WALTER F. WRENN, III M.D. A CLEAR UNDERSTANDING OF ADDICTIONS, PAIN, DEPENDENCY

WALTER F. WRENN, III M.D. A CLEAR UNDERSTANDING OF ADDICTIONS, PAIN, DEPENDENCY

https://youarewithinthenorms.com/2021/12/18/walter-f-wrenn-iii-m-d-a-clear-understanding-of-addictions-pain-dependency/

Walter F. Wrenn III M.D

A CLEAR UNDERSTANDING

There have been many theories surrounding addiction. There have been papers written by so-called experts who sight statistics to back them up.

A medical specialist with board certification in pain and addiction has been established. Recommendations and laws have been enacted without a clear understanding of the problem.

DONATE LEGAL DEFENSE

Health care providers have been arrested and convicted of violations of these laws and recommendations. Despite all the actions taken deaths from addiction continue to rise.

METHADONE 10MGS

Individuals continue to be deprived of adequate pain medication causing them to either go to the streets for relief overdose and die or commit suicide because the pain is too unbearable.

These individuals are ignored when reporting deaths from a drug overdose. As a person who grew up in the inner city, I had a front-row seat watching the consequences of addiction.

The idea that opiate prescription medication is responsible for the opiate epidemic ignores the actual truth.

ADDICTED TO HEROIN

In 1954 I saw people who were addicted to heroin. One of my friends was curious.

The young lady who was the object of his curiosity first tried to discourage him. Eventually, she decided to help him experience injecting himself with heroin. I watched this event as the heroin was being prepared in a spoon and drawn into a syringe.

WALTER F. WRENN, MD

The tourniquet a rubber tube was tied tightly around his arm. The needle was inserted and the tourniquet was released. The heroin was slowly pushed by the young lady into his vein.

He started to feel the effects of the heroin and then entered into a euphoric state. He said I should try it. I told him he was crazy and I wasn’t putting anything into my body. I remember that event until this day. This individual was a good student. 

He finished high school and was accepted to Lincoln University in Oxford but his addiction was so severe eventually he was dismissed from Lincoln moved to California and battled this addiction for his entire life.

FROM THE DOCUMENTARY CRIME OF THE CENTURY

Most addictions begin to like my friends. Curiosity and recreational use. Today it may begin with the use of a parent’s opiate pain medication left in the medicine cabinet. Again curiosity and recreational. 

NELSON MANDELA

The how and why can be debated. Ignored and not discussed even by physicians is the physiological action of opiates on the body and brain and the role of opiate receptors found in the body and brain.

Without this knowledge and understanding, no one can accurately talk about the cause of opiate addiction or how to treat it.

UNDERSTANDING THE MU RECEPTOR

Since the first opiate receptor, the Mu receptor was not discovered until 1972 any study prior to 1972 about addiction can’t be accepted by the medical community or the general public.

Also making studies more difficult is that it is almost impossible to study this unreliable group of individuals.

In order to properly address the problem of addiction, we need to examine our prior thinking and conclusions that have caused great harm to patients and health care providers.

We have to determine the physiological action of not only the Mu receptor but the Delta and Sigma receptors. Let’s study the problem first then do the appropriate clinical trials and then offer solutions. 

Walter F. Wrenn III M.D

 

 

 

FOR NOW, YOU ARE WITHIN

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Update 12/17/2021:Denial of pain: University of Louisville Hospital- stage FOUR metastatic cancer

Per Mona:  Cancer pain is no joke….it’s like living in eternal hell with no way out….it’s not necessary to have to suffer when you’re dying. Whoever said that?

This is a follow up from a post that made the first of the week  Update 12/15/2021:Denial of pain: University of Louisville Hospital- stage FOUR metastatic cancer

 

I tried to reach out to Mona & her Husband and was only able to leave voice mails and I got no return calls. Given that this Tik Tok was posted about midnight last night, apparently they did listen to the VM’s that I left.  I was very concerned about her and the actions of the pain doc that she was seeing while in the hospital and was the first time that this pain doc had seen here abt one week earlier.

In this video, she appears to look as if her pain is being managed much better than the pt that I saw in the hospital this past Tuesday.  Hopefully, her internists got back into the picture and got her back on her pain meds, that she had been taking – for some 5-7 yrs – before entering the hospital.

