But “the CDC guidelines have been weaponized,” said Kertesz. The ramped-up enforcement by the DEA and state regulators has led some doctors to choose caution and to overcorrect in their prescribing, lest they lose their ability to practice medicine at all. Kertesz decried these policies as “simplistic” in a definitive new article published last week in the journal Addiction.

In February, Sessions struck a particularly harsh tone by suggesting that the fate of chronic pain patients was not high on his list of concerns. “I am operating on the assumption that this country prescribes too many opioids,” the attorney general said. “I mean, people need to take some aspirin sometimes and tough it out a little.”

 

“To protect people, you have to take care of the patient, not the pill count,” said Kertesz, who worked on the VA’s April 2017 study but spoke to HuffPost only as an independent researcher. “The findings suggest that the discontinuation of opioids doesn’t necessarily assure a safer patient.”

Even terminally ill cancer patients are increasingly getting less relief, and there are growing shortages of injectable opioids at local hospitals and hospices, spurred in part by DEA-ordered reductions in opioid manufacturing quotas.

 

When my dear, departed Roger was on Hospice, he was in terrible pain from the cancer. The hospice nurse was very reluctant to have his doctor increase the morphine because, "He might become addicted." Good Grief! The man was DYING! Who CARES if he'd gotten addicted to morphine!?

 

I have dealt with the same issue...it is ridiculous when the dying are left in pain because of a quack job by a "medical professional".

 

I do some work for a chronic illness organization, and it IS harming tons of those folks. I can't have opioids myself. I can relate though. I mean, what if they got stupid about my cardiac medicine? (understand apples to oranges before I get flamed). this whole thing is just a disaster for the folks who need it to have ANY quality of life and the terminal folks.

 

The bottom line is that protecting the stupid from themselves is a fool's errand, and one compounded with malevolence when innocent people are forced to endure excruciating pain in the futile attempt to deny a drug user his next fix.

 

When my brother was dying of cancer they gave him whatever he asked for. Pills push button morphine. 4 dose an hour if he pushed button. Machine counted how many times he pushed and they would adjust up accordingly. There was drugs delivery at no cost to us. I don't do pills and they could tell so they did not worry about me abusing situation. When he died they said bye and left everything. I could have used a few minutes of talk over coffee after what I went through. Hospice was good to us.

 

I've lived with chronic pain since my early 20's after serious injuries from a parachuting accident when I was in the Army. At one time all the VA wanted to do was keep me drugged up on pain killers. Now the only time I'm prescribed any is when I have another of the many major surgeries I've had to have. It can be a living hell at times...

 

My wife is an amputee. She deals with constant pain in her residual limb to say the least. We have been to a LOT of "so called" pain clinics. They treat everyone the same............like we are trying to get drugs to sell or to over indulge. We have finally found a Dr who will prescribe pain meds for her. NOW we have to deal with the insurance company that has to have everything "Pre-Approved" You talk about a Pain in the Behind. The DR will write the script, I take it to the Drug store, the Insurance company holds it up for "Pre-Approval" the DR can not get the paper work faxed back to the Insurance Co fast enough so then the prescription is turned down. Our Pharmacist sells me the medicine at cost and I pay for it out of pocket. We are going to get our Ins Commissioners office involved but in the mean time we have to jump through a lot of HOOPS just to have Simple pain relief. My wife is pretty tough when it comes to tolerating pain but she can become a hand full when she starts hurting. I don't want to see her treated like a "Druggy" just because of the Druggies out there. Dsmythe

 

I just want to make the record clear, that,. to the best of my knowledge, my alma mater, Purdue University is not connected to Purdue Pharma. The University was named for John Purdue, who donated the land in West Lafayette back in the 1860's when the school was established. Purdue Pharma was named after a family member with the last name of Purdue--no relation nor connection.

"Purdue University is a public research university in West Lafayette, Indiana, and the flagship campus of the Purdue University system. The university was founded in 1869 after Lafayette businessman John Purdue donated land and money to establish a college of science, technology, and agriculture in his name." Wikipedia

geo

 

I have had to deal with this first hand. I have chronic pain issues. I did nothing to cause this, I do not want this, I keep telling them if they have some magic spring water that will cure me they can keep all their pills. I am on the weakest opioids you can get, but everybody is still WAY overly paranoid about them. The drugs I am on are over the counter in most other first world countries.

