Oregon’s Proposal to Deny Access to Prescription Opioids Is Dangerous
Here is the email I sent to The Oregon Health Evidence Review Commission (HERC) and its subcommittee, Value-based Benefits Subcommittee (VbBS), at the suggestion of a recent National Pain Report article:
I am writing in regards to the Oregon Health Plan’s proposal to limit access to opioids for people in chronic pain.
Certainly, opioid abuse in Oregon is a significant problem and should be addressed. But the proposed policy to force opioid tapering as a way to mitigate the opioid crisis is ill-conceived.
I receive dozens of emails from people in Oregon who struggle to find pain relief. Most of these emails are from people who have already been forced to taper, and their quality of life has greatly diminished. This story from a patient who refers to herself only as “M” is typical.
“Except for my recent surgery, I suffer pain and bed rest mostly but am not willing yet to ask for a prescription. I can walk into a store well but as the cart gets heavy my spine twists inside my body and causes so much pain I lose control of bodily functions. They know me at the store–know someone must take all my purchases out to the car. It is a life….This witch hunt is taxing the strongest of us. It is breaking so many. Life is unfair but this is just hideous.”
Stories like this one will likely increase in number if the Oregon Health Authority’s proposal to limit chronic pain patients’ access to opioids becomes law. It is important to find solutions to the drug crisis, but they must be patient-centered solutions. Complete elimination of opioids for specific pain disorders is not patient-centered, nor is it the right thing to do.
It is critical to recognize that the amount of opioids prescribed is only one factor that has contributed to the opioid crisis and may not be the primary factor. Lack of access to adequate mental health and addiction treatment have also contributed to the problem.
The Bulletin recently reported that the number of opioids prescribed in Oregon has been declining over the past several years. This is also reported on the Oregon Health Authority website (Figure 1). Prescription opioid-related overdoses represent about one half of the total opioid overdose deaths (Figure 2). According to the Centers for Disease Control and Prevention (CDC), there has also been about a 25% decrease in the rate of opioid-related overdose deaths since 2011 (Figure 3). The trends are moving in the right direction, but the proposed elimination of opioids for people in chronic pain may slow or reverse this trend.
https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/SUBSTANCEUSE/OPIOIDS/Pages/data.aspx
https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/oregon-opioid-summary
https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/oregon-opioid-summary
The assumption that denying access to prescription opioids for those in severe pain regardless of the diagnosis will stop abuse is fallacious and dangerous. If Oregon implements this policy, there will likely be at least two negative effects:
First, people with a substance abuse disorder (SUD) who are using prescribed opioids for the wrong reasons are not going to suddenly stop using drugs because they aren’t readily available. Instead, they will seek other sources of drugs. People with an opioid use disorder (OUD) will turn to the streets for their opioid replacements. This may contribute to more deaths, because the streets are where the most dangerous drugs are found.
Several studies have shown the introduction of abuse-deterrent OxyContin led abusers to switch to heroin as a substitute when OxyContin became more difficult to obtain and abuse. The National Bureau of Economic Research is one such study that published a report on how supply-side strategies alone are inadequate for dealing with drug abuse in their 2017 report, “Supply-Side Drug Policy in the Presence of Substitutes: Evidence from the Introduction of Abuse-Deterrent Opioids.”
Second, people in pain who have been functioning on their medication without signs of abuse may lose significant quality of life. In some instances, people will feel abandoned and hopeless. It is not hyperbolic to suggest that some people in severe pain who are denied access to opioids will view suicide as the only way to escape their severe pain. Recent research suggests as many as 30% of unintentional opioid related overdose deaths may be suicides. Inadequately treated pain is a risk factor for overdoses and suicides.
The proposed alternative therapies such as physical therapy, acupuncture, and cognitive behavioral therapy are important to have as options but may be insufficient for many people in severe pain. Alternative therapies should be treatment options, but they are not necessarily replacements for opioids. Pain management must be tailored to the patients’ individual needs, and one size does not fill all. It would be an error to think that alternative therapies would work as well as opioids for all patients.