I never had the opportunity to speak with the pain doc and even though I requested to have the hospital’s patient advocate and the palliative care team on Tuesday – after waiting for FOUR HOURS…NO ONE BOTHERED to grant my request.

I was able to talk to those physicians that had overseen Mona’s radiation therapy that day and a second year resident that stopped by.  Each one, I impressed  my concerns about what was I hearing  about what Mona’s post discharge pain management would be and it was – IMO – NOT GOOD !  I tried to impress on them that someone – UP THE LADDER – needed to be made aware of what appeared to be inadequate pain management proposed.

Any practitioner that refuses to consider what the pt’s prior medication therapy that has worked well for the pt and decides to take the pt’s therapy in an entirely different direction lacks a lot of concern for the pt’s QOL and more may be about feeding the practitioner’s EGO.

While Mona’s prognosis is still not good, her QOL seems to be as good as it is going to get … and for that, I AM HAPPY.

Fentanyl overdoses become No. 1 cause of death among US adults, ages 18-45: ‘A national emergency’

for year 2020, there is a reported 75,000 OD’d that involved ILLEGAL FENTANYL ANALOG – remember – according to Wikipedia – there is some 400 different Fentanyl analogs… with only one analog being a FDA approved for use in humans.  Remember the Vietnam war – a total of 20 yrs and a total of 58,220 USA soldiers died.  So in 2020, about 30% more people died from illicit fentanyl from China and Mexico and WE ARE NOT AT A DECLARED WAR WITH THEM. Or have they declared WAR ON US … and we just have not bothered to figure it out ?  Also remember Pearl Harbor and 911 attack when abt a total of 5000 died ? Still overall – fewer deaths than last year by illicit Fentanyl from Mexico & China

Fentanyl overdoses become No. 1 cause of death among US adults, ages 18-45: ‘A national emergency’

More adults between 18 and 45 died of fentanyl overdoses in 2020 than COVID-19, motor vehicle accidents, cancer and suicide

https://www.foxnews.com/us/fentanyl-overdoses-leading-cause-death-adults

Fentanyl overdoses have surged to the leading cause of death for adults between the ages of 18 and 45, according to an analysis of U.S. government data.

Between 2020 and 2021, nearly 79,000 people between 18 and 45 years old — 37,208 in 2020 and 41,587 in 2021 — died of fentanyl overdoses, the data analysis from opioid awareness organization Families Against Fentanyl shows.

Fentanyl is a synthetic opioid that can be deadly even in very small amounts, and other drugs, including heroin, meth and marijuana, can be laced with the dangerous drug. Mexico and China are the primary sources for the flow of fentanyl into the United States, according to the Drug Enforcement Agency (DEA). 

Comparatively, between Jan. 1, 2020, and Dec. 15, 2021, there were more than 53,000 COVID-19 deaths among those between the ages of 18 and 49, according to data from the Centers for Disease Control and Prevention (CDC).

“This is a national emergency. America’s young adults — thousands of unsuspecting Americans — are being poisoned,” James Rauh, founder of Families Against Fentanyl, said in a statement. “It is widely known that illicit fentanyl is driving the massive spike in drug-related deaths. A new approach to this catastrophe is needed.”

Rauh, who lost his son to an overdose, added that “declaring illicit fentanyl a Weapon of Mass Destruction would activate additional and necessary federal resources to root out the international manufacturers and traffickers of illicit fentanyl and save American lives.”

The DEA on Thursday announced a surge in the sale of fake prescription pills containing deadly opioids on social media platforms like Snapchat.

Experts believe there is a correlation between the impact of the coronavirus pandemic and the recent increase in fentanyl overdoses.

More adults between 18 and 45 died of fentanyl overdoses in 2020 than any other leading cause of death, including COVID-19, motor vehicle accidents, cancer and suicide. Fentanyl also killed more Americans in general in 2020 than car accidents, gun violence, breast cancer and suicide, according to the analysis of CDC data from Families Against Fentanyl. 

Fentanyl deaths doubled from 32,754 fatalities to 64,178 fatalities in two years between April 2019 and April 2021.

In the first five months of 2021 alone, more than 42,600 fentanyl overdose deaths were reported, which represents an increase of more than 1,000 fentanyl deaths per month compared to the same time period in 2020.

