PRESS RELEASE:  Potential for Misuse & Diversion of Opioids to Addicts Should Not Overshadow Their Therapeutic Value

PRESS RELEASE: Potential for Misuse & Diversion of Opioids to Addicts Should Not Overshadow Their Therapeutic Value

The following public release announcement was issued by the Journal of Palliative Medicine and its publisher, Mary Ann Liebert, Inc.:

Opioids are very effective for treating some types of pain, such as cancer pain and postoperative pain, but not for other kinds of pain like chronic low back pain. An increase in the number of opioid-related deaths among addicts has led to the current movement to restrict opioid prescribing by state and federal authorities. While a laudable goal, these restrictions threaten to block their use for safe and effective pain relief when medically indicated. A new Editorial, “The Pendulum Swings for Opioid Prescribing”, calls for physicians to speak out as a voice of reason in their communities, and is published in Journal of Palliative Medicine, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers . The article is available for download on the Journal of Palliative Medicine website.

In the Editorial, Charles F. von Gunten, MD, PhD, Editor-in-Chief of Journal of Palliative Medicineand Vice President, Medical Affairs, Hospice and Palliative Medicine for the OhioHealth system, describes the shifting attitudes toward opioid prescribing he has witnessed during his nearly 30 years as a physician. Although the number of deaths from opioid addiction is rising, it is incorrect to draw the conclusion that the appropriate prescribing of opioids causes addiction in otherwise normal individuals, states Dr. von Gunten. He emphasizes the need for proper assessment of pain and, when indicated, appropriate prescribing and access to opioid drugs.

“There needs to be balance. At the same time we assure there isn’t an excess supply of prescription opioids in medicine cabinets to be diverted by others, we must assure an adequate dose and supply for patients whose quality of life and function is improved,” says Dr. von Gunten.

Journal of Palliative Medicine is the official journal of the Center to Advance Palliative Care (CAPC) and an official journal of the Hospice and Palliative Nurses Association.

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Richard Oberg M.D.

Rose - you are my new favorite hero/person!! Your reply was absolutely delightful and made my day. You wrote the most candid, comprehensive, and correct analysis from a patient perspective I’ve ever read about how medications can affect you that are often viewed with some skepticism by prescribing physicians and brand you as being annoying. And your final summary is exactly correct - not really rocket science, is it? If physician organizations united against this nationally it could be stopped - but uniting physicians is like herding cats who are pretty easy to divide and conquer. It’s really disheartening to read the same nonsense in physician society talking points as the major propaganda machines. Many thanks again.


One of the most disturbing aspects of the new(renewed) prejudice against opiates is the defensive and dishonest behavior of those in the medical profession who deal regularly with pain patients. I assume (I keep meaning to look it up and find out for sure) that doctors are not supposed to avoid prescribing something just because they think it’s a hassle for them, because I have only ever had one doctor admit to thinking this, and that was when he was still willing to prescribe opioids for my chronic pain (fibromyalgia, chronic pelvic pain, psoriatic arthritis). His exact words were “There are so many hoops we have to jump through now that it’s honestly, pardon my language, a pain in my a$$ to prescribe narcotics”. This was at the same time he referred me to a pain clinic, so I suppose he felt comfortable being open about his desire to stop dealing with patients on opioids. When the pain clinic decided to stop treating me (because now even pain clinics don’t want to prescribe narcotics) and I called my old doctor, he told me he no longer prescribed narcotics. I asked him why and he mumbled something about ‘too many side effects’. This is the excuse I am most often given by doctors, only a few of whom have had the grace to look ashamed after I explain that I had to stop taking gabapentin because it turned me into the equivalent of a zombie who slept 15 hours a day and had to stop driving because of the danger of nodding off behind the wheel, not to mention the facial tics and random, jerky movements that I started experiencing or the cognitive impairment, etc and the added bonus of needing to taper my use of gabapentin slowly and gradually because the withdrawal was absolute hell. But it’s an ‘approved’ drug, a ‘safe’ drug — i.e., a non-narcotic, so its use is encouraged in fibromyalgia patients even though the list of side effects is approximately 27 times as long as the list of hydrocodone’s side effects. I have taken hydrocodone for almost nine years now. If I don’t watch my diet carefully, I occasionally get constipated. That’s the sum total of my ‘side effects’. Oh, and yes, you do build up a physical dependency to it over time, and it can be difficult to get through the withdrawals, just as it’s difficult to get through the withdrawals from a number of other prescription drugs (gabapentin - which makes hydrocodone withdrawals seem like a walk in the park - lyrica, a number of anti-depressants such as effexor and zoloft, and the list goes on). I’ve been told you build up a tolerance, but that hasn’t been the case with me, and it isn’t the case with most pain patients. One reason you hear that pain patients need more and more of a narcotic is because it takes so damned long for us to get a doctor who will actually prescribe enough to… Read more »

