Lost in the battle to create fewer new patients addicted to opioids: Longtime pain patients
Krissy Houser is one of many chronic pain patients who are feeling besieged by new government and insurance company policies limiting prescription opioids.
The Bucks County woman was taking high doses of the highly addictive pain medications until her doctor got nervous in fall 2016. Federal officials were looking at his prescribing records, he told her, and she’d need to come down to the much lower dose — about a seventh of what she was taking — that was newly recommended as the ceiling for new pain patients by the U.S. Centers for Disease Control and Prevention.
Houser cried. She injured her back in a recreational vehicle accident in 2006, when she was in her late 20s. Two surgeries helped, but then she fell before the second surgery had healed. She had to leave her job at Merrill Lynch and go on disability. The opioids limited the pain enough for her to be able to help her mother, walk the dog, and see friends.
Since her doctor began slowly tapering her dose, she has suffered withdrawal symptoms and pain that is constant and intolerable, she said. Houser, who had weight-loss surgery before her accident, has gained 90 pounds since her pain treatment changed. She still has not quite met her doctor’s dosing goal. “I’ve lost friends. I’ve lost everything. I’m a shut-in,” she said.
Her mother now walks the dog. “That’s the hardest part,” she said. “She’s now taking care of me again.”
>> READ MORE: How doctors help chronic pain patients taper opioid doses
Houser sees herself as a collateral victim of the war on opioids. Experts say that most people with an opioid addiction today got started on prescription pain pills — either their own or someone else’s. New rules seek to contain the number of leftover pills available for diversion and reduce the number of pain patients who become dependent or suffer serious side effects. But longtime users with chronic pain contend that these rules are hurting law-abiding people. They and some doctors worry that the opioids pendulum, which initially swung too far toward prescribing the pills, has now swung too far toward taking them away.
Situations like Houser’s will likely become more common next January when Medicare starts enforcing its new rules on opioids, which will make it harder, though not impossible, for doctors to prescribe high doses. Medicare, which often leads on insurance coverage policy, is coming later to this issue. But, with its 58.5 million senior and disabled beneficiaries — Houser included — it wields huge influence.
In addition to rules from many private insurers and state governments that make it more of a hassle to prescribe high doses of opioids, doctors are also feeling pressured by law enforcement agencies, which monitor prescribing patterns, patients and their advocates said. Pain specialists say they’re seeing an influx of chronic pain patients who have been dumped by other doctors.
In part due to such restrictions, opioid prescribing has continued to decline from its peak in 2011. Yet U.S. doctors still prescribe more opioids per capita than doctors anywhere else in the world.
Overdose deaths continue to rise in much of the country, including Pennsylvania and New Jersey.
Should chronic pain patients be treated differently from people new to opioids?
Some chronic pain patients and experts argue that those who are accustomed to high doses and are doing well on them should be treated differently. Cutting their doses could lead to greater disability, depression, suicide and illicit drug use. Besides, they note, patients often don’t have access to pain specialists or the multimodal pain programs – employing not only medicine but also physical and emotional therapy — that research suggests is most effective.
Sharon Waldrop, vice president of the National Fibromyalgia and Chronic Pain Association, said most people on long-term, high-dose opioids failed every other option they tried first. The drugs improve their quality of life. “For a certain percentage of people,” she said, “it’s working.”
Kristen Ogden, 65, lives in Virginia with her husband, Louis, 68, who has suffered terrible headaches and widespread pain since childhood. He is taking 28 times the opioids dose Medicare will soon use as a threshold for extra scrutiny. His body does not absorb medications normally, Ogden said. The drugs, she said, make it possible for the two of them to have a social life, and they improve his thinking ability. He says he never feels high. They were traveling to a pain doctor in California for treatment and paying $5,000 a month for the half of his dose that his insurer refused to cover. His doctor says he has faced pressure from the Drug Enforcement Administration, and is retiring.
Ogden worries that they will have “no quality of life” if Louis can’t get high doses of opioids. “I feel very frustrated because my husband has done very well,” she said.
Stefan Kertesz, an addiction expert and physician at the University of Alabama at Birmingham and the Birmingham VA Medical Center, started a petition against Medicare’s initial, and even stricter, opioids proposal. The adopted rules are less onerous, but still require a pharmacist to double-check with any doctor who prescribes more than 90 milligrams of morphine equivalent (MME) a day. (That’s the equivalent of 90 mg of hydrocodone, 60 mg of oxycodone or 20 mg of methadone. A calculator can be found here.) Hospice and cancer patients were excluded from the limits, flagged in 2016 by the CDC as a point above which the risk of dangerous complications and death rose.
But that recommendation was not meant, Kertesz and others said, as a goal for people already taking higher doses.
