The Other Victims of the Opioid Crisis

Teri Peters

Teri Peters

Right leaning libertarian(ish) small govt advocate. Happily Married to a USMC Vet. I choose my battles. Crazy bout Elvis, loves Jesus & America too. On Twitter.

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56 Responses

  1. Avatar Mike Dwyer says:

    Interesting post. As a former sufferer of chronic back pain, I sympathize with much of this. It’s a real catch-22 for doctors. When I was at my worst my doctor was very suspicious of prescribing opioids because he was worried about addiction, so he would prescribe things like Tylenol 3 (the LaCroix of pain relievers) or he would only prescribe muscle relaxers that could be taken at night. It left me in agony most of the time during the day. On the flip side though, when my back wasn’t hurting I would still take at least 2 muscle relaxers per day because I enjoyed them and they elevated my moods considerably. If he had prescribed me 100 Ultrams for a back injury, I would have taken 2 per day for the next 50 days regardless of my pain levels. When they ran out I would spend the next couple of nights with restless legs or arms when I tried to sleep, as my body was going through withdrawls. So I was exactly the kind of patient he feared.

    For me it came down to finally finding the right specialist who did an MRI and figured out what the real problem was. One little arthritis pill per day now and I am nearly pain free. But a lot of people are not this lucky and there needs to be a better way, hence some of the points in this OP.Report

  2. There are no good solutions available. There never will be. The problem underlying all of this is both addiction and our misunderstanding of it. But because we do not want to accept that addiction itself is what is driving this – rather than simply discovering the perfect legislative solution – we will remain on this path forever.

    That said, the idea that big government is the problem is as misguided as the idea that small government would fix it. It was, after all, small government that did nothing while drug companies literally flooded the marketplace with pain pills. It was a thoroughly deregulated marketplace, coupled with the certain belief that only certain people would ever end up getting addicted, and that everybody else could simply be expected to appropriately handle their pain medication, whatever that meant. The reality though is that none of us can predict who is and isn’t going to become addicted. Having the humility to admit that might change our approaches, maybe, but policy makers on both sides aren’t going to acknowledge that, and what’s left involves negotiating the fallout. Which is how we end up an attempts to fix the marketplace problem that maybe fix aspects of the bigger problem while simultaneously creating other ones.Report

    • Avatar Philip H in reply to Sam Wilkinson says:

      There’s also the problem that many conservative politicians cast addiction and poverty (which often co-occur) as individual moral failings not systemic costs. Poor people are poor because they make bad choices because they are bad people, not because the systems in which they live leave them only bad choices. Ditto poor people who are addicts.Report

      • Avatar Mike Dwyer in reply to Philip H says:

        Phillip,

        Isn’t the converse of that “poor people are poor because the system is bad?” As someone who very easily could have ended up an addict after 20 years of being prescribed opioids (and purchasing them in Mexico, taking leftovers from family members, etc)…I still had agency. I am very sympathetic to addiction but feeling compelled to assign blame to anyone (system, government, doctor, patient) is the reason why we don’t move forward on this issue.Report

        • There is certainly plenty of blame to go around. Much, much, MUCH progress could be made if we were willing to think about an addiction diagnosis in the same way that we think about a diabetes diagnosis, but there is cultural pushback toward doing so (much as there is cultural pushback toward thinking similar about all mental health diagnoses).

          There is plenty of evidence of what we’re discussing within this comment thread.Report

        • Avatar Philip h in reply to Mike Dwyer says:

          you mis-read me. I am saying that from the lofty moralizing heights of many pseudo Christian Republican Politicians, they view poor people as being poor because ONLY and SOLELY of individual bad choices. Republican politicians – and a frightening number of individual libertarians – refuse to even acknowledge the system as a player.

          I would also remind you that as a white man, you have always had more agency then many other poor folk, even at the times your income may not have been enough for you to believe you had such agency. I would also gently remind you that many addicts don’t actually have that agency – which is why they often relapse absent systematic support.Report

          • Avatar Mike Dwyer in reply to Philip h says:

            “I would also remind you that as a white man, you have always had more agency then many other poor folk…”

            I love you man, but you have got to get off this soft bigotry of low expectations angle. First of all, the classic line is that ‘addiction knows no boundaries’. It is part of our most basic human impulses and has nothing to do with race or gender. This is an old study, but I would be surprised if the numbers aren’t roughly the same today (bold emphasis mine):

            According to the 2003 NSDUH, 38.2% of White young adults 18 to 25 years of age in the U.S. reported any illicit drug use in the past year, followed by African-American (30.6%) and Hispanic (27.5%) young adults.