Doug M

After reading all the comments left here by chronic pain sufferers and doctors all I can say is its all so very true. To those of you who have had your pain medications unjustly taken away, I truly feel your frustration and pain. To the physicians, I say thank you for speaking up for us. All fairy tales used to be entertaining throughout history, that is until the CDC and it’s spokes people started telling them. It is truly criminal how a fictional story could hurt so many but it has. Millions of lives have become interrupted by the fairy tale known as the CDC guidelines. Tens of thousands of suicide deaths can be contributed to this fictional story. It’s the War of the Worlds all over again and its not funny. The fact that the voices of the suffering are not being allowed to be heard is nothing short of criminal. The really sad part is that the voices of those who have successfully been treating the suffering have been ignored. We can tell that this has to be a government operation because its a** backwards. Very simple common sense, you don’t take away the treatment before you can figure out the cause of the pain. I’m not a doctor, nor am I educated, but I’m smart enough to know that you can’t fix a repetitive problem if you don’t know what is causing it. That would be like leaving the oil out of an engine because you found water in the oil pan. Keep it simple stupid as my grandfather used to say. Drug addiction isn’t caused by prescribed opiates, it’s the tool used to feed the addiction. Just like pain isn’t there for nothing, it’s there to tell us that we have something wrong with us physically. Right now I’m sitting on the back porch of my wife’s cousins house. We drove two and a half hours early this morning because he had a heart attack the other day. Do you think when he went to the hospital on Saturday that when he said he was having chest pain that they told him that it was all in his head? No, they wheeled him into a examination room and went to work on him. The point is that his pain was a symptom that something else was wrong. Do you think it was a Dermatologist that treated him? No, it was a Cardiologist. These educated idiots as I like to call them, at the CDC need to use the right tool for the job. They need panel made up of chronic pain sufferers, people who have lost a loved one to suicide because of chronic pain, doctors who treat chronic pain and addiction treatment specialist. They need to stop only listening to the pi**ed off mothers who have lost their addicted children and figure out a way to treat drug addiction without causing harm to others. Next, our elected officials need to get on board to combat… Read more »

Holly Clowers, MD

Palliative care doesn’t refer to terminal care. Palliative care refers to treating people who have a condition for which there is no treatment for the disease itself but rather only treatment for the symptoms the disease causes OR treatment for patients who have failed every treatment for their condition so that their treatment focuses on relieving symptoms. That actually includes many, many people who are being taken off their successful opioid treatment. The problem with the term “palliative” is that most physicians fail or refuse to recognize treatment that is in fact palliative as such. Many of us who are not imminently terminal and do not have cancer are in fact palliative care patients, but good luck finding a doctor who understands that. Most will equate palliative with terminal or hospice. It just isn’t accurate. And I have not found physicians to be particularly susceptible to learning. They hold onto their preconceived notions as tightly as the rest of humanity does.

Chronic pain is a disease of the human nervous system, yet it’s treatment with effective opioid based pain medications is considered outside the standard of care for that practice.

Millions of people living with chronic pain remain untreated. Thousands will lose effective treatment with pain medicines this year due to CDC chronic pain treatment guidelines developed by a Core Expert Group composed mostly of addiction specialists.

