Opioids: Will We Let Politicians Treat Pain? Need Presidential Debates on Precedent


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Pain kills

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Cutting back my patient’s opioids when they were helping, when there is no better alternative, none better –  it is the most painful thing I’ve ever been asked to do as a doctor. Withdraw necessary medicine. On orders from the federal government forcing me to harm my patient.

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Harm my patient. The thought sickens. Forced by government orders to harm my patient.

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Orders. Cold as a steel gun held by DEA Swat team bursting into my office if I don’t act on government orders. Certain dictatorships treat citizens that way.

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Congress is pushing this opioid bust very hard.

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That is demagoguery

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I am pained and suspicious in several ways.

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Legal nationwide precedent.

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A precedent in government, deciding for each individual person, without good faith history and examination of each, now orders each person’s medical treatment.

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It overrides judgement. I feel my judgement specializing for decades in pain management, with or without use of opioids, using comprehensive multi-specialty approaches has always chosen excellence in the field of pain management, in accord with State and Federal guidelines until this new one, and within the best practices of the American Pain Society.

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Best practices are irrelevant. Choke on that one. The lack of options is impossible to swallow. It is life-changing for the most severely disabled patients across the country.

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It has nothing to do with the subject: pain control.

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Nothing to do with helping to relieve pain.

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It causes grave harm to my patients and their families and sets an astonishing precedent among healthcare insurers to never allow more than the guidelines; the federal CDC-invented, arbitrary, pseudoscience, one-size-fits-all guideline for opioids because:

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the government can’t deal appropriately with the heroin epidemic and the war on drugs. They ignore results from countries that have done more enlightened research to point the way.

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Demogogues order doctors how to treat everyone. This country is has done what China and Russia have done to their citizens. I am in shock. My patients are in shock. Aghast. Feeling forced to bend over and swallow an undemocratic, unscientific piece of

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This used to be a free country with certain rational sets of behavior and one that recognized a need for pain specialists. Only recently did it create specialists in pain management. Specialists who get ignored. Does this happen in every other field? Shouldn’t we all care no matter our expertise because we may all have bad pain if we live long enough? Chronic noncancer pain. What if some federal agency starts ordering you that dialysis will be allowed less often?

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None of us gets away from the grip of the irreligious opioid guidelines. Will we have intractable pain at some time in our lives? Will we allow government to dictate that you or your spouse or gram cannot be given the dose that has safely helped for years? The guidelines were forced on us.

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Insurance will not pay for more.

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This needs to be discussed as a presidential election debate issue.

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Demagogues appear at times of unrest across the country. Politicians may feel forced to bow to the anti-opioid groups, angry because of the heroin epidemic and at how badly addiction treatment is neglected in this country.

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But for pain patients not addicts, to be subjected to directives from federal agencies, CDC and DEA, how do we object to this unscientific, irrational precedent? At least debate it on a presidential level.

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Drug abuse, addiction, pain management and healthcare insurance as it pertains to these new federal opioid guidelines presume to treat pain but force us all into a cage of irrational pseudoscientific dictates. And we are forced to mangle the finely adjusted treatment of your pain, your spouse or your granny’s pain. We’ve slogged through so much to get there. It’s tough to find the right balance with chronic daily pain.

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Those running for president:

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What is the candidate’s position on this unprecedented fiat that dictates your maximum morphine equivalent daily dose (MEDD) you can receive?  It is a dose that is far less than you’ve been on for years that had been helping.

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Is this creating unprecedented pain among 50 million Americans with chronic pain?

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Are we going to let politicians treat our patients with pain?

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This site is not email. Not intended for medical advice.

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This is the start of all sorts of federal dictates

into your medical care.