>>READ MORE: Opioids mean relief – and humiliation – for these pain patients
Kertesz said doctors know very little about what will happen when patients are forced to taper their doses. Many will have prolonged withdrawal symptoms, including depression. He worries they will turn to street drugs or even suicide. Many will need more mental-health support and monitoring.
“We are making large-scale, very aggressive policies in an arena where data is weak,” he said. “I don’t take it as a given that every person can be tapered.”
Curbing dangerous drugs
Supporters of restrictions say that opioids are dangerous, addictive drugs that, at higher doses, raise the risk for serious side effects and death. And, these experts say, there’s little evidence that high-dose opioids are any better than alternatives for chronic pain. The CDC found no studies of long-term use of opioids that compared them with other treatments.
Andrew Kolodny, a physician who is co-director of opioid policy research at Brandeis University, said that 90 MME is an “extremely high, dangerous dose.”
Many doctors – including area geriatricians – say Medicare’s actions will have more impact on its disabled patients than seniors, because older people usually are not on high doses of opioids, which are more dangerous for the elderly. The drugs make them more vulnerable to constipation, falls and mental fogginess, doctors said. At the same time, though, some older patients are also at risk from alternatives such as ibuprofen, which also can have significant side effects.
Kolodny suspects that fatal overdoses in seniors are underreported because their deaths are blamed on other medical conditions.
But he agrees with Kertesz that, during tapering, patients need extra care for both physical and emotional side effects. The drugs can paradoxically make patients feel more pain, plus pain is worsened during withdrawal. Anxiety and a sense of impending doom are also common during tapering. “These patients,” he said, “need a lot of support bringing their doses down.”
Kolodny said opioids should almost never be used for chronic low-back pain, fibromyalgia or chronic headache, but often have been. “What we’re really talking about are the victims of our era of aggressive prescribing,” he said.
In a recent study, Erin Krebs, a researcher at the Minneapolis VA Health Care System, compared two groups of patients with serious, chronic back, hip and knee pain. The group not on opioids tried an average of four pain medications, requiring careful trial and error under close medical supervision. Compared with the second group, who took opioids, those who had other therapies scored the same on measures of function, but reported less severe pain and many fewer side effects.
Krebs, though, signed Kertesz’s petition. “We need to make sure we’re doing this right and not creating a whole lot of new, unintended problems for people,” she said.
Lewis Nelson, a medical toxicologist who is chair of emergency medicine at Rutgers New Jersey Medical School, was on the panel that developed CDC guidelines. Chronic pain patients who have used opioids for years can overdose, he said, even when their dose stays steady. It can happen when another medication is added that interacts with the opioids. Sleep apnea can also be a factor. Or a patient can get a virus that affects the lungs, leading to dangerously low oxygen levels overnight – and death. “This is very, very common,” he said.
Except for metastatic cancer patients and people who are near death, Nelson takes a hard line. He says even after surgery or a substantial injury, few people need more than five days on opioids. “I don’t think anybody should be on them for chronic pain.”
Meanwhile, Houser is miserable with pain. She wishes she could afford medical marijuana. She thinks about suicide, but says her Christian faith keeps her from doing it. “There’s only so much a human being can take,” she said.
What insurers are doing
Locally, Independence Blue Cross now requires annual prior authorization for chronic pain patients on opioids, but doesn’t set a dose threshold.
Aetna, the region’s other dominant private insurer, requires prior authorization at 90 MME. It has new programs for patients who take long-term opioids with sedatives, which increase the odds of overdose, as well as for those on high doses or with a history of overdoses. It is urging subscribers to use alternative pain approaches, including acupuncture, physical therapy and chiropractic care.
From a numbers standpoint, the prescription restrictions seem to be working. Opioid prescriptions peaked in 2011 and doses also dropped in 2017, according to a recent report from IQVIA’s Institute for Human Data Science. Doses for 90 MME and up fell by 16 percent last year.
Drug overdoses, fueled largely by illicit opioids, have continued to rise.
Filed under: General Problems
Talk about dreadful reading…kolodny honking on & the worse-than-useless Krebs study cited. Oy.
An opioid allows me to work. I can support myself financially. I understand that they are not meant to take pain away but to improve my quality of life. I don’t take my maximum dose every day — my pain varies and my activity level also varies. There are days I need to take the full prescribed dose. There is an event once a year when I ask my doctor if I can take an extra pill because it’s an event for work and it pushes my limits (it’s a convention and I’m on my feet on hard floors most of two working days).
My meds allow me to engage in some physical activity. This reduces my risk of additional chronic health issues. My mother, aunt, uncle and grandmother all have/had diabetes. I don’t want to end up with it. If you take meds away from patients who do need help, they will develop other health issues that will threaten their lives… if they don’t commit suicide first. It’s horrible.
Let me tell you about pain management. I tried to go to a pain management “practice.” They wanted me to come three times a week, for 3-4 hours a day for something like 8 weeks. They wouldn’t give me any other options and I HAD to do things their way.
