Is Senate Prescription Drug Caucus the Wrong Prescription?

Is Senate Prescription Drug Caucus the Wrong Prescription?

Senate2This week’s story on the National Pain Report that the U.S. Senate has started a prescription drug abuse caucus stirred up some reaction among our readers, and one of our contributors.

She thinks the Senate’s focus is on the wrong thing - however well intentioned.

Terri Lewis PhD. wrote the problem isn’t prescription drug abuse - it’s our medical system. Lewis is a Rehabilitation expert and advocate for consumers. She’s currently working in Taiwan consulting on efforts to decentralize that country’s health care system. She is the daughter and mother of chronic pain sufferers.

“There is mounting evidence that the galloping numbers associated with chronic pain are correlated to persons who were recipients of medial harms, and who were left with injuries so severe that they now endure painful conditions that are secondary to their treatment,” she said.

Lewis points to the data and says that more children and persons of working age are being impacted by this approach to dealing with pain - resulting in disability.

“This is not an old person’s problem. This is not a cancer problem.  This is not an addiction problem.  This is a problem that belongs to a medical model that has turned the art and practice of medicine into the drive through approach typified by drive through approaches to care,” she added.

Like most chronic pain advocates, Lewis believes drug abuse is a problem, but she says it’s not the root cause of the failure of chronic pain care. But the DEA crackdown on pain medications isn’t the answer. That puts the blame on the patient - which she thinks is misguided.

“The DEA sees failure to cure as abuse of drugs which maintains the chronic pain problem rather than a model failure - after all legitimate doctors cure, don’t they?,” she asked.

She concluded, “The most adherent, conforming patient cannot be cured from their chronic health problem by the medical model.  We need new definitions and new measures of success that have to do with how people live, not how they are not living.”

The story about the Prescription Drug Caucus started by Senator Joe Manchin of West Virginia and Senator Tim Scott of South Carolina also generated some chronic pain sufferer’s comments on the National Pain Report Facebook page. Those comments centered more about their care - and indicated they aren’t thrilled about the idea of the Caucus either.

Dawn Holly Norton wrote, “When are doctors going to learn the difference between abusers and REAL chronic pain sufferers. I’m a legit patient yet I cannot get adequate health care for my fibro, peroneal neuropathy and degenerative disc disease.

Erin Marie Maples-Zevecke had a similar reaction. “Doctors would have to start having compassion again to help us fight this insanity. They’re more worried about all these regulations affecting their pocket book now than in helping the sick. Chronically ill people are the new criminal class.”

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Authored by: Ed Coghlan

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I am a legit chronic pain sufferer. Have been for years due to failed back surgeries, deg. disc disease, nerve damage, fibromyalgia, stenosis, the list goes on. Been seeing my current pain doc for over two years now. I had finally gotten the pain to a managed level with using the 30mg oxycodone as well as other meds. I hae been on that for years up until two months ago. My dr telks me he is not allowed to write scripts for that dose anymore, can only do 20mgs. What the hell?!?! For two mo ths my pain has increased to a level I cannot tolerate anymore. He also switched up other meds and added new ones. So here I go again, like some test subject told to try this or that, when for years ive been thru it all and know what works. Tjis is medical torture on legit pain sufferers. I also now someone who goes to my dr, (dr told me he was cutting all patients back) Her meds were not cut back.. So a dr can pick and chose who is suffering more?!?!? I call total BS to that! Im so sick of being treated like some addict. All I ask is for quality of life. To be able to sit at my sons games, to make it thru my daughters wedding. It wont happen now. .i have so much pain from the neck down to my toes and every dam month I have to explain myself over and over. I now have blackish type bruising all over my lower back. Not sure hat it is. My dr said ” its like the pain is now showing on the outside” WTH??!? But yet I am still forced to suffer in pain 24/7 ?!?! The DEA and government need to stay the hell out of my medical care and well being so my dr can treat me properly. Sickening, the war on drugs is an epic fail, so they go after legit pain sufferers. Walk in my shoes for a few hours. I no longer look forward to anything, why bother..I had to leave my only daughters bridal shower last week as the pain was thru the roof. Only those who are legit know what pain is like. Those who are selling pills and abusing them, shame on you! There are thousands of legit sufferers that cant get the proper treatment because the DEA has failed with drugs on the street. I am so sick of my healthcare being monitored by the government too. I pray that all those who are putting legit patients thru this medical torture get a knock on the doir by karma. I hope they suffer in pain so bad they beg God to take them, like I do.


If they want the doctors to spot the BS ers they need to train the doctors more than one day what to look for before its too late and how to spot it in the beginning. And not do it for one day it should be a standard course before they become a doctor. I have talked to PMs looking at my BP 170/100 on BP meds and literally tell me your radiating pain, I can see it. They know it when they see someone in pain. But now the hospitals, are too scared unless you got a compound fracture and then they will try to give you advil. Ughh.


I agree with the main tangent and a chronic pain sufferer trust me that agency does screw with doctors, mine have told me they get audited regualry and ask the stupidest questions like why isn’t this patient getting better? They reply back are you a doctor? No, then STFU, The whole thing is they need to realign how people are dying, abuse, purposeful overdose aka suicide, hard drugs, like heroin and fentynal, instead of lopping them together, like we know the problem and the pain patients are it? OK how did we get in pain, ususally there was a doctor involved, so the doctors want to save their licenses and undertreat people because they are scared to do their job. I have seen it. When a doctor accepts the Hippocratic oath, he doesn’t also accept the oath to be a private investigator. He does it to help people. No doctor got in it to do that, also my brother is a PM and I asked him one time, how did they tell you how to spot people abusing drugs? 1 day that was it, he then went to Anes school for 5 years didn’t say a word about it. if they want the doctors to BS ers they need to train the doctors more than one day what to look for before its too late.


