Sinyor - Coping and Resilience on Vimeo

We know now that 40-60% of Montana Suicides are health(pain) related.
This talk is about resilience.
If pain is the terrorist,
Resilience is worn down.
Yes, techniques to distract,
And build resilience are useful.
Sleep builds resilience
Relief from pain builds resilience
Weaning opiates causes a DECREASE in resilience, as does
Catastrophic thinking
Self pity

Dr. Mark Ibsen

Of course
All these are increased when someone loses access to opiates,
Feeling powerless,
These folks lose all hope,
Engage in dysfunctional
Isolated thoughts,
And come to conclusions,
Which sometimes IS the conclusion.

Acute opiate deprivation in palliative pain patients causes hopelessness
Self pity.

We know how to treat this syndrome.
This subset of suicidality
Eminently treatable.

Let’s reinvent our approach to Pain.
Addiction is killing the addicted.
Hopelessness is killing palliative pain patients.

We can do better.

Why don’t we?

We are seeing hopelessness and suicidal ideation in the refugees of Samos.
We try to restore
Self expression
In some of the most
Tortured, betrayed and abandoned on the planet.

Why are we abandoning our own fellow Americans who had their suffering effectively treated until arbitrary restrictions were instituted over the last 7 years, even while opiate Rx have decreased 30%.

We are great in American Medicine at treating the acute and life-threatening.
We save more folks from the brink than any other system.
Where are we failing?
We suck and helping folks make the life we have saved worth living.
And, my friends, no one wants to live in agony.
We can do this right.

Please help.

Mark Ibsen MD
Helena MT

Featured image from Learning More about Suicide, Coping and Resilience. American foundation for Suicide Prevention.

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Authored by: Mark Ibsen M.D.

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My heart goes out to Mark Ibsen. Have you met with the Chief of Health and Welfare in DC? Go for It Mark.

Nice to know there are thoughtful,compassionate and intelligent people around. Do any of them have MD’s/ MBA’s ? What is the Red vs Blue statistics regarding policy proposals?
More control of pain patients lives for the worse, less money spent on education and social service programs, less workers, lower tax base. What is a medical fascist to do? Go to Russia.


You’re so correct! Part of the problem with this forced opiod tapering is the feeling of helplessness! I know that when I walk into my doctors office he’s going to insist that I reduce the amount of pain medication even more. I started out with a dose of 220 mg of morphine equivalent and I was able to get around and do things, like go to the swimming pool which helped keep my pain under control, plus my blood sugar & pressure at normal levels. Now that I have been reduced to 90 mg and the doctor wants to reduce it even more because the DEA is trying to find anyone who has had a patient die while on opioids and persecute them for it & since he’s treating elderly sick people some have died over the years! But it isn’t even so much what it’s doing to me as what it’s doing to my son who lives with me and hears me moaning in pain.He’s started drinking more heavily and is really losing it because he just can’t handle the fact that I’m in pain all the time and there’s nothing he can do about it. So I try to figure out what is the best course of action to help him keep his sanity in this. I have thought about killing myself but I’m not sure that it wouldn’t be harder for him to cope with, I’ve thought about insisting that he move away from me and then he at least won’t have to go through it everyday but due to financial restraints and the fact that he just wants to help me it’s very hard to kick him out. So in the end the Trump administration is going to cause an intelligent young man who was doing very well in physics to become an alcoholic with PTSD! And while I’m on the subject of alcohol 6 people die everyday of alcohol overdoses! Where’s the cries for that epidemic & that’s not counting the deaths from alcohol induced diseases and accidents! The whole war on drugs has always been a horrible lie and human rights violation perpetrated on minorities and the CPP and doctors are just the next victims!


Please tweet President Trump and your senators etc every day! Addresses can be googled. For example “Mr President please help fellow Americans tortured through medically unnecessary opioid tapers!”

Or President Trump “my medication has been out of stock x times in 6 months. Please bring sanity to opioid hysteria.”

Tweets and Facebook comments are much easier than phone calls and letters for the ill and in pain. Please join me in speaking up by any means possible.


Thank you Dr. Ibsen!
For ALL pain patients fighting for help the U.S. Pain Foundation is also a site you need to be partThank you for taking action on this important issue. While the U.S. Pain advocacy team is working every day to advocate for the pain community, we can’t do it alone. Your support and activism is essential for us to make a difference.