“Fentanyl has been found in all the drug supply. That’s why anyone using drugs, not just opioids, should carry naloxone,” Dr. Roneet Lev, emergency physician and former chief medical officer of the White House Office of National Drug Control Policy (ONDCP), said in a statement. “The only safe place to obtain drugs is the pharmacy.”

Overall drug overdose deaths are expected to surpass 100,000 in 2021, according to preliminary CDC data, representing a 28% increase between April 2020 and April 2021.

President Biden on Wednesday issued an executive order authorizing sanctions against any foreigner engaged in illicit drug trafficking or production.

“I find that international drug trafficking — including the illicit production, global sale and widespread distribution of illegal drugs, the rise of extremely potent drugs such as fentanyl and other synthetic opioids, as well as the growing role of internet-based drug sales — constitutes an unusual and extraordinary threat to the national security, foreign policy and economy of the United States,” Biden’s order states.

Fentanyl drug seizures at the border have reached record highs in 2021, according to data from Customs and Border Protection (CBP), as the Biden administration faces a continuing crisis at the southern border.

Border authorities have seized more than 11,000 pounds of fentanyl so far in fiscal year 2021, with less than one month to go, dwarfing the 4,776 pounds seized in fiscal 2020. CBP seizures of other drugs, including marijuana, cocaine and heroin have generally decreased since 2018.

Experts recommend people who use any kind of drug carry Narcan, a lifesaving medicine also known as naloxone, which has the ability to reverse symptoms of an overdose and potentially save lives, according to Family First Intervention.

CDC advisory panel recommends Pfizer and Modern vaccines over Johnson & Johnson

Just announced that 800,000 have died from COVID-19 in the USA https://www.nbcnews.com/news/us-news/least-800000-americans-died-covid-rcna8380 and what we have had is the largest clinical trial without any controls…  all those hundred of million COVID-19 vaccinations were provided under EUA (Emergency Use Authorization).  Until the COVID-19 vaccines, all clinical trials have a CONTROL GROUP and generally takes 10+ yrs…  and I can’t count the number of times that a new medication came to market after appropriate and lengthy clinical trials and not unusual that within the first year is pulled from the market for some sort of  previously not recorded serious side effect or interaction.  The numbers are all over the place but it seems that some 16 million J&J vaccinations have been given.  Females between 30 & 49 seem to be the most at risk and the risk is 1 in 100,000 and 1 in 700,000 is FATAL.  For a RUSH TO MARKET MEDICATION doesn’t seem all that STRANGE to me.  Maybe there are some in dealing with this that has some investments in the stock market that will make them some money.  JNJ in after hours trading today – IS DOWN… luckily I sold all my JNJ stock about a year ago.

CDC advisory panel recommends Pfizer and Modern vaccines over Johnson & Johnson

https://www.foxbusiness.com/economy/cdc-advisory-panel-recommends-pfizer-and-modern-vaccines-over-johnson-johnson

An advisory panel to the CDC unanimously voted to give a preferential recommendation to mRNA vaccines, like those made by Pfizer and Moderna, over the one-shot Johnson & Johnson vaccine due to rare but serious blood clots.

The CDC temporarily halted Johnson & Johnson’s vaccine in April while scientists investigated the blood clots, which are known as “thrombosis with thrombocytopenia syndrome.”

Regulators eventually decided that the benefits of the Johnson & Johnson vaccine outweigh the risks, but the FDA released new data this week showing that more cases have occurred in the summer and fall. 

Women between the ages of 30 anjd 49 are most affected by the blood clotting issue at a rate of about 1 in 100,000 shots. 

There have been nine deaths linked to the Johnson & Johnson vaccine through September. 

Only about 16 million doses of the Johnson & Johnson vaccine have been administered in the United States, compared to about 470 million doses of Pfizer and Moderna’s vaccines. 

The recommendation now goes to CDC Director Rochelle Walensky for final approval. 

The BAD OUTCOME that denial of care can cause


For some reason some of the war of words on certain sections of the web jarred up some old memories.., This is a article that I clipped out of a pharmacy professional journal – years ago…

I could not even find this on my computer, I had to go back to paper files to find it..  That means that is at least 30 years old..

This was a bad decision back then and no less a bad decision today, but pharmacists appear to continue to make such bad decisions now.