Before Oregon chooses to implement a new policy, it is imperative that metrics be introduced to measure the impact of any interventions on both the impact of drug abuse and the quality of life for people in pain. The Oregon Health Authority can improve the lives of people in pain while reducing the harm from opioids, but forcing opioid tapers is not an appropriate or compassionate solution.
Sincerely,
Lynn R. Webster, M.D.
Vice President Scientific Affairs
PRA Health Sciences
Past President American Academy of Pain Medicine
Salt Lake City
Dear Dr. Webster,
Your letter spells out the many reasons why limiting access to opioids for people in chronic pain in Oregon makes no sense. It is another one of the many knee jerk reactions people in government make when they don’t have all the information. People looking for the quick fix grab onto ideas like this without checking into what the side effects are.
Yes it’s true, there are side effects , just like a medication.If you cut off all prescriptions for pain medication, there will be no overdose deaths from prescribed pain killers. That sounds like a fix until you look at the side effects. 1. You will force people who truly need them to live in misery. 2. A person in excruciating pain will try to find another source of pain relief. On the street this could mean heroin and fentanyl. 3. Some people living in misery due to untreated pain will eventually commit suicide. I know about these side effects because I am a person living in pain. Right now I am able to get by because I have a understanding doctor, but the non stop push to take away all pain medications leaves me worrying all the time.
Thanks for doing all that you do, doctor.
Best, James
Dr. Lynn Webster hit this one out of the park. Horah, for the knowledge this doctor has. Thank you for understanding chronic pain for those like me have tried to explain to dozens of medical doctors, therapist,pain management groups,and family. Walk a mile in my shoes and anyone would see what we go through every minute of our days,months and years. One of them. Amen
Dr. Lynn Webster, thank you for looking out for people in pain. I’m just wondering if those charts are really outdated? Since the CDC has admitted to overestimating RX opioid related deaths by 50%, it’s time to revise those numbers they’re wrong by 50%. I went to my primary care physician the other day he didn’t know about the CDC admitting anything, neither did my pain management specialist about a month ago. Looks like we have people making rules that are very uninformed and ignorant to the facts.
Dr Lynn Webster; I also am regarding this insane and ludicrous decision you and others have made for those such as are in Pain Management. You want to play God and on top of that you think, you should be the voice for those that are suffering in pain. What gives you the right to make those decision when you yourself has never suffered a day in this life with severe pain. One can’t take a Tylenol and tough it quote as Jeff Session said . He has not a clue to what those whom are suffering in Pain. Because he sits behind a desk all day and most likely goes home and has a glass of wine like so many others do. I ask this question? Why do they have to go home, and take a drink of wine, beer or so forth. Their explanation is because it is relaxing. Well like any other thing, it is a drug and number one killer in America when those drive and drink. I don’t care if it is one drink they still have to have a drink to unwind. So that is very addicting. Then you have pot that is a drug as well but they said well it is plant base natural. DA!!!!! those are not stupid to know the difference between Pot and medicine’s it all ties together they are all classified as addicting and people abuse them. So why don’t we take every bottle and can off the shelves that are of alcohol in stores and all place chuck them out open and discard. I bet you my life that you would not only have Dr.s lawyers, dentist, of all category screaming as to why they can’t have a drink. I bet then they would study more intensely on those that are suffering in pain. Start having a heart of compassion and sympathy for those that are suffering. The Lord said in his world that this world would grow cold and that there would be a day that the world would have no compassion. That is taking place right now. No one is going to escape God no matter what your belief is Sir or Mam. Because every knee will bow and declares that Lord is Jesus. I find it ludicrous and totally insane to what people that have been under a Dr’s contract, too follow by the rules and to live a productive life to then have it all stripped away for what, because a bunch of natural paths that are either heart surgeons, and other Dr’s say it is addicting. They are surgeons they have no clue as to what Pain management is but the only ones that know we struggle is our Pain management Dr.’s. That would be like me being a nurse, and some one took me off for the week too do plumbing. Do you know what would happen? I would make a mess and disaster out of all of it. But we are not dealing with plumbing, we are dealing with real life people and their situations concerning their pain in suffering. This state has become so Liberal that the people in Government, Senators, Dr.’s that are all think things should be by natural alternatives think that they can play games in People’s lives. When in reality they are killing them, and going to continue to do so by stripping them of a life going to work with little to no pain by being treated by a Pain Dr. whom knows what they are doing. Are they