The specialty of palliative care has long ignored the many progressive, degenerative diseases associated with severe pain that when left untreated, cause chronic pain.

This group of specialists has knowledge of pain, and the use of opioid based analgesics to treat severe pain.

Yet palliative care physicians does not treat those of us who benefit from high dose opioid therapy because our diseases are not considered “terminal.”
Why has a group of physicians and practioners, considered to be compassionate, remained silent on the plight of millions living with disabling daily intractable pain?

How long will palliative care continue to ignore an ethical imperative to improve the quality of our lives?

We are all terminal. No one gets out of here alive.


Jean Price

Maybe we are missing a major support group…that of churches. Perhaps if a person asks for time to make an announcement of just what is happening in pain care and ask for perhaps a week of prayer, no need to give out personal information. There are enough case histories from these comments to add pertinent information. Plus most all churches have newsletters and a few sentence would explain the issue and the awful repercussions it’s having. Maybe pastors would supply this same info to other churches. This is a group of usually supportive, compassionate people who could be allied if they knew these problems. Just a thought…see I can stop wanting to input, can I!!

Richard Oberg M.D.

This is a problem in all of medicine - specialization and fragmentation of care. And its gotten progressively worse in the last two decades as medical care supposedly gets more complicated and we have more sub-specialties.

I’ve watched this phenomena for three decades in-house…. physician specialists who pretty much know what they do but over time become less and less informed about what even they may have known years before as they get more involved in their specialty.

Random comments from Palliative Care should know better than make blanket statements about patient cohorts they don’t deal with. Effective for some kinds of pain? Like the ones they’re familiar with and everyone else go fish? It’s always made medical ‘experts’ sound completely foolish when they make dismissive comments again only because it’s outside of what they do as the comments here aptly illustrate. And ‘cancer’ pain yet again? Really? Please. Because my late stage (palliative) psoriatic arthritis doesn’t qualify me because of their artificial definitions? Quite frankly I’m sick and tired of physicians who either didn’t learn much in med school or forgot it all on the way to specialization. I didn’t - what’s their problem?

It’s nice to see something positive at all…… but sometimes it becomes ‘please don’t be on our side’ since the CDC addictionologists will then quote these supposed experts and we’ll eventually have yet another ridiculous ‘opioids not good for this or that’ start showing up in the media machine. And the number of deaths from illegal opioids is rising so they should qualify their statements. I don’t know about everyone else but frankly I’m tired of the overused nonsense that everyone becomes addicts because of pills left over in grandma’s bathroom. Really?

Carla Cheshire

Mark, Great logical comment! I too have been on the same dose of opioid medication for over 10 years. There are a lot of falsehoods being put out as fact. Would it be possible to put together a paper with writings from several of us and attempt to get it published in a Medical Journal? Any interest?


I want to ask the CDC one question. Why do so many Pain Management Specialists prescribe these medications if they don’t do anything for the patien? Are they all incompetent, or are they just stealing our money? I have been to many pain clinics including the University of Michigan (They aren’t slouches)! All these doctors tried treatment after treatment and none worked. I have been taking the same dose of pain meds since 1997. Does the CDC actually think these doctors are just so bad they prescribe meds that don’t work? I say bring on the evidence!


well chronic back pain is exactly what my pain meds help me with and pain from interstitial cystitis and Atypical facial pain…yeah they say it is not supposed to help that either but it does!!! how about people stop telling other people what helps them be able to eat and function and walk …..

Jill McCoy

I was told also that opiods don’t help lower back! Where do they get that from??


