The CDC/DEA/FDA: have declared the ELDERLY, CHRONICALLY ILL AND THE DYING AS THE NEW DRUG ADDICT AND THAT THEY SHOULD BE REFUSED PAIN RELIEF
December 13, 2017
Dear President Donald J. Trump:
Dear Sen. Bill Nelson :
Dear Sen. Marco Rubio :
Dear Rep. Alcee Hastings :
The CDC, DEA and FDA have made a report about an Opioid crisis that is over exaggerated and many of the totals are falsely reported. Their accusations now have caused patients with chronic extreme pain to be viewed as having "DRUG SEEKING BEHAVIOR" and they are being attacked and rejected by pain management clinics that have been managing their care for years, by abruptly stopping their opioid medications without tapering them and treating them as if they are wrongly requesting pain medication. This is not morally right and is abuse directed against the sick, the elderly and the dying.
If you follow healthcare news, The CDC Opioid Guidelines Violate Standards of Science Research By Richard "Red" Lawhern — March 25, 2017
Photo: Shutterstock
If you follow healthcare news, you know that millions of US pain patients are experiencing a world of troubles. If their pain itself wasn’t enough, the US Centers for Disease Control and Prevention added to their agony in March 2016 by issuing a restrictive “Guideline” to primary care physicians on prescription of opioid medications to adults with long-lasting non-cancer pain.
The Guideline was phrased as advisory rather than mandatory. But that distinction quickly got lost as the US Drug Enforcement Administration ramped up disciplinary proceedings and prosecution of doctors for “over-prescribing” opioids like OxyContin and hydrocodone. Even before final publication, Congress made the Guideline mandatory for the Department of Veterans Affairs. More recently, the US Centers for Medicare and Medicaid Services are seeking to turn the Guideline into a mandatory restrictive practice standard for insurance reimbursement.
The new CMS standard will impose legal limits on the maximum amount of opioid pain relievers that a doctor may prescribe to a patient who isn’t actually dying of cancer. A maximum of 90 Morphine Milligram Equivalents per Day (MMED) will be imposed retroactively on patients who have done well on much higher doses for years, with no evidence of addiction or overdose risk. This despite the fact that the methodology of MMED is itself considered a meaningless medical mythology by many experts in the field.
Consequences of these changes are predictable. Even more physicians will leave pain management practice, throwing thousands of patients into the street without medical referral or support when they go into opioid withdrawal. Whole areas of US States are already no longer served by any pain management center. Potentially millions more patients will be forcibly tapered down or cut off cold-turkey, plunging them into agony and disability when they can no longer work or maintain family relationships due to under-treatment of their pain. More patients will be turned away by emergency rooms and family doctors. Suicide rates -- already on the increase -- will soar.
A deceptive bureaucratic maze adds deep insult and possibly criminal intent to this obvious injury.
Many of the core assumptions of the CDC guidelines are supported by only the weakest medical evidence – and others are clearly contradicted by the evidence. Medical professionals have published sharp criticisms of the CDC guideline and of the anti-opioid biases of consultants who wrote the document. A recent paper in Pain Medicine [ref: Pain Med (2016) 17 (11): 2036-2046] offers analysis that shows the writers of the Guideline deliberately distorted the evidence they gathered.
CDC consultants performed a literature review on the effectiveness and risks of three classes of treatments for severe chronic pain: opioids, non-opioid medicines like Tylenol, and behavioral therapies like rational cognitive therapy. Based on this review, they declared that there is very little evidence that opioids work for pain over long periods of time. But they neglected to inform readers that they had rejected any study of opioid medications that hadn’t lasted at least a year, then declaring that there was no proof that opioids are effective over the long term. But they did NOT reject studies of non-opioid medications or behavioral therapies that were similarly short.
As the Pain Medicine paper states, “To dismiss trials as “inadequate” if their observation period is a year or less is inconsistent with current regulatory standards… Considering only duration of active treatment in efficacy or effectiveness trials, published evidence is no stronger for any major drug category or behavioral therapy than for opioids.”