My boss would have let me go. (And I don’t have protections because of the type and size of my employer).
I was discharged from pain management and they told me that they’d put something in my chart that “if (I) wanted to come back, I would be allowed.” Oh, thanks. I’ll let you know when I’m unemployed and don’t have the medical coverage to afford to go back.
These programs have their own issues. I see a physiatrist (a doctor of physical medicine and rehab). I have other chronic health issues and am struggling not to miss too much work due to appointments. Chronic pain patients don’t get support from the revolving-door model that hurries doctors through appointments onto the next patient, either. That’s why some patients don’t use their medications appropriately. But, we’re cracking down on doctors and chronic pain patients when drug dealers are where the heroin and laced fentanyl is coming from that’s killing people.
This country is so screwed up. Why not just line us up in front of firing squads? It might be more humane than what’s happening to people. I’m watching it happen to friends and there’s a trauma going on in the chronic pain community that is CAUSED by the failure of medical associations to stand up and fight back when they know doctors are being forced to made decisions based on fear of losing their licenses instead of medical expertise.
DO NO HARM.
MORE than enough eveidence, truth, through documentation that 10 times or MORE than the current allowed mme dosage has enabled and simply improved the qulaity of life for ifetime pain management patient Isn’t quality of life what all responsible people work so hard for. Does quality of life, medically neccessary medication used to keep from futher declining physiological and emotional health NOT mean anything any longer? People like Kolodny who is profiting from his “opinion” of treatment and DR. Nelson are simply hypocrites and have never expeirenced severe, continuous pain personally or watch a family memeber suffer. I would bet my life, amd that IS what HHS, CDC, and DEA are doing (betting patients’ lives) that if these two experts”experienced what some 10 million or so patients with lifetime, continuous pain have experienced, after using ALL available “legal” substances and therapies to manage pain to a tolerable level they would both beg for effective pain management regardless of the milligrams of “morphine equivalent” it took to gain some control of un managed pain. Even AG Jeff Sessions would findand use even an “illegal” substance such as cannabis to effectively control and manage pain resulting from disease or injury causing never ending pain. However one thing is not overlooked by current pain management patients, the three i have mentioned are “above the law”. They with their influence and “credentials” would not be held to what they are pushing upon current pain management patients therefore the old saying, do as I say, NOT as I do will not FORCE them to comply with CDC “policy”. Even PRESIDENT JOHN F. KENNEDY used a plethora of pain management substances, including OPIOID MEDICATION for spine pain and other non stop pain and he is and was revered as a “truth” seeker” asassinated by the “deep state”. It seems that it does not matter to the elect, the elite want rules and laws made to “control” the everday hard working citizen, it just matters that we do as THEY say! They represent ONLY their personal opinions and disregard any and all documentation of beneficial use of opioid medication and cannabis f to manage everday patients never ending, documented as “incurable” pain. Kolodny, Nelson and Sessions ARE dangerous people simply because they use their own warped, uninformed judgement, not truth. It IS fact that the substance abuse OD rate is still rising even with far too radical reduction use of opioid medication and with MILLIONS less prescriptions issued more than a year after the CDC released its “guideline” and the DEA Gestapo began to threaten and enforce this asisnine policy through our physicians.Not just my opinoin but based upon CDC released infromation.
It is propaganda and intentionally misleading to continually refer to perscribed opiates as “dangerous highly addictive drugs”. Multiple studies, meta studies. and basic math show otherwise. Studies show patients perscribed opiates have addiction rates ranging from .02-2%. There are only 2.5 million addicts in the US but hundreds of millions of opiate perscriptions each year. If opiates were “highly addictive” addiction rates would be far higher. The science behind addiction shoes that Adverse Childhood events and mental health issues are the root of addiction, not a specific medication. Last but not least the number of overdoses due to perscription opiates (over 7/8s with a 2nd CNS depressant present) is less than the total number of deaths due to accidental falls. That is not an epidemic!
The Krebs “study” is an absolute travesty. There are multiple articles shredding the “study” for the problems within the “study” and the inappropriate assumptions and generalizations of the findings.
Considering the facts, it is at best irresponsible and at worst straight propaganda to ignore the facts and continue to mislable perscribed opiates. Patients in pain are being tortured, are dying in pain, turning to illegal drugs, and committing suicide! The real epidemic is the patients in pain! While you may have acknowledged that it is lost amongst the flagrant propaganda.