I moved across the US about 3 years ago, still have not been able to find a new doctor to prescribe the medications I so obviously need. I have plenty of medical records to back my story up. Every six months, I am forced to fly 3000 miles just to renew my prescription with my old doctor. Cost about $1,000 round trip. What a load of BS! Even my doctor thinks it is ridiculous. Without my pills I am a useless member of society, in constant agony. Even with my prescriptions there seems to always be a fight with the pharmacist who thinks she knows better than the doctor. I've had to go without on multiple occasions for a few days, after about 4 days I'd rather kill myself than go without. I am not addicted to opiates, I am addicted to not being in constant pain. With my pills I am a functioning, tax paying adult, without them I would be nothing but a drain on society. I do not "get high" and can pass a drug test any time they want to give me one.

This so called "opioid crisis" is mostly made up, and the worst crisis is those who need the medications not getting them. I watched a documentary about this that was very good at explaining this, and they quoted an ER doctor. Unfortunately, a lot of people who show up at the ER are in fact just looking for drugs, but so what? If you give them a safe amount does it really matter if they use them to get high? The doctor quoted said that he would much rather accidentally give a prescription to somebody who just wants to get high than to deny a prescription to somebody who is genuinely in pain. This only forces those in genuine pain onto the black market, and sometimes to worse things like heroin if that's all they can get. This is what causes overdoses and deaths. If not suicide. It is despicable that we treat people like this in the United States.

Much of the "drug seeking behavior" doctors are taught to look for is exactly the same behavior you will see from a person who is legitimately in pain. This is a HUGE problem, we need to stop teaching doctors this, and the DEA needs to quit harassing them for giving FDA approved medication to those people that demonstrate an actual need for the drug. Doctors/pharmacists should not be held criminally liable if their patient abuses a medication, so long as they can show they followed proper medical procedures while prescribing. This is what is making the doctors so paranoid!

 

We were on kind of a conspiracy theory kick last night and this whole issue came up.

Would it be super duper paranoid of me to think that this opioid "crisis" is being kicked up by the powers that be to replace marijuana in the war on drugs? With medical pot probably going legal nationwide within the next few years (on a state level at least, although I don't think the Feds can hold out much longer, realistically), and most likely recreational following not far behind...what's going to replace the importance of MJ searches/seizures/imprisonments in the War on Drugs? Government agencies at some point always start placing their own existence at the top of the job list, and if things start being legalized and you fear becoming unnecessary, well you better figure out something else you can make illegal to scare people with and show how useful you are.

I have extra tinfoil if anyone needs it. Not saying I believe my own theory but it doesn't feel that far-fetched to me, either.

 

When I began my series of foot surgeries five or six years ago, the various docs offered me opioids like they were WWII cigarettes. I had several new Rx's after each surgery, my pick of hydrocodone, oxycodone, oxycontin. Several spare bottles of the stuff. I think the docs were unaware--at that time--of how addictive they could be, especially if the pain settled down and a person was taking them just for the "rush" they seemed to give.

In the 1850's, when morphine was new, the country went through the same kind of addiction and ensuing crisis. It was great for killing the pain of the Civil War vets, and pharmacists were able to prescribe, then. So, anyone who had a toothache, or menstrual cramps, got morphine OTC from the local druggist.

Now, my local doc is going through the hospital system's crackdown. I had to sign an agreement, to submit to a drug test( to make sure I was using them and not selling them), had to stay aligned with the rate of every pill taken(by submitting to bringing the bottle in at my appointment time to give the accounting)--couldn't be oversupplied(that means you quit using them and you could sell them), undersupplied(you're addicted and taking too many)--and, had to use only one pharmacy(local)--and get only a thirty day supply--and, I had to make an extra appointment with the doc to have him fill out the Rx in his presence(another copay and billing.....) Oh, yes, if they got stolen, no replacement.....

How's come we always lock the barn door after the horse gets out?

(and where' the doctor, patient trust factor?)

geo

 

(and where' the doctor, patient trust factor?)

geo

That was destroyed years ago. We're now in an adversarial doctor/patient system. Everyone is guilty until proven innocent.

 

I do some work for a chronic illness organization, and it IS harming tons of those folks. I can't have opioids myself. I can relate though. I mean, what if they got stupid about my cardiac medicine? (understand apples to oranges before I get flamed). this whole thing is just a disaster for the folks who need it to have ANY quality of life and the terminal folks.

This example isn't so far-fetched... People of color have been dealing with this for decades. If we go to the doctor for just about any ailment, it can be difficult to get a prescription for anything that isn't heart, asthma, digestion or blood pressure-related. African-Americans were viewed as "more likely to be drug-seekers", despite the fact that there is no evidence to back that up. Got a sinus infection? Too bad...No antibiotics for you! Eventually, you end up at the hospital with bronchitis or pneumonia and finally get what you need. Of course, that visit comes with a hefty bill!

Here is a snippet from an article:

White people are more likely to endanger themselves with the misuse of drugs.

