Replacing Opioids Has Just Been Made Harder
This article, in a slightly edited form, first appeared on Pain News Network on November 16, 2019.
EPA’s Plan to Curtail Animal Research
People in pain rely on scientific advances to find safer, more effective alternatives to opioids, and animal research is key to all early drug development. A recent announcement from the Environmental Protection Agency (EPA) threatens to change that, inhibiting science’s ability to replace opioids and create new life-saving pain interventions.
EPA administrator Andrew Wheeler announced the agency’s decision on September 20, 2019 to “significantly curtail its reliance on the use of mammals in toxicological studies conducted to determine whether environmental contaminants have an adverse impact on human health.” His agency plans to reduce funding for most mammal studies by “30 percent by 2025 and eliminate them altogether by 2035.”
Ostensibly, Wheeler worries about the potential mistreatment of animals used in testing, but Natural Resources Defense Council (NRDC) scientist Jennifer Sass believes he may be politically motivated. In an NPR interview, Sass says, “The Trump administration appears to be working on behalf of the chemical industry and not the public.”
Putting Human Health at Risk
Most likely, the American Chemistry Council, which represents chemical companies, would prefer to eliminate mammal studies that could prove the toxicity of their products. Wheeler, however, claims he hasn’t talked to “a single chemical company about this.”
He has announced that five universities, including Johns Hopkins University, Vanderbilt University and Vanderbilt University Medical Center, Oregon State University, and the University of California, Riverside, “will receive $4.25 million in funding to develop non-animal testing alternatives.”
However, according to The New York Times, the American Lung Association, the American Heart Association, and the American Medical Association disagree with Wheeler’s strategy. Lab-grown cells and computer modeling can reduce the need for animal testing. But Penelope Fenner-Crisp, a former senior official at the EPA, believes 2035 may be too soon to ban all animal studies. She states, “There’s currently no substitute for [testing] some of the more complex and sophisticated toxicities, such as the effect of chemicals on animals’ reproductive systems.”
The NRDC, an environmental advocacy group, also opposes the EPA’s plan to ban animal testing on the grounds that, “Phasing out foundational scientific testing methods can make it much harder to identify toxic chemicals — and protect human health.”
Animal Research Is Key to Medical Advancements
Dr. Henry S. Friedman, an academic adult and pediatric neuro-oncologist, leads the opposition to the EPA decision. He explains, “Virtually everything a doctor, nurse, veterinarian, veterinary technician, paramedic, or pharmacist can give the injured or sick was made possible by animal research.” He says this includes medicines, advanced surgical techniques, treatments, and therapies that are used for humans and other species.
Animal research, Dr. Friedman points out, is responsible for technologies such as MRIs, ultrasounds, and CT scans. It has also played an integral role in the development of vaccines, pain (and other) medication, and life-saving emergency care. (He also provides a “myth versus reality” look at the health and welfare of laboratory animals.)
As Dr. Friedman says, sophisticated computers can be helpful in many areas of exploratory scientific research, but they “can’t predict everything a new drug will do once inside you.”
Speaking of Research, an international advocacy group that provides information about the importance of animal research in medical and veterinary science, believes the EPA’s plan endangers human, animal, and environmental health. The organization says, “This directive flies in the face of the EPA’s mission to ‘protect human health and the environment’ and ‘to ensure that national efforts to reduce environmental risks are based on the best available scientific information.’ Animal-based research and testing is critical for understanding how new chemicals and environmental substances affect human and non-human animals.”
Many of us in the scientific community oppose the EPA decision on the basis that it will slow drug development and threaten our ability to find safer and more effective treatments for pain, addiction, and many other diseases. If the EPA decision is sustained, it will be a major obstacle to the advancement of medical science.
Lynn R. Webster, MD, is a vice president of scientific affairs for PRA Health Sciences and consults with the pharmaceutical industry. He is author of the award-winning book, “The Painful Truth,” and co-producer of the documentary, “It Hurts Until You Die.” Opinions expressed here are those of the author alone, and do not reflect the views or policy of PRA Health Sciences.