Here are just some of the many facts about the real opiate crisis- the patients in pain denied treatment.
http://www.lasvegasnow.com/news/i-team-opioid-addiction-versus-dependency/987514320
https://www.statnews.com/2018/03/06/cms-rule-limits-opioid-prescriptions/
https://www.medscape.com/viewarticle/861831
http://www.latimes.com/science/sciencenow/la-sci-sn-opioid-painkillers-no-better-20180306-story.html
https://www.painnewsnetwork.org/stories/2018/3/7/is-new-opioid-study-based-on-junk-science
https://radio.foxnews.com/2018/03/07/the-other-side-of-the-opioid-controversy/
https://reason.com/blog/2018/03/09/does-that-jama-study-really-show-that-ad/amp?__twitter_impression=true
https://www.washingtonpost.com/amphtml/outlook/the-other-opioid-crisis-pain-patients-who-cant-access-the-medicine-they-need/2018/03/09/5ad83b24-2301-11e8-badd-7c9f29a55815_story.html?utm_term=.6a4a2ba04d74&__twitter_impression=true
http://reason.com/archives/2018/03/08/americas-war-on-pain-pills-is
https://www.painnewsnetwork.org/stories/2018/3/10/what-the-krebs-opioid-study-didnt-find#.WqQ71Ir86oY.twitter
https://m.youtube.com/watch?v=cR0QJxt5sI4&feature=youtu.be
https://www.npr.org/sections/health-shots/2018/03/09/592305410/questions-and-answers-about-opioids-and-chronic-pain?utm_campaign=storyshare&utm_source=twitter.com&utm_medium=social
https://www.fredericknewspost.com/news/health/hospitals_and_doctors/chronic-pain-patients-report-struggles-under-tighter-opioid-regulations/article_f6cdf517-ba94-59a6-8395-644ecccc77e2.html
https://www.medpagetoday.com/publichealthpolicy/opioids/71661
https://www.justice.gov/opa/pr/attorney-general-sessions-announces-new-prescription-interdiction-litigation-task-force
https://www.cato.org/publications/commentary/lets-stop-hysterical-rhetoric-about-opioid-crisis
The Problems w Using COD as a data point
https://m.youtube.com/watch?feature=youtu.be&v=FzY2tIU83II
https://www.cato.org/blog/cdc-researchers-state-overdose-death-rates-prescription-opioids-are-inaccurately-high
http://ushealthtimes.com/many-with-chronic-illness-denied-prescriptions-in-fight-against-opioids/
http://ushealthtimes.com/how-fear-of-losing-their-doctor-affects-chronic-pain-patients/
https://www.cato.org/policy-report/septemberoctober-2017/myth-opioid-prescription-crisis
http://amp.slate.com/technology/2018/03/pill-limits-are-not-a-smart-way-to-fight-the-opioid-crisis.html?__twitter_impression=true
https://omny.fm/shows/roy-green-show/cutting-chronic-pain-patients-off-opioid-medicatio
https://www.circa.com/story/2018/04/02/nation/fentanyl-made-illicitly-could-have-inflated-opioid-prescription-deaths-and-wrongly-influenced-cdc-guidelines-on-opioid-prescribing-some-doctors-say
https://www.kevinmd.com/blog/2017/12/7-reasons-pain-pain.html
https://amp.theguardian.com/us-news/2016/jul/12/prescription-drugs-what-if-you-depend-on-opioids-chronic-pain
https://www.acsh.org/news/2017/10/12/opioid-epidemic-6-charts-designed-deceive-you-11935
https://www.rehabs.com/pro-talk-articles/how-the-media-is-fueling-the-so-called-opioid-overdose-epidemic/
ThomasKlineMD/suicides-associated-with-non-consented-opioid-pain-medication-reductions-356b4ef7e02a
http://www.pharmacytimes.com/contributor/jeffrey-fudin/2018/02/opinion-a-reaction-to-deas-efforts-to-target-pharmacies-with-unusual-opioid-prescription-rates
http://ushealthtimes.com/doctors-beginning-to-speak-out-about-pain-patients-denied-opioids/
http://www.practicalpainmanagement.com/resources/news-and-research/aapm-raise-concerns-over-cdc-opioid-guidelines
https://thecrimereport.org/2018/01/09/criminalizing-the-opioid-epidemic-is-no-way-to-help-chronic-pain-sufferers/
http://www.researchgate.net/publication/316769845_Using_Local_Toxicology_Data_for_Drug_Overdose_Mortality_Surveillance
http://ushealthtimes.org/2018/02/11/a-letter-to-those-who-do-not-have-crps-rsd/
https://globalgenes.org/raredaily/a-long-road-to-a-diagnosis-ehlers-danlos-syndrome/
blogs.scientificamerican.com/mind-guest-blog/opioid-addiction-is-a-huge-problem-but-pain-prescriptions-are-not-the-cause/
https://amp.theguardian.com/commentisfree/2017/nov/07/truth-us-opioid-crisis-too-easy-blame-doctors-not-prescriptions?CMP=share_btn_tw&__twitter_impression=true
