Opioid Lawsuits Threaten Lives of Pain Sufferers
Implications for People With Chronic Pain
Several lawsuits have been filed against several opioid manufacturers, distributors, and physicians for participating in what was allegedly a scheme to cause incalculable harm for profit. I am one of the physicians named as an alleged “conspirator.”
The opioid lawsuits are far more than legal matters that involve the defendants. They also have serious implications for people in pain.
The opioid crisis and resulting lawsuits have significantly impacted regulatory scrutiny of prescribing, which in turn has had a chilling effect on physicians who are increasingly unwilling to treat people in pain for fear of losing their license. Unfortunately, the lawsuits and the hyperbolic charges they contain fail to recognize the scientific, medical realities of chronic pain patients.
Earlier this year, Attorney General Jeff Sessions famously suggested that people who suffer from severe pain should take a couple of aspirin and tough it out. But how can anyone reasonably expect all pain patients to suffer silently when unmanaged chronic pain can have catastrophic results? Chronic pain – a horrendous disease that is largely misunderstood – holds great potential for causing serious physiological consequences.
Untreated Chronic Pain Can Endanger the Brain
For example, Pain Management and Injury Relief cites that “…untreated or under treated pain exposes chronic pain sufferers to a lot more than just escalating levels of discomfort—it can cause damage to the brain and a person’s mental abilities.” This finding is supported by EDS and Chronic Pain News & Info, as well as the Australian Broadcasting Company, which both reported that chronic pain can cause brain damage and mental impairment, among other harmful effects.
Some researchers believe that chronic pain decreases the volume of the prefrontal cortex, which is the part of the brain that is responsible for executive functions (cognition, social behavior, personality, and decision-making) as well as modulating pain. That means, over time, people with brains damaged by chronic pain can lose the ability to handle the same amount of pain they could previously withstand.
Ultimately, chronic pain changes the brain structurally and functionally, usually with devastating results.
The potentially good news is that the damage caused by chronic pain may be reversible, at least to some extent. If pain is adequately treated, the brain may be able to regain its ability to function normally. There is some debate about this, and there may not be a definitive conclusion about whether the brain can ever get back to the condition it was in before the onset of pain. But, due to neuroplasticity, it is possible for the brain to heal. However, if a brain is to recover, the pain must be mitigated.
Limiting Chronic Pain Treatment Is Not the Solution
Expecting chronic pain patients to “tough it out” is an entirely unfair, and downright cruel, recommendation. It is not a solution. While many pain patients can manage their pain with aspirin or ibuprofen, 2 out of 10 chronic pain patients (or an estimated 20 million Americans) still require some level of long-term opioid therapy in order to live functional, meaningful lives. They comprise the highest-risk pain population for suicide, which for many of them is a desperate yet preferable alternative to living with their intractable pain every single day. This is why understanding the science of the disease is crucial if we want to combat the opioid crisis effectively without threatening the lives of millions of other Americans who are also suffering.
Policies that limit a physician’s ability to tailor treatment and minimize the acute and chronic pain may be unintentionally contributing to brain injury. Policymakers should be aware that pain has more serious consequences for some people than they might have understood.
Until we find an alternative to opioid therapy, efforts to discourage physicians from treating those suffering from pain may cause reprehensible damage to the very constituents whom they are trying to help.
Thank you Dr. Webster for your continuing excellent contributions to this ongoing War For The Ethical, Compassionate & Humane Treatment Of Pain in all of its many forms, and for those who experience it and attempt to treat it while both suffering persecution and extreme bias as a result of the overly hostile regulatory environment of our current State and Federal authorities and many false media reports on the reasons for the opioid crisis. You continue to show tremendous courage, diplomacy and wisdom in the face of ignorance, intolerance and oppression. We in the pain community are all forever in your debt for all you have done and sacrificed and continue to do in educating the masses while working to bring forth the truth in a sea of suffering and tyranny.
My sincerest gratitude,
Denise R. Molohon
Thank you Dr. Webster for continuing to spread awareness of this situation. It is truly a disgrace what they are putting you and other physicians through, for trying to help those who are suffering in horrific pain.
They are choosing to blame those who are suffering instead of blaming the true problem which is and always has been illicit fentynal, heron, crystal meth, and the likes, NOT prescription opioids. This has got to stop! To many legit pain patients are dying due to lack of proper treatment. The DEA is out of control and has caused a chronic pain pandemic!
More restrictions will only cause more chronic pain patients to die.
Thank you Dr. Webster. I know you are right as I have carefully looked at many of the studies on the brain and chronic pain. I am a disabled nurse and a chronic pain patient after suffering and incomplete spinal cord injury and it long term problems. I learned about brain damage after they did an MRI of my brain trying to get a view of the upper part of my cord since I have metal implanted and cannot have one done below the brain. It revealed significant deterioration of the brain which I have been told is typical of that seen with severe pain. In addition to deterioration, often in a pattern dependent on the type of pain, there is a rewiring of the brain which occurs and physically causes depression among other things. In any evaluation of benefits/harms of the opioid crisis the harms of uncontrolled pain must be considered.
I suffer with severe fibromyalgia, scoliosis, degenerative disc, bulging discs in neck and lower back, severe osteoporosis, bursitis in my hips and arthritis in my hands and knees. My dr is no longer ‘allowed’ to prescribe my pain medication and I was just told that my pain mgmt dr (of more than 10 yrs) will not take over my pain meds. What the heck am I suppose to do? I’ve been disabled since I was 34 and I will be 60 this year. I can’t sleep, I have no life…I can’t even do yardwork which relaxes me. I’ve been given no alternatives. Any suggestions???!!! HELP!!!
As a cpp for almost 20 years and been cut off, can attest to pain, chronic pain, affecting the brain. I have 20% or so loss at front of brain, prefrontal cortex, i believe dr said, and after years of some relief, last 4 years , basically untreated. My brain age is comparable to and 80yr old. I was in my 40s when dx with trigeminal neuragia, and many other issues to follow.
I have had chronic pain for almost 40 years. I thought all my brain damage issues were from when I had a brain cooking from sepsis, now I am thinking it’s also the unending chronic pain. I already have signs of dementia, and I am 55. I have never been on opioids long term, and have relied in OTC, P.T. supplements and dietary changes. My pain is so bad now I have dissociation disorder very badly and I wander off and walk until I have to call 911 because I feel like I am about to pass out or the police because I am completely lost. I feel like Alzheimer’s is around the corner and all my life has been is pain and suffering. I get so depressed, that I dissociate because if I don’t I become suicidal. The way people are treated is sickening and I feel my doctors only have saved my life to continue my suffering for financial gain.
My world is a living hell. I have Adhesive Arachnoiditis & Caudia Equina syndrome. At least stage three. This disease has been compared to bone cancer. I’m not alone on this sinking ship. Those who make idiotic statements like take asprin & tough it out. They obviously have no idea what intractable pain is or what it feel’s like. To add insult to injury,I’m treated like a criminal. I’m near the end of my tether. All I want is some quality of life & there is little hope of that happening.
Living like this does psychological damage,how could it not?. If you don’t know anything about grinding relentless pain…shut your mouth!. You don’t have the right to speak to me.