To learn more about our other efforts, visit If you’re not yet signed up as an official U.S. Pain advocate, you can do so here: of.


Very well stated! I don’t understand why the healthcare industry is going backwards when it comes to treating the symptoms of painful diseases. It’s all very barbaric. All I can think is that someone is getting rich from it and those of us living at the mercy of these new draconian regulations won’t be around when or if they decide to change and repair the damage. Addiction will still be around just as it always has because they are not truly trying to help these patients. I guess I’m not coping very well as your article describes.

Longtime Rsd dude

I think this is another American example of protecting the many at the expense of a view.
“It sucks to be a part of the few.”

Kris Aaron

I’m in my early 70s and disabled by a neurological disability that causes chronic pain. I was prescribed methadone for 15 years — never overdosed, never “lost” my prescription, passed every urinalysis test as required by my doctor, and then…
I’m down to less than half of my original prescription and can barely get off the couch. I spent five weeks on an ever lower dose and discovered that chronic pain will be the reason I end my life. I live every day wondering if tomorrow will be the day I lose my prescription altogether.
Our lives are valueless to the government. Recreational drug users and addicts continue to die in record numbers, even though prescription drug use has significantly decreased during the past few years.
Very few people became addicted to narcotics by following their physician’s advice and taking only the prescribed amount of opiates. But many people will die if the government persists in forcing physicians to take all their patients off the only type of medication that helps them.


A few years back the Republican came out with this death council’s scare. Kow we are actually seeing how its being implemented.. Since chonic pain patients are on average a very expensive patient. And the elimination of such patients would be very cost effective, The CDC wont publish suicides for medicar and medicade.This is nothing more than useing a street and illegal drugs to lay the foundation and eliminating the doctor patient relationships. We saw the elemination of $250000 billion from medicare when the Republicans passed there tax cut. Your congress man knows what the cost elimination and saving are when a chroinc pain patient kills themselfs. And yes i do believe this to be true. Cigarettes kill 10 time the number of people than this maufactured opioid crisis. Funny no epidemic there.


A copy of what you wrote should be sent to every lawmaker in every state in the Union. Like others stated, l saw myself in your writings. Thank you, Dr. Ibsen.

Sandra Mastel

Great article! The government doesn’t care about us chronic pain sufferers.
The government doesn’t seem to understand the difference between dependent and addiction.
Chronic pain sufferers are or were dependent on pain pills to do a job just like high blood pressure persons are dependent on on pills to lower their blood pressure.
I’m praying this oppression of no pain pills will be over soon and chronic pain sufferers can get the relief they need.


Thank you very much Dr. Ibsen. I read about myself in your article.


Bless ypu Mark. I know you mean well. But no maater what some if not most all cannot make ot on 90 mme. INo pffencce . You mentioned suicide. That is where we are . I had an idea to get someone to listen. We stage mass suicide day. The whole idea is get attension not to do it but say we mighz later if wash does mot listen. I will help but it needd to be soon. Any othet ideads. I am in bed due to hert feels lokke it will explode ftom lack pff meedicine does one else have any better idea. We meet at the bridge anf walk across with signs. It might work. We cant talke all our one week sipply all at once because it has tilast 4 weeks
What good is thst?


Thank you, Dr. Ibsen. I’m old and my body is all too cognizant of that fact. I’m retired and no longer the “producer” I was during 57 years in the workforce. The system will be A-OK with my death-that’s just one more off the Medicare rolls. I just wish I didn’t have to suffer until the time comes. The thought regularly occurs to me to make it sooner rather than later. Why haven’t I done so? I can do basic chores, housekeeping and shopping most of the time. I don’t want to leave my spouse (89) and 2 old cats to fend for themselves. but there is no longer much joy in life.

Although I’m lucky in that I’m still allowed a low dose of a mild opioid, I experience panic every month when it’s time to request a refill. I just got a new doctor which causes even MORE fear that I will be cut off. Often, the medication I’m on does not control the pain, but it’s definitely better than nothing. For sure I know better than to ask for anything more. If I did, I would most likely get cut off entirely; at the very least, “drug seeker” would go in my medical record-if it’s not there already!

