War On Opioids Is War On Patients With Pain: Obama Seeks $1.1 Billion to Fight Opioid Abuse


.

.

.

A “war” on opioids is a war on patients with pain. The CDC just radically, across the board, cut access to opioid doses.

.

Obama seeks to fight opioid abuse by arbitrarily limiting access to medication for 100 million patients with chronic pain. This does nothing to help the appalling lack of funding for research on chronic pain.

.

Today, the New York Times announces President Obama is seeking $1.1 billion to fight the opioid epidemic.

.

Obama had already signed a budget agreement in December for $400 million for the same.

.

Imagine war on pain instead of war on addiction, war on drugs. If $1.1 billion were instead spent on finding better pain treatment— would addiction to opioids occur less often? Almost nothing is spent on pain research. Less than half of one per cent of NIH budget in 2008. There are over 20 different splice variants in the mu opioid receptor, some of which are not addicting – research from Gavril Pasternak at Memorial Sloan Kettering Cancer Center. Money for research is urgent.

.

Federal agencies have heard about deaths of addicts, deaths of people with pain (addicts?) who overdosed on opioids, heard from families, from police officers but not from people with chronic pain who have no voice. There is no “BALANCE,” no conversation. Only after the American Pain Society appealed CDC’s radical plans, that CDC allowed one partial exclusion in dosage cuts: to allow opioid for cancer patients, but only if undergoing active cancer treatment. However, not for those cancer patients who are not in active cancer treatment, who have severe chronic pain resulting from the cancer itself that destroyed nerves or bone or spinal cord or brain, not for pain from cancer chemotherapy or radiation: you will suffer the same severe sharp drop in opioid allowed for treatment of your chronic pain.

.

Time magazine in 2011 reported: “Serious, chronic pain affects at least 116 million Americans each year, many of whom are inadequately treated by the health-care system, according to a new report by the Institute of Medicine (IOM). The report offers a blueprint for addressing what it calls a “public health crisis” of pain.”

.

“…and the chronic suffering costs the country $560 to $635 billion each year in medical bills, lost productivity and missed work.”

.

“Yet the reports’ authors said they believed that they had actually underestimated the incidence of chronic pain — that which lasts 30 to 60 days or more and takes a toll on personal and professional life — because their data didn’t include people living in settings like nursing homes. Further, as baby boomers age, the rate of chronic pain increases daily.”

.

Unless you have experienced pain yourself, it is very hard to understand pain in others and to accept the fact that disabling severe pain can exist without obvious signs of fracture or other obvious causes. And if you are among the tens of millions who cannot afford the $10,000 or $5,000 deductible for medicine and doctor visits, heroin is cheap and can be found everywhere – death is the risk thanks to the American healthcare system that will not cover cost of your needs.

.

Before we have an effective alternative,

CDC wants to take opioids away.

.

Yes, side effects are a huge problem, but thanks to some relief from opioids, people are working or able to function. Since the sudden DEA conference late October 2015 announcing limits, I have been deeply concerned about the direction the American government is taking to deny medication for people with chronic pain. I have posted ten times on this radical nationwide experiment since October! – see many articles at top left below my photo. The CDC suddenly imposed limits on opioid medication for treatment of chronic pain, setting the daily opioid dose to be 100 mg morphine or its equivalent. Yet for years healthcare insurers have refused almost all forms of treatment with the exception of opioids, see the detailed list of FACTS at that link. Now the opioids are the last frontier, the final culprit. And then what? . . . nothing?

,

There is no data to support this radical nationwide experiment. Many concerns of the American Pain Society were completely ignored. The anti-opioidists have won.

.

People with chronic pain seem to be content to lose or to think that a few pain specialists can win their denials for drug coverage, while healthcare insurers’ profits go up by refusing to pay, by demanding “prior authorizations” that require doctors to jump one hurdle of forms after another, until finally, always: DENIED. This has gone on for years, vast, time consuming denials rather than practice of medicine. The more expensive the drug, the quicker and more comprehensive are the denials.

.

Bottom line, insurers profit. CDC is interested in deaths from opioids, and they think training doctors in opioids is the same as training in pain management. I have made more than enough arguments on this site for years, and spent more than 15 years in better ways to treat pain.