I also am a legit chronic pain patient. They need to let our doctors treat us as much as they can and not put the fear of God into them for over prescribing. A good doctor can spot a abuser so let the doctors be the judge of how to treat us. Without pain meds in my 24/7 life of pain, I am seriously not sure what I would do. I would like the option of trying medical marijauna also. I know many people in chat groups have turned to heroin because of not being able to get their prescriptions. They just haven’t been left with a choice. If you haven’t lived with chronic pain, you just don’t understand.

My chronic pain was from medical trauma, and I also cannot find treatment to improve my condition. I have been on handfuls of pills for 9 years and am now also experiencing kidney failure. I cannot work and my children live with me in poverty now. The medical system is broken.

The last time a elected official sat down and did
something that was - for the good of those concerned -
was in the 18th century. My gut tells me this group will
only make it harder for those that need pain medicine to get
it in any dose. We might see a PROHIBITION of all
scheduled pain products.

Think about it : when was the last time our government
came up with a solution to a serious problem and what’s
worse is- they won’t be able to agree on what the problem is
and who it affects. If they do change anything it will only prolong
the agony of those that suffer.

My condition is - Acute, Chronic and Progressive according to my doctors. I continue to get worse and no surgeon believes he can help me.
They will only operate if I lose bowel and bladder function and both are not that far off. After eleven operations dating back to 1986 I have tried every form of treatment and medicine - I can’t live without my current medication.


John S

Kurt W.G. Matthies

We have to acknowledge that words have specific meaning. To ensure understanding, each profession has its own nomenclature, whether it be engineering, law, or medicine.

Medline Plus, published by NIH includes a Medical Encyclopedia with definitions and descriptions of medical conditions, the purpose of which is to help patients and their families understand the nomenclature of medicine.

The Medline Plus Medical Encyclopedia is available at:

In the Medical Encyclopedia, the definition of the word ‘chronic’ is written by Dr. Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA, and reviewed by other medical specialists. This defines the word ‘chronic’ in relation with its antonym — ‘acute’.

“A chronic condition, by contrast is a long-developing syndrome, such as osteoporosis or asthma. Note that osteoporosis, a chronic condition, may cause a broken bone, an acute condition. An acute asthma attack occurs in the midst of the chronic disease of asthma. Acute conditions, such as a first asthma attack, may lead to a chronic syndrome if untreated.” *

This definition is puts the word ‘chronic’ into a context by using the example of two commonly known conditions — asthma, and osteoporosis. It is clear, concise, and points out two important characteristics of the chronic disease state: how long it lasts, and its tendency to develop from untreated acute conditions.

We can only hope that these legislators wish to understanding the problem and finding viable solutions to improve the public health and a good place to start is by defining key medical terms like: ‘acute’, ‘chronic’, ‘addiction’, ‘tolerance’, ‘pseudo-addiction’, ‘chronic pain’, ‘opioid analgesic’, and ‘narcotic’, to name a few.


Mark Ibsen

The true prescription is to support the restoration of the physician/patient relationship. We have been winning the War in Pain. It’s in direct conflict with the DEA and their “War on Drugs”
Wars only affect people.
The fact that .0001% of the population suffer from OD ( an inaccurate number anyway)
Has the Feds justifying scapegoating doctors and patients, instead of getting off their asses and doing old school law enforcement work, which they have clearly failed at for over 45 years. Pain is a bloody terrorist.
We don’t shut down the automobile industry because of car crashes.
We don’t stop immunization programs because of harm( unless the harm reaches levels we cannot tolerate)
We must look at the entire picture.
We actually ARE winning at controlling opiate related deaths. In Montana and 22 other states with medical Marijuana laws, deaths from OD are down 35%.
The prescription drug registry has enabled me to treat many patients in pain who are seeking relief: their medication history is available.
The rest of this campaign is really about brief, scapegoating, and a new class prejudice.


david becker
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To: david becker
Ms. Lewis is on the mark for seeing that the medical model is amiss when it comes to serving people in pain. Neither the medical model or the biopsychosocial model are robust enough to be of much help for people in pain. There is a lot of heroic simplification and a illusion of comprehension given to current care delivery models for pain. It is plain to see that their reductionistic roots and their economizing tendency are unmfortunately part and parcel of these models that are failing Americans in pain. Medicine- because it took great pride as a distinct discipline has failed to make full and intelligent use of models and practices from other disciplines.
And so I think it is of great importance to realize current models used in pain care are broken and new models need to emerge.
There is a risk of focusing too much on the capacity of the health care system and too little on the capacity of individuals in pain to deal with their pain. Good leaders make for poor followers. And so society needs to change its focus and allocation of resources and faith to empower people in pain to directly generate their own solutions and use resources in new ways. Ms. Lewis comments seem to reflect a diffusionist focus. I would like to see society give more focus to independent invention- lets give people in pain a set amount of money each year to seek whatever treatments they wish for pain-let them develop new ways of being toward pain.
Finally the interface between people in pain and the healthcare industry needs improving. There is too much othering coming from professionals who view people in pain as inferior and ignorant. Which is remarkable given how little most professionals know about pain. And in this regard another technical approach such as “patient engagement” or “patient activation” is just another McDonaldized form of not empowering people in pain. A rights based approach is needed to counter the focus on techne.
I doubt that anytime soon society will develop wisdom when it comes to pain care. Permissive laws of reason have allowed the health care industry to decide for people in pain-and that is not wisdom to me.