You can find him on Twitter: @LynnRWebsterMD.
I’m an animal lover…always have been. However, I’m also in constant, severe pain. I have around 7 or 8 medical conditions, including back + scoliosis, deg & bulging discs; severe fibro, arthritis and bursitis. It has been so difficult since they’ve made
it so hard to get opiods. The mg are so low they only work for a couple of hrs and I have to wait 6 hrs and can only take 3/day. Now my pain dr isn’t even giving me trigger pts, etc. on a monthly basis like I have been getting for the past 25 yrs. I understand why people are committing suicide, the pain is unbearable. The only thing that keeps me alive is the fact that I couldn’t hurt my family by giving up on life. I know there are way too many others out there in the same frame of mind. Sad and true.
Hang on friend life is never easy and you will grow stronger even though sometimes it seems as you may never . Pain is not easily controlled , but we can do it ! Try to handle the pain in small moments and not all at once. We have the power you need to search deep within yourself . I really feel your pain.
Linda: Please continue to do everything within your power to remain strong and know that there are millions of others experiencing similar, and even worse injustices.
One thing that always seems to bring a little hope in me (as I am suffering to) is the fact that one day (hopefully very soon) those responsible for this horrific human rights atrocity will be getting what they truly deserve. And, no amount or type of medication will ever ease their well-deserved and hopefully never-ending pain and suffering.
The situation has gotten so unbelievably barbaric (like living in the 16th century) that something must change soon. They can’t kill all of us.
Perhaps next election when every incumbent is duly unelected from office (regardless of their party or political positions) they’ll start feeling our unjustified pain and suffering.
Please stay strong! This is unjustifiable.
This situation we (Chronic Pain Patients everywhere) find ourselves in, started by the CDC, in a well-intended, but horribly misguided attempt to curb overdose deaths, supposedly by Opioids, did not do nearly the amount of research they should have before throwing all of us under the bus, and causing chaos among doctors, pharmacies, opioid manufacturers, pain clinics, and more. Theirs (CDC) was nothing less than a knee-jerk reaction to the increasing overdose deaths, which they mistakenly believed was caused by the over-prescribing of opioids for legitimate Chronic Pain Patients, like you Linda, Mick, Stuart, my father, and myself. While our stories of how this CDC nonsense has affected each of us and our pain control are different, the overall personal devastation it has caused us, and our fellow Chronic Pain Survivors is most likely very much the same.
While the CDC did make a half-assed attempt to clarify their original ‘guidelines – taken as mandates’ with a follow-up notice this past April, I thought it would finally help all of us in some way, if only to NOT place the blame on Chronic Pain Patients and our monthly prescriptions, for the overdose deaths. At least, the CDC has finally taken notice of the increased suicides by CPP’s. However, was I ever wrong! I found that the head physician for this Pain Clinic my father was subjected to deal with for his unrelenting chronic pain, did not even bother to read the April announcement by the CDC, nor had any of the people working at the Pain Clinic either (of those I was able to ask.) I found this to be a medical travisty, as this doctor, and his prescribing (or lack thereof) for my father, was just getting worse and worse as time went on.
I have only had one prior, somewhat heated, verbal disagreement with any doctor throughout my lifetime, with the first being an argument with my mother’s awful PCP in 2007 who refused to give my mother ANY pain medications for her awful pain, had misdiagnosed her multiple times over some 8 painful months, all of which finally culminated in her death, some 9 days after I got her into see my doctor, who confirmed that my mother had Lung Cancer. She had been in awful, legitimate pain the entire time we were dealing with her idiotic PCP. My doctor at least prescribed the appropriate pain medications for my mother in her final days, although so much emotional damage was done during that entire situation and remains today.
