep normally.

  105. Robert Ivan at 8:42 am

    If only there were more Doctors such as yourself willing to put it on the line. To tell the truth. To stand behind the Hypocrite Oath they swore to ease suffering and to do No harm.

  106. Rocky46 at 8:18 am

    He does bring up valid points. But in the US many pain management physicians are anesthesiologists. They are board certified in pain management and that requires further training and even more testing. Pain Management became a sub speciality of anesthesia in 1993. Neurologists and Psychiatrists can also become board certified in pain management so all these physicians are veryvwell trained in the treatment of pain.Is he referring to general practitioners only?

  107. Steven Smith at 8:06 am

    This is pathetic! I didn’t think I was the only person now without the medication they need and used to be prescribed even 6 months ago. Depopulation is real friends!

  108. Karen at 8:03 am

    In addendum to my previous comment I would like to acknowledge and thank those physicians who seek to be the best doctor they can be. They work horrendous hours most of us would refuse and get very little, if any, praise for their kindness. Thank you Dr. A, God bless you.

  109. Karen at 7:51 am

    My physician is a board certified, fellowship completed pain management specialist. His specialty was in physical rehabilitation–a physiatrist before he sought to be TRAINED and EDUCATED in order to help his patients he found at the end of the road as far as being helped by standard protocols sans opioid medication. He got the training and has been diligent in trying every alternative available at present before prescribing any opiate MEDICATION. I have been his patient for almost 16 years and of those years we pursued the alternatives for 3 years before I began opioid MEDICATION. We are both mocked and scorned for our decision to let me live with a reduction of about 75% pain relief. Every month for YEARS I travel a gauntlet of shaming and ridicule by my pharmacy and it’s pharmacists. My poor doctor who has the training and certification is attacked in this pharmacy with regularity as being a pill pusher. I agree with Dr. Joshi–it IS about training/education for those in the medical profession. It’s shocking how little medical schools train future physicians in not only pain but in nutrition as well. Until the schools begin to teach Pain we who suffer will see much, much more suffering. I imagine a large percentage of doctor visits originate out of pain whether a few days of ear aches or tweaked backs or lifetime of pain related to grave illnesses. It’s time to come into the 21st century. It’s time to look ahead to new therapies for our suffering and demand experience and knowledge from those physicians brave enough to treat us.

  110. Richard A. Lawhern, Ph.D. at 7:49 am

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

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

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

  111. Clarence Longacre at 6:03 am

    I have been on this type of meds for 20 years and now I can’t get any I am dealing with pain and withdraw my self no one will help I never had any kind of drug or alcohol or problem or been in jail at all I don’t no how much longer I can do this time is running out for me .. like I said I have no one to help it out of my dr hand and in the hands of who ever now . I wish I was a heroin junky or what every that do to get help in lost for help .I no there will be more suicides and people turning to the street pharmacy

  112. Clarence Longacre at 6:01 am

    I have been on this type of meds for 20 years and now I can’t get any I am dealing with pain and withdraw my self no one will help I never had any kind of drug or alcohol or problem or been in jail at all I don’t no how much longer I can do this time is running out for me .. like I said I have no one to help it out of my dr hand and in the hands of who ever now . I wish I was a heroin junky or what every that do to get help in lost for help .I no there will be more suicides and people turning to the street pharmacy

  113. Virginia at 5:59 am

    God bless Doctors like you and God blessed me with a PCP who listens and then is willing to help me with the medicines I ask for: because I do my homework, and I know what I want, and I know what hurts, and I’ve already tried everything else, so God bless her, she writes it!
    And by God so should every doctor out there or they should not be practicing: NOTE: practicing, not profession, medicine. My opinion, VCN

  114. Bunny Wynne at 4:49 am

    As I have been cut off from PM and I’m forced to live with DDD, 8 bulging discs and neuropathy. I no longer care to wait for your “great” new treatments I will take care of myself permanently. [edit] you all.

  115. Kelli Davidson at 4:23 am

    What do we pain suffers do to change this …ww need to take action. I am thinking about talking to a civil rights attorney. I feel like my rights are being violated. I have been stripped my right to pursue happiness.

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