By Neen Monty They deliver it like it’s some kind of mic drop. “Opioids are not a cure,” they say. But here’s the important thing: Almos
They deliver it like it’s some kind of mic drop.
“Opioids are not a cure,” they say.
But here’s the important thing: Almost nothing in medicine is a cure.
Insulin doesn’t cure diabetes. But it keeps people alive.
Methotrexate and Xeljanz don’t cure rheumatoid arthritis. They slow down disease progression though.
Intravenous immunoglobulin is not a cure for Chronic Inflammatory Demyelinating Polyneuropathy. But it slows down the demyelination of my nerves.
Prednisone is not a cure for autoimmune disease. But it reduces inflammation, which improves pain and quality of life.
Anti-inflammatories do not cure inflammatory arthritis, but they decrease pain, increase function and improve quality of life.
Metformin, thyroxine, even chemotherapy in many cases… none are cures.
They manage symptoms, reduce harm, and improve quality of life.
That’s medicine’s job.
Medicine is not purely about curing disease. In fact, it’s rarely about curing disease. That does not mean that all the wonderful things that medicine can do are worthless.
So why is pain relief held to a higher standard than every other kind of treatment?
Why are opioids dismissed simply because they don’t cure the underlying disease that causes the pain?
Pain relief is not a moral failing. It’s medicine doing what it’s meant to do: Alleviate suffering and restore function.
That’s what opioids do. Alleviate suffering, restore function and improve quality of life. Those are good things. (Read more at link)
Although there are people who do think all forms of medication are a weakness. Yes, opioids get the brunt and worst of medicine hatred, but people have also chastised me for needing my asthma spray when I was a kid. I constantly hear people complain about the amount of pills my aunt has to take, and I’m just like, “you know they’re why she’s still alive, right? All those pills have a purpose” Our cultural obsession with cures as opposed to treatments is definitely a factor here.
By Neen Monty I just returned from seeing my GP. I explained to her what happened while she was away — that the doctor who filled in for h
I just returned from seeing my GP.
I explained to her what happened while she was away — that the doctor who filled in for her refused to prescribe the full amount of my pain medication. As a result of being shortchanged, I went through four days of untreated, severe pain.
My GP said nothing.
I asked why the other GP said she couldn’t prescribe. My GP responded with, “I can’t comment on that.”
I was wondering who was lying to me, and assumed it wasn’t my GP. My GP believed my medications would be prescribed, in good faith.
They weren’t. The other GP lied to her.
And in doing so, she knowingly left someone with a painful, progressive, incurable disease to suffer in agony. Because she could. That’s not medicine. That’s abuse.
That GP should not be practicing.
The most fundamental job of a doctor is to relieve suffering. To relieve pain.
We are now in a world where doctors refuse to treat pain -- and most other doctors say nothing about it. There are no consequences for being derelict in their duty of care.
We’re in a world where people with long-term diseases and permanent disability are being left in agony, discarded by a medical system that sees us as burdens, not as patients. We are not being treated, we are being tortured.
Doctors who refuse to treat pain in people with serious, documented illness are not neutral. They are sadists. And they have no business practicing medicine. (Read more at link)
Oh yeah I went through something similar when my then PCP went on maternity leave. This is unacceptable and truly is medical torture.
By Drs. Forest Tennant and Scott Guess There has been no shortage of controversy, scandal and fraud regarding the opioid and pain crises of
There has been no shortage of controversy, scandal and fraud regarding the opioid and pain crises of the past decade. One standout in the debate over opioids and pain treatment has been a lack of an honest, objective discussion of the benefits of pain care.
A basic tenet in medical practice and therapeutics is what is called the “risk-benefit” ratio. This is a simple analysis of whether a specific drug or therapeutic measure has more benefit than risk.
For example, the risk-benefit of drugs taken during pregnancy is well-known and established. But strangely, the debate over whether opioids have more benefit than risk in the treatment of pain has never been broached.
None of the parties involved, especially the anti-opioid zealots, will discuss any benefit that opioids may bring. In fact, essentially their only discussion is that opioids are a risk for overdose and addiction, so they have no benefit and shouldn’t be used. (Read more at link)
Because of opioids I can function and anyone trying to take them away from me are cruel indifferent assholes.
By Neen Monty The headline in Physician’s Weekly screams alarm: “Rising Use of Potent Opioids in Chronic Pain Management” And then th
The headline in Physician’s Weekly screams alarm:
“Rising Use of Potent Opioids in
Chronic Pain Management”
And then the sub heading:
“Long-term opioid use for chronic pain doubled, with potent opioids rising, underscoring the need for stronger guideline adoption”
Terrifying, right? We must do something!
But now, read the article. It’s based on a study recently published in the European Journal of Pain on the prevalence of long-term opioid therapy (LTOT) when treating patients with chronic non-cancer pain…
…And what did they find?
