Politics of Pain

Posted by 19lin @19lin, Mar 2, 2018

I have chronic pain and have had since I lost my leg and injured my back in Vietnam in 1968. Now nearly 50 years later it has gotten worst with advanced age. In the last few years I started using strong pain medicine and now the powers that be want to shut it off unless your a cancer suffer. Even though many opioid users who follow their doctors advise do well and lead near normal lives. So I would like to open up discussion on the politics of pain if it is allowed?
I just received a notice from the pain news network (Painnewsnetwork.org) that the CMS (Centers for Medicare and Medicaid Services) is about to close public comment for citizens on payment for opioid type medicine through Medicare and Medicaid. If their proposal is approved they will restrict payment for pain medicine (opioid) to a small amount that needs to be renewed every few days. The Comments close March 6th and any citizen or concerned person may submit their comments.
For more detailed information please check the Pain News Network (painnewsnetwork.org) February 19, 2018 a post written by Richard Lawhern who provides a lot more information than I can.
You can write direct to regulations.gov (www.regulation.gov) look for Docket ID: CMS-2017-0163 . In the search box at the top of the page fill in the docket ID which should take you to the page with two requests for comment. I believe the one calling for payment is most important but you can comment on both. IMPORTANT make comments by the end of March 5, 2018. Just tell them how this will effect you or your family, of course family and friends can comment also. In addition contact you elected officials on the federal level and state level. Their office address and phone number is in the phone book or you can Google them and send an email. I did an internship in a congressional office and I know that they give more weight to letters sent through the mail but all comments make an impact so phone, email or write to make an impact. The pain news network article provides a direct link to make comments.
There are many sites that have formed to provide information about pain so if you wish to do something I recommend you get in contact with them to find out more information on opioid regulations.
I realize that most people come to this site for support, but if you would like to do more to lobby for change to opioid regulation then maybe we can bring up information on this site also. One of the things that counselors and Social Workers do is advocate for people, so as a Social Worker I have done some of this. 19lin

@stfnwtl89

@wsh66, @19lin thank you both for the posts and website info provided. I too have been researching this very topic in an attempt to help with a family member. This is going to snowball and yet again, it happens over and over people who follow the rules and really need help and rely on prescriptions to make it through the day will be punished for those who are out there abusing the system. And for a senator to use a platform such as this for political gain makes me sick. In the last 3-4 months I have really had to become active in the care of my mom even more so with the dr. and pain management clinic she is being treated by. It's taken me a full month to put the pieces together as to why her treatment has changed so drastically. Around November, December 2017 he seriously began changing her medication, rather than treating her pain. She has been diagnosed with facial neuralgia and has suffered greatly due to a dental procedure gone wrong about 15 years ago. Sometime in 2016 she was assigned to a new pain clinic and I have a feeling her PCP was unable to assist in pain mgt. Things seemed as though we might have a turn around and someone might actually understand and put in some time to find a combination of meds to help ease the day to day pain. Then mid 2017 the attitude of the Dr. shifted – rather than mgt. of pain, the focus seemed to be reduction of medication, as I listened to my mom for months tell me each time she left the Dr. she felt he wasn't listening. By December 2017 the reduction of her medication was so apparent in her ability to function on a daily basis, I begged for help and began calling her PCP and her pain mgt. Dr. We have made several trips to the ER and now are on an every 7 to 14 dr. visit to the pain clinic because the reduction of medication has been too great and she is in a physical and emotional state like I have never seen before. After 2 trips to the ER she is now terrified to go to a hospital to seek help, it was a nightmare for her and for myself and my dad. So I started researching why the change in her care all of sudden…. Since the CARA bill was signed by President OBAMA in July 22, 2016 it took time for it to be implemented and put in place and for the public to actually see the effects. In addition to the funding that has been provided https://www.samhsa.gov provides grant funding for the "opiod crisis" by state and has other interesting information as well. It also came to my attention my state has received a huge grant dedicated to this very purpose and it outlines goals set forth by medical community within your state. I also read within the CARA bill opiod is defined as any drug with highly addictive tendancies and when you research further the answer to reduction of opiods is to replace with narcotics, go figure. Now the DEA is involved and telling Dr.s what they can and can't do with their patients and I realize this was in an attempt to rid the medical community of the those who write prescriptions to those who abuse them and are dealing them out on the streets. Yes I get it, with that being said it has scared Dr.'s and changed the mind set from being in the best interest of their patient to being reduction of medication and keeping my clinic off of DEA's radar. Now I ask who within the DEA has taken the medical doctors Hippocratic oath and/or where would we find the american medical associations code of ethics within the realm of the DEA and on the HILL? FDA should be slapped and pharmaceutical companies should have stricter testing and analyzing I personally have people within my immediate family who were saved in a drug trial at MD Anderson so I am all for new drugs etc…., what I am having a problem with is the polictics that has creeped its way into the dr's office and hospitals across America. If you look on the DEA's website at the most wanted in America I ask you to find a Dr. or patient with chronic pain condition listed with posession or intent to distribute, the majority are hispanic and the drugs listed are cocaine and marijuana, their is 1 Asian and the drug is heroin, there is 1 fellow from Louisiana and the drug is meth. All of which are not manufactured in a pharmaceutical lab well with the exception of marijuana which I personally would like to see legalized in all states, as the benefits would far out weigh the risks. Now I feel as though I am having to take time away from the care of my mom in order to research this new law and CRISIS that has been deemed as EPEDEMIC in order to get her somewhere else for treatment but where?
Below is the current version of the medical oath for dr.'s, I think a bill should be passed to reinforce the oath below.
American Medical Association Code of Ethics (post- 1980)

