That is a question for all of us. Currently we have the FDA, DEA and lawmakers, none of whom have a medical degree, making medical decisions for millions of Americans who have to live with chronic pain. How does this happen ? Why do we allow them to stick their noses into these decisions ? Just what is the greater good they are protecting ? These questions need answers. Why are we allowing people to suffer in pain ? That is the bottom line.
Yes once again this is about chronic pain. The more I write about this the more I learn from people here on DK. The comments are really informative, well okay most of them. Some are just nuts but even those are interesting. I have "met" some very nice people who are suffering just as I am from chronic pain. We have many different causes for our pain. We have had many different experiences but they are eerily similar even though we live in different states and different parts of the country.
Let's dive into this head first. The DEA feels it is their job to protect the public from illegal drugs. They have botched this job from the start. Sure they make arrests and confiscate a ton of cash and drugs but they will never ever win. We saw this with prohibition. The only winner was the criminal gangs that sold illegal liquor. They stop one and another steps in to take his or her place. They confiscate drugs and the gangs just make more. They confiscate money but it is just a drop in the bucket to the drug lords. So now the DEA is changing it's tactics. It is going after doctors and pharmacies. Why is it doing this you ask ? Because they need to feel they are winning at something. If you keep losing you can get demoralized pretty quick. Besides the public seems to be clamoring for action against prescription drug abuse.
America is being led to believe that prescription drug abuse is a huge issue. The DEA is cooking the books to promote this scenario. Some of their "Stats" are really unbelievable. Let's take this one.
there were 16,235 deaths involving prescription opioids in 2013, an increase of 1% from 2012
This is from a Forbes.com article from January 2015. The link is here.
http://www.forbes.com/...
Now that really sounds scary. Heck 16235 deaths from prescription opioids. Sounds like a huge amount but let's put it into perspective. There are 100 million Americans that suffer from chronic pain. So that is 16235 out of 100,000,000 people. That is less than 1% Now let's look at those stats a little closer. Are these deaths where the opioids are the main cause of death or are they counting in any deaths where the patient was on one of these drugs ? I am willing to bet it is the 2nd option. They are counting deaths where the patient happens to have been on them like a Hospice patient who is ravaged by cancer and is on morphine to ease their pain. They die from their cancer yet the coroner lists morphine as a 3rd or 4th or 5th contributing cause of death. So they really died from cancer yet they are counted as one of the 16235 deaths from prescription opioids. That is kind of nuts. That is like saying a guy who was shot in the head died from the heart attack the bullet caused. "See your Honor the man died from a heart attack not the bullet he can not be guilty of murder." Can you see this going over well in a court of law ?
Well how about ER visits for drug overdoses ? Are these stats cooked as well ? Well that depends on how you look at them. There is a program called DAWN. It stands for Drug Abuse Warning Network. They collect data from hospital ER visits. From their web site I found this statement about their work:
Overview of DAWN
DAWN is a public health surveillance system that reports on drug-related visits to hospital EDs.4 DAWN is used to monitor trends in drug misuse and abuse, identify the emergence of new substances and drug combinations, assess health hazards associated with drug use and abuse, and estimate the impact of drug use, misuse, and abuse on the Nation's health care system.
and this is how they decide what data to include:
ED visits eligible for inclusion in DAWN
A DAWN case is any ED visit involving recent drug use. DAWN cases are identified through the review of ED medical records in participating hospitals. DAWN captures both ED visits that are directly caused by drugs and those in which drugs are a contributing factor but not the direct cause of the ED visit. These criteria encompass all types of drug-related events, including accidental ingestion and adverse reaction, as well as drug misuse or abuse. Within each hospital, 50 percent to 100 percent of the days of the month are systematically selected, and a census of ED visits is selected for review for these days.