            Several investigations using data from the College Alcohol Study, a nationally representative sample of U.S. colleges and universities, examined the individual and college characteristics associated with marijuana and other drug use. For example, one study found that approximately three in ten American college students reported using marijuana in the past year (Mohler-Kuo et al., 2003). The study also found that the prevalence of marijuana use was highest for White college students, followed by Hispanic, Asian, and African American students. Other national studies based on the CAS data have found similar racial/ethnic differences in ecstasy use heavy episodic drinking, and nonmedical use of prescription stimulants, opioids and benzodiazepines. In another national study, Meilman and colleagues (1995) compared illicit drug use rates between a sample of 6,129 students attending Historically Black Colleges and Universities (HBCUs) and a sample of 6,129 students attending predominantly White institutions (Meilman et al., 1995). The study found that students from HBCUs reported significantly lower rates of marijuana, cocaine, sedatives, hallucinogens, and other illicit drug use than students at non-HBCUs.

            https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2377408/

            I would also argue that in some ways addiction is more insidious among more affluent groups exactly because of those support systems. Access to private healthcare means it’s easier to get prescription medicine. Middle class and upper class kids are often conditioned to pharmaceuticals at a young age for ADD, depressions and a host of other issues. It’s easier to avoid hitting rock bottom because of the support systems and perhaps more tolerance from schools, jobs, etc. When I was popping pain pills every day my coworkers all knew it because they would see me struggling to stay on my feet as the pills wore off and then bounce back when the next round kicked in. They would joke about how it also improved my mood, which it certainly did. We were working long hours at the time, standing on concrete and more than one of them also asked for a pill from time to time. At the same time I saw management personnel come to work still buzzed after a late night while we were on an out of town project and other members of the management team would quietly drive them back to the hotel to sleep it off. That kind of ‘support’ prolongs addiction, not combats it.

            So my point is, I did have agency within that time period and within my circumstances, but that didn’t somehow lessen my would-be addiction but instead facilitated it. The only thing that kept things from getting worse was the right doctor and dumb luck.

            Report

  3. Avatar DensityDuck says:

    “It was just a guideline.”
    “Nobody intended it to work this way.”
    “Rules are being misapplied.”
    “Understandable errors in judgement were made.”
    “We’re reviewing the regulations.”
    “We’ll definitely look into this.”

    And yet people think that the government writing rules is the solution to whatever problem you’re having.

    The issue is not that people are bad people, the issue is that people rely on guilt to stop them doing horrible things to each other, and when you tell people that they’re following Objectively Neutral Third-Party Regulations, you’re taking away their guilt. Sure, this man is sobbing, but it’s not me saying he can’t have the pills, it’s this regulation.Report

    • Avatar Philip H in reply to DensityDuck says:

      Unfortunately government writing the rule is actually the solution to many problems we are having. Take environmental protection – have clean air to breathe, clean water to drink, and the like. Sure, one could expect markets to price accordingly for pollution and to thus prevent it (since there’s a cost to pollution in terms of human health and all), but history doesn’t tell us that story. History tells us the story of companies not caring where they dump their coal ash slag, or what they emit, or that their dumping into the Cuyahoga River would ultimately lead to it burning in 1968. Contrary to the earnest cravings of libertarians, doing what’s best for me as an individual and a business sin’t going to be preserving resources (like clean air) for others, nor will it motivate me to voluntarily forgo maximizing profits in order to help other people live. Thus regulation.Report

      • Avatar JoeSal in reply to Philip H says:

        Pripyat has plenty of smog free air and plenty of empty real estate. Sure they have a few issues with social truth in applied mathematics/economics, but you’ll fit right in, I’m sure of it.Report

        • Avatar Philip H in reply to JoeSal says:

          99% of the time i have no clue what you are getting at. Chernobyl isn’t a failure of regulation, or free markets. Its a systemic political failure in which cost drives everything, and lying is rewarded.

