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The Champion of Painkillers

The annual death toll from overdoses of painkillers has reached almost 15,000, prompting the head of the Centers for Disease Control and Prevention to term it an “epidemic.” But the American Pain Foundation continues to claim the risks are overblown. The advocacy group’s biggest supporter? The drug industry.

(Darren McCollester/Getty Images)

A version of this story ran in the Washington Post.

The news about narcotic painkillers is increasingly dire: Overdoses now kill nearly 15,000 people a year -- more than heroin and cocaine combined. In some states, the painkiller death toll exceeds that of car crashes.

The head of the Centers for Disease Control and Prevention has declared the overdoses from opioid drugs like OxyContin an "epidemic." And a growing group of experts doubts that they work for long-term pain.

But the pills continue to have an influential champion in the American Pain Foundation, which describes itself as the nation's largest advocacy group for pain patients. Its message: The risk of addiction is overblown, and the drugs are underused.

What the nonprofit doesn't highlight is the money behind that message.

The foundation collected nearly 90 percent of its $5 million funding last year from the drug and medical-device industry -- and closely mirrors its positions, an examination by ProPublica found.

Although the foundation maintains it is sticking up for the needs of millions of suffering patients, records and interviews show that it favors those who want to preserve access to the drugs over those who worry about their risks.

Some of the foundation's board members have extensive financial ties to drugmakers, ProPublica found, and the group has lobbied against federal and state proposals to limit opioid use. Painkiller sales have increased fourfold since 1999, but the foundation argues that pain remains widely undertreated.

The group says industry money has had no effect on its advocacy.

"I'm convinced with every shred of my body that our interest is improving the lives of people affected by pain," said Will Rowe, the foundation's chief executive, "and we want to do that the best way we can."

The problem isn't opioids, Rowe and other group leaders say. It's poorly trained doctors who prescribe them too easily or in excess.

Yet, critics say the Baltimore-based foundation is making it harder to address a major public-health problem.

"If you were a drug company, wouldn't it be smart to make it look like you had a patient-oriented group?" said Dr. Gary Franklin, a Washington state official who tussled with the foundation over new restrictions on high-dose painkillers.

Its funding makes the group "one and the same" with the pain industry, Franklin said.

In stories this year, ProPublica has detailed the close entanglements between pharmaceutical companies and groups representing doctors. Reporting showed that the positions of societies representing specialty physicians often reflected the views of their major funders.

The American Pain Foundation falls into a different category -- health advocacy. It harnesses the power of patient stories to sway politicians, state medical boards, judges and government health regulators, emphasizing that it represents grassroots voices.

ProPublica's review found that the foundation's guides for patients, journalists and policymakers play down the risks associated with opioids and exaggerate their benefits. Some of the foundation's materials on the drugs include statements that are misleading or based on scant or disputed research.

The group has intervened in court cases in ways that appear to counter its stated mission. In one example, it sided with Purdue Pharma, its longtime funder, to block a 2001 class-action case filed by Ohio patients who had become addicted to or dependent on the company's blockbuster painkiller, OxyContin.

And the foundation mobilizes patients to send "outraged" email messages to news organizations that run stories it believes reinforce "stigmas and stereotypes" about the risks of pain medication.

The group's board includes some patients but also doctors who are paid to speak and consult for drug companies, a researcher whose clinic has relied on their funding for survival and a public-relations executive whose firm represents them.

Last year, one board member was the lead author of a study about a Cephalon drug. Cephalon sponsored the study, and its employees were co-authors. The study found that the drug, Fentora, was "generally safe and well-tolerated" in non-cancer patients even though it is only approved for severe cancer pain.

Dr. Andrew Kolodny, a New York psychiatrist who heads Physicians for Responsible Opioid Prescribing, said the foundation has built credibility with politicians and regulators who may not be aware of the extensive industry ties.

"I don't think they realize that in many ways the American Pain Foundation is a front for opioid manufacturers," Kolodny said.

Rowe, however, said it can be hard for critics to understand the mindset of patients whose pain is so severe they are willing to risk serious side effects to gain relief.

"Policymakers can go to bed at night and say, 'Well, I protected society,'" by restricting access to a risky painkiller," he said. "The person with pain or the person with cancer could say, 'You know, I'm sorry. I'm living with this, and I want to take this chance.'"

'The System Is Awash in Opioids'

In the late 1980s and early '90s, physicians who cared for pain patients excitedly embraced opioids as a low-risk treatment for suffering.

Derived from the opium plant, opioids reduce the perception of pain by attaching to opioid receptors in the brain, spinal cord and elsewhere in the body.

"We bought into this idea that opioids would be effective and that the risk of addiction would be low," said Dr. Jane Ballantyne, a longtime pain expert and a professor at the University of Washington.

But along the way, pain doctors split. Some, like Ballantyne, began decrying the increasingly widespread use of opioids and questioned whether the drugs worked. Others, like the foundation's leaders, said the drugs were being unfairly maligned, making pain patients feel like criminals and discouraging doctors from prescribing them.

Despite the debate, sales of the drugs have skyrocketed.

Last year, $8.5 billion worth of narcotic painkillers were sold in the United States, according to the prescription-tracking company IMS Health. Enough of the drugs were prescribed last year to "medicate every American adult around the clock for a month," the CDC said.

"Right now, the system is awash in opioids, dangerous drugs that got people hooked and keep them hooked," said CDC Director Thomas Frieden in a recent news briefing.

Some of the pills have become household names: Vicodin, Percocet, OxyContin. On its own, OxyContin, an extended-release painkiller, accounted for $3.1 billion in sales last year, up from $752 million in 2006, according to IMS Health.

There's little dispute that many people endure chronic pain. In the past, many doctors, especially those providing primary care, ignored pain as a condition that warranted its own treatment.

A report from the prestigious Institute of Medicine last summer said 116 million American adults suffer from chronic pain. The report also cited legal and regulatory barriers to opioids, especially for cancer and end-of-life pain. The findings are lauded by the foundation as underscoring the concern about undertreatment.

In an email to ProPublica, however, the report's chairman said the study panel took a broad look at chronic pain and didn't examine the use of opioids with "rigor or detail."

"It does seem like the issue of opioid use is worthy of a separate study," wrote Dr. Philip A. Pizzo, dean of Stanford University's medical school.

Guides Offer Reassurance About Pain Drugs

The American Pain Foundation's website offers publications for patients, policymakers and even journalists. Each depicts the benefits of opioids, and each is underwritten by the makers of those drugs.

Its patient guide, paid for by four companies, discusses several treatments for pain. It says such pain relievers as aspirin, ibuprofen and naproxen commonly cause gastrointestinal bleeding or ulcers, delay blood clotting, decrease kidney function and may increase the risk of stroke or heart attack. And it warns patients to use these pain pills at the lowest dose and stop them unless clearly needed.

The side effects of opioids, on the other hand, are minor, and most go away "after a few days," the foundation's guide says. The underuse of opioids, it says, "has been responsible for much unnecessary suffering."

Patients, it says, shouldn't worry if they need more of a drug. They are not developing an addiction.

"Many times when a person needs a larger dose of a drug," the guide says, "it's because their pain is worse or the problem causing their pain has changed."

Another guide, written for journalists and supported by Alpharma Pharmaceuticals, likewise is reassuring. It notes in at least five places that the risk of opioid addiction is low, and it references a 1996 article in Scientific American, saying fewer than 1 percent of children treated with opioids become addicted.

But the cited article does not include this statistic or deal with addiction in children.

"I would much prefer that they would put in there something that could be substantiated by a real reference," said Dr. Leonard Paulozzi, a CDC medical epidemiologist specializing in drug overdoses. "That would present a much less rosy picture of the risk."