This didn’t keep the writers of the CDC Guideline from recommending that non-opioid treatments be favored over opioids, despite lack of evidence that they work. Nor did it keep the writers from exaggerating opioid risks – using the term “overdose” no less than 150 times in their biased and unscientific practice standard.
It is time for the CDC to withdraw its misdirected “opioid guideline” for a major rewrite. This time, the effort should be led by pain management specialists, not addiction psychiatrists. Pain patients or their advocates should be voting members of the writers group.
================
An expanded version of this article was published on March 15, 2017 after collaboration with Dr. Lawhern, under the byline of Frank Carroll in the Custer County Chronicle (SD), titled “Opioid Guideline Needs a Rewrite”.
=======================================================
I AGREE WITH EVERY STATEMENT IN THIS ARTICLE, BECAUSE THIS DOCTOR CAN SAY IT FROM AN UNBIASED POINT OF VIEW, AND FROM ONE WHO HAS COMPASSION FOR THE ELDERLY, THE SICK AND THE DYING. When you are sick and have chronic pain that never goes away, life is horrible and not much worth living. SO, I WOULD GUESS THAT THE CDC AND THE DOCTORS THAT AGREE WITH THEM WOULD SAY --- THEN GO KILL YOURSELF, or go FIND A DRUG DEALER AND BUY SOME HEROIN.
But, the directors of hospitals and pain management clinics are treating these guidelines as a law and are stopping all patients from getting their maintenance pain medications. The CDC/DEA/FDA agencies are overstepping the boundaries of their job classifications and are coldheartedly developing measures to cause many suffering members our our society to have no assistance to treat their disabling chronic pain. This is barbaric and has caused an increase in suicide deaths totaling 44,000, compared to overdose deaths of 16,000. The judgment of our officials has become clouded to the point that they want medicare to stop paying for treatments for pain and pain medication. The is a very large portion of our society that they seem to think of as drug addicts. What is more important, to bring comfort to the sick or just let them pine away or kill themselves from pain? Please have a heart and support a class action suit against these agencies that want to kill the elderly, the sick and the dying. There is a crisis of overdoses from heroin mixed with a deadly strain of fentanyl. But to classify all patients that take pain medication as drug addicts is going insane and to take away all pain medication that controls pain is also insane. Will somebody that has some sense take a look at what is happening and take a deeper look as to why these agencies are writing so many new regulations for the medical staff to follow that is causing so much pain for so many people. I supported another petition that only listed the DEA and the FDA, but realized that the CDC has taken the front line in this attack against all chronic pain patients and they need to be stopped.
In the (MMWR) report, titled: Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014
Weekly
January 1, 2016 / 64(50);1378-82
Please note: this report is from material over a 14 year period, during the last 7, Obama made medicine available to many indigent people who may have been soooo indigent that some, who were not true patients, may have sold them----but not ALLLL PATIENTS WERE SELLING THEIR DRUGS.
Historically, CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as "prescription" opioid overdoses (I have a real problem with this statement. read it carefully! ALL OPIOID PAIN RELIEVER DEATHS {NATURAL AND SEMISYNTHETIC OPIOIDS, (methadone was not included in the death list, although the drug is mentioned here) and other synthetic opioids) as prescription overdoses) No coroners reports can justify such a distinctly clarified report to specifically state written prescription opioid deaths.
(1). Between 2013 and 2014, the age-adjusted rate of death involving methadone remained unchanged; however, the age-adjusted rate of death involving natural and semisynthetic opioid pain relievers, heroin, and synthetic opioids, other than methadone {NOTICE HOW THEY SAY OTHER THAN METHADONE} (e.g., fentanyl) increased 9%, 26%, and 80%, respectively. I CHALLENGE THE VALIDITY OF THIS REPORT BECAUSE ON THE REPORT THAT I REVIEWED THEY INCLUDED ALL DEATHS OF ANY PATIENT THAT HAD DIED AND HAD EVER TAKEN AN OPIOID AT ANY TIME, NOT JUST OVERDOSE DEATHS. The sharp increase in deaths involving synthetic opioids, other than methadone, in 2014 coincided with law enforcement reports of increased availability of illicitly manufactured fentanyl, a synthetic opioid; however, illicitly manufactured fentanyl cannot be distinguished from prescription fentanyl in death certificate data.