My pain meds were taken from me over two years ago. After they were taken I could no longer do much of anything. I put on 45 pounds because I was unable to even go for my short walks or do light garden work anymore. Because of this weight gain, and my inability to carry that much weight, I fell and broke my back again. Which was why I was disabled to begin with from being hit by a car years earlier. Now I have put on a total of 55 pounds and am miserable. I was given 9 weeks of medicine for my broken back, and then shut off. I have been on pain meds, or was for 25 years and they were working fine for me. When the new Jewish doctor who came in what looked some some kind of take over coup, took over the only pain clinic for 125 miles decided to boot almost everybody off their meds. They gave me a prescription for clonadine and sent me home to suffer, and suffer I did and still do. My life feels meaningless now. My QOL is so low most days I hope I’ll just have a heart attack and die. I hurt ALL the TIME! I don’t know how much longer I can live like this. There are no other doctors here where I live now that will prescribe for pain. They send everyone to the pain clinic who won’t do it either. I, in 20 years of never calling for early med’s, never losing them, never having them stolen, I keep everything in lock box, was called in one day after the new doctor changed my med’s from 90mg’s of morphine, and 80 mg’s of Oxy, to 20 miligrams of some weird opioid that was like rubber. They gave me no instructions on this med other than 1 every 12 hours I think. I cut a pill in half when I went into withdrawal and then thought after I did I should find out if it was time release. They said yes, and told me not to take I dumped it. The next morning they called me to make the 50 miles round trip to town for a pill count. I was one pill short, so now my improper use of med’s is in my medical record. This is a travesty. It’s criminal to treat people in pain this way. I thought we were over that DEA in our lives shit in the early 90’s. I guess they’re back!


What about the McGill Pain Index? CRPS ranks above cancer & childbirth and is one of the most painful diseases. Who randomly picked cancer as the jackpot disease? Just shows hiw truly out of touch these people are. To take away a mode of treatment working for so many without any replacement is gross negligence. Pain patients have become the sacrificial lambs. They will take away our only form of treatment, stigmatize us and then forget about us. The overdoses will continue as drugs flood into the country. The news cycle will pass. A new cause will be championed. Those left to suffer with no care or access to medication including opiates, will be left like refuse on the street after a parade. We will be broken and forgotten. It’s all worth it as long as an addict is saved, a politician is re-elected, and those who can profit with their drug treatment centers and useless medications have made millions.

Annemarie Brooks

Thank you for sharing. I believe you are absolutely right. I wish I could do something to help the cause of getting the government out of practicing medicine. They can’t tell the difference between junkies and real patients.

Doug M

The fact that so many of the doctors who are involved in government are those who are changing the rules, I have two simple questions. WHERE IS THE SCIENTIFIC EVIDENCE THAT OPIATES ARE NOT HELPING TO TREAT CHRONIC PAIN? WHEN IS SOMEONE GOING TO PUBLISH THE STATISTICS COMPARING OPIOID OVERDOSE DEATHS TO SUICIDE DEATHS? In the movie “Contact”, the main character played by Jodie Foster who was an Atheist asked Matthew McConaughey how he could believe in a God that hasn’t proven his existence. He responded with a question. “He asked, Did you love your Father?” She replied, ” Yes, very much.” Then he said, “Prove It!” TO all you scientists telling the world that Opiates really don’t help chronic pain and that severe chronic pain only exists in the minds of those who suffer, I simply say, “PROVE IT!!!” How can doctors working for the government at government run facilities give impartial and bipartisan views when they are only looking at one side of the conversation? The answer is, THEY CAN’T. For one thing, the original purpose of the CDC becoming involved was to combat addiction and overdose deaths. At the time of the first release of the CDC guidelines, chronic pain was not even considered. As a matter of fact to the CDC views of chronic pain was that it didn’t even exist. It wasn’t until the people who suffer from chronic pain and a good number of Doctors who treat them spoke up that they amended the guidelines to include the use of opiates to treat chronic pain. Then in the short period of time between the first draft and the last release of these guidelines, the CDC did enough scientific studies to determine that opiate will only help with cancer, post operative and end of life pain and proves ineffective with continued use for chronic pain. But if they are used that they should only be used in the lowest dose possible. As a matter of fact, the CDC and other federal agencies even changed this definition of certain words. They changed dependant to addicted and guidelines to rules / Law. For an agency that was developed to combat infectious disease and biochemical weapons, the CDC has now become a thorn in the side of the true medical profession by dictating when, how and why a doctor can treat a patient. They even have their own enforcement branch, if doctors do not comply with the guidelines, the CDC simply releases the DEA to enforce them. The FDA requires years of research and trials before a new medication or medical procedure can be approved. The CDC, at the government’s request can disprove decades of positive results and create a total negative stigmata of a medication in less then two years. They have turned doctors against doctor and nurse against patient. It’s so bad that someone in severe pain can’t even go to the emergency room without being accused of seeking drugs. When honest people with real medical… Read more »