.

Just this moment, three letters of denial from insurance for 20 mg morphine, not 100 mg, no, they are denying a mere 20 mg, for severe pain, multiple diagnoses causing pain, “in accordance with CMS (Centers for Medicare …) guidelines.” That is the “training” in opioids. Why waste our time giving MD’s credit for 4 or 5 hours of training, and obtaining millions of dollars from pharmaceutical companies who make opioids for this “training,” in order for the DEA to go around the country “training” us, when opioids are being denied anyway? Denials for 20 mg morphine is not training. 

.

Americans need to take action through the American Pain Society.

.

..

I have written recently about the radical CDC opioid guidelines:

 

Tapering patients without sound and attainable alternatives

.

Tampering with patient autonomy

.

Failure to provide informed consent

.

Avoidance of coercion

.

Nonmeleficence – Do No Harm – Primum non nocere

.

Treating patients like numbers not individualized

.

Intellectual and academic dishonesty

.

Anti-opioid zealots supported by zealous insurers? 

.

Containment of drug costs, not pain

.

Failure to assess risk vs benefit

.

.

etc, etc – refer to prior posts

.

These arbitrary actions are mind numbing and hopeless until voices of millions become united. Elected officials cannot afford to ignore the mounting deaths from prescription opioids that are killing white people. Clearly they can afford to ignore 116 million Americans with serious chronic pain.

.

.

.

.

 

 

The material on this site is for informational purposes only.

It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

Relevant comments are welcome.

If any questions, please schedule an appointment with my office.