These findings indicate that the opioid overdose epidemic is worsening.
THIS REPORT INDICATES AN ALTERATIVE MOTIVE IN THE COLLECTION OF THIS DATA BY ALL PARTIES THAT ARE LEADERS OF THESE ORGANIZATIONS, WHO HAVE NO COMPASSION FOR THE ELDERLY, THE SICK AND THE DYING.
There is a need for continued action to prevent opioid abuse, dependence, and death,
WHAT IS THIS: improve treatment capacity for opioid use disorders THEY MUST HAVE FOUND A NEW DISEASE IN A NEW SEGMENT OF OUR SOCIETY
and reduce the supply of illicit opioids, particularly heroin and illicit fentanyl." I THOUGHT THIS WAS THEIR JOB: TO REDUCE THE SUPPLY OF ILLICIT DRUGS FROM COMING INTO OUR COUNTRY AND BEING SOLD ON THE STREETS. SEEMS AS THOUGH THEY ARE BEING PAID TO GO AFTER ANOTHER POPULATION, RATHER THAN THE BIG DISTRIBUTORS. IT IS FAR EASIER OF A TARGET TO DIRECT DOCTORS TO GO AFTER THE ELDERLY, THE SICK AND THE DYING. THEN IT WILL APPEAR AS THOUGH THEY ARE DOING THEIR JOBS.
The CDC said there were more than twice as many suicides (44,193) in the United States as there were homicides (17,793).
The CDC lately seems to be very impressed with what they have to say about a lot of things and seem to think that no one can question their logic. However, I am very troubled by what they call "opioid use disorders". The only definition of a drug addict is just that, A DRUG ADDICT. But, they seem to believe that they needed to give the term an addition classification, which includes the elderly, the sickly and the dying.
PLEASE HELP US.
Sincerely,
Ms. Betty White
7630 Juniper Street
Miramar, FL 33023
Dear President Donald J. Trump:
Dear Sen. Bill Nelson :
Dear Sen. Marco Rubio :
Dear Rep. Alcee Hastings :
The CDC, DEA and FDA have made a report about an Opioid crisis that is over exaggerated and many of the totals are falsely reported. Their accusations now have caused patients with chronic extreme pain to be viewed as having "DRUG SEEKING BEHAVIOR" and they are being attacked and rejected by pain management clinics that have been managing their care for years, by abruptly stopping their opioid medications without tapering them and treating them as if they are wrongly requesting pain medication. This is not morally right and is abuse directed against the sick, the elderly and the dying.
If you follow healthcare news, The CDC Opioid Guidelines Violate Standards of Science Research By Richard "Red" Lawhern — March 25, 2017
Photo: Shutterstock
If you follow healthcare news, you know that millions of US pain patients are experiencing a world of troubles. If their pain itself wasn’t enough, the US Centers for Disease Control and Prevention added to their agony in March 2016 by issuing a restrictive “Guideline” to primary care physicians on prescription of opioid medications to adults with long-lasting non-cancer pain.
The Guideline was phrased as advisory rather than mandatory. But that distinction quickly got lost as the US Drug Enforcement Administration ramped up disciplinary proceedings and prosecution of doctors for “over-prescribing” opioids like OxyContin and hydrocodone. Even before final publication, Congress made the Guideline mandatory for the Department of Veterans Affairs. More recently, the US Centers for Medicare and Medicaid Services are seeking to turn the Guideline into a mandatory restrictive practice standard for insurance reimbursement.
The new CMS standard will impose legal limits on the maximum amount of opioid pain relievers that a doctor may prescribe to a patient who isn’t actually dying of cancer. A maximum of 90 Morphine Milligram Equivalents per Day (MMED) will be imposed retroactively on patients who have done well on much higher doses for years, with no evidence of addiction or overdose risk. This despite the fact that the methodology of MMED is itself considered a meaningless medical mythology by many experts in the field.
Consequences of these changes are predictable. Even more physicians will leave pain management practice, throwing thousands of patients into the street without medical referral or support when they go into opioid withdrawal. Whole areas of US States are already no longer served by any pain management center. Potentially millions more patients will be forcibly tapered down or cut off cold-turkey, plunging them into agony and disability when they can no longer work or maintain family relationships due to under-treatment of their pain. More patients will be turned away by emergency rooms and family doctors. Suicide rates -- already on the increase -- will soar.
A deceptive bureaucratic maze adds deep insult and possibly criminal intent to this obvious injury.
Many of the core assumptions of the CDC guidelines are supported by only the weakest medical evidence – and others are clearly contradicted by the evidence. Medical professionals have published sharp criticisms of the CDC guideline and of the anti-opioid biases of consultants who wrote the document. A recent paper in Pain Medicine [ref: Pain Med (2016) 17 (11): 2036-2046] offers analysis that shows the writers of the Guideline deliberately distorted the evidence they gathered.
CDC consultants performed a literature review on the effectiveness and risks of three classes of treatments for severe chronic pain: opioids, non-opioid medicines like Tylenol, and behavioral therapies like rational cognitive therapy. Based on this review, they declared that there is very little evidence that opioids work for pain over long periods of time. But they neglected to inform readers that they had rejected any study of opioid medications that hadn’t lasted at least a year, then declaring that there was no proof that opioids are effective over the long term. But they did NOT reject studies of non-opioid medications or behavioral therapies that were similarly short.
As the Pain Medicine paper states, “To dismiss trials as “inadequate” if their observation period is a year or less is inconsistent with current regulatory standards… Considering only duration of active treatment in efficacy or effectiveness trials, published evidence is no stronger for any major drug category or behavioral therapy than for opioids.”
This didn’t keep the writers of the CDC Guideline from recommending that non-opioid treatments be favored over opioids, despite lack of evidence that they work. Nor did it keep the writers from exaggerating opioid risks – using the term “overdose” no less than 150 times in their biased and unscientific practice standard.
It is time for the CDC to withdraw its misdirected “opioid guideline” for a major rewrite. This time, the effort should be led by pain management specialists, not addiction psychiatrists. Pain patients or their advocates should be voting members of the writers group.
================
An expanded version of this article was published on March 15, 2017 after collaboration with Dr. Lawhern, under the byline of Frank Carroll in the Custer County Chronicle (SD), titled “Opioid Guideline Needs a Rewrite”.
=======================================================
I AGREE WITH EVERY STATEMENT IN THIS ARTICLE, BECAUSE THIS DOCTOR CAN SAY IT FROM AN UNBIASED POINT OF VIEW, AND FROM ONE WHO HAS COMPASSION FOR THE ELDERLY, THE SICK AND THE DYING. When you are sick and have chronic pain that never goes away, life is horrible and not much worth living. SO, I WOULD GUESS THAT THE CDC AND THE DOCTORS THAT AGREE WITH THEM WOULD SAY --- THEN GO KILL YOURSELF, or go FIND A DRUG DEALER AND BUY SOME HEROIN.
But, the directors of hospitals and pain management clinics are treating these guidelines as a law and are stopping all patients from getting their maintenance pain medications. The CDC/DEA/FDA agencies are overstepping the boundaries of their job classifications and are coldheartedly developing measures to cause many suffering members our our society to have no assistance to treat their disabling chronic pain. This is barbaric and has caused an increase in suicide deaths totaling 44,000, compared to overdose deaths of 16,000. The judgment of our officials has become clouded to the point that they want medicare to stop paying for treatments for pain and pain medication. The is a very large portion of our society that they seem to think of as drug addicts. What is more important, to bring comfort to the sick or just let them pine away or kill themselves from pain? Please have a heart and support a class action suit against these agencies that want to kill the elderly, the sick and the dying. There is a crisis of overdoses from heroin mixed with a deadly strain of fentanyl. But to classify all patients that take pain medication as drug addicts is going insane and to take away all pain medication that controls pain is also insane. Will somebody that has some sense take a look at what is happening and take a deeper look as to why these agencies are writing so many new regulations for the medical staff to follow that is causing so much pain for so many people. I supported another petition that only listed the DEA and the FDA, but realized that the CDC has taken the front line in this attack against all chronic pain patients and they need to be stopped.