The 2nd and last altercation, was with my father’s so-called Pain Doctor. My father has a broken lower lumbar in two places, added to by Spinal Stenosis, Arthritis and more, that causes his horrible daily chronic pain. He is couch-bound and never leaves his home, and rarely his couch, due to the pain of trying to stand. This Pain doctor, had my father on a ridiculously low dose of Oxycontin (which as Oxy users will note: Do NOT last 12 hours. Everyone I know on this medication gets some relief, for a maximum of 4 – 6 hours. 12 hours of pain relief is truly absurd) and only two (2) 10mg Norco’s allowed daily in spite of the large number of hours of ‘break-thru pain.’ We were there at the doctor appointment to request an increase in the Oxy strength and a decent allowance of the Norco’s. The so-called Pain doctor responded “No” to both requests, I told him that he was being ‘cruel and inhumane’ by denying my father an increase in the Oxy dose, nor any increase in the Norco’s. His rather loud response was “You can disagree all you want, but I am THE DOCTOR and I have the final say,” with (honestly) a somewhat sinister laugh. When he asked my father about the Norco’s, and my father responded saying that he might as well be taking nothing as they do no good at all when taking a single 10mg dose 2x a day. My father went on to say “2x 10 mg at once does help, but that only last two (2) hours at the most,” which is why he was asking for an increase. (My father should have been on two 10mg Norco’s, 3x per day, for a total of six total pills a day for his break-thru pain.) Then God (Oh, I mean the Pain doctor) said, “Okay,” putting a big black line through the Norco medication information on his clipboard, and said then “Then it’s a waste to give them to you,” and prescribed him NOTHING for his break-thru pain. Then actually tossing a piece of paper at my father, he said, “You can always get a 2nd opinion if you want, but I’m not changing anything from where it’s currently at, and I’ll see you in 3 months,” and he walked out in all his God Glory. I vowed right then and there that I would not subject my father to seeing this particular cruel, inhumane, and non-educated (regarding the CDC, Opioid prescriptions, chronic pain, etc.) doctor ever again.
We did get a 2nd opinion, and a new doctor immediately increased my father’s Oxy dosage, and provided more Norco’s for the break-thru pain for my father. I took great joy in leaving a message for Dr. God, that we followed his advice, with the very first doctor totally in agreement with us, that there was “needless suffering” endured by my father, and he fixed my father’s medications during the first appointment.
Neither my father, nor I, will ever be completely out of pain, but there is no quality of life to live with horrible, unrelenting pain, when one doesn’t have to be! While we all know the suicide rates for people like us have increased at high numbers, the overdose deaths continue to rise as well (at least for a time,) primarily from Fentanyl sold on the streets. The overdose deaths are from still from street drugs and not our prescriptions as we all know.
I just wonder if someone somewhere has comprised a group of mad Chronic Pain Patients (like me,) in order to challenge the CDC, write all of our political representatives, and get this barbaric situation stopped once and for all! I have written all of my political liaisons, attempted unsuccessfully to attend the Summit on Opioids held in my hometown about a year ago, and more. The Summit was ‘Sold Out” but I wrote the organizers telling them that I found it quite ‘odd’ that they did no have a single keynote speaker on the panel and in any of the separate workshops, that was a Chronic Pain Patient. Not one person there to talk about what has happened to the millions of Chronic Pain Patients in our country since this insanity started. Everyone is still ‘knee-jerking’ this situation.
Thankfully, one of our greatest allies is Dr. Webster. I thank God for Dr. Webster, and the regular postings to keep us all aware of things going on, articles that have come out on this issue, and more. Thank you Dr. Webster!
I would be happy to join or form a group of Chronic Pain Patients to start a formal Petition to gather signatures, presenting it to the CDC and ANYWHERE it will be given exposure and help to bring all of us out from the dark, pain-filled world we live in.
Please funnel any thoughts of suicide, into getting just downright MAD about what has happened to all of us, the suicides of our Chronic Pain brothers and sisters, and taking ACTION instead! I don’t know if it will show my email, so I’m posting it herewith, and am most open to involvement in this course of action. If you are aware of any already-formed groups or interested in starting one with me, please let me know. God knows I have no time now as it is, with an overflowing plate, but this is too important and it’s gone on long enough. I’m mad enough to try to do something! How about 1 million Chronic Pain Patient signatures? I bet that would get their attention, you think?
Thank you for putting up with my rather long comment. Connie@HallMarketMedia.com