pain management

2006 CDC Report Finds Pain Affects Millions of Americans

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By R Carter

This update on trends reflects changes on how chronic pain has been viewed and managed as America’s struggle with opioids continues. It’s often insightful to look back at how our government viewed chronic pain and compare that to how they have responded. This report from the CDC published thirteen years ago in 2006 stands in stark contrast to the 2016 CDC Guidelines for Chronic Pain Management, at a time when anti-opioid zealots had clearly gotten the upper hand. More importantly is how our healthcare system has responded, indicating what appears to be an effort to cherry pick the data which fits an ideological point of view.
Blaming pain medication for overdosing epidemic fake news.
Blaming pain medication for overdosing crisis is fake news..

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COVID-19 and Opioid Dependency, what do they share in common?

I’m continuously amazed by the manner in which denial and irrational thought play out in individual behavior. Given the right circumstances, no one is immune from it and sometimes it can even have beneficial side-effects and outcomes, but in regards to COVID-19 and our government’s response to opioids when treating painful conditions, duplicity has been exposed.
How can I find a pain management physician in my area?

Locating a pain management doctor has become a daunting task. Click here to find one in your area.
Newton’s Third Law and Opioid Hysteria

By R Carter

Newton's third law of motion states that for every action (force) in nature, there's an equal and opposite reaction. In other words, if object A exerts a force on object B, then object B also exerts an equal but opposite force on object A, or Fa = -Fb. Notice that force is exerted on both objects and in both directions even if one is resting and not in motion. This force is often expressed as work, work is defined as the product of force, so regardless of whether we’re talking about objects moving through space or something more abstract like a healthcare system, the principle remains because the universe, at the level in which we operate, is based on cause and effect. And if we’ve modeled our system completely, the net effect for a force applied to another system is always zero, they cancel each other out.
Opioid Prescribing Behaviors — Prescription Behavior Surveillance System, 11 States, 2010–2016

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A PDF version of this publication can be downloaded here.

Prologue by R Carter: Prescription Drug Monitoring Programs (PDMP) have been active in most states since around 2010. They are an outgrowth of the need to collect definitive data on the prescribing practices of physicians in the face of a national opioid overdose crisis. Prior to 2011 the only reliable data public health officials had, was the growing number of opioid prescriptions and the number of overdose deaths reported in our national vital statistics system. What happened in between these two events was a black box, an unknown that frightened public health officials enough to justify both the rational motivation to take corrective action as well as fuel the opioid hysteria that continues as of 2020.

At a total cost greater than $500 billion over ten years, the question as to their success in reversing the opioid overdose crisis is still unclear. While it’s assumed these programs have had some benefit, only one state out of 50 has published any data confirming or denying the contribution of prescribed opioids in the so-called prescription opioid crisis, and that number was astonishingly low, just 1.3%. Massachusetts published a report from 2013 – 2015 that showed the following results.

Of 2916 decedents with complete toxicology reports, 1789 (61.4%) had heroin and 1322 (45.3%) had fentanyl detected in postmortem toxicology reports. Of the 491 (16.8%) decedents with ≥1 opioid prescription active on the date of death, prescribed opioids were commonly not detected in toxicology reports, specifically: buprenorphine (56 of 97; 57.7%), oxycodone (93 of 176; 52.8%), and methadone prescribed for opioid use disorder (36 of 112; 32.1%). Only 39 (1.3%) decedents had an active prescription for each opioid detected in toxicology reports on the date of death.
Pain in the Nation Update by Trust for America’s Health

A new publication from the Trust for America’s Health[i], TFAH.org, a non-partisan public health policy, research, and advocacy organization, shows that deaths from alcohol, drugs, and suicides have leveled off for the first time since when records were first kept in 1999.

In 2018, more than 150,000 Americans died from alcohol, drugs, and suicide combined.[ii] The 2018 death rate of 46.4 deaths per 100,000 is level with the 2017 rate of 46.6 per 100,000. This is the first time since 1999 when there hasn’t been an annual increase in the combined figure and the first time in years that there hasn’t been a sizable increase.

However, the stabilization of alcohol, drug, and suicide deaths was not uniform. Some causes, places, and populations had positive or stable trends, many had a decline in the magnitude of the increases, and others are continuing to rise too quickly.
Point Paper for National Centers for Accident Prevention and Control, Board of Scientific Counselors - December 2019 Meeting

Richard A Lawhern, Ph.D., Andrea Trescot, M.D., Stephen E Nadeau, M.D.

Point papers are a long-standing tradition in military and government policy making circles. Unlike most medical journal papers, they are formatted with a minimum of verbiage to summarize an issue for decision making. The authors write in that tradition, adding references for key points. We speak on behalf of millions of people in pain and their healthcare providers, who have been predictably and unnecessarily harmed by the 2016 CDC Guidelines on prescription of opioids to adults with chronic non-cancer pain.