https://www.washingtonpost.com/local/growth-in-md-opioid-fatalities-comes-almost-entirely-from-fentanyl-related-deaths/2017/10/24/fc278b9e-b8f6-11e7-a908-a3470754bbb9_story.html?utm_term=.6527cfd48bf8
http://www.nytimes.com/interactive/2017/08/03/upshot/opioid-drug-overdose-epidemic.html
https://www.ncbi.nlm.nih.gov/pubmed/28582659
https://www.acsh.org/news/2018/02/14/dear-cdc-what-will-you-screw-next-meth-back-12574
https://www.acsh.org/news/2017/08/16/heads-sand-—-real-cause-todays-opioid-deaths-1168
http://www.lasvegasnow.com/news/i-team-opioid-addiction-versus-dependency/987514320
https://www.statnews.com/2018/03/06/cms-rule-limits-opioid-prescriptions/
https://www.medscape.com/viewarticle/861831
http://www.latimes.com/science/sciencenow/la-sci-sn-opioid-painkillers-no-better-20180306-story.html
https://www.painnewsnetwork.org/stories/2018/3/7/is-new-opioid-study-based-on-junk-science
https://radio.foxnews.com/2018/03/07/the-other-side-of-the-opioid-controversy/
https://reason.com/blog/2018/03/09/does-that-jama-study-really-show-that-ad/amp?__twitter_impression=true
https://www.washingtonpost.com/amphtml/outlook/the-other-opioid-crisis-pain-patients-who-cant-access-the-medicine-they-need/2018/03/09/5ad83b24-2301-11e8-badd-7c9f29a55815_story.html?utm_term=.6a4a2ba04d74&__twitter_impression=true
http://reason.com/archives/2018/03/08/americas-war-on-pain-pills-is
https://www.painnewsnetwork.org/stories/2018/3/7/is-new-opioid-study-based-on-junk-science
https://radio.foxnews.com/2018/03/07/the-other-side-of-the-opioid-controversy/
https://reason.com/blog/2018/03/09/does-that-jama-study-really-show-that-ad/amp?__twitter_impression=true
https://www.washingtonpost.com/amphtml/outlook/the-other-opioid-crisis-pain-patients-who-cant-access-the-medicine-they-need/2018/03/09/5ad83b24-2301-11e8-badd-7c9f29a55815_story.html?utm_term=.6a4a2ba04d74&__twitter_impression=true
http://reason.com/archives/2018/03/08/americas-war-on-pain-pills-is
https://www.painnewsnetwork.org/stories/2018/3/10/what-the-krebs-opioid-study-didnt-find#.WqQ71Ir86oY.twitter
https://m.youtube.com/watch?v=cR0QJxt5sI4&feature=youtu.be
https://www.npr.org/sections/health-shots/2018/03/09/592305410/questions-and-answers-about-opioids-and-chronic-pain?utm_campaign=storyshare&utm_source=twitter.com&utm_medium=social
https://www.fredericknewspost.com/news/health/hospitals_and_doctors/chronic-pain-patients-report-struggles-under-tighter-opioid-regulations/article_f6cdf517-ba94-59a6-8395-644ecccc77e2.html
https://www.medpagetoday.com/publichealthpolicy/opioids/71661
https://www.justice.gov/opa/pr/attorney-general-sessions-announces-new-prescription-interdiction-litigation-task-force
https://www.cato.org/publications/commentary/lets-stop-hysterical-rhetoric-about-opioid-crisis
The Problems w Using COD as a data point
https://m.youtube.com/watch?feature=youtu.be&v=FzY2tIU83II
https://www.cato.org/blog/cdc-researchers-state-overdose-death-rates-prescription-opioids-are-inaccurately-high
http://ushealthtimes.com/many-with-chronic-illness-denied-prescriptions-in-fight-against-opioids/
http://ushealthtimes.com/how-fear-of-losing-their-doctor-affects-chronic-pain-patients/
https://www.cato.org/policy-report/septemberoctober-2017/myth-opioid-prescription-crisis
http://amp.slate.com/technology/2018/03/pill-limits-are-not-a-smart-way-to-fight-the-opioid-crisis.html?__twitter_impression=true
https://omny.fm/shows/roy-green-show/cutting-chronic-pain-patients-off-opioid-medicatio
https://www.circa.com/story/2018/04/02/nation/fentanyl-made-illicitly-could-have-inflated-opioid-prescription-deaths-and-wrongly-influenced-cdc-guidelines-on-opioid-prescribing-some-doctors-say
http://ushealthmagz.com/2018/04/07/daughter-says-untreated-pain-led-to-mothers-suicide/
https://atipusa.org/news/atips-response-to-three-things-to-understand-about-americas-opioid-crisis/
https://www.acsh.org/news/2018/04/09/study-links-rising-heroin-deaths-2010-oxycontin-reformulation-duh-12812
https://www.geripal.org/2016/03/chronic-cancer-versus-non-cancer-pain.html?m=1
https://www.acsh.org/news/2017/06/05/just-another-reason-why-one-size-fits-all-opioid-laws-wont-work-your-liver-11367
