Treating chronic pain

Kudos for the letters regarding the treatment of pain in the midst of this heroin/illegal fentanyl epidemic.

I just finished a book by M.Scott Peck, MD titled “Denial of the Soul.” One statement stood out:

“Failure to treat adequately such moderate, severe, or excruciating chronic pain with pain relieving drugs is medical malpractice.”

However, at this time doctors are being encouraged to not prescribe any opioids, even for stable patients who have been treated for years and need them to function. Our government is going so far as to tell doctors what doses they should be prescribing and are often subjected to scrutiny or worse if they vary due to individual patient needs. It has already been published that the CDC guidelines from March 2016 were written with very suspect science and that studies with opiates were not comparable or as lengthy as other medications. How can you say that a drug is not effective for chronic pain if you only looked at studies for a year? This is what they based their conclusions on. Patients who have been stable on the same dose for 20 years or more will tell you that these drugs continue to work far longer than 1 year and even at the same dose for many people. Individuals don’t all metabolize drugs the same way, which necessitates some taking higher doses while others can take far less to control their pain.

I have a pretty serious back condition called spondylolisthesis, along with scoliois and arthritis. I had several epidural injections, which did not work. I’ve been taking tramadol and a non steroidal anti inflammatory drug for over 15 years for these conditions with much success. I’ve been advised by 3 excellent neurosurgeons that back surgery would be complicated because of the scoliosis and would most likely still leave me in pain. His advice was to continue my pain medications, continue to exercise, and continue to have massage therapy, all of which I have done. Until approximately 2 years ago, tramadol was not even a controlled substance. Apparently some people abused it, so now it is classified as an opiate in a somewhat less restrictive class. Because of that change I now have to sign a pain contract and submit to a urine test. This makes me feel like a criminal, even though I’ve done nothing wrong and the government is requiring this scrutiny.

At this time, hundreds of chronic pain patients, many of them veterans, have committed suicide due to denial of pain medications that they were stable on. They have either lost access to their 건마 medications due to refusal of doctors to treat them, pain management doctors leaving their practices, or are not being prescribed the dosage that they need. (This is well documented on pain sites and elsewhere).

When did it become acceptable to let people in pain suffer due to the actions of others who abuse these drugs? Why doesn’t Jeff Sessions target drug cartels and criminals who flood our streets with illegal drugs rather than targeting doctors and pharmacies who are only trying to treat their patients? New laws are in force to stop unethical doctors and pill mills from continuing to prescribe.

Denying needed medications to people who don’t abuse legal prescription drugs is doing nothing to combat this epidemic.

Doctors, why aren’t you speaking up for your pain patients? Your rights are being taken away, just as the rights of your patients are being taken away. And for those of you reading this who think that this isn’t your problem, remember an event such as a serious auto accident, a severe case of shingles, etc. could very quickly make it your problem.