• African Americans and Hispanics were more afraid than were non-Hispanic whites of opioid addiction [4].
• African Americans and Hispanics were less likely than white people to misuse prescription opioids [4].
• The overall rate of drug-related deaths was highest among non-Hispanic white people [4].

Despite this, whites receive more and better pain treatment than African Americans and Hispanics.

• African Americans and Hispanics were less likely than white patients to receive any pain medication and more likely to receive lower doses of pain medication, despite higher pain scores [4].
• They had their pain needs met less frequently in hospice care than did non-Hispanic whites [4].
• They were more likely to wait longer to receive pain medications in the emergency department than whites [4].
• Several studies of patients with low back pain found that African Americans reported greater pain and higher levels of disability than whites but were rated by their clinicians as having less severe pain [8].
• African American and Hispanic veterans with osteoarthritis—particularly African Americans—received fewer days’ supply of a nonsteroidal anti-inflammatory drug than white veterans did [8].
• “Minority” and low-income children were less likely to have oral pain assessed and treated appropriately, especially if they had Medicaid insurance coverage [8]. For example, Hispanic children received 30 percent less opioid analgesia after tonsillectomies or adenoidectomies than white children [4].

These findings suggest that clinicians incorrectly believe that Hispanic and African American patients are more likely to abuse drugs than whites and therefore should have less access to them, when in fact they are less likely to do so, and that Hispanic and African American patients experience less severe pain than whites, when in fact they report comparable pain. The findings suggest, in other words, that variations in treatment are based on misconceptions rather than evidence.

You can find the rest of the article here:

https://journalofethics.ama-assn.org/article/pain-and-ethnicity/2013-05

 

Hospice nurse x 24 years, and had to deal with my own pain and formerly addicted-to-opiods/or alcohol patients with pain. It's not a panacea, but next time you are dealing with a severe exacerbation can you ask a doctor for a dosepack of Medrol or some other steroid? That's where you take like 6 pills the first day, 5 the second, etc etc down to zero. I had found it very useful to knock pain back in those instances.
I know that NSAIDS and Tylenol have their own issues but in an emergency 2 naprosyns, 1000 mg of Tylenol and a cup of regular caffeinated coffee AND 7 1/2 ounces of dark chocolate MAY be able to reduce your intense pain somewhat.(Margo McAffrey "What to till the Dr Comes " from her Pain Control handbook. The chiropractor also measured my feet and ordered me custom orthotics to correct 3 problems that were contributing to my back pain. Last of all, if you can afford it, massage can help. May we all survive until this social nightmare ends. If nerve pain is a component check with chiropractors in your area on non invasive laser therapy.

I have had to deal with this first hand. I have chronic pain issues. I did nothing to cause this, I do not want this, I keep telling them if they have some magic spring water that will cure me they can keep all their pills. I am on the weakest opioids you can get, but everybody is still WAY overly paranoid about them. The drugs I am on are over the counter in most other first world countries.

I moved across the US about 3 years ago, still have not been able to find a new doctor to prescribe the medications I so obviously need. I have plenty of medical records to back my story up. Every six months, I am forced to fly 3000 miles just to renew my prescription with my old doctor. Cost about $1,000 round trip. What a load of BS! Even my doctor thinks it is ridiculous. Without my pills I am a useless member of society, in constant agony. Even with my prescriptions there seems to always be a fight with the pharmacist who thinks she knows better than the doctor. I've had to go without on multiple occasions for a few days, after about 4 days I'd rather kill myself than go without. I am not addicted to opiates, I am addicted to not being in constant pain. With my pills I am a functioning, tax paying adult, without them I would be nothing but a drain on society. I do not "get high" and can pass a drug test any time they want to give me one.

This so called "opioid crisis" is mostly made up, and the worst crisis is those who need the medications not getting them. I watched a documentary about this that was very good at explaining this, and they quoted an ER doctor. Unfortunately, a lot of people who show up at the ER are in fact just looking for drugs, but so what? If you give them a safe amount does it really matter if they use them to get high? The doctor quoted said that he would much rather accidentally give a prescription to somebody who just wants to get high than to deny a prescription to somebody who is genuinely in pain. This only forces those in genuine pain onto the black market, and sometimes to worse things like heroin if that's all they can get. This is what causes overdoses and deaths. If not suicide. It is despicable that we treat people like this in the United States.

Much of the "drug seeking behavior" doctors are taught to look for is exactly the same behavior you will see from a person who is legitimately in pain. This is a HUGE problem, we need to stop teaching doctors this, and the DEA needs to quit harassing them for giving FDA approved medication to those people that demonstrate an actual need for the drug. Doctors/pharmacists should not be held criminally liable if their patient abuses a medication, so long as they can show they followed proper medical procedures while prescribing. This is what is making the doctors so paranoid!