Posted on 07/13/2019 5:27:23 AM PDT by GailA
Senator Joe Manchin (D-WV) and Mike Braun (R-IN) are still trying to address the fentanyl and heroin overdose crisis—soon to be joined by a methamphetamine and cocaine overdose crisis—by denying chronic pain patients access to pain relief. They have just introduced a bill they call The FDA Opioid Labeling Accuracy Act, which would “prohibit the Food and Drug Administration (FDA) from allowing opioids to be labeled for intended use of ‘around-the-clock, long-term opioid treatment’ until a study can be completed on the long-term use of opioids.”
Set aside the fact that most pain specialists agree that, in some cases, long-term opioid therapy is all that works for some chronic pain patients. The 2016 guidelines on opioid prescribing put forth by the Centers for Disease Control and Prevention have already been misinterpreted and misapplied by legislators and regulators, leading to forced and rapid tapering off of opioids in many chronic pain patients, causing many to resume lives immobilized by pain, and in many cases, seek relief in the black market or by suicide. It has gotten so bad that the CDC recently issued a “clarification” in April, reminding regulators that the guidelines were only meant to be suggestive, not prescriptive, and did not in any way mean to encourage the rapid tapering of patients on chronic opioids for pain management. Johns Hopkins bioethicist Travis Rieder, PhD delves deeply into this subject and relates his own experiences in his book, In Pain.
(Excerpt) Read more at cato.org ...
Surgery for the relief of pain as you are aware is most effective at the acute stage, within 6 months to a year after onset. You probably also know that the use of surgery for lower back pain comprises only a very small fraction of the total number of people treated for chronic pain.
Decompresion procedures can remove pressure on a nerve and improve pain and function in the acute setting, but rarely is there improvement after the nerve has been damaged long term. And I’m sure you’re aware that patients with co morbidities such as psychiatric conditions, other chronic diseases such as Lupus, MS, serious heart disease, poorly controlled diabetes don’t fare well with surgery much of the time as well.
While effective in select cases, spine surgery is certainly no panacea and will not solve the much larger problem of rational and effective treatment for chronic pain patients.
I referenced a text book that was published in the 60s that detailed one of the country’s best “40 year experience” at that time describing some 400 different procedures directed explicitly at “the relief of chronic pain.” Yes, I am well aware that over time pain “centralizes” which is precisely why these procedures should be offered widely and promptly. Unfortunately, this is not currently the case. So, many of these procedures have been known for 100 years and yet one cannot find a neurosurgeon that will do them. THAT is what our government should be investigation.
When you look at their record on gun violence, it’s pretty clear they are above the law and more about death by socialism. I bet their families get all kinds of exemptions and special insider trading deals, just like the rest if the ruling class.
Pretty good analysis. Thanks for the insights.
“The only thing you are accomplishing by treating chronic pain with opiates is you are creating an addict.”
Why do you keep saying addict? Even Scott Gotlieb at the FDA states that chronic pain patients are not addicts. Would you please crack open a medical book and look up the definition for yourself because you are embarrassing yourself and confusing others. Pain patients are tolerant to and dependent on opiates and when taken off they will have a withdrawal syndrome. They are not taking the medication to get high. They use the medications for positive reasons such as keeping a job and ADLs. They have an adverse result when they go off medications.
The reason we have more opiate deaths is because of the illicit drug trade, not opioid prescriptions and the recent studies prove it. Opioid prescriptions down, opioid deaths up.
Addiction to opiates occurs after short term exposure. In most cases it takes just a few doses and others may take weeks or months. The addict will get a high whereas a non addict will get some analgesia and sedation. There is a strong genetic component to opiate addiction. You won’t stop addiction unless you completely eradicate exposure legal and illegal. That means that no one should receive an opiate after surgery or injury ever, and all illegal opiates will have to be stopped. Do you think that will ever happen? Maybe we could all become Mormons or Amish, that would eliminate exposure and addiction. Or put all addicts in prison for life.
IF you re in Hospice, getting hooked long term is a contradiction.
I can eat Tylenol like M & M’s and won’t get any pain relief. I learned years ago that it doesn’t work for me. Plain Bayer aspirin & Advil work well.
You mean the same FDA that for 15 years encouraged doctors to create addicts? I can’t tell you how many CME sessions I had to sit through during which “doctors were taught (by representatives of the Federal Government) how to prescribe opiates for chronic pain”. I seethed for every hour and there were a lot of them. For the first five years I actively engaged these morons but after a few years I just decided they would learn the hard way. They have.
[[until a study can be completed on the long-term use of opioids.”]]
Studies HAVE been done, and it’s been proven that less than 3% of patients who take the medications as directed ever get addicted-
This IS going to push people with severe pain to seek drugs off the street which are not controlled, and one won’t know the dose they are getting or whether the drugs have been cut with other crap- it WILL increase deaths
Come on. For the 3rd time, look up the definition of addict. Pain patients are dependent on opiates but have a positive result.
The only reason we are having a problem here is that the federal government has intervened in a harmful and draconian fashion. It is really too bad that with respect to abuses, problems could have been resolved at the State level and through medical boards and not the federal police state agencies. With respect to the majority of cases, this is essentially a medical and public health issue/ controversy, not a criminal issue.