A recent report by the National Institute on Drug Abuse said estimates of addiction among chronic pain patients using opioids range from 3 percent to as high as 40 percent.

One Foundation-related publication this year provided a case study of how physicians could convince patients that the drugs are not addictive.

In an e-newsletter paid for by a drug company, Florida family physician Louis Kuritzky summed up the advice he'd give to a patient with knee pain: "We have learned that when patients have important pain problems like you do, they can use such medications successfully over the long term without any major risk of addiction."

This advice is contradicted by a respected medical review organization that looked at research on the use of opioids for osteoarthritis of the knee or hip. The Cochrane Collaboration concluded that "the small to moderate" benefits of opioids "are outweighed by large increases in the risk of adverse events" and the drugs should not be routinely used.

Kuritzky said he had not read the Cochrane review but believes that the downside of opioids is "very, very small" based on his experience with his patients.

"There are many issues where you will see wise men and women differ about the right answer to a difficult and important question," he said.

Rowe, the foundation's chief executive, acknowledged that some of its publications need updating. He pointed to additional materials on the group's new PainSAFE website, which include a broader description of the risks. But the foundation continues to post outdated guides and even refers to them in newer materials.

And while the PainSAFE site discusses the risks more completely, it is based on the assumption that the drugs have proven to work well for chronic pain sufferers. The site says studies have shown opioids improve daily function and quality of life for such patients. In contrast, a new guide by New York City's Department of Health and Mental Hygiene says there is "insufficient evidence" that "pain relief is sustained or function improves."

Dr. Lewis Nelson, chairman of the federal Food and Drug Administration's Drug Safety and Risk Management Advisory Committee, said he believes the foundation's guides can't help but be biased.

"If you're taking drug-company money and you're working as an advocacy group for patients, I think by definition you're biased," said Nelson, an emergency room physician in New York. "I take everything they say with a grain of salt."

Fighting in Court for Painkiller Access

The foundation doesn't just offer advice about opioids; it takes its arguments into court.

In 2005, it filed a friend-of-the-court brief in the U.S. Fourth Circuit Court of Appeals in support of Dr. William Hurwitz, a pain doctor in Virginia who had been convicted on 50 counts of drug trafficking.

The doctor had been accused of prescribing a single patient as many as 1,600 Roxicodone pain pills in one day. Hurwitz allegedly had prescribed that patient alone more than 500,000 pills between July 1999 and October 2002.

The pain foundation and its allies argued that the jury instructions in the case didn't distinguish between criminal behavior and mistakes by a well-intentioned physician. "It is not drug dealing to prescribe opioids to patients that might be 'suspected' addicts or substance abusers," the foundation and two other groups wrote in a brief.

Rowe said the foundation intervened in the case on principle, fearing the drugs would be "demonized." The appeals court threw out the conviction, but Hurwitz was retried and convicted on 16 counts of trafficking.

Years earlier, the foundation opposed several pain patients who had sued Purdue Pharma in an Ohio county court for allegedly obscuring the risks of OxyContin.

The foundation filed a friend-of-the-court brief backing Purdue, arguing that the health of all pain patients would be harmed if the class-action lawsuit went forward because doctors would become fearful of prescribing opioids.

Ohio was plagued by "opiophobia" according to a brief co-authored by the foundation and two smaller pain nonprofits. "Consequently many, if not most, of the state's residents had been deprived of adequate pain care," it said.

The Ohio Supreme Court decided in 2004 not to allow a class action.

In a separate federal case in 2007, Purdue pleaded guilty to misbranding OxyContin "in an effort to mislead and defraud physicians and consumers," according to a statement from prosecutors. The company agreed to pay $600 million in penalties. Three top officials also pleaded guilty to misdemeanors and agreed to pay $34.5 million.

Two months after the conviction, however, then-foundation chairman Dr. James Campbell praised Purdue in a statement to a U.S. Senate committee.

"I believe Purdue and its management deserve recognition for their contribution to the welfare of these many patients," Campbell wrote. Prosecuting the executives, he wrote, sent a "chilling message to those who dare to develop high-risk drugs for important diseases."

Campbell mentioned his foundation role in his remarks. Rowe said the former board chairman was not speaking for the group, and stressed that strict rules keep funders from influencing its work. The foundation is working to diversify its support, Rowe and others said.

Nevertheless, the group often finds itself on the same side as drugmakers in state and federal debates over how to regulate painkillers.

In 2009, the FDA suggested changes to address concerns about the risks of long-acting opioids, recommending that physicians and pharmacists be certified to ensure they had been educated about those risks.

Although foundation officials blame poorly educated physicians for the growing problems with opioids, the officials joined with other pain groups and drugmakers to assail the plan.

The FDA backed off key elements of its proposal last year and said doctors could voluntarily attend courses about the risks.

That move was criticized by an FDA advisory committee, which voted overwhelmingly that it wasn't enough to stem the tide of overdose deaths.

"When you look at 14,000 people dying on an annual basis, that's more than we've lost in Iraq and Afghanistan since 2001 in active duty," Dr. Mori Krantz, an advisory panel member and director of the prevention center at the University of Colorado in Denver, said during the meeting.

Little Evidence That Narcotics Work for Chronic Pain

Missing from the American Pain Foundation literature is any suggestion that the drugs don't work for many chronic pain sufferers.

Recent editorials in medical journals and scientific reviews cite little evidence of long-term benefit.

Most of the clinical trials for opioids to treat chronic pain "were small, lasted less than 16 weeks and excluded patients with a history of substance abuse, psychiatric illness and depression, who are at increased risk for opioid misuse and abuse," three physicians wrote in an editorial this year in the Archives of Internal Medicine.

"How can a therapy be considered if there's no evidence that it works and there's evidence of lots of side effects?" Dr. Mitchell Katz, one of the authors and director of the Los Angeles County Department of Health Services, said in an interview.

Rowe said he knows plenty of patients for whom the drugs work, "and their lives are together because they use them."

The foundation board's chairman and president, Dr. Scott Fishman, is stepping down at the end of the month. In a statement to ProPublica, he said his views have evolved and that he now believes opioids are both overused and addictive. But he defended the group.

"I have not always agreed with APF positions and have had disagreements with some APF leaders and patient advocates about many issues in pain management, including the appropriate place of chronic opioid therapy," wrote Fishman, chief of pain medicine at University of California, Davis.

"Nonetheless, I have always believed that patients in pain in the United States need strong patient advocacy, which APF has offered."

Brandon Adams

Dec. 23, 2011, 1:53 p.m.

In a series of four surgeries, I had to have parts of my tongue excised.

It was the worst pain of my life, and I’m well acquainted with pain.  I’ve broken my collarbone, part of my hand, and worst of all I have broke my femur into three pieces.  Those were nothing compared to tongue pain.  I was prescribed OxyContin for the femur and collarbone, and I found that I could manage the pain without those if I just kept the breaks immobilized.

However, the only thing that helped with the tongue pain was opioid drugs, specifically Vicodin.  You can’t immobilize a tongue without taking a complete vow of silence, drinking all of your meals through a straw, and working hard to override the urge to sweep your mouth every now and then.  NSAIDs are worthless for this kind of intense pain.

While I was still in a great deal of pain, my doctor cut me off from the pain meds.  I’m guessing he was worried about getting flagged by the authorities as being too liberal with pain meds.  As a result, I spent the next week in terrible pain.  I showed up to work, but got nothing done, all I did was try to distract myself from the pain by browsing the web for eight hours at a time.  Once I got home I’d try to kill the pain with a couple of drinks and distract myself with television.  Another week of Vicodin would have been far better for my quality of life.

Mark me down as a patient for which opioid drugs have worked.