Here is recent court ruling regarding a “bad decision” by a practitioner that ended up with a chronic pain pts that had been a paraplegic and wheel chair confined for 10 yrs .. committing SUICIDE and the pt’s estate was awarded SEVEN MILLION DOLLARS

https://www.statnews.com/2021/11/22/her-husband-died-by-suicide-she-sued-his-pain-doctors-a-rare-challenge-over-an-opioid-dose-reduction/

 

Knowledge is knowing the rules and clinical experience is knowing the exceptions to the rules

When a self-centered doctor is diagnosed with cancer, he becomes better able to empathize with his patients and appreciate a life outside his career.

A “war of words” somewhere else on the web jarred my memory about this movie from abt 20 yrs ago. There is a old saying and favorite one of mine…. Knowledge is knowing the rules and clinical experience is knowing the exceptions to the rules.

These words are exceptionally appropriate when dealing the pts dealing with chronic health issues and especially those involving subjective disease.

“Books Smarts” can not always be relied upon when dealing with certain segments of pts… those dealing with subjective diseases and those living with a number of complex/complicated health issues.

“back in the day” , I was one of those healthcare practitioners what totally relied on my “book smarts” and then I grew up and clinically matured

 

 

Another pharma putting out opiates with questionable efficacy ?

Steve, last year I noticed no pain relief after taking my hydrocodone 7.5  that I had been on since 2007. So I called my Pharmacist and she said tolerance build up. So I told my doctor and he increased to 10 mg. Still no relief. So, I started rummaging around in my drawers and found some that I had managed to squirrel away for emergencies, tornado, etc. At least a couple 10 years old, couple 9 years old and I took one, and had relief in 15 minutes!  Could walk without pain, my back is affecting my walking now. I am in such shock over this, are manufacturers doing deliberately or is someone stealing opiods that works for manufacturer? I asked a friend who I used to work with at assisted living in town if patients there complaining of no pain relief  She said yes they are! Same drugstore delivers most there. The company is LUPIN. 

     Should I find a lab that does comparative analysis to prove it and if so, do you know of one?  I know Pharmacist probably uses what she thinks is best cost, profit wise so really need proof for her??
     And my mser 15mg doesn’t seem to be as effective either but do get some relief and it’s by another maker so I’m really just so upset by this that I dont know what to do! But I’m tired of not being able to cook now, do things I used to do because of pain .    Any advice much appreciated,  will not mention your name. Thank you for all you do for everyone!  Good people like you are rare now!! 
Barb has already had a non-efficacy experience with a C-II produced by Rhodes pharmaceutical     which according to their website is part of Purdue Pharma  which is now in or a finalized bankruptcy.
Now according to this pt, we apparently need to add to this list another pharma producing – distributing a product lacking efficacy Lupin Pharma and depending on which website that comes up… is either showing them as a USA based pharma or Leading global pharmaceutical company in India – Lupin Pts and pharmacists can do what they want but my list of pharmas that I would not accept for us just got a little bigger

Another prescriber INDUCED SUICIDE

My dad was a chronically I’ll patient. He was 75 and underwent multiple back surgery’s and nerve decompression along w recently broken hip and spine. He fought like hell to live but his family doctor told him due to the FDA guidelines his pain meds had to be controlled by a pain doctor. After months of waiting to get into a pain doctor he was able to get his medicine but the following visit his doctor cut him down to a 1/4 of his dosage, he was not cut down slowly. My dad suffered, he went back to see doctor the following week and doctor was only interested in giving pain shots which don’t work for my dad due to scar tissue. Doctor refused to up my dad’s pain meds even tho he told them he was suffering.
5 days after that visit my dad committed suiside. I blame the doctor as well as whoever decided to play God and not allow proper dosages of pain meds to chronically sick people.

Update 12/15/2021:Denial of pain: University of Louisville Hospital- stage FOUR metastatic cancer

 

I spoke with this pt this AM and before going into the hospital one week ago – using those UNPREDICTABLE MME CONVERSION PRGMS this pt was on near 500 MME/day. before entering the hospital and was discharged with 40 MME/day.  Before entering the hospital the pt indicated that she was around a “5” on the pain scale – on average  & when in the hospital on some sort of IV opiate/PCA and claiming that her pain was at “the upper end of the sale”.