Preamble: The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility not only to patients, but also to society, to other health professionals, and to self. The following Principles adopted by the [AMA] are not laws, but standards of conduct which define the essentials of honorable behavior for the physician. II. A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception.

III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.

IV. A physician shall respect the rights of patients, of colleagues, and of other health professionals, and shall safeguard patient confidences within the constraints of the law.

V. A physician shall continue to study, apply and advance scientific knowledge, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.

VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical services. VII. A physician shall recognize a responsibility to participate in activities contributing to an improved community.

I am left with the overwhelming fear of not being able to make a difference and sub par medical care for those who actually need it. The CARA 2.0 which is now being pushed by 8 senators who have really made this their mission really scares me as to what effects it will have for medical care. I came to this website and joined in an attempt to help find answers but all I am seeing is other people who are frustrated and their pain is not being managed either. Very disheartened

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Jim The way it is stated any recommendation would be to limit Medicare and Medicaid payment or allow it to the insurance people to decide. I went to the gov site and it was not clear but the article in Pain News Network I referred to was much better written so please check there. It sounded like they were going to reduce payment for long term pain medicine. I would be happy to be wrong. 19lin

REPLY
@janet111

The problem I believe is Jeff Sessions. It literally makes me crazy, this ignorant man not only wants our drugs but marijuana too. I have had this disease for twenty years and in the last 5 years it was joined by arthritis and two back surgeries. AND NOW when I finally agreed to pain relief they want to take it away.

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Jeff Sessions is trying to restore his trust from the boss. His boss is President Donald J. Trump.

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@janet111

The problem I believe is Jeff Sessions. It literally makes me crazy, this ignorant man not only wants our drugs but marijuana too. I have had this disease for twenty years and in the last 5 years it was joined by arthritis and two back surgeries. AND NOW when I finally agreed to pain relief they want to take it away.

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@predictable, Martin, as I have stated my belief previously, I won't repeat myself. My wife just finished the statistics class in her doctoral program and she could use the numbers from states reporting about opiate overdoses and help the "do nothing positive" congress understand what would be effective policy to address the opioid "crisis". One of the things they should always be able to do as a body is to remove the emotion from decision making, but they look at the pics like the ones that Time devoted an entire issue to last week and have a knee-jerk over-reaction.

REPLY
@janet111

The problem I believe is Jeff Sessions. It literally makes me crazy, this ignorant man not only wants our drugs but marijuana too. I have had this disease for twenty years and in the last 5 years it was joined by arthritis and two back surgeries. AND NOW when I finally agreed to pain relief they want to take it away.

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@gman007, I've detected evidence that the most powerful emotion the engulfs a politician is assurance that his/her beliefs are being supported by statements from almost anybody else. The degree of their confidence in their rectitude varies according to the number or reputation or financial achievement of the approving persons, the extent to which beliefs dominate their demand for facts, whether their supporters call them to account for questionable conclusions or simply cheer what s/he says, the extent to which s/he is allowed to preach more than s/he is pressed to perform measurable activities, thus how much of their credibility is based on secret consultations and thoughts and prayers rather than publicly transparent accounts of their stewardship, etc. On the other hand, sometimes a strong case based on detailed reporting and reliable data lies fallow until a story or a picture or a tragedy seizes the imagination and throws it into the arena of public consideration. Too often, any political reaction is an over-reaction for a time; that's why wise leaders try to calm the winds of public opinion until the atmosphere is right for constructive analysis, documentation of potential consequences, development of a full range of optional solutions, and a good night's sleep before launching an offensive toward a solution.

REPLY
@stfnwtl89

@wsh66, @19lin thank you both for the posts and website info provided. I too have been researching this very topic in an attempt to help with a family member. This is going to snowball and yet again, it happens over and over people who follow the rules and really need help and rely on prescriptions to make it through the day will be punished for those who are out there abusing the system. And for a senator to use a platform such as this for political gain makes me sick. In the last 3-4 months I have really had to become active in the care of my mom even more so with the dr. and pain management clinic she is being treated by. It's taken me a full month to put the pieces together as to why her treatment has changed so drastically. Around November, December 2017 he seriously began changing her medication, rather than treating her pain. She has been diagnosed with facial neuralgia and has suffered greatly due to a dental procedure gone wrong about 15 years ago. Sometime in 2016 she was assigned to a new pain clinic and I have a feeling her PCP was unable to assist in pain mgt. Things seemed as though we might have a turn around and someone might actually understand and put in some time to find a combination of meds to help ease the day to day pain. Then mid 2017 the attitude of the Dr. shifted – rather than mgt. of pain, the focus seemed to be reduction of medication, as I listened to my mom for months tell me each time she left the Dr. she felt he wasn't listening. By December 2017 the reduction of her medication was so apparent in her ability to function on a daily basis, I begged for help and began calling her PCP and her pain mgt. Dr. We have made several trips to the ER and now are on an every 7 to 14 dr. visit to the pain clinic because the reduction of medication has been too great and she is in a physical and emotional state like I have never seen before. After 2 trips to the ER she is now terrified to go to a hospital to seek help, it was a nightmare for her and for myself and my dad. So I started researching why the change in her care all of sudden…. Since the CARA bill was signed by President OBAMA in July 22, 2016 it took time for it to be implemented and put in place and for the public to actually see the effects. In addition to the funding that has been provided https://www.samhsa.gov provides grant funding for the "opiod crisis" by state and has other interesting information as well. It also came to my attention my state has received a huge grant dedicated to this very purpose and it outlines goals set forth by medical community within your state. I also read within the CARA bill opiod is defined as any drug with highly addictive tendancies and when you research further the answer to reduction of opiods is to replace with narcotics, go figure. Now the DEA is involved and telling Dr.s what they can and can't do with their patients and I realize this was in an attempt to rid the medical community of the those who write prescriptions to those who abuse them and are dealing them out on the streets. Yes I get it, with that being said it has scared Dr.'s and changed the mind set from being in the best interest of their patient to being reduction of medication and keeping my clinic off of DEA's radar. Now I ask who within the DEA has taken the medical doctors Hippocratic oath and/or where would we find the american medical associations code of ethics within the realm of the DEA and on the HILL? FDA should be slapped and pharmaceutical companies should have stricter testing and analyzing I personally have people within my immediate family who were saved in a drug trial at MD Anderson so I am all for new drugs etc…., what I am having a problem with is the polictics that has creeped its way into the dr's office and hospitals across America. If you look on the DEA's website at the most wanted in America I ask you to find a Dr. or patient with chronic pain condition listed with posession or intent to distribute, the majority are hispanic and the drugs listed are cocaine and marijuana, their is 1 Asian and the drug is heroin, there is 1 fellow from Louisiana and the drug is meth. All of which are not manufactured in a pharmaceutical lab well with the exception of marijuana which I personally would like to see legalized in all states, as the benefits would far out weigh the risks. Now I feel as though I am having to take time away from the care of my mom in order to research this new law and CRISIS that has been deemed as EPEDEMIC in order to get her somewhere else for treatment but where?
Below is the current version of the medical oath for dr.'s, I think a bill should be passed to reinforce the oath below.
American Medical Association Code of Ethics (post- 1980)

Preamble: The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. As a member of this profession, a physician must recognize responsibility not only to patients, but also to society, to other health professionals, and to self. The following Principles adopted by the [AMA] are not laws, but standards of conduct which define the essentials of honorable behavior for the physician. II. A physician shall deal honestly with patients and colleagues, and strive to expose those physicians deficient in character or competence, or who engage in fraud or deception.

III. A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.

IV. A physician shall respect the rights of patients, of colleagues, and of other health professionals, and shall safeguard patient confidences within the constraints of the law.

V. A physician shall continue to study, apply and advance scientific knowledge, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.

VI. A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical services. VII. A physician shall recognize a responsibility to participate in activities contributing to an improved community.

I am left with the overwhelming fear of not being able to make a difference and sub par medical care for those who actually need it. The CARA 2.0 which is now being pushed by 8 senators who have really made this their mission really scares me as to what effects it will have for medical care. I came to this website and joined in an attempt to help find answers but all I am seeing is other people who are frustrated and their pain is not being managed either. Very disheartened

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@19lin

I hope it's only addressing post op prescriptions. Having to get a fresh prescription every month is a real inconvenience to me. Any more frequently would be a problem, living in the country, and what in the world would we do if we were to go on a trip out of state? Two years ago, my wife and I took a 5 week road trip to visit our kids in New Hampshire and Indiana. It's basically impossible to fill an opioid prescription in many states when you're from out of state.

I did read the link to the Pain News Network.

Jim

REPLY
@janet111

The problem I believe is Jeff Sessions. It literally makes me crazy, this ignorant man not only wants our drugs but marijuana too. I have had this disease for twenty years and in the last 5 years it was joined by arthritis and two back surgeries. AND NOW when I finally agreed to pain relief they want to take it away.

Jump to this post

@gman007

I wrote my first letter to a magazine last week after I read the opioid special edition. I was disgusted.

Jim

Liked by Parus, christy363

REPLY
@janet111

The problem I believe is Jeff Sessions. It literally makes me crazy, this ignorant man not only wants our drugs but marijuana too. I have had this disease for twenty years and in the last 5 years it was joined by arthritis and two back surgeries. AND NOW when I finally agreed to pain relief they want to take it away.

Jump to this post

What magazine?

REPLY
@janet111

The problem I believe is Jeff Sessions. It literally makes me crazy, this ignorant man not only wants our drugs but marijuana too. I have had this disease for twenty years and in the last 5 years it was joined by arthritis and two back surgeries. AND NOW when I finally agreed to pain relief they want to take it away.

Jump to this post

@wsh66

Time

The whole issue was about street drug addiction. Not a peep about the legitimate opioid medication for pain control. It was almost exclusively about heroin abuse.

Jim

Liked by jlfisher56

REPLY

This is not a reply, but something that might interest chronic pain suffers. https://www.painnewsnetwork.org/stories/2018/3/15/human-rights-watch-investigating-treatment-of-pain-patients This is a connection to an article that human rights watch maybe investigatig the treatment of Chronic pain patients.
I am not sure if this will lead to anything, but it may help by bringing attention to the struggle that pain patients are having in America. 19lin

REPLY
@19lin

This is not a reply, but something that might interest chronic pain suffers. https://www.painnewsnetwork.org/stories/2018/3/15/human-rights-watch-investigating-treatment-of-pain-patients This is a connection to an article that human rights watch maybe investigatig the treatment of Chronic pain patients.
I am not sure if this will lead to anything, but it may help by bringing attention to the struggle that pain patients are having in America. 19lin

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@19lin

Thanks for the link. I sent a message to Laura about what I'm going through with my doctor. He's gradually cutting back on the dosage of opioids, and told me to take NSAIDS, which I shouldn't take because of the risk of bleeding. I'm fearful of the future of my pain control.