“The prevalence of LTOT increased twofold from 0.54% (95% CI: 0.51–0.58) per 100 patient years in 2013 to 1.04% (95% CI: 1.00–1.07) in 2022. The proportion of LTOT episodes solely involving potent opioids slightly increased between 2013 and 2022”
In plain English, the prevalence of long-term opioid use by patients at the end of the study was just over 1%.
Yes, that’s right: 1%.
And the prevalence increased by just half a percentage point over a decade.
Hardly a crisis. Hardly anything to scream about…
…This tactic is often used in presenting medical research – using relative percentages rather than the actual numbers. That is because relative percentages -- Opioid Use Doubled! -- sounds worse than “Opioid Use Increased by Half a Percent.”
It’s a trick that researchers and the media use all the time…
…It was nice to see some accurate reporting in Scimex, an Australian online news portal that tries to help journalists cover science.
Instead of the usual deceptive, sensationalist headlines, this one tells the truth:
“Pain Reprocessing Therapy (PRT) could help those with mild chronic back pain”
This was so refreshing to see! Because it’s so very, very rare.
Most reporting on PRT glosses over a critical point: It has only been studied in people with mild, non-specific back pain. An average of 4/10 on the pain scale.
That nuance is often lost in the hype about alternative treatments like PRT, cognitive behavioral therapy, mindfulness and TENS units.
You do not treat 8/10 back pain the same way you treat 4/10 back pain.
So what happens when people are misled? PRT is recommended to people with severe, pathological pain - often with clearly identifiable causes - and everyone acts surprised when it doesn’t work.
Let’s be clear:
* PRT is not for severe back pain
* PRT is not for pain caused by pathology
* PRT is not a cure-all
But you wouldn’t know that from the headlines about PRT, such as “New therapy aims to cure back pain without drugs, surgery” and “A New Way to Treat Back Pain.”
We’ve all seen the bold claims: People cured after 10 years of chronic pain! Life-changing results! Breakthrough treatment!
Then you read the small print: All the participants had non-specific back pain from an unknown cause. And they had mild pain.
This kind of spin harms people with severe chronic secondary pain. It feeds the narrative that if you're still in pain, then it’s your fault. You didn’t try hard enough. You’re catastrophizing. You need to retrain your brain.
It feeds the stigma that all chronic pain is mild and easily curable. And that anyone who says their pain is severe, has psychological problems.
No. Maybe their pain is caused by pathology, like tissue damage or herniated discs. Maybe their pain is nociceptive or neuropathic.
This is why chronic pain patients must be included on every research team. Someone with real-world, high-impact chronic pain would never let this kind of misrepresentation slide. And the rest of the team wouldn’t be able to claim ignorance.
We need more honesty and integrity in research and the media. We need headlines that reflect the actual findings. We need conclusions that match the data, not some predetermined narrative. Right now, most media coverage doesn’t even try. (Read more at link)
I usually don’t paste as much from an article (so authors can get paid for traffic) but I thought it was very important to have the examples here instead of behind a link. And as long as it is it’s still not the full article, which I avoid doing.
In any case, the big takeaway is that headlines are not the story, read the article and decide for yourself if the data is convincing or being manipulated. The opioidphobes are determined to take the medication us chronic pain patients desperately need away because of how they hate addicts. Don’t let them fool you.
By Pat Anson The CDC’s 2016 opioid prescribing guideline not only had disastrous consequences for many pain patients, but raised the cost o
The CDC’s 2016 opioid prescribing not only had disastrous consequences for many pain patients, but raised the cost of treating them in primary care practices, according to a new analysis.
Researchers at the University of Wisconsin-Madison studied the budget impact of four different strategies used at primary care clinics to comply with the guideline, which strongly encouraged doctors to reduce opioid prescribing.
The strategies primarily relied on prescriber education, evaluations and auditing to see if the clinics were successful in reducing the use of opioids. Whether patient safety and pain relief improved were not part of the study.
The cost per clinic for implementing the strategies ranged from $4,416 to $8,358, with prescriber education being the cheapest approach. However, while education alone cost less upfront, the clinics that used it had the largest increases in downstream expenses, such as greater use of urine drug tests (UDTs), patient contracts, and depression screening. That made it the most costly approach overall. (Read more at link)
By Crystal Lindell Cancer patients needing pain treatment were always meant to be exempt from the recommendations of the 2016 CDC opioid gu
Cancer patients needing pain treatment were always meant to be excluded from the 2016 CDC opioid guideline, including the updated guideline released in 2022:
“This clinical practice guideline does not apply to patients undergoing cancer-related pain treatment, palliative care, or end-of-life care because… for many persons at the end of life, serious potential long-term opioid-related harms such as opioid use disorder might not be relevant.”
A new study reveals that many older cancer patients were deprived of opioids anyway, even though they often require opioids as first-line pain treatment.
The study looked at nearly 12,000 older adults on Medicare who were being treated for cancer from 2010 to 2020, including about 1,300 with advanced cancer or cancer pain. (Read more at link)
This is what I call medical torture. These fucking opioidphobes can’t even let people die in comfort and peace.