So what does all of that mean ? Well it means that they collect the information on drug related ER visits but these stats can be very misleading. If you take just the visits that were directly caused by misuse or abuse of drugs you can get a pretty accurate picture but when you start using the data from the 2nd portion where they include drugs as a secondary cause you start to get into a murky field of stats. This example would be included in the second set: A guy who is being treated for chronic pain happens to be walking along a sidewalk when he gets hit by a car. Well the 2 broken legs, the shattered arm and the various scrapes and contusions were caused by the car accident but because the guy happens to have some Loritab in his system the visit counts as drug related. The DEA likes to use the 2nd set of stats. It is much more impressive and scary. You can take a look at the charts and more info on DAWN here at this link:
http://www.samhsa.gov/...
Let's head on down below the orange snow doodle
So we know the DEA is playing with the stats. Heck we all do it to prove our point. It is said that 75% of the population would cook the books on stats to show their point. Oh wait I just did it myself. Doctors are not off the hook either. There are about 4000 doctors certified in pain management. Too bad there are 100,000,000 patients in pain in America. Lots of other doctors have gotten into the pain management racket.
Yes pain management is a freaking racket. See patient office visits don't bring in much money from insurance companies. They knock down those bills to about $75.00 per visit. Sure that can add up but it won't pay for the vacation home or the fancy sports cars. So what to do? They push shots and other therapies that bring in a nice check for the 15 to 20 minutes they take to perform. There are hundreds of different shots they can recommend. Sure these shots can work to bring temporary relief for some but most do not do anything except bring in more cash to the practice. Another little trick they do is bring in PAs or NPs. PAs are physician assistants and are much cheaper and less educated than another doctor. They may have had no training in pain management at all. I like to call them the pushers. That is their main job pushing the shots. They at least have some medical training. Unlike some other groups in this fight like the DEA or lawmakers.
We have lawmakers designing laws to stop the abuse of prescription medications. The problem is they do not have a medical background and they do not understand the system. The end result s laws like those in many states but Tn has some real doozies. Now in Tn. you have to go into the office every 30 days for an exam. They also wrote it into the law that law enforcement can walk into any clinic and with no warrant and no probable cause ask for and get all the records of the clinic. That is just nuts. The only common thing among all these laws is that they cause legitimate pain patients to jump through all kinds of hoops to just get their medications.
Lastly we get to the FDA. Thanks to them our drugs cost more than in most other countries. They take forever to approve new drugs. They allow drug companies to extend their patents so generics are slower coming onto the market. They have yet to demand that drug companies come up with a way to make the opioid medications impossible to abuse. That may be impossible but they can try and make them less able to be tampered with.
I actually forgot one last party in this fight. The drug companies. They have a big dog in the fight. The more addictive their drugs and the less tamper proof they are the more drugs they sell. They are setting up a perpetual motion machine. They are also real good about sending drug reps out into the field and getting doctors to prescribe the new drugs. They take them out to eat and just about all of the big companies have had issues with the truth, telling doctors all kinds of benefits of prescribing them off label for all kinds of things. Between these companies and the stranglehold by the DEA we have seen the cost of these drugs skyrocket.
The only people in this that have the goal of being pain free is the patients. Doctors running pain management clinics have a vested interest in NEVER fixing us. The drug companies have a vested interest in keeping us in pain. The DEA has a vested interest in keeping people addicted as well. If we had no addicts we wouldn't need them. Besides they have to have a new role. The fight against marijuana is winding down as more and more states approve medical marijuana or even full use legalization. All of these groups are working together. Isn't it time the patients got together and said enough is enough ? 100 million is a heck of a lot of people. We can wield some real clout if we band together. We need to work to change society's view of addicts. We need to change society's view of pain and pain medication.
Pain is not a good thing. No one ever deserves to live in pain. We are not weak willed. We are not little wussies who can't handle a little pain. Don't believe me ? Live with our pain for one freaking day and you would be screaming for more drugs. We don't want to be walking around like a zombie and we sure are not looking for some kind of high. We want relief from pain. We want to be treated like humans and we want our lives back. Come on society get off this puritanical kick that pain is good is sure as hell is not. It is not fun to spend our days fighting pain just to do the basics in life like going to the grocery store, going to the movies, eating out at restaurants or just spending time with our families. Don't we qualify for that ? Are we not members of the human race? The answer is YES. So society you can stick your scorn and derision right where the sun don't shine. You can take that puritanical view that pain is good a cram it in as well.