Remember she has a cancer in her spine that  “showed up a couple of months ago” and she has been on opiates for chronic pain for some 30 yrs

The pt told me that she had left a “voice mail message” at the internist’s office she was a pt of for some 17 yrs, but the pain doc at the hospital may have interfered with that relationship… since both of them are employed by the same hospital system.

She promised to keep me “in the loop” with how things were evolving… As of yesterday, she had enough of her previous medication that she will run out over the weekend.  I can’t imagine the pain and withdrawal issues with a patient dropping their opiate dose by 90% in a matter of days.

Torturing prisoners of war is illegal and we are in a 50 yr war on drugs/pts… but it is not a REAL WAR… it is only a SOCIAL WAR…  so apparently torturing pain pts is perfectly legal and it keeps a couple of hundred thousand people employed “fighting this war”

The War on Drugs Is Actually a War on the Human Condition

The War on Drugs Is Actually a War on the Human Condition

https://thenewsstation.com/the-war-on-drugs-is-actually-a-war-on-the-human-condition/

Like many kids of my awkward generation, which lies in the forlorn space between the groovy nihilism of Gen X and the hustling blingism of the millennials, I was raised on Nancy Reagan’s “Just Say No” anti-drug program in the 1980s. I was taught that all drugs (except alcohol and nicotine) were pure evil brought straight out of hell by sociopathic monsters in human form who thought nothing of handing out free crack and LSD to preschoolers from the back of their windowless vans. Drug users were addicts one and all, and addicts were damned souls, lost and devoid of humanity, willing to commit any atrocity in pursuit of their next fix of marijuana or heroin. A single puff off a joint or a single bump of cocaine was a suicidal leap into this zombielike purgatory, and no one but the most foolish or insane would take such a unretractable leap into the abyss.

I came of age in the 1990s, though, that era of strung-out Seattle grunge singers and heroin-chic model-waifs, when Nancy’s stern exhortations became an ironic punchline. I was smoking and drinking and getting high by the time I was 13 years old; and for the next 30 years, I worked my way through most of the smorgasboard of street drugs available in North America. I hung out with psychedelic philosophers and their acolytes and read about Aldous Huxley and the doors of perception and Wade Davis in Haiti, hunting down the concoction used to turn people into literal, not metaphorical, zombies.

Along the way, I discovered why the so-called “War on Drugs” was utterly doomed to failure. It wasn’t just the staggering corruption and incompetence displayed at every level of the entire system that was built to fight this imaginary war, from the politicians and policymakers who use it as an excuse to perpetuate institutional racism on empoverished minority communities to the local cops who use it to arm themselves with military-grade weapons. 

No, the fatal flaw that lies at the heart of the War on Drugs is it’s not a war on drugs at all; it’s a war on the human condition.

“Every species of mammal,” the screenwriter Lawrence Kasdan once wrote, “has found some way to drug, inebriate or anaesthetise itself, even if it’s just banging its head against a rock.” I have no idea if this is actually true of every mammal, but it certainly applies to every human I’ve ever met.

Aside from the occasional pot brownie to help me sleep, I’m pretty much done with the liquor and drugs these days. This is not because I fought my way out of the Gehenna of addiction through sheer will and perseverance, because — aside from cigarettes — I’ve never been addicted to any of the drugs I’ve done.

In fact, as the late comedian Bill Hicks used to crow: I had a great time on drugs. I have been arrested precisely zero times; I have committed precisely zero crimes to fund my drug habit (aside from, y’know, buying them); I have never lost a job over drugs, never ended any relationships, never done anything particularly degrading for drugs, other than making awkward conversation about video games with my dealers as I waited for them to sell me drugs.

So why, if I wasn’t addicted to drugs, did I do them for so long? Simple: because they were fun, and because they helped me cope with crippling depression, stress and pain that I couldn’t manage without help. 

I’ve spent my entire adult life writing about hard subjects, like climate collapse and social injustice, and spending time in a lot of hard places, like the slums of Nairobi or the homeless camps of Las Vegas. A lifetime of this has left me haunted — and drugs were a way to push those ghosts aside when nothing else would. Psychedelics, in particular, have been fantastically useful for me, both as a way of examining myself and my own mind and of extending my philosophical proprioception, my understanding of my place as an indistinguishable part of the universe rather than something apart from and observing it. I loved doing drugs.