Where is the data that show opioids are not effective for lower back pain?? I read the whole CDC guideline and they could not find a single study done about the benefits of long term opioid use, so this statement seems to be coming out of someone’s bias! As a chronic lower back pain sufferer, I assure you they ARE effective, more so than ibuprofen or Tylenol alone (there is Tylenol in my codeine, and I’m more worried about that than any side effects of codeine). We need to demand the data that they are using! Show that the Emperor has no clothes! I will go along with the results of objective studies (ie: funded by those with no bias) but as yet I have not found a single one, and I’ve been reading these journals for a while.

I have written a note to the author of that commentary, and hope that he will respond with the citations that will lead me to the information I seek. I am so grateful that some doctors are willing to speak out - but I hope they don’t speak only for their clientele (as he seemed to) but instead demand evidence-based (and that means doing studies and finding results, not just “we haven’t looked yet”) approaches to pain care.

Dr. von Gunten echoes the standard of pain care using opioid-based medication supported by the World Health Organization (WHO), International Association for the Study of Pain (IASP), AAPM, APS, and a majority of pain scientists and clinicians worldwide: “(we) must assure an adequate dose and supply for patients whose quality of life and function is improved.”

In America (and in a few totalitarian governments) government health agencies, guided by “experts” from the anti-opiate cartel, are ignoring these pain treatment standards. They wish to minimize “harm” by minimizing the use of these medications, regardless of improvements in function and QOL recieved.

I am grateful for news and opinion sites like the National Pain Report.

Where else would people in pain get this kind of information so vital to their wellbeing?

susan walls

if they take the opoids completly away people with chronic pain it will be really life threating more so than if they take opoids. there has to be a better way. the pain meds help people with chronic pain have a better qaulity of life. there able to do a little more. the depression will probaly still be around but not as bad. i agree the doctors need to think of there patients. i have chornic pain have lived with it for sevaral years. they took away what was helping. i have fibromyalgia plus really bad nerve damage from a lobectomy i have cancer i have been in remission for two and a half years. please find a way to help us chornic pain patients.

Mark G.

It is rediculous to make such blanket statements that narcotics are not effective in treating chronic pain. Even more than that it is a lie! We are witnessing a new McCarthyism and chronic pain sufferers are the communists. They are pointing their fingers of accusation at us and saying “you don’t need these medications”.
I have undergone EVERY possible treatment for my chronic pain, most of them 3 or 4 times! None worked. The pain meds only reduce the pain enough so that I can have some life. But the people who think they know everything about pain say I cannot have that. I was a Radiation Therapy Technologist and was always proud to be a part of the Medical profession. Now I am not so sure!

Carla Cheshire

I too am greatly helped by opioids for lower back pain and pain that emanates from that region. Once again, these doctors prove their ignorance with regard to opioids and pain. What is Ms. Liebert’s source for the statement that opioids work for cancer pain and post operative pain but not for other kinds of pain like chronic low back pain? I don’t see one cited. I’ve also had cancer and post operative pain maybe someone might want to ask me if there was a difference in how opioids worked for each of these conditions. But no, of course not. Asking a patient how opioids work for them is not allowed. I’ll let you in on a secret, “There is no difference in cancer pain, post op pain and chronic low back pain, opioids work for all of them!”