The “Golden Years”? What a monstrously cruel joke!!

I know, when I was run over and broke c4 c7 jaw with 2. Plates, seven teeth, right arm with plates and 11 screws, left elbow with tendons taken from wrist to support elbow. Compound spiral fracture of right tibia (rod). Later they found out I have no pituitary or hypothalamus function. After every surgery I was sent home without pain killers. I’ve tried to commit suicide more times then I can count because of pain!

cindy grossman

Yesterday was the first time I actually considered suicide b/c my pain was so horrible. I don’t know why, but a few days ago it got totally out of control and has stayed this way. Today is Day 4, and I finally just took another percocet — and a tiny dose of valium b/c I was panicking. I shouldn’t have waited so long for the percocet, but I’m afraid to take it unless I’m totally desperate b/c my pain doc cut back my percocet Rx a few months ago by 1/3 due to the CDC so-called guidelines, and so I’ve been conserving; terrified of running out. Not moving unless absolutely necessary, and taking small doses of valium to fight the panic and stress caused by the pain. And sleeping more too, since if I’m sleeping, I’m not suffering.

Yesterday I finally realized that I still have enough pills to take what I need, and that at least for now, I’m not out of pills and that it’s too soon to kill myself b/c I will be out of pills in future. I need this pain spike to end. I have no idea what caused it. My pain is awful all the time, but this is really unbearable.

But — if I had my old Rx amount of percocet, I wouldn’t have been so afraid to take the extra pills I needed and so it never would have gotten to this point. So, my suicide thoughts were absolutely and solely caused by the forced taper. I do not want to die but I can’t take that level of pain.

I know w/o a doubt that if I hadn’t had my opioids for the last 10 years when my pain began after a surgery, that I’d have killed myself long ago. I tried a bunch of alternative treatments and none worked. I am totally dependent; but absolutely not addicted. But, even if I were addicted, — given the alternative — unbearable endless pain leading to suicide, so what? Wouldn’t addiction be better than that?

Reading about other people thinking about or committing suicide is totally different than thinking about it yourself. I really don’t think I’d be here today if I hadn’t taken the extra 2 pills I needed. It’s eery.

Tootie Welker

The best way I can try ti explain what living in chronic pain is like the drip drip drip of water torture. Yes it ebbs and flows, sometimes almost intolerable, other times it’s still there but maybe not quite front and center. But IT NEVER GOES AWAY. This wears you out. Every task becomes such an effort you just give up. Most of the chronic pain folks I know have an exit plan for when it just becomes too much. Poor sleep due to pain reduces your ability to recover which leads to thinking along the line of “if this is what it’s going to be like for the next X years, is it worth it?” Suicide due 2 pain is real but those who are so eager to count every OD, whether by heroin or fentanyl, are not interested in also tracking those who’ve given up.


Why won’t Pain Doctors identify aracnoididas, I’m 100% sure I have aracnoididas from a 1975 milgram that went bad for me pain Doctor says I have Fibromyalgia and pain meds won’t help. I was on 4 -5 10 milgrams of Norco per day for 5 years, I never asked for more and even though my goal was to eliminate it was for taking the edge off the pain so I could relax or go do something. My pain is so bad now I’ve pushed everyone I know away from me. I’m grumpy all the time from lack of sleep. I can’t sit, stand or lay down very long, the pain in my feet and hips is insane. Not sure what to do but I can’t go on much longer. My Doctors have labeled me a drug seeker for explaining to them my pain. I think I’m on a list at the hospital, when my blood pressure is 220 / 115 they I’m so embarrassed, now I’m labeled mental health, drug seeker, Liar and complainer. I only trying to stay alive as long as I can.


Sounds to me like Big Brother is watching us. I am disabled but ambulatory. Three major back surgeries and have multiple sclerosis. I don’t stand on the corner and look for drugs. This has to stop. There is a many good folks who need meds. Myself included. I am a very responsible person. Don’t want to live in my bed for the rest of my life.


