Yes, Doc Alex, Tami, Ian, Kim, Frank, Lori, Deanna, Axe, Hope, and everyone else here,
Constantly reading through the endless stream of anti-opiod propaganda that relentlessly comes at us from all directions is a dirty task indeed. Thank you all so much for doing it, because we cannot counterattack what we do not know exists. To be honest, I have reached a point where I have to limit the amount of my reading, so that I can continue to function without being totally disheartened. I guiltily thank all of you here on this forum who do my "dirty work" for me when I just can't read or think about the war on pain patients for one more second without a break.
I am sooooo sick of hearing the "opiods change the brain forever" lie and I am so tired of having to refute it. This is not the first time that I've seen this or the rest of the misinformation printed above used to satisfy a CME (Continuing Medical Education) requirement for doctors. It's a truly disgusting way to kill two birds with one stone. The doctors fulfill the CME requirements for licensure, (probably online, guaranteeing that they will never have to come into actual contact with a live, suffering pain patient), and then return to work with a whole new arsenal of lies to help them refuse to prescribe opiods and a bogus rationale to dump their pain patients by inappropriately referring them to addictionologists and anesthesiologists who do not actually treat opiod dependent chronic pain. I also know that they teach this stuff to med students, interns, residents etc., thereby ensuring that the new generations of docs who emerge from such "training" are thoroughly steeped in lies, misinformation and the caveat to completely avoid treating pain patients, EVER. They should have a "JUST SAY NO" motto emblazoned on the front of their lab coats. It has gotten so bad that when I am looking for a doctor for anything, if I see that they have graduated from medical school or completed a residency after 1995, I automatically rule them out because I know that they have been brainwashed against people like me. When other people ask my opinion about selecting a doctor, I say try someone as old as possible without getting someone who plans to retire soon. It's a terrible, but I believe accurate, assessment of the future of medicine. I hope that I die before only the new doctors are left, because I know that they will give me no help or relief.
Even the "good patient" in the "story" who decided to accept the addiction model and go to a methadone clinic was rewarded with the label of "addict who needs a fix every day". If he misses a "fix" he apparently becomes a dangerous junkie and all hell breaks loose. Yeah, right, must be true if a doctor says it. It follows that all good people, (those who do not take opiods), are really in mortal danger from him, and from us, because we need our daily fixes too. Like that "good patient/addict", we need them to function, ergo we're all addicts who are, at best, drains on society.
I, personally, believe that methadone is a bad medication for pain because it's long half life makes it extemely unpredictable, it has dangerous interactions with many other meds, it is often not very effective for stopping pain and it can easily kill people. However, I do know that some people use it and are helped by it. Those who are forced to go to methadone clinics pay hundreds of dollars for methadone that costs the clincs pennies. Most insurance doesn't cover it, so if people lose their jobs, they are cut off from their meds. These people are also often terribly abused by clinic staff members, forced to endure complete obliteration of any right to privacy, and are constantly threatened with termination of meds, cold turkey, for the slightest, actual or imagined, infraction of the most minor rules. I encourage everyone to check out a site called "We Speak Methadone" and read some of those people's stories. The last post I read stated that cameras were being installed in the bathrooms of clinics. Even if you accept the addiction model, (and I, personally, don't believe this is the only way to deal with that issue), how can anyone possibly call that "treatment"? I call it dehumanizing tyranny. If you treat people like criminals, and deprive them of their even their most bast human rights, it is likely that you will wind up with angry criminals. By the way, the people being treated like this are can be completely legal patients with sustained histories of "compliance". However, individual situations beyond their control, are often not taken into account.
Doesn't that sound familiar? Everything I see, hear and read tells me that all pain patients, (it has already happened to so many of us), will soon be relegated to the addiction model. I fear that we will no longer have any other choice and that we will get no opiod treatment for pain, except possibly methadone or suboxone in inadequate doses. We might, as an alternative, be offered new, inadequately tested, expensive, under patent, off label, non-opiods that make us sick and do not help with pain. We might also, out of desperation and lack of any other options, be forced to further risk our health by accepting injections that can pose many problems.