This site is not for email.

~~~~~

For My Home Page, click here:  Welcome to my Weblog on Pain Management!

.

.

.

.

.

Please be aware any advertising on this free website is

NOT advocated by me and NOT approved by me.

.

.

.

.

 

 

.

.

.

.

.

.

.

.

.

Advertisements

10 Responses to “War On Opioids Is War On Patients With Pain: Obama Seeks $1.1 Billion to Fight Opioid Abuse”

  1. Jon wheeler Says:

    Dr. Sajben,

    Thank you for all your efforts. I’ve sent emails to both Senators in my State as well as my Representative. I know it will do no good as I’m in a red state where the politicians would deny an end stage bone cancer patient a single mg of morphine because everyone knows drugs are bad. Don’t do drugs. Pray for God to relieve the pain. It is absurd to limit dosages to an arbitrary amount without patient or doctor feedback. Notice the steep rise of heroin use in the past year? That is no coincidence. There are people out there with horrible pain, ambivalent or overburdened doctors that simply won’t prescribe anything but over the counter meds and, in my case, spinal cord stimulator implants, which has given me no relief at all. I’m not even close to where some are in the pain scale, but I will only get worse as my spine degenerates. To take away what little help we have to control our chronic, debilitating pain without funding research for new ways to manage pain is negligence and inhumane.

    What is crazy about this is that with a doctor monitoring their patient’s opioid use carefully and allowing a reasonable level of control for the patient to have over their pain, there would be very few problems. The pharmaceutical database clearly shows what the patient is taking. I’m certain the suicide rate will skyrocket as people with severe chronic pain find themselves getting rushed out of doctor offices with prescriptions for ibuprofen ( what my dr. has prescribed for my advanced degenerative disc disorder and multiple bulged and herniated discs). Believe me, I want to live, work, play. Instead I find myself trapped in a world of pain, stuck in bed, and thoughts of just ending the hurt racing through my mind.

    Sent from Jon

    • Nancy Sajben MD Says:

      Amen

      It breaks my heart and destroys my soul to see what has happened in this field the last 10 to 20 years.

      I will post an even more shocking event in the next few days – never enough time.

  2. Pam Says:

    What our government is doing is TORTURE! I suffer from multiple debilitating conditions that cause me excruciating pain 24/7/365 and there is NO CURE FOR! I did everything I was told to do by the medical community years ago. Had two FAILED spinal fusions that left me with severe nerve damage. I did years of physical therapy, massage, chiro, accupuncture, tens, discetomies, epidurals that probably screwed my spine up but the doctors look the other way, facet Injections, nerve blocks, trigger point injections, tried every other medication besides opiods that did not work or I had horrible side effects from. Ive taken bottles of tylnol, ibuprofen, advil only to ripe my stomach apart. Opiods were my LAST RESORT and when I was put on the correct dose I finally had my pain at a managed level amd had some quality of life. I was able to take a daily shower, cook a meal for my kid, do laundry, light food shopping sit at my sons games or my daughters plays she directs. I was on the SAME DOSE for eight years with success, never painfree, but it was controlled, I DO NOT GET HIGH, I GET RELIEF! I DO NOT ABUSE MY MEDS, I DO NOT SELL THEM, SHARE THEM OR ANYTHING ELSE THE GOVERNMENT WANTS TO BRAINWASH THE PUBLIC WITH! My doctor lowered my meds last March and I now suffer in agony, I am bedridden most days, I am losing precious time with my kids and missing out on their accomplishments because I am in to much pain to even watch them perform. I do not sleep nor do I eat. Ive lost alot of weight. I am grateful my son is ok with just eating simple things that go in the microwave as it kills me to stand by the stove and try and actually cook a meal. The guilt I carry on my back for not being the Mom my kids need me to be is awful. Because of this hell I am being FORCED to exist in my anxiety is thru the roof, which also goes untreated as well as the depression. Back in December I pleaded with my doctor of almost five years to please put me back on the mg that worked for me. He immediately treated me like a pillseeking addict and told me I was bargaining for pills. I wanted to hit him with a bat! I to,d him DO NOT MAKE ME FEEL THAT WAY WHEN YOU KNOW DAM WELL I AM A LEGITIMATE PATIENT! He quickly got out those dam needles though, another $3000 office visit. But in order to get the very minimal dose of pain medication, I have to endure those injections almost every month or every other. I am sick and tired of paying the very high price with my health and overall well being because of those who CHOOSE TO ABUSE! Because of the DEA and the governments addiction driven agenda that is causing tremendous problems for the ones who need the medication. In the above article, I don’t think it’s fair to say that we are basically sitting back and doing nothing about it. I have called multiple senators and written to congress multiple times as well as the president, the DEA, CDc, PROP, FDA, the United Nations, ACLU, my absentee governor, ive contacted many media outlets such as CNN, FOX, ABC, NBC, CBS, my local tv stations and newspapers. Ive signed the petition2congress first do no harm page, please google it as I cannot post the link here for some reason, over 21,000 and growing heartbreaking stories from legitimate pain sufferers who are in agony because of this witch hunt the DEA and government has brought on. When a patient has medical records, mri’s , scans, xrays, lab test, etc to back up their pain and have tried the alternative therapies their bodies could take and financially afford, there should be absolutley no reason we are being DENIED OUR RIGHTS TO MEDICINE TO EASE OUR PAIN! In fact, our rights are being violated everyday, our rights to privacy, HIPPA, our rights to be treated with dignity and respect, the patients bill of rights clearly states we have the right to treat our pain, our right