I don’t understand why the Government decides if I take pain medication. It’s surpose to be the land of the free. I am refused pain medication because of depression. Well how do they think I got depressed. I have all kinds of arthritis and it has invaded my lungs. The only part of my body not affected is my heart and I am sure that will happen also. If it wasn’t for my family I would have ended it a long time ago when I could no longer receive pain medicine.

Thank you so much Dr. Ibsen! You care and that makes all the difference in the world. I wish there were more of you. I’m very blessed to have a physician like yourself. I wish everyone did. It breaks my heart to read most of the stories on the National Pain Report. The others leave me angry. It’s very seldom to read something in between, such as your outlook on this Injustice. Hopefully you can continue to get the word out. I’ve often wondered if more doctors like yourself would stand for what they know is right, where might we now be? I realize several have tried, apparently to no avail although they tried and that’s what counts! Still that leaves many who have done absolutely nothing. When you state there’s an issue in helping people make the lives that physicians have saved worth living, that pretty much says it all. May God bless you and give you the strength and wisdom to continue the path your on. 💝

Susan L Blaine

I am very angry as I write this. I was “allowed” pain meds. for 10 yrs. I am a 63 yr. old women who was given hep c in 1976 with unnecessary surgery that never should have happened. Then in 2008 I was given further injury by the negligence of a doctor by the name of Alexander Read and Nurse Ann Croghan. Their negligence and greedy pockets caused me to acquire Sjorgren’s syndrome. I live in chronic pain and am unable to get pain meds. I live in Seattle, Washington. I have already written my obituary with both Read and Croghan’s name included so they won’t be forgotton. They should not be allowed to practice medicine of any kind, not be allowed near patient’s in need. I do not know how much longer I can go on. If anyone knows of a compassionate doctor in Seattle, Washington, please post.


What can we do about this? I am angry that the government is becoming communist, fascists. I want to get around the government and get my pills anyway. I’m not trying to get Fentanyl or oxy time release. I have taken hydocordone for 25 years to manage my chronic pain. It really helps! Where can I go get what I have taken for years?

Rebecca Hollingsworth

Every day, more and more sad and extremely upsetting real life tragedies are being told. We are all in the same situation. I had a face to face with my US senator thurs night. No answers of course, just more phone calls to make, but I’m not quitting. I,’m just getting started. Please everyone, let’s fight this and put chronic pain at the forefront. Be a proverbial pain in the ass and speak out anywhere and everywhere you can. Family, friends, neighbors, congressmen, senators , call, write, be heard. We are many and we need a voice. This abuse needs to end.

Deb Liccketto

You forgot depression. While my husband waited for his 8th back surgery within 11 years he overdosed. He had seen my father pass away after knee surgerythe month earlier. He did feel hopeless after that but because of his fear of becoming paralyzed. His depression became greater and he passed from an overdose the day before he was to be seen for help from mental health at the VA.

Kelly-Anne Bryan, RN

Pain patients are tortured, betrayed, abandoned indeed. By the very ones entrusted to rescue and protect: health care and government. There is no earthly help anywhere.
Thank you for speaking out, Dr. Ibsen. It is heartening to know there are some left in the helping professions who understand pain management and addiction, and the perils of getting it wrong.

Maureen M.

Well said Dr. Ibsen. It is good to hear from you again. I pray that all is going well for you in Montana.

Rosalind Rivera

The found results are right on target. I love my fellow men and women however it would be a powerful, telling situation if some relative of those enacting these laws against pain medications even for those who have proof through medical tests that they would also be sufferers if just for one day, of pain.

Allison Duncan

Untreated pain, chronic pain that will never get better until its bad enough for surgery! Which I find in my case and great state where I live. Degenerative is called Degenerative for a reason. I have been a single mom, an athlete in school. I was quite active, could conquer anything! So I thought. At age 50 I was diagnosed with Spinal Stenosis, degenerative disc disease, and bulging discs in L1-L5. Excercise, PT, Shots to the back and the left leg for sciatica help for about 6 months. I am 59 years old now. Quality of life as I once new it,….gone. I see a pain management specialist, every month. I am incompliance with their rules and regulation guidelines,, that these fine doctors are held accountable for. Thank you Lord for the one I have that understands, knowledgeable on Federal Guidelines, and adheres to them. I believe there is an opioid problem in the US today…..with DEA, ICE, state and local authorities it’s Abusers, Users, and greedy money makers who make it difficult for the folks like me who has some kind of hope and motivation as I take my medication as ordered. And frankly, I too don’t want to be another statistic who just falls through the cracks, because the pain would be so severe, I couldn’t see another way to stop it!! Until States like mine realizes that if they try to interfere between patient and doctor, they have no business involving themselves and these poor doctors, who keep us safe with our medication and help us to try healthy lifestyles to relieve pain that never ends……I get how you feel sir when your hope is lost. So in conclusion I urge others to write, to to use your voice, Some of us Disabled folks just want to be able to function. Don’t let us suffer!!