Perhaps I am being overly pessimistic, but that really is the direction that I see so called "medicine" moving toward. Addictionologists, who use the addiction model of getting chronic pain patients completely off opiods, have already renamed themselves "pain management" doctors in many places. Anesthesiologists, who also are NOT TRAINED to manage chronic pain and DO NOT USE oral opiods for treating pain, have also renamed themselves "pain management" doctors too. Their way of "managing" chronic pain is to give injections that are of limited dosage and duration, and often, are of limited efficacy. (Anyone who is considering getting injections from an anesthesiologist would be wise to look up arachnoiditis, iatrogenic Cushings Syndrome, the side effects of cortisone and all the other potential risks associated with injections before they make a decision.) These two types of doctors are now those who most chronic pain patients get dumped on, aka "referred to for pain management" that doesn't really exist.
I think THE LIE THAT I HATE MOST is the lie that primary care doctors, rheumatologists, neurologists, orthopedists, et. al. tell patients when they say that they "cannot prescribe long term opiods" and that patients "must be referred to pain management" doctors for long term opiod prescriptions. THEY ARE LIARS! If you have a DEA number, and they all do, any M.D. or D.O. can prescribe any controlled substance, unless they are using methadone or suboxone TO TREAT ADDICTION, which requires a special license. If either of those drugs are being used to treat pain, however, no special license is required. Even your psychiatrist has a DEA number and could help you out by prescribing opiods if he or she wanted to do so. DOCTORS CAN PRESCRIBE OPIATES, THEY'RE JUST AFRAID TO DO IT. It may be something that they don't want to do, it may be something the senior members of their practices tell them not to do, it may be some "association's" trumped up "guideline", it may be the preference of an influential insurance company, but it is NOT THE LAW, (not yet anyway), AND THEY CAN DO IT.
If doctors would at least be honest about their refusal to prescribe controlled substances, I might be able to summon up a modicum of compassion or respect for them, but when they tell the BIG LIE, they become nothing more than barriers to treatment. I cannot see liars as caregivers, let alone allies.
Once all the doctors have officially reached the same, lie based consensus, whether out of fear or ignorance, where will we go? I just don't know how to fight those lies, when doctors, the people who hold the power of the prescription pad and stand, directly, between me and my treatment as a chronic pain patient who requires opiates, choose to embrace these lies and base their practice of "medicine" upon them. I understand that the long term goal of PRN is the repeal of the CSA and the removal of the DEA from medicine. I fully support and am committed to this. However, this will take a long time to do via the courts, the Congress, a new Attorney General to reign in the DOJ/DEA terrorist tactics, whatever is effective. What do we do in the meantime?
I do not believe that pain patients can fight the lies about opiods alone. Doctors must step up and help us if we are to be successful. There are ways that they can do this and still protect themselves. One way would be to distribute risk in a given area. If everybody agreed to take a few opiate dependent chronic pain patients as part of the rest of their practice, they could not be easily labelled as "pill mills". Once you marginalize pain patients and force them all to go to "pain clinics", the pain clinics become very easy targets for the DEA. Lots of prescriptions from one doctor result in a high pill count that triggers DEA investigation and federal prosecution. I'm sure that other strategies that would protect both doctors and patients could also be developed. However, doctors, in large numbers, need to start helping us, and stop rejecting us. Maybe I'm wrong, but I just don't see any other way out. Am I recognizing the elephant in the living room by calling most doctors unethical liars when it comes to long term opiods for chronic pain patients?
Good doctors, you know who you are and you know that I am not talking about you. If I have offended you with my somewhat harsh words, I am sorry. I have said what I, as an opiod dependent chronic pain patient, felt needed to be said. I hope that you understand that I am simply doing my best to try to help solve a terrible human rights problem that no one outside of PRN wants to touch.
tabt