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One Response to “Opioids: Will We Let Politicians Treat Pain? Need Presidential Debates on Precedent”

  1. Pam Says:

    Dr. Sajben, I thank you from the bottom of my heart for taking the stand with the legitimate chronic intractable pain sufferers thruout this country. Just reading what you wrote has given me some faith in doctors again. I, myself, have been suffering for over ten years. I have MULTIPLE DEBILITATING conditions there is no cure for. I did everything I was told to do by the medical community including YEARS of physical therapy that started doing more harm then good, massage, chiro, accupuncture, water therapy, TENS, epidurals that did more harm then good, discographies, facet injections, nerve blocks, nerve burning, trigger point injections, two FAILED spinal fusions that left me with severe nerve damage, tried all the OTC and NSAIDS out there that tore my stomach up. Nothing worked and I was left with horrible side effects. The conditions I suffer from are failed back surgery, DDD, fibro, CRPS/RSD, severe stenosis, osteoarthritis of the hips/spine, cervical disc degeneration, sciatica, pancreatitis, migraines, three herniated discs, lyme disease, radiculopathy, neuropathy,cervicalgia, anxiety and depression. Anxiety and depression started affecting me about a year ago, when my doctor of four years started lowering my meds to INEFFECTIVE doses and each month he gives me scripts for all kinds of BS meds that I have already had over the years, and he knows this as I don’t know how many times I have to remind him. I call it medication roulette. I was on the SAME DOSE for seven years with success, never painfree, my pain was MANAGED and allowed me some semblence of a QUALITY OF LIFE. I use to take one soma at night, which was the only muscle relaxer that helped me greatly, especially at night as it calmed everything down and I was able to get sleep. That was taken away and I was told it could not be used with the pain medication. (a lie I know as I know people who go to the same dr and NONE of their meds were even touched) I also was on oxycontin 60 mg one in the morn one at night and oxucodone 30mg every six hours ( I was on it every four hours with my old PM dr, but he retired and boy was it hell trying to find a new dr to take over my meds. I found the one I am with today, but upon my first visit, the oxycodone was immediately cut back to six hours). There is no way I can go six hours in between taking a pill so I had myself on a schedule where I would take it four times a day, every four hours during the day to get thru the day and then I would take the soma at night and had a full nights sleep. Well Last March that all changed. Soma was totally taken away, oxycontin was switched to morphine sulphate ER and he had switched the oxycodone to 20mgs. For months I was in complete agony. Finally in December I pretty much pleaded with him to put me back on the MG that worked for me. After making his degrading comments at me, trying to make me feel like something I am not, he agreed to put me back on the 30 mg but only for every 8 hours. He also took away the 60 mg of morphine ER I would take at night. I am down to just one 60mg morphine sulphate ER in the morning and the three oxycodone every 8 hours, Which I can never ever do. He has put me on all kinds of stuff that has made me sick or some other bad reaction.I just don’t understand this hell I have been thrown into,all of us have. It is so cruel and inhumane to allow chronically ill people to endure even more pain and suffering because the corrupt pen pushers in Washington think they know better. It is the DEA who fails to stop the heroin from coming in, it’s the addicts who CHOOSE TO ABUSE, and I am paying the very high price because of it, as well as millions others. This needs to end now. This past week alone I have heard of 15 suicides from Legit patients who could not take the pain anymore. My anxiety is thru the roof, I am so dam depressed anymore. I am pretty much couch bound, only time I go anywhere is to the dr. He sees me suffering so much and yet refuses to put me back on the correct doses of meds that worked for me. What kind of country are we living in?? Why is saving the lives of addicts, people who CHOOSE TO ABUSE, more important than the lives of innocent law abiding citizens who are crippled in severe never ending pain?? The government, CDC, DEA and FDA are committing GENOCIDE and are responsible for every suicide that occurs because of this INHUMANE and BARBARIC mistreatment. The degrading alone can send someone over the edge, when it’s done enough times. I am fed up and furious at our government. It’s all about the money though, Kolodny and Ballantyne and the rest of them stand to gain a fortune by stripping legitimate pain patients of their LIFE SAVING MEDICATIONS. Why doesn’t the government just line us all up outside a warehouse and give us the allotted amount of medications since they are limiting everyone to the same ridiculously low dose of meds. I no longer have a QUALITY OF LIFE. There are so many simple things I can no longer do on my own and it is extremely depressing. most importantly though, I cannot be the MOM my kids deserve and need me to be. I am a single mom and have raised them on my own. They need me and what good am I to them if I can’t even cook a meal!!! Thank you so much for all you do..Peace- Pam


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