Annemarie Brooks

I agree sir. There many injuries and illnesses that benefit from opiods. I have a spinal cord injury with incomplete paraplegia. If it weren’t for gabapentin I wouldn’t be walking. I have associated back and without a moderate amount of pain meds I wouldn’t be able to do at least some household chores. Each pt. is unique and should be treated as such. Isn’t that how you would want to be treated.


Doesn’t work for back pain? What gives you that idea? Otherwise I applaud your effort to encourage balance.

I believe the problem with opioids is a lack of education concerning them. Drugs, including Lortab & Percocet, have Tylenol in them. When someone is sick and goes looking for something over the counter, the majority of patients are unaware that acetaminophen is Tylenol. This leads to liver damage and other side effects. I have several chronic pain diseases. I think doctors should inform patients of what to look for; at the same time, pharmacists, not the technicians, should do the same with every prescription. It makes the doctor, the pharmacist and the patient responsible. Another issue is that the pain pills fo make you feel like you can do more things. Pain is the body’s natural reaction that something is wrong. When a medication takes that away, patient, myself included, do things and cause more harm. There need to be limitations set for a patient using certain dosages and things that are off limit. I was a pharmacy technician for over 10 years and the daughter of a pharmacist. I have had the opportunity to work retail, hospice, call center and patient. I can see everyone’s view point. At this time, I rarely take pain meds, over the counter or prescription, because my neurologist says it causes rebound migraines. If I did not have my sister’s boys to want to watch grow up, I would have ended it a long time ago. So for now, it is a day to day process.

scott michaels

severe spinal stenosis and splondiosis cause enough pain for a patient to need opioid therapy. In some cases highmdoes are nesessary, based on thee patients lifestyle. If a patient has been taking opioid therapy in hi doses for several yeara and the patient ahows no sign of misuse, changing thier medication coud cause additional.undue pain, severe depression and even suicide.If changes in prescribing are to be enacted and patient must be grandfathered in because can not get more.medicine orr changing their dose will cause more harm the good. This has been proven by the large number of suicides by opioid overdose. Those that have been told they are cut off or going reduced by up to 90% &have turned to the street for relief and purchased bad drugs. Or they hoarded enough medication to end life. This is because many states like ohio and massachusetts did not put any patients in the equation. the o ly concern was the junkie. I just drove through a town and found the local drug areas. I witnessed at least 30 people shooting up. I stoped my car and spoke to a few of them. All were ising heroin. When i asked if they see middle aged peoe or elderly buying heroin, the reply was, THEY SUPPORT THEIR HABBITS. Because their doctors wont give them pain medication “WE ARE THEIR ONLY SOURCEOF RELIEF” They would rather go to a pharmacy and get the medication they have recieved for years but the govt. basically told them suck it up.. Wben i asked how they got started it was no different then it has been for decades. Peer pressure., alcohol stoped working or “try it youll like it” Im quite sure the high must be aweso.e, or soany people wouldnt use it. When i asked about pain pills they said, ever since ixycontin changed the sucks. You would have to take 5 to 10 8p mg just to get a lite buzz. At 40 to 60 dollars a pill its umaffordable and not nearly as good or cheap as heroin. the only reason pain medication would be taken would be to stave off widthdrawls if H wasnt available. They said they would steal a r few pills from a relative or be given a few from a friend. “WIDTHDRAWLS ARE A B**CH” I asked if cli iv were more available for methadone would they be utilized the response was an over whelming yes. They dont like steeling grandmas medication because that means she will encounter pain because of them. Wow is was surprised that some of the junkies had a conscience. When i asked if any of them ise heroin because they started on pain pills, i was laughed at. They said thats the lie we tell. If we told our parents we ise because we just wanted to try it, or they drive us crazy or school is too hard, ” its our failt and we look weak” but if we say it… Read more »

Janet Wilson

Speaking as someone with chronic lower and cervical pain with a companying nerve pain that gabs pending nor lyrica did not work on, dear, doctors that are not in pain the statement is not true. I do see a psychiatrist and other
I do take ssri two of them and they don’t work either for helping pain or depression. Doctors you are so wrong and hurting so many. Shame on all of you. I now and forever vote for suicide.