crazy here, are their heads screwed on back wards,, have they lost a few marbles? All I know if they take Opioids away from the people then we need to take every wine glass and every beer can out of the hands of those, that sit there and need to have a drink to unwind. All addicting none of this verbo judo language. The so called betting around the bush. People are way to smart for that. So lets get real these men and you need to start thinking more clearly because the number intake of those dying is not from Opioid abuse addicts so called but they are dying from the drugs out on the streets. I know because we live right in the middle of it all and see people of all ages, along with the poor and wealthy buying street drugs. We look out our windows to see them women snorting up nose, to changing baggies in the middle of the road and in return for cash. Those are the ones you need to be after not the innocent. I for am one of those that had not a life before I cried and cried day after day with pain. They injected, needled me, they did therapy, and the list goes on. At that time I wanted to die. But a Dr with compassion help me with my pain and today I am living proof after years of being on Opioids living a well and productive life. So I pray you and others that don’t understand pain and how one suffers will take a step back and look at the real situation.. That is druggies selling too those out in the streets. All focus is on the addiction part, I have not yet once heard about the person’s pain. WE like so many others are going to fight this and pray that the Lord doesn’t happen to let some one like those that don’t understand about this situation.won’t have to endure what we are Pain with out end, Pain with out ceasing, Pain when you go to bed, Pain while you in bed, Pain when you get out of bed, and pain all day long and then to have them say to bad go home take a tylenol and tough it out. .If you call yourselves Dr.’ and take a oath, too save lives then tell me how can you sit back and watch humane after humane being commit suicide? If they do, you all will say it’s because of their addiction. When in reality it will be second degree man slaughter because you Dr.’s took took their pain relief, sanity, and willingness too live.
Thank you Dr Lynn. Well said, One Love!
That’s right Bernadine! I hear you! I also suffer as you do. You are absolutely right, there has been an ongoing war against any kind of compassion whatsoever for anyone except the unborn in this country and it has almost reached a zenith. Even many of those who claim to care about the unborn are being hypocrites because if they truly cared about the unborn the would have to care about toxic pollution of all kinds that harms the unborn more than anyone else and causes disease and birth defects and autism and damages the developing fetuses. Also if anyone really cared about the unborn they must make sure that all pregnant women get prenatal care because prenatal care doesn’t just save the lives and health of the mother but does even more to save the lives and health of the unborn. Every dollar spent on giving poor women prenatal care saves taxpayers five dollars in caring for a critically ill newborn, usually one suffering from prematurity, which often can be prevented by adequate prenatal care.
This country and the American people need to wake up and stop squabbling over petty nonsense. We are all Americans and we must care for one another. The focus we need is on getting the truth and on compassion. We need truth and brotherly love, not lies, hate, bigotry, greed and selfishness. This opioid issue is being handled wrongly because a radical anti-opioid group called PROP and its leader Dr. Kolodney who have pushed their extreme anti-opioid agenda on the American people based on lies and hysteria, greed for money and funding for his addiction treatment centers. Kolodney is a psychologist with zero experience or understanding of the treatment of any kind of pain and he cannot even prescribe any medication to any patient. Why should an unqualified psychologist be allowed to dictate all medical practice to doctors, especially over issues that he is completely unqualified to address. Kolodney has a PhD, not a MD degree. He is also extremely unethical and ought to be investigated. The CDC lied and only used unqualified family practice doctors and addiction psychologists to make its findings and write the 2016 guideline. The data they cited was deliberately falsified to create sensationalism and to mislead and misinform people in order to promote their radical anti opioid agendas that is leaving millions of innocent patients all over America in lifetimes of unbearable suffering and does nothing to address substance abuse or addiction. In fact these restrictive policies are directly responsible for the thirty percent rise in heroin and fentanyl deaths from overdoses from people who were formerly using twenty times safer prescription opioids and since this so called guideline was put into law in many states they have been cut off from legitimate sources of opioids either to treat real physical pain or for drug abuse or addiction, they have been forced to take much more dangerous street drugs. It was much safer for them to have been under a doctor’s care instead where they could have been more safely monitored and perhaps referred to addiction treatment instead of dumping them out into the streets to have to try to get relief from taking unsafe street drugs obtained from unscrupulous drug dealers. What are you people thinking here? It seems very insane that regulators are so naive here!