lyrica problems
http://ushealthtimes.com/lab-reports-updates-neurontin-and-lyrica-adverse-effects-the-silent-killer/
http://www.healthsystemtracker.org/chart-collection/how-has-spending-on-opioid-prescription-use-and-addiction-treatment-changed-over-time/
?_sft_category=spending&utm_source=facebook&utm_medium=cpc&utm_campaign=opioids-fb-ads#item-children-and-other-dependents-account-for-the-largest-share-of-large-employer-spending-
http://www.conservativereview.com/articles/congress-screw-drug-overdose-crisis/
https://www.gop.gov/fighting-americas-opioid-epidemic/
https://atipusa.org/news/has-the-opioid-pendulum-swung-too-far-finding-the-balance-between-pain-and-addiction/
https://atipusa.org/2018/04/02/atip-white-paper-on-prescription-opioids-and-chronic-pain/
https://reason.com/blog/2018/04/19/as-opioid-prescriptions-fall-opioid-deat
https://www.military.com/militaryadvantage/2018/04/06/court-rules-chronic-pain-va-disability.html/amp?__twitter_impression=true
http://usahealthtimes.com/2018/03/15/sudden-unexpected-death-in-chronic-pain-patients/
https://www.acsh.org/news/2018/04/06/prescribing-opioids-let-physicians-be-physicians-12805
http://nationalpainreport.com/opinion-dea-denying-necessary-medications-8836075.html
https://www.pharmaciststeve.com
http://www.foxnews.com/opinion/2018/04/25/greg-gutfeld-opioids-facts-and-fallacies.html
https://www.pharmaciststeve.com/?p=25476
http://nationalpainreport.com/opinion-the-dea-draws-a-firestorm-of-criticism-8836146.html
http://www.painnewsnetwork.org/stories/2018/5/3/study-finds-opioid-medication-effective-for-chronic-pain
https://www.statnews.com/2018/05/01/fentanyl-opioid-overdose-deaths-prescription-painkillers/
https://medium.com/@jonleighton1/why-access-to-morphine-is-a-human-right-80ce2965de1a
http://www.painmedicinenews.com/Web-Only/Article/04-18/CDC-Deaths-From-Synthetic-Opioids-Doubled-in-1-Year/48515?sub=5D69EC3B9D3D4FC2DE842B61731C826FEC96BC1C185E597A5BC274C75F94&enl=true
https://www.cbsnews.com/amp/news/fentanyl-deaths-now-outpace-prescription-painkiller-overdoses-study-finds/
https://medium.com/@robertdrosejr/calling-bull-crap-on-story-by-us-dept-of-state-f656aa241820
https://nypost.com/2018/05/24/the-insane-crackdown-on-pain-medication/amp/
He is a complete idiot. My old dr had patients that needed 1500 mgmme daily i order to have a quality of life. I take 5/15 mg oxycodone faily and wear a 100 mcg fentanyl patch.
I have never been high from my medicine 1 time in my life.
There was one time in my forever pain timeline. That was when my dr wanted to lower the oxycodone. Re replaced it with soma. That night i passed out and went to hospital. He immediately ediately took me off and apologized. Saying his co.pany.wanted to reduce opioids and use muscle relaxers or antidepressants to make yhe dea happy. I stressed i am not the deas gunnea pig.
I also wanted to see what everybody was talking about. So 1 day after acquiring narcan i wanted to see how much of this pain relievers it would take to get me to the level of being high like a smoking a few hots of weed like i did in high school well over 40 years my father was present at the time so i was not alone. At the time almost 3 yrs ago i was prescribed 3/ 80 mg of oxycontin ER and 3/30 mg of oxycodone for breakthru pain daily. For 7 yrs i never adjusted my dose, it lasted 30 days, the medicationtook me from bedridden to being active, severe pain with every movement to being able to walk, be with my wife enjoy hugs wothout grimacing. This was vey controlled.
Instead of spreading out the 3 oxycontin er over the day, i tookit all at once. For the fo
Irst time in years my pain was 95% gone. ABSOLUTELY NO MIND ALTERING FEELING. AFTER 2 HOURS I TOOK THE THREE OXYCODONE. I SWALLOWED AS DIREECTED. I KNEW THE MEDICATION WOULD WARE OFF IN LESS THEN 8 HOURS. NOW IN ORDER TO ACHIEVE ANY MIND ALTERING EFFECTS, I TOOK 1 EVERY HOUR FOR FOUR HOURS.
THIS TIME I CHEWED THEM. SO I WOULD GET IMMEDIATE RELEASE INOW HAD 650 MGS OF OXYCODONE/CONTIN DISOLVED IN MY SYSTEM.
BECAUSE I DIDNTT WANT TO RUN OUT TOO EARLY IN THE MONTH I STOPPED THERE. AT THAT TIME AN OCCASIONAL 3 DAY EARLY REFILL WAS OK.