          But hey, keep throwing noodles – something is bound to stick.Report

          • Avatar JoeSal in reply to Philip H says:

            “systemic political failure in which cost drives everything, and lying is rewarded”

            So there is some social truth issues there, specifically about a government controlled production. Do we need to move those dots really close together for ya?Report

            • Avatar Philip H in reply to JoeSal says:

              There’s no government controlled production aspect to the opiod crisis. That was all private sector actors, sometimes fueled with federal dollars but still private sector. Apples and ice cubes to Chernobyl.Report

              • Avatar JoeSal in reply to Philip H says:

                Huh, so Unca Sam would have been just fine with a backyard opium pill mill, or maybe even a backyard smallish nuke reactor.

                Ohmergod, people might screw that up!!Report

              • Avatar Philip H in reply to JoeSal says:

                There’s a vast difference between a pill mill – which are being prosecuted FYI – and a state run nuclear power plant in a country that refuses time and again to deal with its own failings. Kind of like a country that starts a war over a belief there are weapons of mass destruction when that country’s own weapons inspectors report there aren’t.Report

              • Avatar JoeSal in reply to Philip H says:

                I’ll make you a deal, you can have as big a State as you want, as long as there are no statists in it.

                You can have as much socialism as you want, as long as there are no socialists in it.

                You can have as much standing army as you want as long as it doesn’t have arms or force in it.

                We good?Report

      • Avatar George Turner in reply to Philip H says:

        Nobody arrived in time to get a picture of the Cuyahoga burning in 1968 because it was just a quick flash fire, so the press ran pictures of it seriously burning back in 1952 and let everyone think that no progress had been made on pollution. It is perhaps an early example of noble cause corruption.Report

      • Avatar DensityDuck in reply to Philip H says:

        “History tells us the story of companies not caring where they dump their coal ash slag, or what they emit, or that their dumping into the Cuyahoga River would ultimately lead to it burning in 1968.”

        So the people who need pharmaceuticals for pain management can’t have them because fifty years ago there was pollution. Got it.Report

        • Avatar Philip H in reply to DensityDuck says:

          No. The people who prescribe drugs thoughtlessly because it pads their bank accounts need regulation because they can’t control their own greed. But nice try.Report

          • Avatar DensityDuck in reply to Philip H says:

            The opioid crisis is caused by Chinese imports, not pill-mill doctors, but hey I guess you are right that the answer here was “regulation”. (albeit “enforce the existing regulations” instead of “make a bunch of new ones on people who aren’t the problem”, but you’re right, the same way a stopped clock is right at least once per day.)Report

            • Avatar dragonfrog in reply to DensityDuck says:

              The opioid crisis is caused by people becoming addicted to opioids. Often that’s because they started with a prescription they probably needed and the doctor was assured by Purdue that this particular opioid was totally non-addictive.

              Nobody wakes up one morning totally sober and decides by the same evening they’re going to go down to skid row and buy some shady eighties. That’s the end of the road – Chinese imported fentanyl is at the end of the road of the opioid crisis, not the beginning.

              Fentanyl / Carfentanil in particular are products of prohibition. They have the most favourable risk / reward ratio for importers and upper-tier distributors, because you can fit as much ‘high’ in a couple of fake dessicant packs inside a pair of sneakers, as a whole kilogram of heroin. It’s incredibly easy to smuggle. That wouldn’t be a consideration, if people could just buy laudanum or some similarly weaker opioid.

              It’s the Iron Law of Prohibition.Report

  4. Avatar Terri McFarland says:

    Excellent article. Until such time that some type of replacements (that work) can be developed the government needs to restore high dose pain therapies to patients that need it. Most pill mills and undesirable patients have been weeded out, now all that’s left is the suffering of people who live in intractable pain every second of every day and it must not continue.Report

    • The problem here is always going to be, “patients that need it” and figuring out exactly who that is.

      And as for the idea that “pill mills and undesirable patients have been weeded out” I would be interested to know where that claim is coming from.Report

      • Avatar George Turner in reply to Sam Wilkinson says:

        Prosecutors sent many pill mill doctors to jail. I met one of them who got busted for writing prescriptions in Eastern Kentucky. He was a very nice man, but strangely enough, his son was shot and killed while trying to escape from the state police while he was showing them where he’d planted all his homemade pipe bombs. He had sworn allegiance to either Al Qaeda or ISIS and wanted to kill American infidels. The story sounds so utterly trite and cheesy, like the laziest possible plot for an episode of “CSI: Harlan”, that our local reporters probably had trouble covering it with a straight face.

        Anyway, once legislators and law enforcement focused on the problem, it was easy to shut down pill mills because the pharmacists knew which doctors were writing ridiculously high numbers of prescriptions, in some cases for millions of pills per year.

        It had all probably started off quite innocently, as hill folks with disabilities from mining, logging, or just getting old gossiped about which doctors would help when so many others wouldn’t. “Go see doc Taylor. He’ll fix you right up! He cares about his patients.” It probably took some of the doctors a while to realize they’d gone from being the town’s savior to being the town’s drug pusher, but who can argue when the patients are lined up out the door waving wads of cash?

        So once Kentucky cracked down on our pill mills (we were one of the first states to do so), our addicts and dealers started making trips to Florida, where plenty of pain clinics catered to out-of-state tourists whose prescriptions had run out while they were on vacation. Bluegrass Airport had to add flights to accommodate all the extra traffic, and the drug runs were a running joke among airport staff. So we raised the issue with Florida officials, and their legislature cracked down on their own pain clinics. As more and more attention focused on the growing addiction problem, more and more steps were taken to try and plug the holes.

        Here’s an old 2011 story in the Lexington Herald Leader about the pill battle, with lots of details, such as:

        In the past year [2010], more than 400 Florida pain clinics have closed or been shut down, and the amount of the painkiller oxycodone that Florida doctors bought in the first six months of 2011 was down 97 percent from a year earlier, The New York Times reported in August.

        And of course the doctors became acutely aware that some of their patients were just trying to get painkillers, and that it wasn’t always the obvious ne’er- do-well drug addicts. Heck, even Rush Limbaugh got addicted to opiates from a prescription for back pain.Report

        • George,

          These responses that you’re describing are part of the reason why it is now so difficult to get pain pills. That’s the point. You can crack down on the illict acquisition of painkillers, but you’re inevitably going to inconvenience folks who continue to need those painkillers.

          That said, doctors who prescribe more freely than others, and pharmacies that fill more freely than others, still exist, and keep being busted. They’re still there because the desire is still there because the problem here is much more bone deep than anybody offering quickie solutions is prepared to acknowledge and/or accept.Report

        • Avatar George Turner in reply to George Turner says:

          Well that’s exactly it.

          We’re fighting a war and our shotgun approach produces lots of innocent casualties, not that the people getting hooked on opiates aren’t also innocent casualties.

          The problem started with pain and suffering, and the solution to that, painkillers, inadvertently produced a side-effect of more pain and suffering due to drug addiction. The approach to solving the drug addiction problem has restored the original pain and suffering we were trying to solve, while not yet solving the opiate crisis.

          This is a common failing of ham-fisted shotgun approaches and moral panics.

          But the pill mills had to be reined in, otherwise there wouldn’t be anyway to go after the drug addicts go-to supply, and the fact that there were pill mills indicated that some doctors were part of the problem, not the solution.

          So that bumped the decision making up from doctors to bureaucrats and legislators, who aren’t exactly renowned for brilliant ideas. We always hope to get a ruling from King Solomon, but usually we get a decision by Bob From Accounting.

          But as has always been true, people who will suffer silently – will.

          Thus the need to make a lot of noise.Report

  5. Avatar Terri says:

    I am one of those chronic pain sufferers that you’ve written about. I was successfully on a high dose medication for 19 years without incident or increase. My pain was managed with a fentanyl patch which allowed me to live my life and be a productive member of society.
    After my state adopted the guidelines as law I was dropped by my primary of 25 years and sent to pain management. My new PM had one goal. He was dropping me regardless of outcome to under 90 mme.
    I went through 14 months of horrible withdrawals on top of unimaginable pain. I am now at 90 mme and I am now mostly homebound. I can no longer take care of things that were my responsibility for the past 20 years. My marriage has suffered. My relationships have suffered and there are many days that I wonder how much longer I can endure this torture.
    Bottom line is that the government must get out of our doctor’s office. Physicians must be allowed to help their patients once again. This needs to happen today not tomorrow. We are loosing too many good people to suicide. This must change immediately.Report

  6. Avatar Sheila Tone says:

    Because it can’t be the addicts’ fault they’re addicted. It has to be the doctors’ fault and the evil corporations’ fault.Report

    • Avatar Mike Dwyer in reply to Sheila Tone says:

      Shiela,

      Have you ever been addicted to anything? Cigarettes? Alcohol? Candy bars? Porn? Shopping?Report

    • Avatar Pam in reply to Sheila Tone says:

      It’s called taking responsibility for your actions, only that doesn’t apply to those who CHOOSE2ABUSE! They get a free pass to blame anyone else but themselves. Even though it was thier CHOICE to pop pills recklessly while boozing it up with thier friends, cuz life’s one big party right?? My ex was addicted to pills as well as many of his buddies at work. and NO they did NOT start with a legal script in NO WAY, SHAPE, OR FORM! It was thier personal CHOICE to call the dealer while their partying at the bar, NO DOCTOR EVER INVOLVED!! BUT guess who got blamed when my ex got caught by his boss……wait for it….DING DING!!! He blamed his popping pills on some fictious dr that got him hooked. And he’s not the only one who blames anyone else but themselves! MAKES ME SICK!! Here I am, an intractable pain sufferer for nearly twenty years, was on the SAME STABLE HIGH DOSE FOR EIGHT YEARS WITH SUCCESS, in steps the corrupt CDC and lawmakers DENYING LIFESAVING PAIN MEDICATION to chronic pain pts and my dr of ten years abandoned me, handed me my last scripts that he cut way back, no slow wean, and sent me on my way not caring if I lived or died, he said his license was more important than treating pain pts!!!! WTF?! DO NO HARM !! I was able to participate in life and now I am homebound begging God to take me daily. THIS IS INHUMANE, BARBARIC, CRUEL AND IT SURE AS HELL IS TORTURE!!! To leave human beings in agony until they kill themselves to end the pain is GENOCIDE!!! How many more pain drs will be shut down, how many more INNOCENT LAW ABIDING CHRONICALLY ILL CITIZENS/VETS WILL BE FORCED TO TURN TO THE STREETS FOR RELIEF OR WORSE #SUICIDEDUETOPAIN!!! I bet not one in government is being denied pain relief! All of them need to be drug tested monthly like we the ppl, they need to have thrir medical/pharmacy records made public like every government agency having access to our PRIVATE records, There is no way they are all in perfect shape, many up in age comes painful conditions. How many of thier family members are DEPENDENT on pain medication?! Wana bet thry don’t get treated like a pill seeking junkie out for a high?! I am so fed up and done with paying the price with my health and overall well being!! How about the DEA Target the cartel like they are our drs!! We have an ILLEGAL FENTANYL/HEROIN crisis not coming from our drs!!!Report

  7. It can very easily be all three.Report

  8. Avatar Shannon Villarreal says:

    I too am a patient who suffers from chronic severe back pain. I was taking my pain medication for years as prescribed without any variation and was able to maintain a full time job and raise a family, maintain a household and all that entails. When the CDC guidelines came out, my prescription was cut to below the 90 MME point. I had to take a disability retirement from my job. Fortunately, my children are grown but now I have a grandchild that I cannot get down on the floor and play with. I need help from my spouse to do the many chores around the house that before I did on my own. People don’t understand how our lives are being drastically altered.Report

  9. Avatar Shelley says:

    Things have to change. I have had a chronic illness for 30 years and I am only 42. I did absolutely nothing to cause this illness and have done most everything to make it better – that said – I still have pain. After a recent move I was told by my new PCP that she doesn’t do any narcotic prescriptions in her practice. She sees the need for narcotics, but the consequences, as the prescribed, are too big if the medications are not taken as prescribed by the person the prescription is written for. Therefore she referred me to the pain management doctor. Upon arriving there I was subjected to a urine drug screen and had to sign a contract. I was treated like a criminal and I had done absolutely nothing wrong. I said to the provider that I felt like I was being treated like a criminal. Her response, “Oh – all of my patients say that.” In what world is that okay??? Chronic pain patients usually have a very complicated physical history as to why they are in chronic pain. They have been through hell already and now are made to feel like criminals???? The opioid epidemic has done horrific things to those of us with chronic pain. Most chronic pain patients just want to be able to function – live their lives, do their jobs and be somewhat comfortable. They are not after a “high”. The need for the medication is just to function and live their daily lives. The “opioid epidemic” has gotten so out of control that those of us with real pain are not trusted and treated as if we are criminals. If you think this doesn’t effect you – it might not today – but you never know how your life could change tomorrow.Report

  10. Avatar Barbara Schalk says:

    PAIN relief is a human right, especially if we have the means to help those suffering.Report

  11. Avatar DensityDuck says:

    There are some very weird bots finding this post, I think.Report

    • Teri Peters Teri Peters in reply to DensityDuck says:

      If not bots, there is absolutely those who are driving the opioid hysteria in a clinical setting. I hope they never need major surgery, or are unlucky enough to get cancer. It’s not just chronic pain patients who are suffering. The acute pain patient is as well.Report

      • Teri Peters Teri Peters in reply to Teri Peters says:

        Typo. Brilliant. I’m the author and I post a typo in the comments. I’ll answer some of these tomorrow. No question is stupid and I do see some things posed that can and should be addressed. There *is* an opioid epidemic. It’s not the chronic pain patients who are overdosing. Re read the piece, people. I’m not denying that people are abusing opioids. Nor was this intended to be all encompassing. It’s why I ended it with “stay tuned.”Report

    • Avatar Terri in reply to DensityDuck says:

      No bots. Just real people who are suffering the consequences of a failed policy. Facts don’t lie. No increase in overdose deaths of age 50 and up. Large numbers of overdose deaths in the 16 to 30 age group despite a reduction in opioid prescriptions. These are CDC figures. It doesn’t take a genius to deduce that the problem is illegal fentanyl and heroin.Report

      • Avatar Sam Wilkinson in reply to Terri says:

        Seems like you’re saying that the problem is young people who don’t need it versus old people who do.Report

      • Avatar RB in reply to Terri says:

        This March, HHS released nearly $500 million to the states, in an effort to combat the opioid crisis. The total cost to date: $1.4 billion, because government throwing more of our money at the problem is working!

        Illicit OD’s continue to climb with little-to no impact, but the chronically ill have been impacted in a big way. THIS IS NO LONGER affecting JUST cpps. This is a national crisis now; affecting cancer pts, returning veterans and surgical patients.

        Everyone needs to start paying attention! Studies are being done on unsuspecting patients because lets face it folks: theres a lot of money up for grabs. Its financially lucrative to be an anti-opioid problem solver and wait for it——YOU are the participants whether you like it or not.

        Anti-opioid stakeholders & their new treatments need an expansive market & YOU are the guinea pigs; after all who wants to play Russian roulette with a pain regimen that may or may not work? No one will volunteer for this. You have cancer: (well maybe or maybe not) you will probably be guaranteed relief in your last dying hours——maybe?
        Cuddle with those thoughts while you’re healthy! Great writing Teri (-;Report

  12. How are you differentiating between all chronic pain patients and those who are overdosing? Surely there is overlap between the two.Report

  13. Here is four quotes from the CDC opiates guidelines:

    https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

    “The guideline is intended to ensure that clinicians and patients consider safer and more effective treatment, improve patient outcomes such as reduced pain and improved function.”

    “Clinicians should consider the circumstances and unique needs of each patient when providing care.”

    “Clinical decision making should be based on a relationship between the clinician and patient, and an understanding of the patient’s clinical situation, functioning, and life context.”

    “This guideline provides recommendations for primary care clinicians who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.”
    CDC guidelines were for RECOMMENDED LIMITS for acute pain for opiate naive pts – NOT CHRONIC PAIN PTS
    Out of the 90+ pages of the CDC guidelines.. many entities have fixated on their favorite sentence, paragraph or page where the 90 MME limits were mentioned and totally disregarded the balance of the guidelines. The CDC, FDA, AMA and other have stated that the guidelines have been grossly misapplied.Report

  14. Teri wanted me to pass along that she is reading and appreciates the comments. She is not able to reply right now or probably today, but will tomorrow or as soon as she can.

    Thanks everybody.Report

  15. Avatar Lisa says:

    Good article. Thank you for writing the truth about all this.Report

  16. Avatar Anne says:

    The truth is that we are fighting two diseases here- Addiction and Chronic Pain and with the current method, we are losing on both fronts. Both Addiction and Chronic Pain are diseases that damage people and society. You can’t fight two diseases with one radical policy that is hurting both.
    Chronic pain doesn’t completely go away when you take opiates. However, Opiates do allow many to lead fuller, happier, and productive lives. Most also use mediation and other things to help. But Chronic pain is terrible. I would not wish this on my worst enemy.

    Addiction doesn’t stop when you cut off the supply. The narrative that “I took opiates or stole my friend’s after surgery and became addicted” it a simplified version of the story. One that is trotted out too much. In an ideal world, no one would be an addict. However, cutting off the supply doesn’t work- It didn’t work in prohibition and it doesn’t work now. What addicts need is treatment- AA, Rehabilitation, therapy, etc. they do need to be treated, but not at the expense of Pain patients.