Patients with serious medical pain ought to be able to get pain relief from their doctors, as pain relief is a legal and legitimate thing, yet these policies are forcing patients in severe pain to have no other recourse than to turn to drug dealers or to commit suicide because living a life of untreated pain is unbearable for very long. We are pretty tough or else we would already be dead by now, but we are only human and not made of steel. Each person has their human breaking point where they will eventually resort to anything to get pain relief. If we commit suicide it is not because we are depressed and really want to die but because living in unbearable pain has become too intolerable. If we turn to street drugs it’s not because we are trying to get high ot are drug addicts but because we want to end our severe suffering as anyone would want to do if they were n the same situation. We see that it would be better to be a living illegal drug user than a dead pain patient from suicide. So tell me how is driving addicts and drug abusers and chronic pain patients to black market drug dealers for pain relief and drugs for addiction going to reduce overdoses or save any lives or reduce addiction or drug abuse? It makes no sense if you can see it from my perspective. Lease try to see this. It is much better for everyone, pain patients, drug abusers and addicts alike to use twenty times safer prescription opioids and stay alive long no enough to get into addictions n treatment and recovery than ot is to force everyone onto the streets into the willing arms of unscrupulous drug dealers. Better to get treatment from a qualified doctor than from any drug dealer. This ought to be obvious, so why is government doing this? It is only going to cause even more harm and no good at all. What are you people thinking? Mere exposure to opioids does not cause addiction or drug abuse. Opioids are not an infectious organism that is contagious. Most people who take opioids, over 92 percent will never becom addicted, so why the hysteria and draconian over reaction by government and the government takeover of medical practice? Why deprive over ninety percent of all Americans of adequate pain relief because of a population of people of less than one percent or at the most ten percent of the population? It doesn’t really make any rational sense. Why can’t we think rationally anymore and why do we insist on knee jerk solutions to complicated, poorly understood social and medical problems that have no easy or one size fits all solutions?
There are over two hundred documented cases of suicides already that occurred directly because these patients with severe chronic pain from serious incurable painful medical conditions were forcibly cut off of opioids by their doctors. There is lots of innocent people’s blood on Kolodney’s hands. You are right to point out the immorality of this situation. God demands that we love others and treat them as we would want to be treated if it were us. Yet how many of those who are making these draconian policies have ever considered that one day it could be themselves or someone that they love and care for who could be affected with chronic pain? No one is immune from pain, as we age the probability of having pain goes up. We have a huge, unprecedented aging baby boomer generation right now. One out of every three Americans, 120 million people, have chronic pain, and ten percent of these or 12 million people, require treatment with opioids because none of the alternatives work for them.
I do not believe that there ever was any overprescribing of opioids by legitimate doctors, other then the now closed pill mills. I do not believe that there were any doctors who overprescribed opioids such that this led to any increased opioid addiction at all. If any doctors were ever duped by patients falsely complaining of pain to get opioids it was still better for them to have gotten twenty times safer prescription opioids than for them to have to turn to street drugs, as they would have anyway if they could not get them from doctors. People seeking opioids for addiction or drug abuse reasons are not just going to give up if all doctors turn them away, they will go to drug dealers or the dark web instead where they might get drugs that will kill them twenty times over,so perhaps it was better to not worry so much about doctors prescribing habits but to focus instead upon getting patients properly screened and under the care of a regular primary care doctor who will get to know the patient better and who can screen them for addiction and substance abuse and get them into treatment sooner, rather than just dumping them out onto the street to be at the mercy of unscrupulous drug dealers. It’s obvious that these restrictive policies are wrong because this will cause these patients more harm, rather than focusing on getting them the proper diagnosis and treatment for their condition. We have to stop being so obsessed with people abusing drugs and instead focus on saving their lives and getting them the proper treatment for their appropriately diagnosed condition, whatever it is. Substance abuse is about numbing out because of trauma and child abuse issues and other psychological and emotional problems, it is not about substances as much as why the person wants to use substances. If you only care about the drug abuse, you miss treating the underlying condition that is the real problem here. Get rid of the triggers, the need to abuse substances, pull the problem out by the root and the need for substance abuse goes away.