MY PAIN WAS GONE, I WAS ABLE TO MOW MY LAWN WHICH I HAVENT DONE IN YEARS, AND I WASHED MY CAR. THERE WAS ABSOLUTELY NO HIGH. AT ALL. ONLY PAIN RELIEF. IF I WERE ABLE TO GET A DOSE SIMILAR TO THAT IW OULD NOT BE DISABLED, I WOULD BE ABLE TO BE A 100% FUNCTIONING ADULT. I MADE LOVE TO MYWIFE THAT EVENING. SHE ASKED ME TO TELL THE DR AND TRYTO GET MY DOSE INCREASED. I TOLD HE IF I TOLD HIM WHAY I DID HE WOULD DROPE AS A PATIENT IN A MINUTE.
NOW IN THE EARLY AND MID 1990S I TRAVELLED QUITE A BIT FOR MY JOB. WHEN I WAS IN DOWNTOWN SAN FRANCISCO I HAD TO SEE MACYS ONCE A MONTH. I USEDTO WALK 5/7 MILES EVERY MORNING. BESIDES THE CRACK COCAINE BEING SMOKED EVERYWHERE I WITNESSED PEOPLE SHOOTONG HEROIN ALL OF THE TIME. I SAW THE ENTIRE PROCESS. MOST OF THEM NODDED OUT IN SECONDS, COULDNT WALK, THEY WOULD JUST SIT THERE WITH THIER HEADS SHRUGGED. THEY WOHLD SLUR EVERY WORD AND THEY WERE FRIGGIN WASTED. I WOULD NEVER WANT TO FEEL THAT WAY. I THOUGHT FOR SURE THE OXYCONTIN WOULD HAVE AT LEAST HAD ME SLUR MY WORDS, BUT THEY DID NOT. MY MEDICATION ONLY TOOK THE PAIN AWAY. WHEN I SPOKE TO A DIFFERENT PAIN DR ABOUT A YEAR.LATER, HE SAID ITS SIMPLE
I LIVE IN PAIN, SEVERE PAIN. THE MEDICATION ATTACKS THE PAIN. IF I DIDNT HAVE THE SEVERE PAIN I WOULD HAVE GOTTEN HIGH ST SOME POINT. HENSAIDBINALSO HAVE A FAST METABOLISM AND A HIGH TOLERANCE.HE ALSO SAID HEROIN IS A COMPLETELY DIFFERENT CHEMICAL MAKE UP. IF I WERE TO INJECT 1/100 THAT AMOUNT OF HEROIN I WOYLD PROBABLY GET A MINOR HIGH, BUT HALF THAT AMOUNT WOULD MOST LIKELY KILL ME. THATS WHY HE HATE PEOPLE LIKE KOLODNEY THAT COMPARE PAIN RELIEVERS TO HEROIN. BECAUSE MOST PEOPLE THAT WERE UNDUELY CUT OFF OR TAPERD RAN TO HEROIN AS A REPLACEMENT TO HELP WITH THIER PAIN. BECAUSE OF THE PROPAGANDA AND LIES THAT KOLODNEY SPEWS EVEN CHUCK SHUMER CALLED A VICODIN A HEROIN PILL YEDTERDAY. SINCE THEY WERE TOLD ITS THE SAME, THE PATIENT IMMEDIATELY USES THE VISUAL EQUIVALENT ONLY IN HEROIN FORM OR ILLEGAL FENTANYL FORM. THEY OVERDOSE IMMEDIATELY AND THEN EITHER DIE OR ARE IN A COMA. THIS IS THE GOVT GETTING INVOLVEDN OR A FOOLISH PERSON LIKE KOLODNEY THAT MAKES MONEY OFF OF EVERY ADDICT THAT WALKS THRU HIS NATION WIDE DOORS AND INSURANCE COMPANIES THAT ENJOY DENYING PAIN MEDS AND SAVING BILLIONS OF $$$$$$. PLEASE DONT TRY WHAT I DID AT HOME. EVERYBODY REACTS DIFFERENTLY. I WOULD NOT WANT ANYBODY TO TRY THIS, I TOOL ONE FOR THE TEAM. I WANTED TO MAKE SURE WHAT I AM FIGHTING FOR IS THE TRUTH. IT IS THE TRUTH. IM NOW ON AVOUT 210MGS OF OXYCONTIN AND OXYCODONE DAILY. LESS THEN HALF OF MY STABLE DOSE.
