Millions with disabilities get heavy-duty painkillers
http://www.thv11.com/story/local/2014/01/01/14113725/?storyid=14113725
From the article:
“We don’t know whether that practice is safe, and we don’t know if it’s effective,” said Michael Von Korff, an epidemiologist with the Group Health Research Institute in Seattle, who was not involved in the work.
The Dartmouth study examined the prescription records of the 9 million Americans who receive Medicare benefits because they have become too disabled to work — largely because of muscle or joint pain.
Some of those prescriptions are certainly necessary, but other patients would likely do better with a combination of physical therapy, exercise and non-drug treatments, Von Korff said.
“Almost half — over 40% — filled a prescription for opiates in a year, and one in five was filling six or more prescriptions per year,” said Ellen Meara, an economist and associate professor at Dartmouth, who helped lead the research.
Many of those people were taking extremely high doses. “The risks of dying are much higher when you start to exceed 100 mg of opioids a day,” said Meara, who estimated that 220,000 Medicare recipients receive a dose that high; many of them twice as much.
Cindy Reilly, director of the prescription drug abuse project at the Philadelphia-based Pew Charitable Trusts, said she found those dose amounts “astounding” and “staggering.”
“I’d say many of the leading authorities would encourage caution in using opioids for long-term management of back pain,” Von Korff said. “Pretty much everyone agrees that the risk of overdose and addiction are considerable, and greater than we thought.”
What do you get when you have a article that quotes a epidemiologist, economist and director of a prescription drug abuse project… ?
IMO.. you get a article full of conclusions based on personal biases and phobias and totally lacking facts… BUT.. feeds into the DEA’s agenda of the war on drugs.. and that is the primary reason that it gets published
Filed under: General Problems
NABP recent newsletter had an article about our ‘dear AG HOLDER’ saying something needs to be done about prescription drug abuse in this country. Rather ironic coming from a man who isnt supposed to pursue marijuaina laws passed by the states.
Just going by the numbers listed, 9 million people on SSDI getting medicare. Of those, between 40 and 50% (not exactly clear) have at least one opioid prescription a year, which could be just 12 tablets of hydrocodone 5/325 after a dental procedure. About 20% get more then 6 Rxs a year (again, doesn’t say how much, could be a broken bone, or a torn tendon, at 20 norco 5’s a pop, for a month and a half), and when they give actual doses, 100mg or more a day, they estimate “220,000 Medicare recipients”, which they don’t specify what type of medicare. If out of the 9 million on SSDI, that is 2% of recipients, if out of the 48 million getting medicare is only 0.45% of recipients.
So 2% of people of people the government declares is too disabled to work, or 0.45% of people too old or disabled to work, receive more then 100mg of opioids a day? Doesn’t sound like much of an epidemic to me. As they say, “Lies, damned lies, and statistics”.
Hi Hirka. Great idea! Would you (or someone else here) post those stats to the comments section of Steve’s link? One has to be a Facebook member or I would do so myself. Breaking it down into real numbers like you did brings the whole piece into proper perspective.
http://static.thv11.com/conversation-guidelines/
I think the REAL amazing stat from this piece is that upwards of 60% of the sickest of the sick in this country didn’t require even ONE Rx for an opioid in a full calendar year. Now THAT is something to think about when people scream epidemic among those with REAL chronic pain as opposed to inflated stats which throw in addicts with no need (or Rx) for these meds.
Despite the issue of pain med use being front and center all around the US,
a great many still identify the terms addiction and dependence as being one and the same.
It looks as though PROP’s and the DEA’s propaganda campaign by media blitz has been very effective. Many of those with real pain who take their meds as prescribed even describe/consider themselves as being ‘addicted’
*I did notice something interesting and offers a glimmer of hope. There were actually a couple comments from those NOT in chronic pain who are not buying into the hullaballoo over the epidemic of addiction among those w/ chronic pain.. Usually the only comments I read in sections such as these that are in defense of pain medication come from those who are in pain themselves.
As one who’s close friend was in a near fatal car accident and I have a cousin with Juvenile Arthritis, I know first hand they are doing all in their power to put off SSDI and are utilizing everything they can afford. But their future is probably that- SSDI and pain meds. Steroid shots are fine but end up doing more damge in the end than helping after so many. I think the majority of SSDI on pain meds are legit. Maybe THESE PEOPLE should go work VA sometime and tell our wounded vets their chronic pain is all in their heads, because once congress cuts them loose into the community while the VA is getting cleaned up , I can’t wait to see all the BS being pulled on the legit pain patient now being attempted on our returning Iraqi and Afganistain veterans in chains.
Hi boilerrph and I express your same sentiments. Not that anyone deserves to be treated (or ignored) like those disabled citizens with chronic pain are now, but definitely not those servicemen who have put their very lives on the line to ensure freedoms that are being slowly eroded by more and more rules and regs to protect people (supposedly) from themselves.
[JUST SAY NO] TO THE NANNY STATE, and profiteering off the misery of others in the name of ‘moral decency’, the children, or whatever lame excuse they roll out to extend this war on US citizens and their liberties.
The worry over the number of ODs, even if NOT obviously skewed, and tilted towards those who have no business taking these meds, often chased w/ Jack Daniels and Xanax, should pale in concern over very real stats that show the US leading the way in # of citizens behind bars, many for non-violent drug crimes.
Let the land of the free be the land of the free. If addicts want to destroy themselves, more power to ’em, give them that freedom as long as they are adults. AND to those disabled as well, who in most cases, pain is but ONE symptom among many in a constant battle to attain some quality of life. It is an uphill battle physically, mentally, and financially in the BEST of times as a disabled citizen. Most benefits (at least mine) go towards paying doctors, for prescriptions, procedures, testing, etc, we don’t need any piling on or extra road blocks/hoops thank you very much, we have enough already !!
*I added these links in case some were not aware of the recent scandals w/in the VA and the uphill battle our servicemen face in attaining quality (or any) care upon returning home. It really is a shame.
http://www.physicianspractice.com/blog/private-doctors-may-soon-treat-va-patients
http://www.cnn.com/2014/06/11/politics/va-fbi-probe/
“The risks of dying are much higher when you start to exceed 100 mg of opioids a day,” said Meara, who estimated that 220,000 Medicare recipients receive a dose that high; many of them twice as much. [from hack #1]
I’m not a betting man BUT I would be willing to wager that ‘the risks of dying are much higher’ too when the Social Security Administration denies most legitimate disability claims for 2+yrs. During this time, which seems to be about the normal waiting period for all but terminal diagnosis’, the disabled citizen is unable to work, limited to medical care, including much needed prescriptions, due to cost and lack of access to insurance. I’m not exactly sure why one needs to be seen before an ALJ with several binders of medical records spanning 10 yrs to be approved for disability insurance.
Cindy Reilly, director of the prescription drug abuse project at the Philadelphia-based Pew Charitable Trusts, said she found those dose amounts “astounding” and “staggering.” [hack #2]
One has to watch out for these addicts especially. The disabled go through a pretty elaborate system to make their addictions appear to be a legitimate need by feigning diseases and injuries that fit the bill for chronic pain and opioid therapy. They game the system for an ‘early retirement’, often times w/ monthly incomes all the way up to $1,000, not counting all the scheduled drugs they want (if they are 1- good actors, 2- have family or an organization(s) that help them to afford these ‘staggering’ treatments (hint, Medicare meds aren’t free).
Finally [hack #3]
“We don’t know whether that practice is safe, and we don’t know if it’s effective,”
and
“Some of those prescriptions are certainly necessary, but other patients would likely do better with a combination of physical therapy, exercise and non-drug treatments, Von Korff said.
No offense but while PT, exercise, and other pain relieving methods are certainly a welcome addition to treating chronic pain (I use several myself) if they took care of the problem I’m sure there would be no need for pain medication. Unlike the stories portrayed in the media, most legit SSDI patients (non-pill millers) run through the gamut of non-Rx treatments (PT/exercise/dietary adjustments/TENS/nerve blocks/etc and non-opiate Rx therapy FIRST until exhausting all options before being given opioids (like candy if one were to believe the garbage in the media).
As far as answering the first question about being safe and effective? We are people here, just ask us. The man acts like he’s addressing a study on chimps and their reactions under medical testing in which feedback is limited to observations. HELLO Mr. Epidemiologist feller, we are right here.
http://emedicine.medscape.com/article/325370-overview#a1
Sorry for the misspellings on my comment. Touchscreens suck sometimes
I wholehearted agree with you. The people quoted in this article don’t have the experience to make intellectual comments. I just wish everyone reading the article could see it.
You get the sme junk science that has fed fhe “War on Drugs” since the Harrison Act and Nixion and now preys on vaccines, so called global warming, and genictically modified foods. You also, get government control telling you how bad your supposed to hurt and how much medication you may have, in other words….Healthcare Rationing