This is where I’m supposed to be apologetic and ashamed and repentant, right? But why on Earth would I be any of those things? There is absolutely nothing wrong with hedonism, and there’s also nothing wrong with finding external tools to deal with the flawed neurological architecture that evolution has left us with. 

Consciousness is both a gift and a curse — it gives us reason and the knowledge of the self, but for many of us, these powerful tools don’t have an off switch. We are left acutely aware of our own failings, of the inevitability of death, of the casual injustice that often seems to be the true currency of modern life and the utter pointlessness of most of the labor we engage in, just to pay our bills. A lot of us suffer from the moment we’re born into a society that despises the color of our skin or the way we’re wired to love and lust. Many of us are wounded in childhood by abuse or neglect or casual cruelty and spend the rest of our lives trying to heal.

These are the deep, dark, dissonant notes that play in the background of every moment of our waking lives, like the score to a horror film; how can you blame anyone for finding whatever tricks they can conjure to drown them out, if only for a few hours at a time?

Of course, we all know this, deep down. That’s why so many of us face the morning with a cup of coffee and a Prozac or an Adderall or two when we really need to focus and crunch at work, or Zoloft, or Ambien at bedtime, or Xanax as needed. We take these drugs with our heads held high, as though there’s some fundamental categorical difference between the pills our doctor gives us and the powders we get on the street.

But the effects are the same; the only difference between the Adderall you get from your shrink and the crank you buy from a biker in the toilet of a dive bar is the purity. The active chemicals are nearly identical, and the effects are identical. (Trust me; I speak from experience.)

So if it’s not the actual drugs we think are bad, then what is it? Why do we feel bad for the guy who hurts his back and gets an Oxycodone prescription, only to despise him when his scrip runs out and he switches to smoking heroin instead? Why do we approve of someone taking Adderall to make it through pre-med mid-terms, but sneer at someone doing a line of meth to make it through the swing shift at their second job loading boxes at the Amazon warehouse? Why do we smile in bemused tolerance at the gaggle of secretaries or shoe salesmen putting away half the bar between them on a Friday night, but still, in so many places, frown on the teacher who comes home after a long day doing a difficult job for shit pay and wants to take a few hits from the bong?

Because street drugs are more dangerous than prescription drugs, cut with dangerous additives, and easier to overdose on because you don’t know how strong they are? Is it because they tend to be manufactured and sold by murderous cartels? If so, these are very easy problems to solve: legalize drugs, all drugs, and subject them to the same stringent safety standards and regulations we established for alcohol after Prohibition and that cannabis farmers and sellers face in the states where weed is legal. Create honest drug awareness programs for both youth and adults, to help people understand the actual dangers of drug use and the real dangers of addiction, instead of banging them over the head with false and hysterical propaganda.

That’s if safety is your actual concern. But it’s hard to believe the War on (Some But Not All) Drugs is really about public safety, when pharmaceutical manufacturers fund the lobbies who fight legalization and the cops routinely claim to “smell marijuana” when pulling people over for the crime of driving while black while rich, white “cannapreneurs” end up on the covers of business magazines. 

What this idiotic half-century of tilting at windmills really comes down to is what most shitty things in America have always come down to: greed, power, racism, the lingering stench of hypocritical Puritanism and the nagging fear that someone, somewhere, is having more fun than you are.

Eventually, it seems likely the United States will come to its senses; after all, cannabis is legal in 18 states and decriminalized in 13 more, and all of them have conspicuously failed to collapse into reefer madness and perdition. Several cities and states, including Oregon, are cautiously beginning to decriminalize and even legalize psilocybin mushrooms, which have shown great promise for dealing with depression and addiction in clinical studies for decades

But nothing will really change until Americans recognize that drugs and drug use — recreational and otherwise — have always been a fundamental part of the human condition, and they’re simply one of the ways we have learned to compensate for the less pleasant side effects of being conscious beings in an indifferent world. Life is a short and hard and treacherous road to walk down, and we get only one shot at it; should we really begrudge anybody, anything, that makes it a little less painful and a little more fun?

Joshua Ellis is a writer, musician, coder and futurist. He lives in North London with his fiancee and a very surly cat named Mr. Fukkles. You can read more about his writing here.