PHARMACIST STEVE

Montana Pain Patients Rebuttal To: Montana Know Your Dose Statistics

December 6, 2015

In 2014 there were 243 completed suicides in Montana:

• 81% involved Males

• Almost 25% of completed suicides involved Veterans

• Most common age group was 55-64 years old, or 51 suicides

• Approximately 9% of suicides involved Native Americans

• Often over-looked number is that 40 percent of Montana’s completed suicides involved people with severe medical problems, including terminal illness or chronic pain. “We have to change something with this issue … with people who are tired of the pain, who didn’t want to have another surgery,” said Karl Rosston, Montana’s suicide prevention coordinator and a member of the Montana Suicide Mortality Review Team.

Montana DPHHS reports the following statistics on Montana poisonings (August 2014):

Year of Death Total Deaths Accidents Suicides Homicides Undetermined Intent

2009 139 91 30 0 18

2010 115 60 32 0 23

2011 135 86 21 0 28

2012 109* 72 19 0 18

*NOTE: There were 90 poisonings (109 minus 19) of accidental or undetermined intent. Suicide statistics should not be included within the “overdoses” as this skews the statistics shared by the MT Know Your Dose campaign. According to our research, some coroners accommodate grieving families and categorize the cause of death as accidental since suicide typically voids most insurance benefits. According to more recent statistics from MT Department of Public Health and Human Services, Montana is gaining the upper hand on prescription drug abuse, and yet intentional suicides are increasing.

Problems: Poisoning Deaths quoted in Montana Know Your Dose statistics include intentional suicides and many other classes of drugs in addition for opioids for pain control.

“…There is mounting evidence that patients on chronic opiates usually have a poorer quality of life and life expectancy, when compared to those treated by other means,” Dr. Marc Mentel, D.O., Associate Program Director for Osteopathic Curriculum at the Family Medicine Residency of Western Montana and MMA Prescription Drug Abuse Reduction Faculty.”

This quote was retreived from Montana Know Your Dose website with no citation regarding supporting studies on which Dr. Mentel is basing his claim. Is it peer reviewed research or anecdotal?

“…there is no consistent, high quality, evidence that chronic opioid therapy is effective for the treatment of non-cancer pain,” Dr. Camden Kneeland, Medical Director, Montana Center for Wellness and Pain Management and MMA Prescription Drug Abuse Reduction Faculty.”

Again, this quote was retrieved from the Montana Know Your Dose website with no citation on which studies Dr. Kneeland is basing his evidence. Is it peer reviewed research or anecdotal?

There were no disclosures regarding Dr. Kneeland’s potential conflict of interests. Dr. Kneeland receives research grants from St. Jude, manufacturer of implantable spinal cord stimulator units. Dr. Kneeland performs other interventional pain procedures, including epidural steroid injections for back pain. There is no steroid approved by the FDA for the epidural route of adminstration. Patients are not warned of the potential risks, including the serious complication of adhesive arachnoiditis. The FDA issued a warning on the risks on April 23, 2014. We have requested that the FDA warning be added to the MT Know Your Dose website since the guidelines from the American Society of Interventional Pain Physicians was posted. ASIPP’s protocoal for the treatment of pain is not appropriate for this website.

Questions:

1. The number of prescription drug-related deaths also numbered 109 in 2013, according to references below. This results in 109 poisoning two years in a row (2012 and 2013). Is there an error in reporting?

2. Should physicians who are quoted, and whose recommendations are listed on the state funded Know Your Dose website, be required to disclose their potential financial gain from promoting procedures they perform?

Our Position: The Montana Prescription Drug Registry (MPDR) has been a success. It is time to focus on pain and suicides resulting from untreated pain conditions and overuse of invasive procedures for chronic pain. Combining statistics from 2011-2013 for drug overdose deaths misrepresents the data and doesn’t show that prescription drug overdose deaths have declined. The MPDR is working.

Addiction problems affecting Montana’s youth should be addressed separately from chronic pain patients suffering from Veteran combat injuries, bad backs, arthritis, and many pain conditions associated with an aging population.

References Retrieved From:

1. http://missoulian.com/news/state-and-regional/percent-of-montana-suicides-in-were-males-nearly-percent-were/article_c5ab2cdf-0b7f-54af-b2fb-23bb2cd3cd0c.html

2. https://dphhs.mt.gov/Portals/85/publichealth/documents/Epidemiology/MTHDDS/Special%20Reports/Drugdeathshosps.pdf

1. http://m.missoulian.com/news/state-and-regional/montana-struggles-to-combat-prescription-drug-abuse-drug-registry-ineffective/article_6bbcefda-20b6-11e4-a7d3-001a4bcf887a.html

2. http://www.alcoholalert.com/drunk-driving-statistics-montana.html

Filed under: General Problems