Healthy and happy people do not need substance abuse or addiction. Sure everyone might party once in awhile or use substances socially on occasion, but this is not drug abuse or addiction anymore than taking a drink of champagne at a wedding is alcoholism. There are between 2and 4 million opioid addicts in America. It isn’t so much that so many more people are getting addicted to opioids, it is that there were many more overdoses. Yet most of those who died from so called opioid related overdoses had six different drugs in their bodies, and many of these drugs were not opioids at all! Many times it was called an opioid related overdose if the person took an entire bottle of benzodiazepines, drank a half gallon of alcohol and took only one Vicodin. They would not have overdosed at all if all they had taken was the one Vicodin. Besides, this kind of overdose looks to me as more likely to be an intentional suicide. No one takes a whole bottle of benzodiazepines just to get high! Therefore, there has been way too much potential for misinterpreted information, and bad forensics, as heroin tests as morphine and a heroin overdose could be misinterpreted as being a prescription morphine overdose, and street fentanyl tests the same as prescription fentanyl. Bad, poorly reported statistics were taken out of context and too much deliberatly biased research was used in order to create a very false and misleading narrative by anti opioid fanatics with radical agendas.
We need the truth, the whole truth, and nothing but the truth to guide our nation’s policy in these matters, not bad information put out all over the media in one sided, sensationalized and hysterically biased manners, either pro opioid or con opioid, but to get to the bottom of what is actually going on here. Everyone has chosen sides, but we don’t actually have much of any reliable facts to guide us at this point. Let’s do more and better unbiased research before we jump to any more unfounded conclusions about the medical use of opioids. There is plenty of evidence easily available for any honest researcher from Medicare and Medicaid patient records of many millions of patients. Why are these studies not being done right now? There are millions of patients who have been cut off their meds or who have had their doses reduced so why are we not contacting them to find out how this has affected them? Why haven’t we actually done the research on the apparent effectiveness of opioid treatment for millions of patients with chronic pain over ten and twenty or more years? These records and patients are easily accessible and their doctors and these patients want to help us better understand this problem so why aren’t we doing the needed research right now!?
I do not believe that most doctors are over prescribing opioids in an irresponsible manner. I have had to beg for pain relief over and over again over many years to get even minimal treatment with anything that would help. I went for three years taking every kind of NSAID and doing every kind of alternative treatment. Since I became ill in 1999 I have never ever seen or heard of any doctor who handed out opioids like candy, far from it, most doctors are extremely reluctant to prescribe any opioids at all to any patient, even those dying of cancer. As a nurse I have seen far too many patients die in unnecessary agony because doctors are too afraid to prescribe opioids and nurses are too reluctant to give them to patients even when the doctor orders them and the patient needs them and this state of affairs had existed long before there was any opioid crisis. As a chronic pain patient over the last fifteen years I am well known by my doctor and staff. I follow my pain contract faithfully and obey all the rules. I am routinely drug tested and must use only one doctor and one pharmacy and keep my meds locked up. How can allowing people like myself to continue to take my opioids as prescribed under the strict medical supervision of my doctor cause anyone any harm whatsoever? If I should ever take more of my opioids than I am supposed to, then I will have to go without and suffer later on in the month as there are never any early refills. If I should ever develop a problem with drug abuse or any other such problem, I have no problem discussing that with my doctor and working to address that issue. I am sixty years old. I live with my 92 year old mother and my disabled son. I am not able to live a wild lifestyle, as my mother is very conservative and watches everything that goes on, but even she sees me suffer and thinks these restrictions are insane. I rarely ever go out. Since my meds were reduced by 2/3 so they dont work well, I haven’t had a shower for two years because of under treated severe pain. The dose I was on, about 300 mmeq.of morphine was considered high, as I took methadone 10 mg four times a day, yet this is the lowest dose of methadone given to heroin addicts every day in the methadone clinics. Why are patients with real documented severe painful incurable medical conditions being deprived of pain relief medication that is freely given out every day to millions of opioid drug addicts when we have real medical pain? If anyone should be cut off of opioids it ought to be the drug addicts rather than people with severe medical pain. However, I do not think anyone should be cut off of opioids if they need them, even recovering addicts. This is like taking away insulin from a diabetic. No one says to diabetics that they are addicted to insulin. Our bodies need pain relief, that is why our bodies make endorphins, but sometimes our bodies can’t make enough endorphins to keep our pain controlled, just like diabetics no longer produce enough insulin. We would never think of telling doctors to use only one milligram dose to treat hypertension, or diabetes, the dose must be individualized to each patient just as with opioids, so why are we cutting off opioid doses at arbitrary limits when each patient needs a different dose, and this should be determined by doctors, not legislatures.
The entire so called opioid epidemic, in my opinion, is way overblown hysteria promoted by the anti opioid lobby in order to make money off of drug companies, and to get more funding for addiction treatment. I say this because there are almost as many suicides each year as there are opioid overdoses, but no one is calling for a suicide epidemic. There are 120 million people with chronic pain in America which is a super mega pandemic of pain compared with the so called opioid epidemic so why isn’t addressing chronic pain and getting better care for our aging population being seen as a priority at all!? The results of all the legislation overall has been to gain political points by banning the use of opioids for medical patients with chronic pain even though the opioid overdoses were not primarily chronic pain patients. So why attack chronic pain patients? Is it because we are often misunderstood and discriminated against, as there has been a huge rise in the acceptance of every kind of predjudice and bigotry in this country under Trump and his kind of people? I think so. I think that part of the reason that chronic pain patients have been singled out for this abuse is predjudice and misunderstanding and discrimination against the disabled and chronically ill. We are supposed to either get well or die in this culture, not live for years disabled and in pain where far too many people see us as a burden on society. Too many Americans, including half of my family members are so cruel and ignorant that they think that disabled people with severe pain who take opioids like myself, are just really drug addicts and scammers living off of cushy government disability benefits when we should just get off opioid drugs, get sober and get off our fat behinds and go back to work like everyone else. They just refuse to get it that we would love to get well and be able to work and enjoy life as they do, but we are unable to do this. I am the least lazy person in the world but you would never know it because of how I have been forced to live because of undertreated severe chronic pain. I can’t have the three surgeries that I need because I have primary lymphedema and I am very high risk for infections, but all everyone sees is fat on me when much of it isn’t fat at all but lymphedema. Far too many Americans are way too ignorant about medical issues and they are far too quick to judge others before finding out the facts. There is also terrible fat predjudice in this country, but there are some fat people who are fat from medical conditions and we should not be so quick to judge others. These predjudices are also very common among medical providers and even psychologists and psychiatrists who ought to know better.
Thinking that disabled chronic pain patients are just lazy loafers is so untrue and outrageous as to be ridiculous to any decent person who knows better, but millions of ignorant, predjudiced, self centered Americans share these predjudices, even the doctors and nurses that are supposed to care for us as patients. I have had doctors throw books at me, shout at me, patronize me, tell me that they don’t prescribe opioids to any patient no matter what, and tell me that my pain couldn’t be really so bad without even reading my chart or doing any history or physical first! It is really unbelievable how cruel and ignorant and easily and unquestionably misled people can be. I think that taking opioids away from chronic pain patients is more about cruelty and predjudice than anything else because chronic pain patients really do have the very lowest rates of drug abuse and addiction of all patients, if they are properly screened for having a problem with addiction in the first place, and if they have proven and documented real chronically painful incurable medical conditions then there is really no legitimate reason to deny them pain relief, even with opioids if they are needed. There have been many research studies showing very low rates of drug abuse and addiction for chronic pain patients so why are so many people lying and misusing data and falsifying data and creating phony research to try to prove by deception that we actually have much higher rates of addiction than we actually do have? Is it because Kolodney says than anyone who takes opioids for more than five days or for chronic pain is a drug addict, when we know that that is not true? It is obvious that Kolodney is predjudiced against those of us with chronic pain and does not believe that we are truly suffering as much as we are. I wish I could tie him down to a medieval torture machine and ratchet it up until he screams and then leave him there for a week or so and then offer him some cognitive behavioral therapy, or meditation, as has been offered to us instead of opioids, and then tell him to use meditation to deal with his pain, and leave him there a few weeks more and offer him acupuncture, massage and physical therapy, and see how he likes it. I can take him off the medieval torture machine at any time and stop his suffering, but for millions of us the medieval torture machine is within our own bodies and we can never escape until we die. Those who are healthy and don’t have to suffer are in massive denial of these things until it affects them or someone that they love. The refusal to adequately treat severe pain in this country is very wrong because even if opioids are needed to control pain, these drugs should never be denied to those of us who must suffer as this is torture and a violation of our human rights and our right to health. Anyone who denies us appropriate treatment with opioids if they are needed to control our pain is being unforgivably cruel.