to medicine that works to ease our pain, our right to pursue happiness, how can we do that when we are left bedridden in agony. I feel the government, DEA, CDc and anyone else who is denying us our rights to pain medication should have to make their medical and pharmacy records public for all to see. There is no way in hell that none of them depend on pain medication to ease their pain or their loved ones. And I highly doubt they are put thru the stigma, the degrading, the abuse, neglect, mistreatment and DISCRIMINATION that the rest of us are put thru. Our government and country are a disgrace! The CDC should be held accountable for FALSIFYING the overdose deathrate but that won’t happen as it was done to fit the governments agenda. If they are so concerned about addiction, why are they not targeting alcohol, whose deathrates FAR EXCEED that of their FALSIFIED overdose deathrates. I do not know how much more I can take of this nightmare, How many more suicides is it going to take!?!? The government is to blame for the heroin epidemic and they have the blood of thousans on their hands from legitimate patients who took their lives due to inadequate pain relief. God help us all..

    • Nancy Sajben MD Says:

      Thank you for speaking out. The millions with untreated pain need millions to speak up for them such as what happened in the mid 1950’s for cancer research. One person’s voice brought hundreds of thousands of letters writing to congress. Suddenly congress began to support cancer research on a major scale then and every year since.

  3. Jane Babin Says:

    Dear Dr. Sajbe, Great website! I am not a pain patient (at least for now…) but I became irate when I learned about the CDC’s opioid guideline and have been learning more about this topic. I am an attorney and former basic bimedical researcher. I have been sending emails to Congress, the President, CDC and I submitted comments on the opioid guideline (although my comments could have been much better if given more time). But I would like to do something more that may have a greater impact.

    I am considering starting an advocacy/resource project to support pain patients. I have several ideas and would do all, but for the time. Wondering which of these you think would be most helpful/ have the greatest impact:
    A legislative report card type site that identifies important bills in Congress or CA to support and then reports on how Individual Congress people voted, giving a score for each on their pro-pain voting record. USD Law Chikdren’s Advocacy Institute does something like this (i worked on it in law school) and it has become very influential. no one wants a D- grade on supporting children;
    An Angie’s list style resource that patients could enter information about pain care providers (such as specialty, approach, willingness to take chronic pain patients and/or prescribe opiods). I think there is real need for this, but I have concerns about how to keep it from being misused by the DEA.
    A site I’ve given the working title “faces of pain”, where patients could tell their stories and optionally post pictures and/or videos and I could link/send to legislators, Agencies, medical boards, etc. to advocate for pain research funding, legislation, policy changes. The addiction side has been very effective posting stories and pictures of people who have died from drugs and putting a face (even in silhouette) could be equally powerful.
    Thanks for any input you might have!

    • Nancy Sajben MD Says:

      I admire your energy!
      I have nothing to suggest because I don’t have any evidence which may guide me to choose.

      You might check with the American Pain Society, and Jennifer Bolen, Esq.

    • Bob Schubring Says:

      Is all of this ambition coming from patent attorney and litigator Jane K Babin of San Diego? I need to hire someone like you!

      I co-founded #GivePainAVoice, with documentary film producer Tina Petrova of Toronto (“Rumi Turning Ecstatic”), for one simple reason: Pain patients aren’t being heard. Outsiders are guessing at what our needs might be. This makes them susceptible to being misled. We recorded a brilliant interview with Dr Joel Hochman of Houston, before he passed away, in which he explains one particular interest group’s agenda…Worker’s Comp insurers. (it turns out that Worker’s Comp payments terminate, as soon as a patient becomes eligible to collect SSI or SSDI. So insurers don’t want a patient to begin physiotherapy, while receiving adequate pain management, because the patient will simply take breakthrough meds and go right on exercising until he or she can return to work. A patient with too much pain to actually work at physiotherapy, quickly plateaus to a Level Of No Further Improvement, because the exercise is painful, and thus, qualifies to be a Disabled Person, saving the insurer the cost of restoring the patient’s functionality and shifting the burden onto the Social Security Trust Fund, which is approaching insolvency.)

      Our goal is to teach patients to speak up for themselves in the proper forum.

      One such forum is the courts.

      We have a Belgian human-rights attorney who practiced in The Hague. We need attorneys who can practice before SCOTUS.

      I can send over a prospectus if you’ll kindly reply. Meanwhile, do please visit our collection of video at http://www.givepainavoice.org

      Yours very truly,
      Bob Schubring
      Co-founder, #GivePainAVoice

      • Nancy Sajben MD Says:

        Thank you for your work. Please contact Jane Babin, Esq, directly, or Jennifer Bolen, Esq, and/or the RSDS.org and the American Pain Society.

      • Jane BAbin Says:

        Hi Bob,

        Yes, I am patent attorney, but unfortunately not a litigator. I’m admitted to Southern Dist. California, and worked on some patent litigation cases at a big firm in a previous life, but definitely not admitted to SCOTUS bar – not even appeals cts. I’m going to send you a message on your website so we can take this conversation off Dr. Sajben’s blog.

        Jane

  4. Nancy Sajben MD Says:

    Also the RSDS.org that is a major advocate for everyone with chronic pain, not just those with RSD.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: