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What Epidemic? Did the CDC Get it Wrong on Prescription Pain Killers?
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cweinbl posted:
WebMD recently published an article titled, "40 U.S. Deaths a Day from Prescription Pain Killers." In it, WebMD refers to a flawed CDC report to suggest that there is an "epidemic" of deaths from opiate medications. The article cites a plethora of empty statistics, such as, "states with the most painkiller sales have the highest death rates." Ya think? All of this "concern" is based upon a new campaign by the U.S. Centers for Disease Control. This report suggests that prescription analgesics are a threat to public health. The report calls prescription medications for pain, "killer drugs." It indicates that prescription medications should become a target to be reduced, when in reality they are a valuable and necessary tool that helps millions of innocent Americans who are victimized by unrelenting pain. This medication helps pain patients to remain employed and participate in family activities. In many cases, when pain is overwhelming, medication is the only intervention that allows those victims to remain alive.
The report repeatedly refers to "15,000 opiate-related deaths in America." Yet, that number does not remotely approach the 15 most frequent causes of death in America. So, is this really "an epidemic?" If so, why is the number of lost lives much lower than the other common causes of death? For example, each year well over twice that number of deaths are caused by suicide. But the CDC isn't calling suicide an "epidemic." Why have they targeted pain medication?
Worse yet, the CDC report infers causation from flawed correlation data. In response to a recent flood of physicians who have stopped prescribing narcotics (because their fear of going on a DEA list outweighs their desire to ease their patients suffering), thousands of chronic pain patients now denied their medication are flooding rehabilitation centers, rather than go cold turkey at home. Ironically, those admissions are used to prove that there is an "epidemic" of pain medication.
Strangely, within all of the shouts of "epidemic" the most recent and objective research data on addition reveals that the rate of addiction among chronic pain patients using narcotics is less than 3% (see references below). How does this low addiction rate related to the "epidemic" shouting? It doesn't. And that's part of the problem.
In reality, there are hundreds of thousands of people in this country without pain who use opioid pain medications. From hard-core drug abusers to adolescents exploring a new barrier, to purveyors of prescription mills - these are the people who should become targets of government agencies, not physicians, pharmaceutical companies or innocent patients crippled by unrelenting pain who take their medication as directed. When government agencies cry "epidemic" based upon flawed statistical data, they do none of us any good. Worse yet, all of this shouting about the "epidemic" of narcotics makes victims of pain patients using the only substance that allows them to have a life.
References:
WebMD reports "epidemic of prescription drug abuse." Nov 1, 2011. http://www.webmd.com/pain-management/news/20111101/40-us-deaths-a-day-from-prescription-painkillers?ecd=wnl_cbp_111011 .
PainTopics.org— News/research Updates. Nov. 5, 2011. "Are opioid Pain relievers an Epidemic?" http://updates.pain-topics.org/2011/11/are-opioid-pain-reliever-deaths.html .
PainTopics.org— News/research Updates. Jan. 14, 2011. "Study Finds Low Risk of Rx-Opioid-Use Problems " http://updates.pain-topics.org/2011/01/study-finds-low-risk-of-rx-opioid-use.html .
PubMed.Gov, Jan. 20, 2010. "Long-term opioid management for chronic non-cancer pain." http://www.ncbi.nlm.nih.gov/pubmed/20091598?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

cweinbl
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Anon_1421 responded:
Oh I just love articles like this, every time I hear about another death from someone who has abused pain meds, or hear about a drug raid on people who obtained them illegally, I cringe-I start wondering if this is going to give my pain management doctor an excuse to cut off my meds that have actually given me some quality of life. I start wondering what new hoops I'm going to have to jump through next, and with a messed up spine I just don't jump too well anymore! And don't even get me started on the snotty attitude I get at my pharmacy when I go to pick up my meds (have used the same pharmacy for over 10 years!). And the "helpful" people who aren't in pain every day who just love to quote these articles, and think it's their duty to warn me about becoming a "drug addict"! I also find it ironic that some doctors don't want to prescribe older pain drugs that have been around for years and some actually work quite well, but they will prescribe newer (and more expensive because there is no generic) ones that sometimes don't work all that well. I think the government (and DEA) won't be satisfied until they get their way (through misinformation, hysteria, and propaganda) and all the chronic pain patients are denied the meds that give them some quality of life, some relief from the sheer hell of constant pain...I'm so tired of the government "saving me" from myself! And the epidemic that scares me most is the epidemic of ignorance.....
 
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CTBeth responded:
Right now, as I am writing, there is a local TV news segment on this topic.

The subject of chronic, intractable pain is not mentioned; all of the persons who have "beat" addiction to prescription "pain killers"

All of those interviewed who have successfully completed addiction recovery programs look happy, healthy, have gone on to get education, new jobs, got their children returned to them from protective services.

The segment did not even hint at those of us who would be essentially bed-bound and unable to participate in life if not for opioid therapy.

Proper use is not abuse.

The segment is still on, and on, and on....."addiction to pain killers"- it's a drug treatment counselor blaming doctors of prescribing too easily.

There is NO mention of proper use. They portray persons in pain as taking it after no longer needed for the "euphoria". I have not felt euphoria from morphine contin in....uhn, well- I never felt it.

This new drug abuse awareness is going to make MY life more difficult. I'm sure my family is going to latch on to this and probably use Thanksgiving dinner as a Beth intervention. UGH.

I tried going off of all my meds last month and my quality of life was somber and the pain was intolerable. I was well-past the withdrawal period.

I do not take morphine to get "euphoria" and my "pain killers" do not actually kill my pain; they make the physical hell with which I live less intolerable. My pain is never "killed".

I am mad as a striped snake at this ridiculousness and the effect it's going to have on me.

If I hear this garbage one more time from a friend, family member, I'm going to show them my emergency room photographs. They are so disturbing that one-of my girlfriends vomited. She never expressed any concern about my being an addict, either.

All I am hearing quoted and interviewed is recovering addicts and drug re-hab (12-step mostly) "counselors".

Why aren't they interviewing pain management MDs or persons whose professional career was prolonged for many years due to pain management?

............or me?

This is going to be a problem, I fear, for all of us who need opioid management and are fatigued of being called an addict or having to defend ourselves.

I will not defend myself. My medication is between me and my MD. Of course, the "12-steppers" call that denial, LOL (sad, but true)


God please help us who suffer.

Love to you all,
 
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lazydazey replied to CTBeth's response:
Oh Beth, I so agree, I already get enough judgement from ignorant people as it is! They never mention people who don't abuse meds and are never going to get better! I wish all these judgemental ignorant folks could spend one day in our bodies-without pain meds! Isn't our life already hard enough? God help us! And if your family dares try an intervention, walk out. A good link with something to print out and give to your family....
http://www.howtocopewithpain.org/blog/47/are-you-pain-free-10-things-those-of-us-in-pain-would-like-you-to-know/ .
Take care and God bless.
 
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cweinbl replied to CTBeth's response:
Right... God help us. The rate of addiction among chronic pain patients is lower than 3%. But TV news directors rarely let facts get in the way of ratings opportunities. And don't get angry with your doctor when he or she tries to change your meds away from the narcotics which allow you to have a life. You may never find another physician willing to prescribe them, as doctors seem more motivated by fear of going on an FDA list than easing their patient's pain. It's a sad modern world we live in when those saddled with intractable pain rarely receive the medication that can allow us to manage it. Even when we do, we are shunned or ridiculed by family, friends and co-workers, suspected of being an addict or treated like second-class citizens. I know it's not nice to wish our pain on someone else. But it is occasionally tempting.
cweinbl
csw2@bex.net
 
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MaryDeeGoettsche replied to cweinbl's response:
Oh my! Sometimes I wish that there were a pain medication that I could take. Due to allergies I am not able to take any pain medications! I found out that I was allergic to morphine when the doctor used it for surgery on my ankles! Codeine makes me terribly nauseated, so I don't take that, either! I can handle the pain better than the vomiting! True, much of the time I'm unable to sleep, but I try to not stress about it....that doesn't help at all! I'm sure that there are many people much worse off than I am.

A couple of months ago I received an email message called "Attitude is everything"....there were pictures of several pre-school boys with big grins on their faces.....and no legs! Truly, attitude is everything! You can always find someone worse off than yourself!
 
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Anon_6772 responded:
They will try to take away our sleeping meds as well. Where will it end?
 
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billyf27 replied to Anon_6772's response:
It is amazing how little we hear about alcohol. I took my daughter and friend to a concert and people were drinking beer like crazy. Someone even spilled it on her. The stadium vendors pushed alcohol left and right. People left drun driving and often there were fights. But they don't want to stop all that revenue. How many die from alcohol and drunk driving? It is advertised everywhere.

Also, how many from suicide. I think 30,000 a year. Isn't that an epidemic. I won't even mention cigarettes.
 
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cweinbl replied to MaryDeeGoettsche's response:
Mary, ask your doctor about Fentanyl Transdermal. The narcotic enters your bloodstream through your dermis (skin). This might (and I emphasize "might") reduce the nausea.

Another option is to use a narcotic that you're not allergic to (there are dozens of options in addition to morphine or codeine) and take an oral anti-nausea medication, such as Compazine simultaneously. Many chronic pain patients with medication-induced nausea do this successfully.

Good luck
cweinbl
csw2@bex.net
 
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MaryDeeGoettsche replied to cweinbl's response:
Thanks! I'll look into that! My doctor has said that the only pain meds that he could give me I am allergic to! Maybe I need to find another doctor! Too bad, because I really like him!

I've tried several oral anti-nausea meds without success. My stomach has a tendency to get nauseated very easily!

I appreciate your input! God bless you!
 
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lazydazey replied to billyf27's response:
I so agree billyf27! So sick of the hysteria about pain medications while the booze continues to flow......I had what used to be a friend call me a drug addict for taking pain meds to help manage pain from spinal problems, ironic thing-she was drunk when she called me that!
 
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vIvianwilso5 responded:
I was in pain management from January 2006 until June 2009, I spent 3 and 1/2 years in Pain Management, I suffered through more than treatment of pain, I was humiliated by the treatment, people look down on folks that take pain medicine, and most Doctors do too, I started pain management on low dose Lorcet 2 times per day, I went to work and at one point I had 2 jobs, I was never off work Why? I had to pay my pain management Doctor outrageous fees to take care of me every 3 months I had a Botox injection that cost out of pocket $330.00, not to mention insurance premiums, and on the 1st of the year when my annual deductable had to be paid I had to pay him $1700.00 out of pocket, this service is not reasonable, and to make matters worse, I had lumbar injections every 3 months with an additional co insurance of $230.00, I had no choice but to take pain medicine and work. I could handle my medicals and pain no more by July 2007, I went on SSDI, and pursued fixing my spine once and for all and getting out of the situation for good, I had already had 3 cervical fusions and 1 microdiskectomy, and December 2007, I had a lumbar diskectomy fusion, (rods In the Back) I was on Oxycottin and Lorcet, following this surgery nothing controlled my pain, it felt like I did not even have pain medicine, I left the hospital convinced that I would be on this junk the rest of my life, and I wanted nothing to do with that life, i became extremely depressed and the more the depression the more the pain, I changed to a Fentynal Patch and Lorcet no more Oxycontin and on June 20th 2009, I jerked the patch off and flushed all Lorcet, I refused to fill prescriptions for narcotic pain relievers, I sought help from my family Doctors to get rid of it, and there was no easy way to get rid of it, today if a Doctor wants to use a narcotic to treat my pain, it has a 2 week window following surgery and that is it, I only take Zanaflex a muscle relaxer and Naproxen 500 mg. prescription strength, I take 100mg. per day Nortriptyline, and for depression I take Prozac 20mgr. I learned that if I gain weight I have more pain, and if I do not walk every day I have stiffness and pain, in January 2011, I had my 6th spine surgery this time it was a cervical fusion, and I am happy to say that 6 days after this surgery, I stopped all Narcotic pain relievers without a problem. As for the extra weight I went on line and found a company called RocaLabs they have a program called the Gastric Bypass Without Surgery Formula, and I began this on November 18th2011 and on November26th 2011, I weighed myself and I lost 8 pounds and I am already feeling better, with a lot less pain. The next 10 years is going to be awesome
 
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cweinbl replied to vIvianwilso5's response:
Vivian, I'm pleased to hear about the good cervical surgery outcome. Cervical problems are much easier to repair than lumbar. But, if you needed powerful narcotic pain medication for your lumbar spine after surgery, how is it that you don't require it now? I believe that you said that nothing was controlling the pain after your lumbar fusion. So, how is it that you don't require pain medication for that now? Your recent surgery was cervical, not lumbar.

I'm happy that you're feeling better and losing weight. Good for you! You did say, "The next ten years is (sic) going to be awesome." That's wonderful, Vivian. So, have you stopped the SSDI? Are you planning a return to work soon? What type of work will you be seeking?

P.S. Nortryptaline and Prosac and BOTH anti-depressants. Why are you using two anti-depressant at the same time?
cweinbl
csw2@bex.net
 
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sonic1519 replied to cweinbl's response:
Im glad your doing better Vivian. Good for you.I too take lorcet
for a back injury.All the hoops the Doctors make you jump
thru is a shame. I understand why they do it, meaning all the other people using the system to get the narcotics.
I had to sign paper work stating i would not seek other doctors
or he would drop me from his pratice. they will only allow one
pharmacy. and the random drug testing. which i don't mind.
i'm glad to do that. it just makes it harder on the ones who really need it.
 
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annette030 replied to cweinbl's response:
When one is given general anesthesia, or even IV sedation and a spinal, the anesthesiolgist uses a group of medicines. Some are stored in fat cells and release very slowly over time. My doctor told me about 6-8 weeks. This can alter your perception of pain for quite awhile.

I had breast reduction surgery last January, and was able to cut my methadone in half within 2-3 weeks after surgery. I had much less back/shoulder pain, but also had less hip and leg pain than prior to surgery. It was about six months later that the hips and legs started hurting more again.

My surgeon said that she injects strong anti-inflammatory steroids among other things during surgery. It made my blood sugar jump up for a short time. But, I think the steroids helped with my general pain also.

Her nortryptaline and Prozac are both antidepressants but they target different neurotransmitters. Nortryptaline is a tricyclic antidepressant, and Prozac is a SSRI. It is not that uncommon to use both at one time.

Losing even a small amount of weight can also improve outcomes. It sounds to me like Vivian is doing all the right things to be well.

Take care, Annette


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