By Pat Anson Despite lackluster results in clinical trials, the U.S. Food and Drug Administration has approved a new non-opioid pain r
Despite lackluster results in clinical trials, the U.S. Food and Drug Administration has approved a new non-opioid pain reliever for moderate to severe acute pain in adults.
Journavx (suzetrigine) is the first new medication for acute, short-term pain in over two decades. Unlike opioids, Journavx blocks pain signals in the peripheral nervous system, not in the brain, so it doesn’t have the same “liking” effects of opioids, which can lead to dependence or addiction.
The FDA calls its approval “an important public health milestone.”
"A new non-opioid analgesic therapeutic class for acute pain offers an opportunity to mitigate certain risks associated with using an opioid for pain and provides patients with another treatment option. This action and the agency's designations to expedite the drug's development and review underscore FDA's commitment to approving safe and effective alternatives to opioids for pain management," said Jacqueline Corrigan-Curay, MD, acting director of the FDA's Center for Drug Evaluation and Research…
…In Phase 3 clinical studies of acute pain after minimally invasive surgeries, Journavx was no more effective than a low-dose combination of hydrocodone and acetaminophen, more commonly known as Vicodin.
In a recent Phase 2 study, Journavx was essentially no better than a placebo in relieving chronic back and hip pain caused by lumbosacral radiculopathy.
A recent report by ICER, an independent, non-profit research institute, said there were “uncertainties” about the efficacy of Journavx due to the design of the clinical trials.
“We have concerns about as-yet-unknown harms of suzetrigine as we would for any drug with a new mechanism of action; we are particularly concerned about whether there could be an increased risk for cardiac arrhythmias… and possible acute renal injury given a study in people with diabetes,” ICER said. “The above uncertainties inform our ratings that the evidence for suzetrigine for the treatment of acute pain in comparison with no systemic treatment, in comparison with opioid analgesics, and in comparison with NSAIDs are all promising but inconclusive.”
Desperate for an alternative to opioids, they’re pushing through a lackluster pain medication. I have no problem with developing knon-opioid pain medication, but it has to fucking work. If they force this shitty pain reliever on people, and it doesn’t help them, then that is akin to medical torture to me.
By Crystal Lindell Attorneys General from 55 U.S. states and territories recently accepted a $7.4 billion settlement with Purdue Pharma
Attorneys General from 55 U.S. states and territories recently accepted a $7.4 billion settlement with Purdue Pharma and the Sackler family, potentially ending over a decade of legal wrangling over the company’s role in the opioid crisis.
But much of the media coverage still doesn’t seem to grasp what Purdue Pharma actually did wrong with its marketing of OxyContin.
Purdue Pharma’s original sin was not too many OxyContin pills flooding the market – it was too few. OxyContin’s share of the opioid market was never more than 4 percent. That small share, however, was magnified by higher dose pills, which made OxyContin more likely to be misused.
The company drove opioid misuse by claiming that OxyContin pills lasted for 12 hours. In reality, they only lasted 4-6 hours. I know, because I’ve been on them myself for chronic pain.
This is how the Los Angeles Times described Purdue’s marketing campaign in 2016:
“Purdue tells doctors to prescribe stronger doses, not more frequent ones, when patients complain that OxyContin doesn’t last 12 hours. That approach creates risks of its own. Research shows that the more potent the dose of an opioid such as OxyContin, the greater the possibility of overdose and death."
So if a patient wasn’t getting steady relief from two 10mg OxyContin a day, the doctors would be encouraged to up it to two 20mg OxyContin pills a day. In reality, it would have been better to keep the dose at 10 mg and increase the frequency to four pills a day.
Purdue was well aware of the problem. They knew the pills did not last the full 12 hours. But it was OxyContin’s 12-hour dosing regimen that was its main selling point. It was supposed to set it apart from much cheaper opioid options like hydrocodone, morphine and oxycodone.
Here’s what happened when doctors prescribed more OxyContin pills to give patients relief, according to the LA Times:
“When many doctors began prescribing OxyContin at shorter intervals in the late 1990s, Purdue executives mobilized hundreds of sales reps to ‘refocus’ physicians on 12-hour dosing. Anything shorter ‘needs to be nipped in the bud. NOW!!’ one manager wrote to her staff.”
Purdue then encouraged doctors to prescribe higher dose 80mg pills, because the higher the dose, the more Purdue made off the pills. While the company charged wholesalers about $97 for a bottle of 10mg pills, a bottle of the 80mg version went for $630.
The company also based the commissions and performance evaluations for its sales team on the proportion of high-dose pills they sold. (Read more at link)
So instead of giving people low doses more frequently, which is proven to be safer, they had the doses raised because of a disproven 12hr efficacy claim. And this forced people into a withdrawal cycle unless they took more pills and were forced to resort to other methods to get some. They forced a method of prescribing that raised the risk of addiction. Fantastic.🤬