    Chronic Pain patients also need treatment, I can tell you that most people would not let their dogs suffer in as much pain as most chronic pain patients. It is wrong. It is in humane. I applaud everyone who participated.

    This is not a hopeless situation. I think there are many ways to address both issuess.
    1. Physicians should be the ones responsible for prescribing medication. The government, lawyers, DEA, etc should GET OUT OF THE DOCTOR’S OFFICE. I guarantee that my doctor knows me and my condition better,
    2. The government does have a role, but it is not in practicing medicine. Their job is to make sure that medicine is safe, and that it is not being misused, the same role they have in making sure things like insulin are safe.
    3. Addiction is a disease that deserves treatment, I think that if the people fighting against pain control would us their energy to come up with better ways of treating addiction, rather than paying lawyers to sue pharmaceutical companies, we’d be further along in this fight, too.

    I’m glad that pain patients are standing up. The problem is that they should not have to engage in political campaigns to get the treatment they deserve.Report

  17. Avatar FC says:

    It is economic. Theres much, much more money to be made from forcing chronic pain patients into surgeries to implant, revise, or remove saline pumps for pain or spinal cord stimulators.
    Even more to be made from investments in drug addiction treatment centers and rehab clinics if you can create a new population of “addicts” seeking treatment by shifting CPP and Cancer patients out if those categories and diagnoses into “Substance Abuse(r).
    Patients’ needs are revenue generators. Repeat Medical device implants and addiction treatments are profitable because they’ll be repeated each time the treatment fails and treatments for the wrong condition usually do have poor outcomes. Yet, it’s not the doctor, facility’s, pharmacist’s, or insurer’s error. It can be blamed on the patient (who already has “poor judgment” attached to them because they were once a “drug user”. When they finalky lose hope, it’s a “failure to follow treatment or doctors advice. If they kill themselves, the suicide is almostvtreated as “drug related” and used as proof of just how badly they needed those mental health services that had been offered to them …for a price.Report

  18. Avatar Pam says:

    It’s called taking responsibility for your actions, only that doesn’t apply to those who CHOOSE2ABUSE! They get a free pass to blame anyone else but themselves. Even though it was thier CHOICE to pop pills recklessly while boozing it up with thier friends, cuz life’s one big party right?? My ex was addicted to pills as well as many of his buddies at work. and NO they did NOT start with a legal script in NO WAY, SHAPE, OR FORM! It was thier personal CHOICE to call the dealer while their partying at the bar, NO DOCTOR EVER INVOLVED!! BUT guess who got blamed when my ex got caught by his boss……wait for it….DING DING!!! He blamed his popping pills on some fictious dr that got him hooked. And he’s not the only one who blames anyone else but themselves! MAKES ME SICK!! Here I am, an intractable pain sufferer for nearly twenty years, was on the SAME STABLE HIGH DOSE FOR EIGHT YEARS WITH SUCCESS, in steps the corrupt CDC and lawmakers DENYING LIFESAVING PAIN MEDICATION to chronic pain pts and my dr of ten years abandoned me, handed me my last scripts that he cut way back, no slow wean, and sent me on my way not caring if I lived or died, he said his license was more important than treating pain pts!!!! WTF?! DO NO HARM !! I was able to participate in life and now I am homebound begging God to take me daily. THIS IS INHUMANE, BARBARIC, CRUEL AND IT SURE AS HELL IS TORTURE!!! To leave human beings in agony until they kill themselves to end the pain is GENOCIDE!!! How many more pain drs will be shut down, how many more INNOCENT LAW ABIDING CHRONICALLY ILL CITIZENS/VETS WILL BE FORCED TO TURN TO THE STREETS FOR RELIEF OR WORSE #SUICIDEDUETOPAIN!!! I bet not one in government is being denied pain relief! All of them need to be drug tested monthly like we the ppl, they need to have thrir medical/pharmacy records made public like every government agency having access to our PRIVATE records, There is no way they are all in perfect shape, many up in age comes painful conditions. How many of thier family members are DEPENDENT on pain medication?! Wana bet thry don’t get treated like a pill seeking junkie out for a high?! I am so fed up and done with paying the price with my health and overall well being!! How about the DEA Target the cartel like they are our drs!! We have an ILLEGAL FENTANYL/HEROIN crisis not coming from our drs!!!Report