Jim

REPLY

Hello. Thank you for the info. I did not know about the painnews site. Went to the docket – comments closed March 5. 639 comments left. I am dependent on opiods after failed back surgery. The rest of my story is the same as ever other story.

Liked by jlfisher56

REPLY
@19lin

This is not a reply, but something that might interest chronic pain suffers. https://www.painnewsnetwork.org/stories/2018/3/15/human-rights-watch-investigating-treatment-of-pain-patients This is a connection to an article that human rights watch maybe investigatig the treatment of Chronic pain patients.
I am not sure if this will lead to anything, but it may help by bringing attention to the struggle that pain patients are having in America. 19lin

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@jimhd I am now experiencing not getting help for pain control and was told to walk. I can no longer use NSAIDS and have done everything I know to do. I only requested 1 hydro 5 mg. a day. Also having thyroid issues now because of severe, but rare side effects of Nature-Throid. TSH 13.36 as of last Friday and when they increase the dose the side effects become so severe it scares me. Weight on the rise and fear becoming a fat old sow.
Sorry, need to take the thyroid issue to the proper place. Now awaiting a call from from endo doc. Feeling my life is ending and cannot stop it. If this is all it is going to be it is no longer worth the trying. 🙁

Liked by jlfisher56

REPLY

Many of us are going through this also. Just wish there really would be better relief for us. Don't believe they understand the mechanism of chronic pain yet and we are all experiments. Even when something works, law/s get passed, we are no longer allowed to use. Subjective opinions of our pain instead of objective. Very frustrating. Don't know many who want to use all the various modalities every day to deal with pain… but we do (not just relying on medication. Drug addicts are making the lives of some chronic pain patients who need and responsibly use narcotics, difficult and are forced to stop using them. Also, any benzodiazepine used as a muscle relaxant. I know what works for me after 24 years. I have tried many different medications and use many modalities. I decrease my dosages depending upon my pain. Now we are going back to years ago when the main drugs were the anti-seizure drugs. They are not without their own side effects too. There is no "magic pill" for any of us but I get tired of doctors "pretending" resulting "pain" is not real. I have read new medical journals about, "what has happened to chronic pain patients who can no longer obtain narcotics"? They are turning to the street. I have not and will not, but this population is forgotten and being treated terribly. So far my doctors are helping me and being compassionate but I do have to STOP my narcotic.

REPLY
@19lin

This is not a reply, but something that might interest chronic pain suffers. https://www.painnewsnetwork.org/stories/2018/3/15/human-rights-watch-investigating-treatment-of-pain-patients This is a connection to an article that human rights watch maybe investigatig the treatment of Chronic pain patients.
I am not sure if this will lead to anything, but it may help by bringing attention to the struggle that pain patients are having in America. 19lin

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HI parus, I was on Acella natural thyroid and the balance of T3 and T4 was not in synch. I am now on Canadian Erfa which is doing a better job than Acella's version. Acella was working great for about 6 years till the fall and winter of this year. See if you can get a script for Erfa. It might help you. 1 hydro is nothing – I'm really sorry you are going through this. Dorie

Liked by jlfisher56

REPLY
@19lin

This is not a reply, but something that might interest chronic pain suffers. https://www.painnewsnetwork.org/stories/2018/3/15/human-rights-watch-investigating-treatment-of-pain-patients This is a connection to an article that human rights watch maybe investigatig the treatment of Chronic pain patients.
I am not sure if this will lead to anything, but it may help by bringing attention to the struggle that pain patients are having in America. 19lin

Jump to this post

Parus where do you live? I'm so sorry you feel this way my heart goes out to you the info Dr did wonders for my friend hope for you the same.Love Lioness

Liked by Parus

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