Just more ridiculous stuff coming from one of the most useless industries on this planet.  Of course all of those side effects listed from other medication will send you back to the doctor as well.  Is anyone else thinking that doctors are just making money off of people through the side effects of drugs?  I certainly do…  Don’t forget it’s all doctor recommended…

Walter D. Shutter, Jr.

Dec. 23, 2011, 2:51 p.m.

I love opioid drugs because they work. Over the course of 20 years I have passed 4 kidney stones.  You don’t know what pain is until you are passing a kidney stone. Opioids got me through.

Now, with respect to the abuse and overdose issues, please be advised that opiods are dispensed from pharmacies in little vials.  On the little vials are instructions, in English, setting forth the dosage information to include how much of the drug to take and how often to take it. If you follow the instructions, you will not die of an overdose, neither will you become addicted.  If, however, you take the drug to get high, you will probably become addicted and may also die of an overdose.  But I figure that is not my problem, and i don’t think it should be the government’s problem, either..

Clark Baker (LAPD ret)

Dec. 23, 2011, 3:05 p.m.

Although this is an important story, this is NOT news.

The vast majority of non-profit “patient advocate” foundations and medical certifying boards are funded almost entirely by the drug companies and healthcare providers that profit from billing insurers, MediCare and MedicAid for delivering the products and devices advocated for.  The scheme provides a tax-deductible marketing campaign under the pretext of compassion and patient rights.  Without this scheme, HIV and AIDS would have never become the $300 billion industry it now is.

Having physically examined more than 2500 heroin addicts, it is clear that while the initial short-term opiate delivery provides effective relief to unaddicted patients, the ONLY relief to ADDICTS comes exclusively with the perpetuation of addiction and the delay of withdrawal - which is why Congress passed the Harrison Act nearly 100 years ago.

And unlike most addictions that temporarily suppress the production of various neurohormones, the pituitary gland does not restart the production of endorphin.  So once addicted to opiates, your neurochemistry is altered forever and you are a slave to the industry that poisoned you.

It’s a clever scheme that began with the Opium Wars and was sold in elixirs a century ago.

I have suffered chronic pain for 5 years. Until I had both shoulders reconstructed and a spinal fusion from L3 to S1 23 days ago. In the time before these surgeries i was not able to do basic physical mechanical movements. There is NO DOUBT that the Norco (10mg hydro/325 apap) plus the Soma and xanax made the night and day difference in my ability not just to work, but to enjoy my time with my family. Im 46. November 30th I had the spinal surgery. They did not want to provide me enough pain medication or the correct medication due to the 5 years I had of pain management. i was on 3 Norco a day. 1 Soma a day and 2 xanax a day. I am still and even worse, in extreme pain. I am not an addict but i do and did depend on the relief i received from the medications and now, at the worst possible time…I am flagged and they do not care about my pain. something is very wrong here.

Now for the other side- I have been a chronic pain patient for many years. The ‘usual’ pain incidents of sports injuries and surgeries (e.g.- 2 knee surgeries, rotator cuff, carpal tunnel, etc) have no relationship as to the type, and length, of pain I now suffer. I have a ‘status’ migraine (non-stop) going on 17 years; I get 8 additional waves of migraine/clusters every 24 hours. The clusters are so intense, you beat your head against the wall, or the floor, because it feels better. The doctors say it’s the worst pain that exists, and this sub-group of pain sufferers has a 40% suicide rate. There is absolutely no way that I can explain it to someone else; I use the mantra that a migraine is to a ‘regular’ headache as a cluster is to a migraine. Briefly, I have been everywhere and tried nearly everything from multiple surgeries to botox to acupuncture (I’m a Reiki master); I use self-hypnosis to get to sleep at night. I have been totally disabled for 12 years.
Nearly all migraine/pain control doctors in the central Ohio area have quit because of hassles with the Feds. At one point, to simply get a monthly refill of my prescriptions, I had to drive over 100 miles to OSU pain control, wait for 2-5 hours to be seen, go through the levels until you finally see the doctor, get the prescription and drive to the pharmacy and wait another hour. A typical day lasted anywhere from 6-10 hours simply to get prescriptions refilled; to add to the ‘fun’, I had ruptured a disc in my low back, and sitting was very painful. I still have to see a doctor monthly to get a simple refill of the same meds that I’ve been on for over a decade. The Feebs pulled my decongestants because someone else abused them (making speed). Without these meds, I don’t function at all- I lay in a darkened bedroom, head packed in ice and pillows; my ‘useful’ life simply ends; if this was all that I could look forward to, my actual one would shortly follow. As the old Native American saying goes: “Walk a mile in (my) moccasins.” For those who have no idea whatsoever about this (and other) kind of pain- stay the Hell out of our lives, and stop harassing and forcing out the few docs willing to help us. Address the drug issues through counseling. I would never take another pill in my life if I had the choice, but I don’t. At least attempt to learn of the other side before you act. There is no doubt that serious drug abuse is a major problem, but don’t throw out the baby with the bath water. These medications were made for people like me; I don’t want them, nor ever thought I’d be taking them; I was directly active in sports for over 36 years. I hope it never happens to you.

The American Pain Foundation is just a front for a major pharmaceutical company.  The U.S. healthcare industry has hundreds of pseudo patient care entities like the APF.  The Health Care Financing Administration - now the Centers for Medicare and Medicaid Services (CMS) - has been holding Open Door Meetings for at least 15 years at its main complex in Baltimore County.  These meetings were originally sold to federal career staff and the public by the Clinton Administration as working with the industry, allegedly our “partners” in making Medicare and Medicaid better.  Most of the people who attend these meetings are lobbyists and/or representatives from organizations like the APF.  You see them at Open Door Meetings for the dialysis industry, the specialty hospital industry, home health, nursing homes, hospitals, physicians, labs, etc. etc.  A hundred or so attendees might be in the main conference room with hundreds more linked in via conference call lines.  I attended these meetings regularly whenever my program areas were directly involved and I could count on one hand the number of times anyone asked a question about patient health and safety or expressed any concerns about patient health and safety.  With very few exceptions, every question was about how to get more reimbursement from these public programs.  These meetings are publicly advertised by CMS and anyone can call in or attend.  I wish ProPublica journalists would start attending regularly.  The APF is just another tick on this dog’s hindquarters.  The abuse and over-prescription of painkilling drugs like OxyContin and Percocet are a national disaster.  Millions of Americans are directly or indirectly affected by people who are addicted to these drugs, thousands of them are in prison, and thousands of them are dead.  I have a close family member who is recovering from addiction to drugs pushed by the APF.  This happened right after back surgery.  It nearly ruined this individual’s life and the lives of the people who were caught up in this struggle.  The physicians, who have a dismal record of taking drug company money, over prescribing this stuff, and policing their own guild system membership, are a national disgrace.  This is a bottomless pit for an ongoing ProPublica expose.

@ Clark Baker. - That was a great post.  One of the best ever on this website.  Thank you for sharing your knowledge about addiction.

Pete,

I was in similar shoes for most of my life.  Headaches started when I was twelve.  Horrible.  No one could figure them out.  I would feel intense, pulsating and radiating pain on one side of my head, then just as it began to get better, the pain would switch to the other side and I would spend another 12-24 hours in agony.  This would happen every week, so basically I would suffer greatly 2 or 3 days out of every week.  Missed so much because of it.  When I turned forty things got even worse.  Started getting nasty cramps and huge knots in my muscles.  Many days it felt like a gorilla was squeezing my shoulder or the back of my neck.  Ended up having several unnecessary surgeries as most doctors thought it was nerve compression.  I was on every pill they could prescribe and I know for a fact that without opiate based painkillers I would have taken my own life.  But here’s the punch line…FOOD ALLERGIES!  Turns out I was very sensitive to wheat, dairy and sugar.  (All inflammatory catalysts)  My diet had never been good; growing up in a very lax home.  We always laughed about the family sweet tooth.  Turns out it was literally killing me.  Please!  If you haven’t tried it, eliminate wheat, dairy and sugar for 30 days.  That’s all it took for me to notice a huge improvement.  I am no longer taking pills of any kind.  Now I am 95% pain free and will only get a headache or spasms after cheating and eating something I know I shouldn’t.  It may sound ridiculous, I know it did to me…how could something so awful be caused by something so simple?  Try it!

You really ought to look into the whole “pain relief” industry. Anecdotally, it seems a new “pain clinic” opens every week here in Central Jersey. My cynicism leads me to think the medical profession has found a loophole in reimbursement plans (public or private) making it very lucrative.

Clark,

I used large doses of opiate based painkillers for several years, between surgeries and trying to find out what was generating my debilitating pain.  Including injections.  When I finally found out what the problem was, I got better and stopped the drugs.  Felt bad for 48 hours and that was it.  THAT WAS IT!  Haven’t had another pain pill in a year and a half.  Never even an impulse.  And I am sure that I am not special.  So generalizing about broad use and its implications is unwise.

Those people raising cain about prescription drug killers have definitely had an effect:  I have recently begun hearing stories here in Western Pennsylvania about doctors who simply will not prescribe “C2” painkillers.

That is not good - no matter what the “Saving Americans from themselves makes me feel good!” types want to think - as poverty and the reliance upon government programs restricts the number of doctors who will even accept individuals who lack cash and private insurance.

So when one of the disappearing breed of doctors who believe in the Hippocratic Oath gets scared away from granting the mercy of pain relief, hundreds and even thousands of people who could not afford to “doctor shop” even if their government insurance would let them in the door are doomed to foreshortened lives of misery.

But what does that matter to those who see controlling society as their right?

Wendy Burnett

Dec. 23, 2011, 5:08 p.m.

First, a disclaimer: I’m a patient who has lived with chronic pain for almost 20 years. I have used opiods in the past, and will probably use them again in the future, IF they are still available, and I need them, however; I don’t use them on a regular basis (I’ve taken maybe 20 doses in the last year, most of which I used when I got injured at work.) I don’t like or trust the pharmaceutical companies; I have no ties, financial or otherwise, to any company that sells prescription medications; and I advocate other methods of pain control whenever possible.

That being said, the restrictions that are being put in place are making the lives of many chronic pain sufferers an agonizing horror that never ends. It seems to me that society as a whole is now fine with condemning chronic pain patients to live in a state of constant torture with no relief, so that we can protect those who CHOOSE to abuse opiods from the results of their own choices. Prevailing opinion seems to be that it’s okay if a patient who can no longer tolerate a life of constant agony with no hope of relief commits suicide, as long as we’ve prevented an addict from accidentally overdosing.

An addict is going to find something to be addicted to, and if they can’t get prescription opiods, they’ll use something else. I feel bad about the folks who get addicted after surgery or severe injury, but is it really better to force hundreds of patients to live through the horrors of unrelieved pain to prevent the chance that a few of them might get addicted? Shouldn’t we be focusing on follow-up care and treating the ones that do get addicted, rather than torturing patients by refusing to treat their pain?

Finally, there is a HUGE difference between addiction and physical dependence. I know, I’ve lived through both. I’ve become physically dependent on opiods several times in the past because I needed them for a couple of months, and withdrawal was quite uncomfortable, but I never had any desire to take more pills because of it. On the other hand, I’ve been ADDICTED to tobacco, and even after the physical symptoms of withdrawal had resolved, I craved it for years . . .  (be aware that if someone who is in pain is forced to stop taking pain medication, they ARE going to want to take it again simply for the pain relief, and that may NOT be a sign that they are addicted. If a patient is not provided with other, EFFECTIVE methods of controlling their pain, of course they’re going to want to take the medication that helped them.)

I wonder how many death certificates have identified cause of death as suicide secondary to untreated, intense chronic pain. Patients, especially those in severe chronic pain due to failed back surgery or other illnesses need opiate pain control.  Lets close down the pill mills and let us failed back surgeries live as near normal life as possible.
Those of us taking opiates for true pain control do not become addicted.   
I am hoping Charles and Tracy will investigate complications related to spinal surgery using Medtronic’s Bone Morphogenic Protein -2. The intense chronic pain second to inflammation related to the use of this product is unbearable.

I wonder how many death certificates have identified cause of death as suicide secondary to untreated, intense chronic pain. Patients, especially those in severe chronic pain due to failed back surgery or other illnesses need opiate pain control.  Lets close down the pill mills and let us failed back surgeries live as near normal life as possible.
Those of us taking opiates for true pain control do not become addicted.

Without painkillers, I can’t imagine how would I manage my back pain. God gave all these chemicals on Earth for both the good and the bad porposes. Beneficial balanced Usage depends on the wisdom of users.  .

Rush Simonson

Dec. 23, 2011, 6:34 p.m.

Having to cope myself with an occasional paralyzing migraine I agree with the use of opioids.  They are the ONLY meds capable of relieving the pain enough to endure until they resolve.  I have discovered my trigger, paprika, and now have fewer than 3-5 per year (accidental exposure in many cases). I have also learned that paprika is a common trigger. 

My wife however had suffered from chronic headaches for years before we met and even the opioids would not help her.  I did however find a wonderful naturopath, Matt Brignall who prescribed high dose magnesium.  This has helped 99% and she now rarely gets headaches at all.  She had been diagnosed by over 15 different physicians over the years to no avail.  She had been prescribed any number of different meds to no avail.  She also takes a liquid calcium/magnesium complex before bed and that has eliminated her heartburn and reflux.

I would encourage the many sufferers not to loose hope, but to continue to modify diet, lifestyle, chemical exposures and vitamins until they find their solution. Migraines are NOT normal and many times, as in our case, easily avoidable spices, and nutritional supplements can do wonders.  Opioids though are very important to help get us through those rough spots.

Clark,
Good post!  I’ll expand on this a bit more so that everyone knows exactly what has been going on, I am a fourth generation German-American.  My family fought on three sides of WW II.  German, American, and the Soviet Union.  This industry has done more to de-stabilize societies more than any other industry out there.  Many people do not realize the role IG Farben (now “Bayer”) played in that war.  They funded the German war machine, they supported the Nazi’s, they ran a concentration camp, they drugged Hitler, they drugged up soldiers, they drugged up everyone that they could.  A top U.S. prosecutor at the Neuremburg trials by the name of “Telford Taylor” stated factually that the the German war simply could not have happened without their influence (in short it was a drug war). 

And now they are still going strong.  Bayer recently spread the AIDS virus.  Of course when they do stuff like that, they do it with the hopes that people will then buy their other products to combat the disease.  All of that can be googled.  These people through our “Church Owned” hospitals are more of a danger to society than people really do want to realize (I personally believe many Churches have known about this for a long time).  At one point in time, German medicine was considered the best in the world, that’s why we (Americans) sent our doctors over there.  Now we are learning that these drugs that are proving to be more harmful than good (please reference the above “Bayer Aspirin”, Bayer’s most successful scheme) has been known by doctors to be harmful to you.  I personally think that this is a seditious act by our medical and some religious organizations.  They’ve know for years the harmful side effects of drugs and how highly addictive this medication is but they’ve said nothing because doctors were paid to “Recommend” them.
Anyways, I’ve lost many family members to that war.  I’ve lost others just to the drugs themselves.  At the end of WW II, we hung doctors and nurses in Germany for the atrocities they committed in those concentration camps, I don’t look at American doctors any better than that trash…

How many deaths are caused by non-addictive drugs like Vioxx?  For someone in chronic pain opiates are the safest drug one can take to manage pain.  They may be addictive but they work and don’t destroy your organs like alcohol or other drugs like Vioxx. 

Propublica ought to spend their resources on reporting on the effects of 300M injections of a toxic - heavy metal into the population. The gadolinium based contrasting agents used for MRIs, MRAs and sometimes for CT scans are making people sick and causing chronic disease, diseases that require the use of powerful non-toxic pain relievers. 

Now that Propublica is taking money from GE though their association with NBC (GE has a controlling interest) this story won’t get out.  Gadolinium is being found in the reproductive organs of women of childbearing years long after it should have been gone.  That’s right, should a woman conceive with gadolinium swimming around in her reproductive organs – a toxic heavy metal that is cause for alarm. But I guess you can worry about a few thousand deaths from people that probably want to die due to their chronic pain than a whole generation of people poisoned by these highly toxic, mitochondrial altering contrasting agents. 

Give me a break Propublica and report on something worth reporting on and leave those suffering from chronic pain alone.

As a nurse who has treated many patients in chronic pain, I take great offense to this article and it’s veracity.

Pain is real.  Pain is debilitating.  Thank goodness there are pain meds usually available for people who genuinely need them.  I write usually, because a witch hunt has ensued for the doctors who prescribe them.

To trash an entire industry which DOES help many people, is poor reporting and not something I’d expect frm ProPublica.

Please read Julia Kristeva’s wonderful book, “The Body in Pain” for more on the individuality of pain and it’s consequences.

M A Galbraith

Dec. 23, 2011, 7:55 p.m.

As a healthcare worker who has been with many patients in chronic pain, I take great offense to this article and it’s veracity.

Pain is real.  Pain is debilitating.  Thank goodness there are pain meds usually available for people who genuinely need them.  I write usually, because a witch hunt has ensued for the doctors who prescribe them.

To trash an entire industry which DOES help many people, is poor reporting and not something I’d expect frm ProPublica.

Please read Julia Kristeva’s wonderful book, “The Body in Pain” for more on the individuality of pain and it’s consequences.

The folks profiting from this are rationalizing their position.  I need pain meds because I’m too young for knee replacement surgery, but I don’t get them because my MD is an upstanding man.  Living in FL, I could get thousands of them if I worked the circuit of greedy physicians.  We have carloads of out of state “shoppers” getting all they can carry back home.  They OD in hotel rooms some of the time and enable others to do the same.  My pain is severe but the effect I get from these drugs doesn’t help the pain as much as make me not care for a bit of time.  I manage on under 50 pills a year, stay fit and use crutches as needed.  People need to deal with their obesity, fitness levels, nutrition, blood pressure, diabetes (etc).  Let’s get real folks!  Beware of big Pharma.

Will Harper is right on. I went on the Eat 4 Your Type diet and within 24 hours felt healthy for the first time in years. For a type O blood chemistry, corn, wheat, and dairy are the cause of much suffering. Get this book and read up on your blood chemistry. Try the diet for your blood type and within 24 hours there’s a good chance you will feel better. I can’t believe more people don’t know about it. I buy all the second hand copies of this and Cook 4 Your Type and give them away to anyone I meet who has ‘allergies,’ ulcers, stomach problems etc.

For pain treatment, try Trigger Point Therapy Workbook, by Clair Davies. I have given away dozens of this one to everyone I know who complains of pain. Years of all kinds of medications for my back pain that didn’t help and an hour reading up on the source of the pain and the treatment and it’s a new world.

I don’t tolerate chemicals (drugs) well and Eat 4 explains why. You, too, have a chance at relief without strong drugs. It’s no wonder the doctors don’t mention these helpful books, that would be giving money to publishers instead of the medical establishment. (Have you seen the fancy buildings some of the clinics are building? More empty cubic feet of space than I can believe. And fancy landscaping. And so on….we are paying for it all…...)

These two books will change your life.

The problem with pain management is that is not well understood . Failure to treat pain can result in greater sensitivity and more pain. It is also tolerated more by some than by others. It is often a symptom of a disease that we don’t know how to treat therefore the symptom is treated.

Catherine A. Fitzpatrick

Dec. 24, 2011, 12:43 a.m.

I’m so glad you’ve performed this public service of investigative journalism. What’s particularly important about this article is your expose of the use of fake sock puppets on forums comments like this one, which are run in fact by the drug companies.

Let me present to you two real cases right in my neighbourhood so you can try to grasp the real horror of this situation. When you say 15,000 died, that’s a statistic. On the way to addiction and on the way to even dying, the addicts leave a trail of damage and destruction.

I had never heard the term “roxies” until I saw it crop up on my son’s friends’ Facebook pages. I googled it and peered into a chamber of horrors I had no idea existed before.

One young friend in high school without any pain or disease issues at all became addicted to roxies after first smoking weed for a number of years—severely addicted very rapidly, so that soon he was stealing from friends everywhere to maintain his addiction. Half a dozen laptops disappeared and more, and he was so disoriented he was even arrested in school with a lot of drugs in his backpack and forced into a program—but to no avail. Addiction is VERY hard to treat. Finally he was arrested again and sent upstate for 40 days to detox and rehabilitate. I pray for him every day. But…I’m skeptical. I know treatment plans don’t work—I’ve seen family members never recover from addictions. Addiction is a horror to a family and a community that you just cannot understand with your apologia for drugs here.

To be looking only at “harm reduction” and “pain alleviation” in social policies and never at the destruction of *addiction* and the ineffectiveness of current treatments is to be committing a grave evil.

I learned as I began to ask more about this issue that another friend of my son’s is also wholly addicted to roxies—even smoking them, which is even more dangerous. While he did have health issues as a child, he was cured and had no pain and no justification to be on any painkillers. But he, too, graduated from pot to oxycontin and now family members are actively afraid he will overdose and die. It’s a horror to watch, as nothing will get through to him.

These were two kids I have known since they were babies, watching them grow up. To see their lives ruined in this fashion and their families traumatized and community harmed from theft and violence and fear is just awful. It’s due not only to the greed of pharmaceutical companies, but the apologists we see here for screw-you hedonism and laissez-fair “legalization”.

Brandon Adams

Dec. 24, 2011, 1:37 a.m.

For the record, I’m not a sock puppet.  I’ve seen WillHarper’s posts at the CSM, and I’m reasonably sure that he’s not a sock puppet, either.

I also don’t doubt that some unscrupulous doctors write dubious prescriptions for anyone that knocks on their door.

However, it seems to me that those that are prone to destructive relationships with drugs are probably going to end up getting their escape with whatever is available.  If you take away painkillers, they’ll just move to heroin, or to alcohol.  Meanwhile, the people in pain are left suffering while the addict is still getting high.  Maybe the person in pain will desperately turn to getting relief from street drugs, while they expose themselves to all the dangers that come with street drugs.

It’s a similar story with pseudoephedrine, though thankfully that’s just strictly controlled rather than banned.  However, I’d still be better off if I could just buy a few months’ supply from Costco than have to visit the pharmacy every couple of weeks when my sinuses act up.

Since these drugs are already prescription-only, I can’t conceive of any legislative solution that isn’t going to end up discouraging many doctors from prescribing to patients in need.  Some will be so worried about the potential punishment for mistakenly prescribing to an abuser that they’ll put the pad away and tell their patients to take Tylenol, instead.

As an aside, the most dangerous component in Vicodin isn’t the opiate, hydrocodone.  It’s the acetaminophen – Tylenol, the same that you can buy over the counter.  As little as 6 grams per day can lead to liver failure.  The Vicodin preparation I’ve been given has 500mg per pill.  If you start exceeding the recommended dosage then the acetaminophen will kill you way before the hydrocodone does.

I am pleased to see that a number of people who suffer from chronic and severe pain have commented.  I am such a person, suffering from rheumatoid arthritis.  My doctors wasted a lot of time and destroyed any quality of life I could have had during the early phases of onset by doing everything they could to avoid prescribing narcotic pain relievers, which turned out to be the only thing that worked.  In my opinion, this was malpractice, plain and simple. I had to do the footwork myself to get referred to a pain clinic associated with a major hospital in my area.

You ought to see the people who come to this clinic—people with advanced cancers, severe back problems, neurological issues, you name it.  It is pitiable. On my first visit to this clinic, I was in such terrible pain that I could not hold a pen to sign my name.  When the pain was full-blown, I was just short of losing consciousness and could not “will” my body to move from its curled-up position.  Isn’t that just how victims of severe torture describe their pain?  Like others with this kind of pain, I feel a cold terror and dread at the thought of having to go through it.  Treatment with narcotic pain relievers has given me my life back.

I hate these doctors and pharmacists who enable and encourage irresponsible use of these medications, and I hate even more the zealots who would close off this treatment option or make it more difficult for people like me (and the doctors who treat me for pain) to get the medication I need.  If these zealots experienced this kind of pain for just one hour, they would be screaming for relief.

I hope this debate can be kept in balance.  The most important thing is for people who need treatment with narcotic pain relievers to get their treatment without hardship.  If anyone wants to stand in the way of that, they may as well go ahead and kill us.

Perspicuousme

Dec. 24, 2011, 8:30 a.m.

There is far too much profit to be made off of things that don’t really solve your symptoms and even more profit if they end up adding a few more issues on. That is how and why modern medicine is not quite understood fully in many areas to the extent most people believe it is. Why sell something that actually heals the patient when you can sell something that doesn’t 100 times over for the same price or more? The best solution is to go to the source of the problem and remove it. Pharmacies should be regulated and put in their place so that good doctors can actually do their job without a conflicting influence looming over them.

I’m not a sock puppet but perhaps Catherine is. I do suffer from chronic pain and there is no cure or treatment for the disease I suffer from.  This article is a hit job by Propublica.  They were the only media outlet that WAS reporting on a new man-made disease called nephrogenic systemic fibrosis but should be called gadolinium associated systemic fibrosis.  This disease is caused primarily by GE’s product Omniscan and Bayer’s product Magevist both of which I’ve had.  Gadolinium is a toxic heavy metal and over 300M+ doses have been administered worldwide.  They are finding gadolinium in brain tumors, it passes the blood brain barrier and these patients have normally functioning kidneys.  They are finding it in the reproductive organs of those with normal kidneys as well. 

If it becomes more difficult to treat my pain I’m going to show up on ProPublica’s door so that they can see the suffering for themselves.

ProPublica just made a deal with NBC.  Remember NBC use to be totally owned by GE but recently sold an interest in Comcast but GE still has control of NBC.

If you don’t believe in reincarnation, read the comments:  I suspect that you will be able to detect shades of Carrie Nation.

Or at least her argument that because some abuse, all should pay.

It is very sad indeed that there is still this conversation going on.  There is no one that can claim with a straight face that there is not a REAL problem with pain management in this country.  And that opioids are part of an effective way to address that pain.  And that there is tremendous pressure on doctors to avoid the use of opioids for legal reasons as well as unfounded fears of addiction.  The gist of this article seems to indicate that pain is not an epidemic and that even if it is it’s probably largely overstated by the people suffering from it and that even if that is not true opioids are not all that effective anyway.  This is a travesty.  I know people personally who suffer chronic pain that have been successfully treated with opioid drugs and have been “shut off” because of all of this ridiculous nonsense about addiction and legal requirements that are heaped on doctors who could prescribe them.  Then you have the prosecutions as well which serve as a not so subtle cue to pharmacists and doctors that you better watch yourself or we might come after you if you prescribe or fill “too many” prescriptions for opiods.  Until pain is treated as a REAL medical condition that needs to be addressed and treated with whatever works best and without stigma there will continue to be articles like this which downplay the suffering of people.

I am sorry, love ProPublica, am on one of your advisory boards, but could not disagree with this article’s trajectory more strongly,

Do you KNOW what it is like to live in intractable pain?  I pray you never do…but as one who was in a near fatal taxi crash 6 years ago…and who almost lost my leg…and who was in excruciating, unbearable pain for over a year…I could not have LIVED without OxyContin!  It was a godsend.  It allowed me to continue to work, to continue to be a little bit of who I am in the worst times…and to think, and partially function.  nothing else could have done this. 

I thank god, and every pharmaceutical company associated with this class of drugs, for continuing to fight to make and market them.  They were there when I needed them…and OxyContin WORKED. 

Once the pain lessened, i was easily able to get off the drug…though I am still in pain daily, but manage it with over the counter Advil, no need for OxyContin. 

That is because I followed the instructions.  I did not abuse it.  I used self control. 

And it literally saved my life.

I think that ProPublica must avoid any tinge of self-satisfied superiority while reporting tough issues.  Because you do not know it all…and though I am sure your facts have been checked…there is an all important human element, and elemental truth you have missed.

This is disappointing on two levels: that one of the few pain patient advocacy groups clearly has serious conflicts of interest; and that ProPublica has uncritically embraced a mainstream position on the issue of opioid prescribing.  I have been unlucky enough to come down with a neurological issue that I will probably be living with for the rest of my life.  I have tried every medication, acupuncture, meditation, etc.  And it seems like opioids are so far one of the few options that allow me to maintain a normal life.  I am not looking forward to a lifelong struggle to avoid addictive behaviors while keeping pain from taking over my life.  The added suffering of being treated like an addict by some doctors, pharmacists, and others is significant.  And what I fear most is being left to face the pain without any opioids at all, because that is a level of suffering I will not be able to endure.  I also feel sorry for compassionate doctors whose job is to judge my pain and the level of risk I represent, particularly when legislators make the stakes higher every year.  I would like ProPublica to shine light on this dark corner of the healthcare system, and why patient care is being dictated by frequently uneducated moralistic forces.  And no, no one is paying me to post this comment.

Thank you, DB, Brandon, and the others who are capable of making the distinction between those who would abuse cough syrup if nothing else, and those many, many who suffer intractable and debilitating pain.  I swear!  I think they are putting something in the water that chemically inhibits the ability for critical thinking.  Addictive behavior and overdosing is a symptom of psychological and emotional despair.  Young people and adults who don’t care anymore what happens to them personally.  They are consciously or subconsciously on the road to self destruction.  That is entirely different from those who use these drugs because they suffer PHYSICAL dysfunction and the sever pain that is often part of it.  C’mon!

Of course this painkiller issue wouldn’t be a issue at all and would just cost a quarter, if some really wise and bold guys in the world think tank could successfully make a little attempt to change the way and attitude with which the global public look at the actual killers and killing things. Banning dangerous killer: the private guns in the global street and legalizing opioid type things instead, would have facilitated a peaceful situation of lesser crimes and made possible lesser people die but more happily.

The Crown of Canada is 100% percent responsible for forcefully inflicting on me the suffering of excruciating back pain and at least these pain killers are helping me making a difference.

The gifted plants are one of the cheapest vegetables on Earth, the idiot politicians of the past abnormally made it expensive for their personal monetary gains eventually and this fact is going unaddressed. All of wise ones of us can help make it normal again by awareness, knowing the true fact: much less people will die from abusing the plant when all of a sudden stops the globally occurring millions of deaths, caused by the drug manufacturing and trafficking businesses, just in a second! Let’s push Brilliant: Obama and he is the only available Leader with enough Wisdom capable of making the World safer than ever and a less violent place. 


Shahislam

Wendy Burnett

Dec. 24, 2011, 5:25 p.m.

I am not a sock puppet, nor are most of the patients who have weighed in on this article. If you don’t believe me, you can check out transformyourchroniclife.com/wordpress/2010/01/08/big-pharma-and-chronic-illness/ and/or search the tag “big pharma” on that blog. You’ll see that I seriously dislike pharmaceutical companies and the way they do business.

Not liking pharmaceutical company practices does not mean that I don’t understand that without them, many lives would be totally unliveable. Without insulin, diabetes would be a death sentence; without antibiotics, people would die every day from minor infections; and without access to opiods, THOUSANDS of people who live with chronic pain would commit suicide.

Yes, addiction is an issue, but legislators and law enforcement agencies that have no understanding of medical issues need to keep their noses OUT of medicine. How can someone who has never had to deal with severe, unrelenting, never-ending pain ever understand how absolutely necessary pain medications are just to be able to get out of bed in the morning? How can someone who knows nothing about medicine or medication tolerance issues judge how much medication is needed to ease MY pain, or the pain of someone dying of cancer? How does an “addictionologist” who has no training in pain management (and doesn’t (or won’t) understand the difference between PHYSICAL dependence and psychological addiction) justify making people with a legitimate need for pain relief live (and die) in agony to protect people who don’t WANT to be protected, who have CHOSEN to take drugs inappropriately?

How do YOU justify it? I’m sorry, my father was an alcoholic, as were many of my relatives on both sides. I’ve LIVED with addicts most of my life, and I know the horrors that come with that; but I also know the torture of pain that doesn’t end, that never stops for so much as a second, that keeps you awake for days because there’s NO position that doesn’t hurt. I wouldn’t force that on my worst enemy, let alone some stranger who never did anything to harm me, and I truly don’t understand how anyone else can.

Alcohol causes much more death and destruction than opiods ever have, but we all know what happened in this country when we tried to eliminate it. Do we really think that making opiods more and more difficult to get is going to prevent addiction? People will just use other, more available drugs to feed their addictions. Have all the drug laws already on the books stopped addiction? Prohibition failed, the drug war on drugs is failing, so now we’re attacking legal medications?

Responsible adults, US 99%ers, are now faced with the prospect of having to “tough it out” adding opiates that have been around for centuries to the DEA’s list of what the government knows is better for US than ourselves, perpetuating the most useless federal agency in existence. Thanks for making something that accounts for abuse by less than 0.001% of the population a ‘problem’ for anyone with chronic pain. Is an ulcer or the risk of a heart attack a better alternative as MDs will now pretty much prescribe mostly those awful NSAID, which are good for the most part for only reducing swelling and don’t relieve pain for a lot of US. With all the problems out there, I’m surprised and disappointed that Propublica would harp on this issue. Now the real bad guys will start making bootleg versions of these opiate drugs and just like poisoned bootleg liquor during the 1920’s, they’ll kill more people than are currently abusing and ODing. Way to go!

I hope the authors of this article enjoy the holidays knowing that they have made treating chronic pain even harder for those of us suffering and for the doctors that try to help.

If one does not suffer from chronic pain, they have not a clue what it is like for some to be so pain stricken they can’t get out of bed or start their simple daily task at home.

Drug abuse is the cause of death, not the prescribed dosage of opiates. Doctors never tell their patients to shot up their medication in an illegal fashion. Drug abusers will fine their way to death regardless of federal regulation; an abuser knows the risk. The suicide rate would rise above overdose rates if people were not allowed medical help with their pain.

Even with pain medications, I still have to push myself through the day, yet without my pain medication I would not want to live at all. I take Hydrocodone and am a bit of a none believer of the opiate Oxycontin because I do see more addiction, crime and abuse with it in my area. I do think Doctors need to be held accountable for the number of Oxycontin patients they have and should be made to do clinical profile updates with pain management contracts with these them. Doctors who write an unreasonable amount of these medications to one patient should be Jailed at risk of losing their licence.

I had two sisters die six months apart by morphine overdose. So do not tell me I do not understand the problems that arise from these drugs. I pray fro anyone who is suffering with pain of any scale.

My second thought is drug companies billions in profits should not be allowed to play a role in FDA affairs or the courtrooms of America.

For five long miserable years I have suffered from surgical mesh inside of me after two double-hernia repairs. Five years. 24/7 every day. Push your knuckle into your arm until it starts to hurt a little more than you can stand. Now imagine that pain in your groin on either side of your scrotum. Every day, every hour of the day, and being told there is virtually no way to fix this. If it were not for opioids I don’t know how I could possibly function and get work done to take care of my family. Its not severe pain, on a scale of one to ten, I’d say its a solid 3.5 24/7, with times it jumps up to a 4 or 5 if I’ve been running errands, or grocery shopping.

Its disgusting, judgmental articles like this, and attitudes like this, combined with the junkies out there, who make life for people with real, debilitating chronic pain a living hell. Its bad enough we have to deal with this very real, constant, life-chaning disruptor nearly always through no fault of our own, but the process of even being treated is a lesson in humility. All I am guilty of is having two hernias repaired and my body basically deciding to grow scar tissue around the places the mesh is tacked into my groin. That’s my crime. As punishment for my crime of having two hernia surgeries (the first one failed, the second one done six months later), I get to enjoy costly monthly doctor’s visits, random pill counts to see if I am using my medication as I should be, urine tests to see if I am actually taking the pills instead of selling them (yes, they want me to fail the test for opioids), and the uncomfortable and awkward discussions with the pharmacy employees who see what looks to them like a normal middle aged man who can get around just fine and doesn’t “look like” he needs pain meds.

The author of this article owes me and everyone in chronic pain like me a big apology. I don’t know about or belong to any pain advocate organization. I just know that I go through absolute misery to get treatment for something that isn’t my fault, have subjected myself to all kinds of other treatments in my groin from nerve burning to full pelvic injections of steroids, I could go on and on, to try to stop this living hell I was sentenced to for the crime of having a double-hernia twice.

Christmas Eve, two years ago, my pain management doctors office made me give urine before I could get my prescriptions. There are no refills allowed for opioids. That means monthly visits. I have already gone to the bathroom before I went. Not once in any visit did I ever “fail to comply” as the chart says, by failing a drug test for other substances, or fail to have the right pills, I’ve been a perfect, model citizen patient. In spite of that, Christmas Eve, 3PM two years ago, I had to leave the doctor’s office, go buy a quart of Gatorade and then stand in the little bathroom right outside the desk at the doctor’s office, pitifully trying to urinate for them so I could get my medication and go home for Christmas.

To say opioids don’t work for chronic pain is bunk. Without them, I simply can’t function. With them, the pain is masked just enough that I don’t have to suffer as much. Opioid don’t cure anything, but without them, my life would be unbearable. If you’re a woman, perhaps you won’t understand the level of pain and sensitivity a man has in his scrotum, but every man reading this should thank God or whoever they believe in that they don’t have to deal with what I have to deal with, or they would repent of their wicked disparaging of chronic pain sufferers and leave us in peace.

frank tarantino

Dec. 25, 2011, 1:43 a.m.

The authors of this article appear to me, to be part of the moral majority
Social Values goon squad, they are everywhere..
I think Pro Publica, was bought up by Gods chosen Money Managers, and is no longer a viable source of unbiased information.
Common Dreams is also a tainted site.
The way these groups work, is to appear Progressive, but actually are part of a worldwide group of brainwashed humans whose ultimate goal is world subjugation and destruction.
The people at the higher levels actually believe that they were chosen by god to be the caretakers of vast sums of wealth, they are not concerned with how they accumulate the money,defrauding the federal and local governments of trillions of dollars.
Over the past twenty years they have grown exponentially, so they are able to control mostly all branches of government, the feds giving out trillions of dollars to WHO KNOWS.
The CEO of the investment banking company,( forget his name) slipped when he said he was doing gods work, the public though he was arrogant or just kidding. No he was deadly serious, ( the employees of the firm are getting an average of three hundred thousand dollar bonuses, mail clerks, janitors, dishwashers all the way up.the ladder.
The good thing is , some of us see through the fog and will be able to
snatch the taste of victory from their mouths, and let the Light of Universal Love eliminate the darkness in all its forms of expression, from our conciousness.
An analogy is Light expands, and darkness collects upon itself, so we both will occupy the Universe, Light becoming infinitely expanding , and darkness being the black hole that it is, becomes infinitely small.
IS THIS RESOLUTION AGREEABLE TO EVERYONE ?