This kind of Prohibitionist legislation is causing more harm than good. Prohibition does not work, we learned this with the prohibition of alcohol in the 1920s. We need to check out Switzerland and Portugal. While they have legalized all drugs and they are providing better treatments for drug addiction, they also have less addiction, better addiction treatment, and very few overdoses and are putting drug dealers out of business. But we are doing the opposite with opposite results. Perhaps we ought to try a different approach, like Switzerland has. Insanity is doing the same thing over and over and expecting different results. When are we ever going to realize that we cannot ever win the War on Drugs and stop fighting drugs but start treating the real problems like lack of access to health care and the need for universal single payer health care for all Americans including medical, mental health, and substance abuse and dental care. If we want to act like a Christian nation, then this is the very least we can do for the people of this country, and access to mental health care can help reduce addiction and substance abuse because trauma and child abuse is the number one underlying cause of addiction. It isn’t drugs that cause addiction per se, it is underlying trauma and psychological and emotional pain that leads to the need to self medicate away unpleasant painful feelings. We need to wake up and face these truths before it is too late. In the meantime, taking away opioids from suffering patients who need them is evil, cruel, unnecessary, and counterproductive and it will kill many people.
If your goal is to kill people than go ahead and continue to take opioids away from patients who truly need them and force drug abusers to have to go to unscrupulous drug dealers or the dark web where they will get drugs that will also kill them. That way we can save money by not having to provide people with medical care. I suspect this is how the government expects to save money, by depriving us of pain relief so that as many of us with severe chronic pain as possible will kill ourselves due to severe suffering or to have us die from the severe stress of undertreated pain that will cause is to suffer with heart attacks and strokes. This government is committing murder by neglect and cruelty and it must stop now. There is no overprescribing problem if you consider the amount of opioids needed by the aging population in America right now and realize that these drugs are needed. Just saying that there is a bottle of opioids for every American is not a good comparison as every one of the twelve million chronic pain patients who take chronic opioids alone must get a new prescription for each opioid they take each month by law in every state, so this requires twelve opioid prescriptions per year for each patient. 12 times 12 million patients equals 144 million prescriptions and many people as I do take two different opioids or 24 prescriptions per year just for myself! This takes no account of acute pain, post surgical pain, cancer pain, or dental pain so you can see how this could add up to a lot of prescriptions each year in America without being really too much. As far as taking more opioids than other countries, there are over 100 countries with zero access to opioids at all and this is not a good thing at all. Billions of people in poor third world countries are forced to live and die in unspeakable agony as I write this. We are very fortunate to have access to these drugs,,but this is no reason to deprive us of these life saving and essential medications. This is how easy it is to tell half truths and lies and use bad statistics and biased research to mislead people. No one has corrected the record and explained as I have why we don’t have so many excess prescriptions for opioids as it has been made to seem. We have only heard all one sided arguments and the pro opioid side has been intentionally left out of the discussion. That is why pain specialists and cancer doctors and those who treat chronic pain were not allowed on the CDC panel that wrote the 2016 so called guideline. It is enough to make us all very angry at this deliberate fraud and massive injustice and it ought to make every American angry also because no one is immune to having pain at some time in their lives and we all deserve proper pain treatment. Therefore I loudly say that we must stop the war on chronic pain patients, and the war on all patients with serious pain!