Pamela Kay Russell

Hope resilience given for pain
Where I live communities have turned on,people literally put them on cameras so anti assist groups can psychologically torture the already sick Its so sick the harrassment ( a hate crime ) can be so openly committed in our America
Doctors openly brag they would rather see opioid users living under a bridge on H or dead than to give them the medications they require
The rules here are so strict one can barely make it Not even one. short The prices for visits went way up and some offices set people up some pharmacies have to be watched constantly a lot of fake medicine around here
I have been suffering so bad the last year I just bout can’t go on I’m in constant pain I cuss all the time stay angry or depression cuz just can’t go do like want to
I stay pain at work all the time and my time off no fun Conversations even become tough I never get good nights sleep
The crew that cameras people that are at pain management tell others in the community what to do say to people when there out Shame maled harder days at work Pain goes up even more I can’t believe how many involved
I was injured years ago double frost bite feet /hand injuries severe back pain from work related injury/water intoxification_ neuropathy/ osteoarthritis cysts nodules
My disability came through right during Marshalls awareness shut down and DEA How do Marshalls even have authority for such with the DEA? So all my medical papers were frozen got missing M office said I to pretty to be on disability or need meds Unreal Like complimented insult__ I’m not a dog but I’m far from pretty I was given No to my claim The day my dad died as denial da Really how coincidental
They call me a junkie now won’t let me work as nurse shame on them. I went through school twice raised kids kept house worked but they claimed new ways you are a junkie So now I’m a junkie wow Year no meds cuz I missed a visit Cameras don’t go away got to remind us were still the shamed( I’m hurting bad)


Very well stated. Thank you for caring, Dr. Ibsen.

Lisa Snider

I know I don’t want to live like this. I had a near fatel car accident in 2004. I have been on 2 kinds of pain meds for that long an I lost my Dr. I have no idea what to do. She weaned me off of them but I’m worst than ever now. I’m not a recreational drug user. I need that medicine. I’ve been miserable for 2 months now. What do I do

Gary Raymond

First, abolish the CDC. They lead the pack on this witch hunt. Second, stop enabling the sadomasochists within the medical fields. People in chronic pain are being tortured mentally and physically by those we are supposed to trust.

Mary W.

This is a poem speaking to everybody with wittiness, honesty about chronic pain. Points out the fallacy of opioids instead of the proper standard of care. This poem put a smile on my face.
Let us strive for better days ahead,

Debbie Nickels Heck, MD

I was the only 4th yest med student going into primary care to take an elective in pain management in 1992. I was often viewed with disdain at treating pain during residency but I did it. I was one of 2 primary care Drs treating pain appropriately in my community until we both lost our licenses on bogus accusations in the mid-2000s then drug dealers took over and ODs in the ER skyrocketed, but did anyone make this correlation? Our county became number one in the state for methamphetamine labs. We’d been keeping tabs on the drug seekers and turning in those we knew to be problematic to the local drug task force or getting help for those in need. The unethical social worker with the state hell bent on making it appear she was getting “bad Drs of the street” gave the board false information on good Drs and caused patients to lose access to good care and illegal drug use to rise. That was in the days when we had a good relationship with the DEA. Now that they’re on a witch hunt in so many states, Drs who have practiced good pain medicine are put out of practice daily, leaving more and more patients with nowhere but the streets and potentially tainted drugs to relieve their suffering which can result in death or have such severe pain suicide begins to look like their only way out, all because of the inability to obtain legal medications they’d had successfully for years, now removed due to the removal of their Drs or the ability of their Drs to write appropriate dosages. That’s the tail wagging the dog and must be stopped.