In the (MMWR) report, titled: Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014
Weekly
January 1, 2016 / 64(50);1378-82
Please note: this report is from material over a 14 year period, during the last 7, Obama made medicine available to many indigent people who may have been soooo indigent that some, who were not true patients, may have sold them----but not ALLLL PATIENTS WERE SELLING THEIR DRUGS.
Historically, CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as "prescription" opioid overdoses (I have a real problem with this statement. read it carefully! ALL OPIOID PAIN RELIEVER DEATHS {NATURAL AND SEMISYNTHETIC OPIOIDS, (methadone was not included in the death list, although the drug is mentioned here) and other synthetic opioids) as prescription overdoses) No coroners reports can justify such a distinctly clarified report to specifically state written prescription opioid deaths.
(1). Between 2013 and 2014, the age-adjusted rate of death involving methadone remained unchanged; however, the age-adjusted rate of death involving natural and semisynthetic opioid pain relievers, heroin, and synthetic opioids, other than methadone {NOTICE HOW THEY SAY OTHER THAN METHADONE} (e.g., fentanyl) increased 9%, 26%, and 80%, respectively. I CHALLENGE THE VALIDITY OF THIS REPORT BECAUSE ON THE REPORT THAT I REVIEWED THEY INCLUDED ALL DEATHS OF ANY PATIENT THAT HAD DIED AND HAD EVER TAKEN AN OPIOID AT ANY TIME, NOT JUST OVERDOSE DEATHS. The sharp increase in deaths involving synthetic opioids, other than methadone, in 2014 coincided with law enforcement reports of increased availability of illicitly manufactured fentanyl, a synthetic opioid; however, illicitly manufactured fentanyl cannot be distinguished from prescription fentanyl in death certificate data.
These findings indicate that the opioid overdose epidemic is worsening.
THIS REPORT INDICATES AN ALTERATIVE MOTIVE IN THE COLLECTION OF THIS DATA BY ALL PARTIES THAT ARE LEADERS OF THESE ORGANIZATIONS, WHO HAVE NO COMPASSION FOR THE ELDERLY, THE SICK AND THE DYING.
There is a need for continued action to prevent opioid abuse, dependence, and death,
WHAT IS THIS: improve treatment capacity for opioid use disorders THEY MUST HAVE FOUND A NEW DISEASE IN A NEW SEGMENT OF OUR SOCIETY
and reduce the supply of illicit opioids, particularly heroin and illicit fentanyl." I THOUGHT THIS WAS THEIR JOB: TO REDUCE THE SUPPLY OF ILLICIT DRUGS FROM COMING INTO OUR COUNTRY AND BEING SOLD ON THE STREETS. SEEMS AS THOUGH THEY ARE BEING PAID TO GO AFTER ANOTHER POPULATION, RATHER THAN THE BIG DISTRIBUTORS. IT IS FAR EASIER OF A TARGET TO DIRECT DOCTORS TO GO AFTER THE ELDERLY, THE SICK AND THE DYING. THEN IT WILL APPEAR AS THOUGH THEY ARE DOING THEIR JOBS.
The CDC said there were more than twice as many suicides (44,193) in the United States as there were homicides (17,793).
The CDC lately seems to be very impressed with what they have to say about a lot of things and seem to think that no one can question their logic. However, I am very troubled by what they call "opioid use disorders". The only definition of a drug addict is just that, A DRUG ADDICT. But, they seem to believe that they needed to give the term an addition classification, which includes the elderly, the sickly and the dying.
PLEASE HELP US.
Sincerely,
Ms. Betty White
7630 Juniper Street
Miramar, FL 33023
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