- Describe your topic.
- The issue is restoring legally prescribed and tracked opiate medications as a long-term treatment option to be made readily available for chronic pain patients with intractable pain who have not been helped by any other treatment options available to them currently. The population of interest is the large, diverse group of chronic pain patients today. The details are many and varied, as chronic, intractable pain affects humans of all ages, races, genders, and diagnoses; it does not discriminate. The intervention in question is legally prescribed opiate/opioid medication used properly and tracked, for patients with chronic, intractable pain. Comparisons, although considered HIGHLY IN-appropriate, are the untested methods being put forth currently. These include long-term use of neuroleptics, antidepressants, and implantable devices, especially. While long-term use of tricyclic and novel antidepressants have been studied long-term for use in the treatment of depression, they have not been studied for use in chronic pain patients who DO NOT HAVE depression. In the case of neuroleptics, there is just no long-term research indicating that this class of drugs should be used in the treatment of ANYTHING OTHER than seizure activity, considering the broad impact that they have on circulating brain chemicals. Certainly not on humans without seizure activity. As for requiring implantable devices, this should be considered the treatment of LAST RESORT, when ALL else (including legal, prescribed, and tracked oral opiates/opioids) have failed, not as a "step therapy" or "something to try." "Mechanically-enhanced humans" are things best left to Marvel movies and fantasy. The important outcomes for the chronic pain community are both a return to a state of functionality and lessened pain levels, previously obtainable through the use of legal, prescribed, and tracked opiates/opioids.
- Describe why this topic is important.
- This topic is very crucial to the well-being of the chronic, intractable pain community, many of whom have had their prescription medications severely tapered or stopped altogether, following the 2016 Opioid Prescribing Guidelines put forth by the CDC--who has experience in dealing with contagious and infectious diseases, and not in the treatment of chronic, intractable pain. ("Pain" is not even listed in the CDC's catalog of chronic conditions; so they really have no business issuing sweeping guidelines for treating it.)
- Tell us why you are suggesting this topic.
- Not only am I a person with chronic, intractable pain conditions (more than just one), I am a member of a very large, diverse, and increasingly vocal community of chronic pain patients, advocates, and self-advocates who are not being afforded the benefits of proper treatment by their physicians. In this supposedly First World country, we are being “treated” as if we were in the Dark Ages (although in the Dark Ages, humans had the benefit of having opiate treatment available to them!). For some people and conditions, there just is no other treatment that suffices in producing not only lowered pain levels, but restored functionality, than opiate/opioid medications. The current illegal fentanyl/addiction crisis should NOT be used as an excuse for not treating the severe pain that we face daily. The issue at hand is not the over-prescribing of legal opiate/opioid medications to pain patients; the issue at hand is the influx of illegal fentanyl/fentanyl analogues and carfentanil that is not being staunched by the DEA, who is currently more focused on physicians, patients, and legally prescribed and tracked medications. Stopping these substances at the borders where they flow into the country would be a more noble endeavor for the DEA, which should focus on the “E” part of the department’s name (Enforcement) and leave practicing medicine to those who have undertaken the years of education to do so. The CDC, who should be studying infectious and contagious diseases and their prevention, as they were meant to do in the first place, has ADMITTED to skewing and falsifying their “opiate data,” which was used to justify the Prescribing Guidelines. This then puts the whole PURPOSE of the Guidelines (which were honestly meant only for Primary Care Physicians’ use, as stated in the Guidelines themselves) into question. The only other research study I can think of that used (eventually) ADMITTED falsified data to arrive at its conclusions and recommendations is the infamous Andrew Wakefield, (formerly) M. D., study that accused the MMR vaccine of “causing” Autism. We all know the fallout from THAT endeavor, and I would think that the U. S. Research organizations would NOT want to stand accused of using such skewed numbers for their studies.
- Target Date.
- 2018-11-30
- Describe what you are doing currently and what you are hoping will change because of a new evidence report.
- Currently, I am suffering, with no medications. I have an implanted, automatic “drug” delivery system (pain pump) that is filled with a non-effective, non-narcotic substance that may as well be water, courtesy of my pain “management” group, who is afraid of the DEA shutting them down. They completely “cut” my very low-dose opioid medication regimen that I had been on for YEARS with no complications. I dutifully submitted to the Pain Management contract that I had signed with my previous physician, before “having to” use a pain management specialist in the wake of the Guidelines’ issuance. I attended all appointments, submitted my pill bottle for (always accurate) “pill counts,” supplied urine for the drug screens that they required, and never once, ever, misused or abused my medication. Yet I was punished anyway. As are many others. What I am hoping will CHANGE because of a new report, is that the CDC’s Prescribing Guidelines will be NATIONALLY revoked, leading the way for the re-entry of personalized pain management. I believe the EVIDENCE and ACCURATE DATA will uphold my—and many other chronic pain patients’—beliefs that legally prescribed and tracked opiate/opioid medications CAN, in fact, be used responsibly by people. The currently held opinion that physicians over-prescribing “pain pills” is SO out-of-date, that certainly a brand-new query, with other eyes (NOT influenced by the money-hungry PROP people who want to sell MAT and rehab spaces), can show the world that the problem is NOT physicians wanting to help their patients live more functional, comfortable lives, but rather that the problem is the addiction epidemic the world is facing. People are addicted to opiates/opioids, but NOT the medications WE need. They are addicted to substances such as heroin, which is often “laced” with fentanyl, fentanyl analogues, or carfentanil to “stretch” it further. Some people KNOWINGLY take the heroin with the fentanyl, wanting a higher “high,” and knowing that they are taking a chance with what they call “scramble.” Others figure they will just get naloxone if they overdose and are willing to take the chance.
- How will you or your group use the information from a new evidence report?
- Our group, Don’t Punish Pain, will use this new evidence to prove our stance that patients can use these medications responsibly, and we will nationally advocate for the redaction of the CDC’s flawed Guidelines for Prescribing, in favor of a newer, accurate policy.
- How would you or your group plan to disseminate information from the report? Who would you plan to disseminate it to?
- Our national group would disseminate it EVERYWHERE: in the press, media, and especially the politicians and physicians, in ANY WAY we can!
- Do you know of organizations that could use an evidence report to change clinical practice? Are you a part of, or have you been in contact with, any organizations that might implement the research findings of an evidence report?
- The FDA, the DEA, and the AMA are the main organizations that should receive the updated information; the CDC should expect to receive the info and NOT have the grounds to interfere with due process in redacting their flawed guidelines. There are many Pain advocacy organizations, divisions of the AMA, JCAHO-approved organizations, other in-patient, as well as outpatient, organizations who can use the newly updated evidence to form better policy. It is only fair that the anti-opiate/opioid factions should receive the updated evidence, as well; however, as the issue is "apples and oranges" (patient treatment versus addiction treatment), they should not have a say in the physicians' treatment of their own patients. Addiction and its treatment is a totally separate issue, and, as such, should be addressed in that way.
- Information About You: (optional)
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- Provide a description of your role or perspective.
- Patient/advocate
- If you are you making a suggestion on behalf of an organization, please state the name of the organization.
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- Please tell us how you heard about the Effective Health Care Program.