WaIlter D. Jr., barney, Pete, Ronnie, TN Jed and some more sufferers of pain,
I understand very well the kind of sufferings you have and been enduring, especially without pain-killers help; because I am just another one like you.
Let’s try to generate awareness about the benefits of making these natural drugs cheap like spinach or lettuce by legalizing its production and as free bonus help reduce immediately at least 50% of the neinous crimes committed by guns on the global streets only for drug-traficking-business.

Here is the difference, between legitimate pain patients, and “addicts”: Addicts don’t have a prescription.  Doctors are able to distinguish between regular patients with severe pain, and addicts.  For every Rush Limbaugh, there are dozens of people with a legitimate need for these medications, who will suffer horribly, if they are unable to obtain them.

Opiate addiction is indeed a serious problem that requires medical treatment, but banning or severely restricting access to these drugs for patients with a legitimate need for them is throwing the baby out with the bathwater.

Authors of articles like this one have probably never experienced long term, debilitating pain, like I have for the past six years due to an orthopedic surgeon’s “mistake” (read: negligence). Absent access to such drugs I would not be able to function as a reasonably normal person and probably would have killed myself several years ago. I know there are abuses, what is a reasonably available alternative? Until you can answer that question, I suggest you confine your opinions to some other sphere of scientific inquiry.

There have been too many doctors in Okc, Ok that refuse to give pain medications especially to women. Clearly to us believers these are the satanists who don’t give a dam and are not in medical field for people’s sakes. Some are highly suspect of writing the diagnoses and using a prescription for the patient to fill and sell for the doctor. Those are the drug pushers out on the street and raising med prices. When is it going to be STOPPED???

Clarification: prescription to be written for the patient TO the doctor’s pill-pusher to sell on the streets, NOT the patients! Bust’em DANO!!!

This is quite interesting that ProPublica is taking on this issue in the postulating manner they have.  For one thing everyone that is remotely informed knows that Big Pharma doesn’t make that much money on opiate pain meds.  And when Pharma isn’t making money poisoning people the health-insurance companies’ profits will rise. Everyone knows if you can’t patent a drug you won’t have an unfair competitive advantage or the government enforcing your patent rights. It is interesting that ProPublica is smearing the very cost effective, least toxic, pain management tool available; the opiates.

We now know that the health insurance industry’s profits will be healthier if they can keep their insured healthy or at the very least medicated if the pain is chronic.  This is because under the new ObamaCare legislation they can’t kick the sick and dying off their rolls, they can’t deny you for pre-existing conditions and they can’t limit your life-time benefits.  So this leaves these health insurance executives to pay attention to what is depleting their profits.  By far it is the ongoing science for sale mentality that permeates the industry and of course toxic drugs and treatments.  Pharma rigs clinical trials, a few doctors get rich on a new product or drug, a lot of people get poisoned and PhRMA makes billions. Then after years and years we just might get the FDA to take the product off the market but not until industry can submit cousins and children of these products and drugs so the process can start all over again.

Medical marijuana and the opiates are relatively safe, and have medicinal properties.  If the health insurance industry truly wants to be profitable they must embrace these natural products that are the least toxic and have the most benefit for about 1/100th of the cost.  Are they up for it? That’s a decision the health-insurance industry is going to have to make but if I’m an executive of the health-insurance industry and I want to stay in business I’m going to look at the cheapest, least toxic solutions and embrace those.  I might even donate to ProPublica to do a story exposing the truth about these issues because it benefits the health-insurance industry and the safety of their insured. 

Opiates are by far the best choice for chronic pain so it is likely a pharmaceutical company would love a story like this in the hopes that if they create a public outcry about the very safe but “industry labeled evils” of the opiates then when this unnamed pharmaceutical company comes out with their next block buster Vioxx-like drug the public will just eat it up like cotton candy.  Of course ProPublica doesn’t say how many people died from taking Vioxx a year.  That number in total was 27,000 – 55,000 according to whistleblower Dr. David Graham in testimony before the US Senate. Perhaps ProPublica doesn’t know they are being used or they are being funded by a company that has an ulterior motive for wanting to harm the millions in chronic pain that don’t ask for much and only want to function at a level that allows them to be present emotionally during important days like Christmas and to minimally function on other days without wanting to be taken out back and shot.


See this very important article on famous opiate addicts that lived a fairly normal life and were able to function.

http://www.druglibrary.org/schaffer/library/studies/cu/cu5.html

catherine martin

Dec. 25, 2011, 7:33 p.m.

I would love to have the 4 years these pills have stolen from my daughters life.  The pain I have suffered at the hands of a stupid pill I would rather pass a kidney stone have my finger nails pulled out any thing AND MY PAIN CANNOT BE HELPED WITH ANY PILL I would gladly walk a day year whatever in your shoes BUT to walk a day in the shoes of a parent of an adict there is no greater pain!! and I would not wish this on any one

Get your daughter treatment, but not at the expense of people suffering with debilitating chronic pain. I am not an addict, but I am dependent on opioids, because without them I cannot work, I cannot stand up and walk for very long, or sit up a desk because of the downward pressure on my groin where the mesh is inside of me. I’m sorry that your daughter is an addict, but the truth is its addicts that make it hard for people with real chronic pain problems to get their pain managed so they can try to lead normal lives. I can quite assure you, even as a parent of three myself, you would absolutely not want to live with the pain I live with in my groin in yours, and you would not gladly walk a day, even a few hours in my shoes without begging for relief. Again, I’m sorry you’re hurting because your daughter is an addict, but the truth is not everyone who has a prescription and treatment plan to manage quite debilitating pain is an addict, or an abuser, and myself and people like me have absolutely nothing in common with your daughter’s addiction. I’ll let you in on a little secret, those of us with chronic pain don’t get the euphoria and high from these pills that addicts do, we get mild relief allowing us to function. Your daughter is getting high, I’m not. If I want to get high, I sure wouldn’t do it with pills. The pills didn’t steal four years from your daughter’s life, her addiction did. She could have been addicted to anything, from food to booze to gambling or any other number of compulsive behaviors. She’s compulsive with pills and thus an addict. I have nothing in common with your daughter. I’m not getting high, I’m getting enough relief to not suffer and support my family while doing so.

TN Jed, there was a good article on HP regarding surgical mesh.  I truly have empathy for you and understand what you are going through.  The FDA banned them but not before they allowed another company to push through approval of a similar product.  Here’s the link. 

http://www.huffingtonpost.com/bruce-a-barron/medical-practice-government-regulation_b_995419.html

Conventional medicine is saying that there is no cure for gadolinium associated systemic fibrosis or nephrogenic systemic fibrosis but I’m looking to find answers elsewhere.  I totally agree with your post. People that don’t live in constant pain should have to walk in our shoes a couple of days to know what it is like before they make blanket statements about pain management.  Take care.

This article is part of an ongoing investigation:
Dollars for Doctors

Dollars for Doctors: How Industry Money Reaches Physicians

ProPublica is tracking the financial ties between doctors and medical companies.

The Story So Far

ProPublica is investigating the financial ties between the medical community and the drug and device industry. In October 2010, ProPublica compiled the list of payments that drug companies make to physicians and built a publicly searchable database so that patients could look up their doctors.

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