  19. Avatar Megan says:

    I’ve been suffering for 5 years. Each year worse than the last. My dose is capped at the 90mme and this prevents me from switching to extended release (ER) so that I can stop watching the clock and carrying around all my meds. My doctor is discussing switching me to a stigmatized medication used to treat addicts which would ban me from receiving further treatment. With the passing of time I become more immobile, lost almost my entire support system, lost myself and now I’m treated like a criminal and when my doctor goes on leave I can’t find anyone who will treat me. She is so scared that she refuses to take the advice of my pain mgmt. doctor so even though I have a team, my quarterback refuses to pass the ball and take on their recommendations. It’s life shattering, soul crushing, body wasting pain. An emotional, physical and economical assault. These providers are so afraid, that they are committing patient abandonment and malpractice with abruptly changing the treatment plan without patient consent and dropping their patients all together. Most of us can’t afford the lawyers willing to prosecute the providers for malpractice and many won’t even touch it. Not all the providers are misinformed but are just scared and their fear of the DEA is stronger than that of a lawyer. They are getting sanctioned and more from the government and sued by their patients (if at all) and feeling pressure from both sides and they are just as much victims as we are. They too are losing their livelihoods and more. Most pain clinics have closed their doors due to FDA and DEA overreach and patients are unable to find a new provider! We are asked to fill out questionnaires and if we check that box that we have pain we are immediately dismissed. It doesn’t matter if they can treat us with other modalities, if you have pain at all, in any form, you are dismissed and deserted. These providers took the Hippocratic oath and it’s now reflecting it’s name, hypocrites. They promise to do no harm and treat patients and not leave one behind but they are leaving millions behind and causing irreparable harm. Families and loved ones are suffering too; watching their loved ones in endless pain without being able to help them, having to care for much of our needs because we are unable to anymore. The mass casualties of this mislabeled crisis (illicit drugs NOT legitimate scripts) should be enough for action! Recalls are done rather quickly for everything else but what about recalling the harmful policies? It’s one thing to say it and publish new guidelines and statements but it’s not changing anything. We don’t have time to waste! WE ARE DYING! Every day that goes by without treatment or undertreatment is lives lost. I suffer from suicidal ideation (more like suicidal longing now) and I REALLY struggle to dismiss those thoughts because I have responsibilities that I struggle to manage. It’s not enough for us to stand up. Doctors at risk, STAND UP! Doctor’s who still believe in treating patients humanely, STAND UP! Government officials who know and are being offered money to look away, STAND UP! Supporters and loved ones of pain patients, STAND UP! Journalists and Anchors, STAND UP and TELL OUR SIDE! Millions of people are talking about how wrong it is to make us suffer…GET TOGETHER AND STAND UP! We are flooding news stations, senate, representative, social media, newspapers, medical conferences and boards with our plight and NOBODY is taking action. Oregon rolled back it’s policies adopted but even as recent as yesterday patients are STILL NOT BEING TREATED! There’s a LOT of talk and a LOT of action by us but nothing is changing. What will it take? How many of us have to die before we are seen and heard?Report

  20. Avatar Jaybird says:

    A great post about a really awful situation.

    One of the things that I thought would help was Medicinal Marijuana legalization (or recreational for those who, for whatever reason, can’t get a prescription). As it turns out, it looks like that’s not the case.

    I have no idea what might help. Yelling that we have to “do something” tends to get the government to say stuff like “well, if people are dying from overdoses… maybe they should have less of the stuff they’re overdosing on?” and tightening their grip on doctors (making non-doctors more likely to deliver product that doesn’t have any QA whatsoever making overdoses more likely).

    “We need to be doing less” will never be a big rallying cry, though.

    And I wish I knew what to do.Report

  21. Avatar RB says:

    You FC are spot on: 100%…& Therein lies the problem. All the revisionary statements re:CDC etc. will do little. When “harm” occurs whether by faulty procedure, device, or surgery & under or no treatment for cancer: EVERY occurrence is potentially “actionable” & legal consults must be had. This is how it BEGINS. A little media attention never hurts!Report

  22. Avatar Terri McFarland says:

    BRAVO!!!Report

  23. Teri Peters Teri Peters says:

    Thanks for reading and for all of the great comments!Report

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