Bernadine: I forgot to tell you that Dr. Webster is a wmderful doctor because she has done everything that she can do to advocate for those of us who suffer with pain. We cannot blame our doctors unless they fail to stand up and advocate for us, as Dr. Webster has. Their hands have been tied by government legislation, like the horrible 2016 CDC guideline that many states and the federal government have made into law so that our doctors are not allowed to give us the doses of opioid medications that many of them know that we need and many know that we are suffering needlessly but they cannot change the laws. If our doctors were to prescribe more opioids for us they would go to jail and lose their medical licenses, so their hands have been tied. It will take as many people as we can get to fight this outrage and Dr. Webster is out on the front lines fighting for us every day, so your criticism of her and of other doctors is unfounded. Those in government are the ones who are really responsible and those like Dr. Kolodney who are pushing a radical anti-opioid agenda on America for some reason and who has misinformed these legislators. I went into some of this in my previous comment. Anyway, the only doctors who are at fault for taking away our pain relief are those who side with Kolodney and say that people with chronic pain should never need opioids when many of them know that at least ten percent of those 120 million people with chronic pain really do need opioids. Most doctors have been terrorized by the overzealousness of the DEA which should not be going after medical doctors anyway. The practice of medicine and the regulation of medical doctors and medical practice should only be done by the State Boards of Medicine, not the DEA. Many in the DEA are also grossly uninformed about medical care and the truth of the situation. Innocent compassionate doctors have been criminalized for prescribing opioids, if even one patient overdoses as if the doctor had any control over the behavior of their patients to any large degree. Many innocent doctors have been falsely accused of murder and manslaughter when they load dying patients up with morphine as they should in order to treat their severe pain, even those dying with cancer because DEA agents are completely ignorant of routine medical practices. One unscrupulous DEA agent went to the newspapers and falsely accused one California doctor in 2004 of being the biggest drug dealer and mass murderer in American history and this innocent doctor lost his license and his medical practice and millions of dollars and his livelihood as the State Board wimped out on him. Even though he was completely innocent of all charges he still cannot practice medicine, and his dying cancer patients had no place to go to get their opioids as all other doctors were afraid this would happen to them if they dared to treat these patients with opioids. Our doctors are placed between a rock and a hard place, damned if they treat us and damned if they don’t treat us because of this medical controversy and the fear of patients developing addiction from taking medically prescribed opioids, even though I believe that this fear is exaggerated and the level of hysteria is unwarranted and is causing us all more harm than good.
It will take much better research and a greater willingness to seek the truth and be more open to the possibility that one could be wrong about one’s assumptions rather than the extreme bias and entrenched positions people are having. We need good research and truth to guide our policy, not to create false research or political rhetoric to match our agendas so we can make bad policies based on lies and a self serving agenda. We won’t help any patients without the truth, and truth these days is getting harder and harder to find. Far too many people don’t care about the truth they just try to push false self serving agendas onto everyone based on predjudice, fear, lies and hysteria. We must follow the truth with brotherly love and compassion and let the truth guide our policy, rather then to decide on the policy one wants and then to create false facts and lies to justify the policy, as is being done right now. All the facts need to be laid on the table before any public policy is created, not just one side of the story as was done by the CDC in 2016. So it is not the fault of most of our doctors at all, it is the DEA and the legislature and Dr. Kolodney and other people who have been pushing a radical anti opioid agenda because of fear and predjudice and who have lied and misled our public elected officials to believe a false narrative for their own financial advantage. Kolodney and his addiction treatment centers just got 6 billion dollars to treat addiction, but where is the money for the many tens of millions more suffering chronic pain patients who are being thrown under the bus? There isn’t any money for us at all, we are just being deprived of our opioid medications and our pain relief and left to die. It is truly outrageous and abusive and evil and it must be fixed. However, do not blame Dr. Webster as she is doing everything that she can do to help. It is not our good doctors fault it is other bad players in this scenario who are to blame for indoctrinating our elected officials and the public in a false narrate to serve their anti opioid agenda who have caused many millions of us suffering patients very serious harm and death for no proper reason, and if they do not know any better, they truly ought to know better.