A Chronic Pain Advocate Fires Another Salvo

A Chronic Pain Advocate Fires Another Salvo

Judie Bruno and dog Fred

Judie Bruno and dog Fred

When Judie Bruno’s story about her decision as a chronic pain patient to file for disability was published on Friday, the response from National Pain Report readers was immediate and strong.

Good idea they said.

Check the comment section of the original story (here) and our Facebook page (here).

Bruno is a 68-year old California woman, an army vet who lost her leg years ago. She’s also an advocate for the disabled and she has taken that knowledge to file a complaint under the American for Disabilities Act.

She sent us a narrative about what happened at the Loma Linda VA this week and said it was ok to share with our readers:

OK here’s what happened at my Pain Management appointment at the VA, Loma Linda yesterday and tell me, anyone, how this makes any sense at all?

Last month they cut my Xanax prescription in half which really affects my quality of life. The Xanax is the only thing that relaxes my bowels which are in a knot and causes dry heaves, pain, constipation, nausea, in ability to eat etc. I thought for sure this month they would refuse to fill the prescription but I think they are afraid to just cut it off as one pharmacist did to the morphine in Sept so they gave me the choice of how I can remove myself from this medications, gave me one more month’s prescription of the half dose, I also have extra of the regular dose as again proof I never abuse any narcotic medications and it’s now up to me to take myself off of this medication. Of course it’s in my records that the patient disagrees with this process but at least they didn’t just stop it.

The reasons they have given me for doing this is the use of Medical Marijuana and I was told, if I didn’t use it I could then have the narcotic medications I wanted. How does that make any sense at all?

First the VA and the Fed’s don’t recognize Medical Marijuana as a Pain Medication and yet are judging it as one. I truly believe that is illegal. The excuse I’m given to remove Veterans from narcotic medication is fear of accidental overdose and yet medical marijuana had never been associated in anyway with accidental overdose of any drugs. If we didn’t use medical marijuana, we would be able to stay on narcotic medications. Do they all have blinders on as to this discussion?

This is the reason for my ADA Complaint and its right there, now in my records, that if I didn’t use medical marijuana, legal in my state, they would give me more narcotic medications. That is discrimination against those who live in states where medical marijuana is legal and refusing to acknowledge the rights of states to make these laws against what the Federal Government wants.

Judie Bruno has promised to keep the National Pain Report readers apprised of her efforts with the ADA and the VA.

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Authored by: Ed Coghlan

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Marian Medvec

Pharmacist Steve, you are so right. I had a pain mgmt appt this week and was basically told that I am okay, healthy, strong. I told them I can’t walk far. He said why not. I said my back hurts when I walk. He said just do it. He told me to go on with my life, go travel, go wherever I want, there is nothing wrong with me. Exercise and you will have no pain. Enjoy the rest of your life. I am on Tramadol and said I have occasional days when the Tramadol doesn’t do much and I am hobbled. He ignored that. He was a fellow. When my real doc came in he told me he was getting his kids a dog for Xmas and that was the remainder of our conversation. This is ridiculous.

The chronic pain community has more in common with those that are abusing some substance than there is differences.. 100 yrs ago our country decided that those suffering from the mental health disease of addictive personality disorder .. when opiates were involved was a crime in and of itself.. they made it illegal for doctors to treat/maintain addicts. Are we now headed down that same path with chronic painers.. where they are driven to the street or commit suicide - both illegal acts.
The chronic pain community is being “herded ” just as you would sheep, cattle or other livestock.. We have all heard time and again from certain groups that those with mental health issues . just need to “suck it up”…. get out and socialize.. and other such nonsensical phrases.. and we are now hearing the same phrases about those in chronic pain.. “it is all in your head”.. “you can’t be in that much pain”.. We are seeing those making their career on “substance/opiate use disorder” What disease state will be their next target ?

Sheryl Donnell

You certainly are not alone. My pain management doctor will not write prescriptions for medical marijuana and opioids. The clinic (a very large teaching hospital in Chicago), made the unilateral decision. So, even though it should be legal for me, and I would like to use marijuana, my doctor has suggested I get it illegally even, I cannot get a legal rx to see what other medications I could lower or if my quality of life could be increased. I have never taken more of my meds than prescribed and also have extras left every month as well. But, I am treated as though I cannot manage my medications after 8 years with the same doctor.