I would hope that if you claim to be a conservative that respects individual and States rights, and you would agree that the current federal approach is excessive and egregious. The deep state mole and creep Sessions was largely responsible. I don’t know what Trump actually knows or thinks, but he is too busy at times defending his ego on Twitter from leftist idiots that he can be bothered if it doesn’t affect him directly.
[[A 1982 study of 145 burn treatment centers representing 20,000 burn patients found after prolonged parental (injections) opiate treatment only 22 people became addicted (1). In 2010, the Cochrane Collaborative (a highly regarded reviewing agency in the UK) reviewed 26 long term opiate use studies and concluded: “serious adverse events, including iatrogenic (caused by the treatment) opioid addiction, were rare”(2). A recent study at Loyola showed only one person addicted out of 1100 cases given postoperative opiates (3)
A carefully designed epidemiological study studying occurrence rates of addiction was conducted by the respected epidemiologist Lee Robins at Washington University in 1977 She studied 700 soldiers returning from Vietnam on high dose, pure, I.V. heroin.(4) Expecting nearly 100% addiction, she was “surprised” to find though most had withdrawal symptoms confirming the habituation most all get taking medicinal or street opiates, or antidepressants for that matter. Why was she surprised — only 2% became addicted.
Using the confirmed government figure of 2 million people with Substance Abuse Disorder (SAD) (not all of which have true addiction) divided by population of 320 mil the figure is 0.6% or one half of one percent confirming the incidence of “addiction” of less than 1 %.]]
And so on and so forth- Addiction is very rare-
https://medium.com/@ThomasKlineMD/opioid-addiction-is-it-rare-or-not-abaa3722714
Jerry West & Don Nehlen both cut commercials for Manchin.
Don Nehlen - former WVU football coach, now in college football hall of fame - only coach to take WVU to a near national championship - beat out by Norte Dame in the 1980s!
West (”The Profile!”) - hasn’t lived in WV since he was drafted by the Lakers. However his name is still magic here! And to be fair, West honors his hard scrabble WV heritage!
Nehlen - not sure if Nehlen still lives here or not.
The reason we differ is I took an Oath to “first do no harm”. I have never seen making someone dependent on opiates as anything less. Sure a Juarez cab driver can support a habit for 40 years easily but if for whatever reason the supply is cut off they will literally do ANYTHING. I would put that into the “serious harm” category. I have no problem with individuals deciding on their own to do that to themselves.
When people let their sports heros influence their political views they get the government they deserve.
yep
also those opioid deaths that they love to tout to bolster their false ‘prescription opioid epidemic’ claim are almost ALL due to druggies getting prescription drugs and using them with either alcohol, or other street drugs together- they are not due to people taking the prescriptions as prescribed-
You bring up a great point about defining opioid addiction- opioid dependency and opioid addiction are two distinctly different things- As stated above- opioid addiction is very rare- opioid dependency is not addiction, and doesn’t lead to the problems associated with addiction.
An Addicted person is psychologically addicted to the drug- the dependent person is not. The addict is a drug seeker, the dependent person is not. The dependent person can and very often does- infact almost always does, quit the drug despite the physical need for it- The Addict does not-
Again- it must be pointed out- that psychological addiction to prescribed drugs is very rare- While folks can and do develop physical dependencies on pain meds- they should NOT be denied life improving medications if other means have not worked simply because people who are addicts abuse prescription drugs—
Again- addiction to prescribed drugs is very rare- and while drug deaths by opioids is large- it is almost exclusively the result of misusing the drugs by taking more than prescribed and combining them with alcohol and or other street drugs- To make people with severe pain suffer because addicts kill themselves when the studies show that there is a very low occurrence of drug addiction is unkind to the millions of people suffering with crippling pain
Until they come up with a non narcotic pain relief medicine that works as well as opioids, or better, there is no need to deny pain patients the use of life improving medicines that can help them get through a day without wishing they were dead
I guess thinking and independent thought is just too much for them. Far easier to let old jocks tell you how to vote.
Lots of lazy minds out there, and no one knows that better than the politicians. They rely on it to keep their jobs.
I agree. Even 2016 ASAM lists about 500k heroin addicts and 2.5 million other opiates addicts. So that still about 1% in U.S.
We just have too many people that simply want to label anyone on opiates as addicts. The implication is that these people lack moral fiber or character. If they could tough it out, they could get over their pain without an opiate. These people are control freaks and they don’t want people to decide for themselves (with expert medical advice of their personal physician) and instead want the central government to decide for them. It’s sad that too many purported conservatives hold this view.
The fact is that even actual drug addicts would be better served getting opiates from a physician than on the street where it is likely to be contaminated or not pure. In fact in Switzerland they give needles and pharmaceutical grade heroin to heroin addicts.
Although people often tout addiction centers as a cure for addiction, and that in certain cases some patients can maintain abstinence
or at least a healthier lifestyle, most addicts will fail to participate or complete treatment, and after treatment, most relapse.
IF- and it’s a big IF- IF a person who has chronic debilitating pain must be taken off, who is merely dependent- then you don’t cut them off cold turkey- a Dependent person will suffer physical withdrawals, but IF it is necessary for them to quit- then they can get through those physical withdrawals with help- The addict on the other hand can get through the physical withdrawals, but they have a lifelong battle with psychological addiction to deal with
Your arguments are ‘all or nothing’- and that’s a false argument meant to demonize a medication
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