IM BEDRIDDEN, I NEED HELP GETTIMG DRESSED, MAKING.LOVE CAN KNLY.BE A DREAM. I FEEL SO SORRY FOR MY.WIFE. I CANY AFFORD A GARDNER SO EVERY FEW DAYS I FORCE.MYSELF TO PUSH.IT 2/3 ROWS EVERY FEW DAYS. IT TAKES TWO WEEKS TO DO THE JOB
IN OTHER WORDS ITS NEVER DONE I CANT WALK MORE THEN 25/30 YRDS WITHOUT MNEEDING TO REST FOR AT LEAST 10/15 MINUTES. I ONLY SLEEP 4 HOURS A DAY I AM PERMANANTLY DISABLED AND ALWAYS DEPRESSED. I KNOW HOW WELL THE MEDICINE WORKS AND WHAT IT CAN DO FOR ME
YET, BECAUSE OF THE JUNKIES SHOOTING UP HEROIN AND ANYTHING ELSE THEY CAN PUT IN THIER ARMS THOSE OF US IS SEVERE PAIN DUE TO INOPERABLE DISEASES, WE MUST SUFFER.
IVE HEARD AND SEEN TERRIBLE THINGS DONE TO HUMANS. HIS I BELIEV WOULD MAKE THAT NATZI DR THAT EXPERIMENTED ONJEWS GAYS AND OTHERS VERY VERY PROUD. SHAME ON ANY OF YOU THAT THIN PAIN SHOULD HE UNTREATED BECAUSE JUNKIES MADE BAD CHOICES.
PLEASE FEEL FREE TO COPY AND SHARE
ONLY 1 DAY REMAINS TO SUBMIT YOUR COMMENTS TO THE FDA TO HOPEFULLY STOP THE DEA CAPPING PAIN REVIEVERS, ALLOW OUR DRS TO TREAT US ACCORDINGALLY AND GIVE US OUR KIVES BACK
THIS WAS THE NEW FORMULATION BY THE WAY.
Kolodny is a mediocre doctor with poor “critical thinking” skills, prone to hyperbole, misinformation and outright BS.
He is the root of 100s of suicides, at fault for my ER trip with afib, due to my pain not being controlled. Then 2 days in ICU and no pain control. You have caused good ppl immense pain, stolen quality of life.
I wish you crippling RA and CP, yelling un pain. They give you a Tylenol.
Kolodny is now benefiting from considering every chronic pain patient on high doses of opioids an addict. I can’t remember exactly how (I just read about it this week) but he is tied to the suboxone and treatments they want to force us to take and therefore benefits, it’s bullshit and should be so transparent.
Kolod runs a bunch of addiction treatment centers…I’m sure that has nothing to do with his campaign against opioids; he surely has only the best interests of those patients at heart….all the zillions of $$$$ he’ll make of ’em is surely just a mionor detail in his campaigning.
10 of America worst atrocities of human torture were done by psychiatrist,,Andrew Kolodyns is #11,,Our Government is allowing a true psychopath the power of authority over human beings in physical pain from medical condition,thee authority to take away effective medicines to lessen physical pain of thee archaic ideology that opiates are ONLY DRUGS TO GET HIGH OFF OF and not recognizing opiates are also a medicine for those w/painful medical conditions,,maryw
How difficult is it to understand that pain generating disease, injury and suregry, even unneccesary suregry can put the mind with such intolerable physical pain into a state of depression and the body experiencing literal intolerable pain into a quick and steadily declining state of health requiring medication not neccessary if lifetime pain is managed to the patients tailored effective dosage of opioid medication when it is the LAST effective medication known to man? Kolodny, eveidently has NEVER experienced contiinuous, lifetime pain and he IS a hypocrite if he has never expeieneced the pain that “good” people, Jeff, are enduring with CDC “guidelines to the disastrous point of taking their own lives to escape it. Mr. Nelson “could” be right about adding a medication to an otherwise “stable” dosage of pain relieving opioid medication when stably treated with a dosage that exceeds 90 mme so that is why that the treating physician should know of ALL medications being prescribed to an opioid pain mangement patient. How difficult is this to do for those of us that have used opioid medication beneficially for decades.Kolodny and Nelson “thinking”, without experiencing never ending “7” or “8” plus level on the pain scale is more than dangerous to pain manag,ent patients, it IS deadly. The statistics of “legal” alcohol use and the devaststing effects of using it for a few years is accepted yet, we who are dealing with torture ;evel degrees of continuous pain should simply “tough it out”? I don’t even need to reference all the treating physicians that KNOW that opioid medication in a tailored to the patient, effective dosage FAR outweigh the “opinions” of Kolodny and Nelson. O thou hypocrites, how can you take a position when the overdose rate is still rising even with too far tailored dosages of opioid medication and MILLIONS less prescriptons issued in 2017? I will STILL be more than happy to provide my documentation that a higer dosage than 90 mme has enabled me, allowed me to remain active and employed for 23 years until the CDC “guideline was enforced. The “opinion” of MANY more treating physicians along with their patients documentation instead of the one physician profiting handsomely by the CDC “guideline”. I do not understand why these two can not understand that not all patients metabolize medications the same along with other relevant physical factors with opioid medication use and I am not a doctor, just one of the tormented.