Diane Ibarra

So, as an individual With Chronic Pancreatitis, Interstitial Cystitis, Bleeding Ulcers, 3 bulging Discs, PTSD as a Suvivor From Incest, as Well as Sexual Abuse From Others in a Posistion of Trust… Who Does Also Use MMJ, and Recently applied for Disability… I Guess Denial, & The Powers That Be Are Now Going To Take Away My Meds? And I Cannot Obtain Employment because I use MMJ? Might as Well Shoot Me Now, Or Just Push Me To The Edge Where I Do It Myself?? That’s Just Awesome…😤

M. Shank, M.D., Ph.D.

For the benefit of those who have not read the comments on your previous post, “VHA [Veterans Health Administration] policy does not administratively prohibit Veterans who participate in State marijuana programs from also participating in VHA substance abuse programs, pain control programs, or other clinical programs where the use of marijuana may be considered inconsistent with treatment goals.” Moreover, denial of Veterans Health Administration services, on the basis of the patient’s use, under state law, of medical marijuana, is prohibited, and “in those situations” any decision by providers “to modify treatment plans” is required to be made “in partnership with their patients.”[i] Negotiating, as you have already done, a reduced dose of morphine, in exchange for continued use of marijuana prescribed under your state law, is consistent with this Directive, but forcing a choice between your other medications and the medical marijuana which is legal in your state is an unambiguous violation of it.

Although it had many shortcomings, there is at least one study suggesting that, in the short term, vaporized THC (one of the two major cannabinoids in marijuana) “may allow for opioid treatment at lower doses with fewer side effects,” without affecting the levels of either morphine or oxycodone.[ii] Keep in mind that THC is also available for oral use as dronabinol (Marinol), as is a similar cannabinoid, nabilone (Cesamet). Since both of these drugs are FDA-approved for nausea, there may be less prejudice against taking them off-label than against medical marijuana. There is evidence for pain relief with both of these, and I have personally seen two patients, with incapacitating pain only modestly relieved by high doses of opioid analgesics, who experienced substantial pain relief when dronabinol was added for otherwise intractable nausea and excessive weight loss due to gastric-bypass surgery. Furthermore, standardized quantities of an oral product that is known to be free from contaminants is arguably safer than smoking marijuana.

Very little is known about interactions between other medications and marijuana, but it seems likely that they are modest.[iii, iv]

i. Department of Veterans Affairs Veterans Health Administration. Directive 2011-004, January 31, 2011, p. 1. https://www.va.gov/vhapublications/viewpublication.asp?pub_id=2362
ii. D.I. Abrams, P. Couey, S.B. Shade, M.E. Kelly, N.L. Benowitz. Cannabinoid–Opioid Interaction in Chronic Pain. Clinical Pharmacology & Therapeutics. 2011;90(6):844-851 https://www.maps.org/research-archive/mmj/Abrams_2011_Cannabinoid_Opioid.pdf
iii. John R. Horn, Philip D. Hansten. Drug Interactions with Marijuana. Pharmacy Times, December 9, 2014. https://www.pharmacytimes.com/publications/issue/2014/december2014/drug-interactions-with-marijuana
iv. Anonymous. Marijuana (Cannabis sativa). Natural Standard® Patient Monograph, 2015. https://www.mayoclinic.org/drugs-supplements/marijuana/interactions/hrb-20059701

Sandy Auriene Sullivan

Ok this is not just happening in one or two pain specialist offices. Nationally every chronic pain patient is going to be kicked of benzodiazapines *unless* they go to a psychiatrist for their script. I do it twice a year now for 2 years.

The reason for it is the government and FDA don’t recognize that benzodiazapines and diseases of the CNS are a ‘pain related problem’ and so doctors who write pain meds are being forced to kick paitents off of xanax especially. That’s the *hot drug* to boot everyone off of.
Lucky klonopin was comparable for me. Not only is my CNS hosed I have non-combat related PTSD.
Be sure to ask around about psychiatrists [bonus you are paying for a vent session] who are not benzo-adverse! Don’t argue too much about which SSRI they will give you. They can’t/won’t prescribe just benzos. I was given a low dose prozac 10mg [20 is standard] to ‘boost’ serotonin.

Mark ibsen

You go girl.
They messed with the wrong veteran.


My heart goes out to you. We need change at the Federal Level. Physicians in all 50 states need to be able to prescribe Medical Marijuana on the same basis as every other medica4etion and no state should be able to forbid them from doing so. Please call the White House comment line at (202) 456-1111 and email the President, and, hand write a letter to the President as well. Get your story into the mainstream press. The more people know of your plight the better your chances are of helping effect change. God Bless you for your service to our country