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During the recent Interim Meeting of the American Medical Association, the organization’s president, Dr. Barbara McAneny, told the story of a patient of hers whose pharmacist refused to fill his prescription for an opioid medication. She had prescribed the medication to ease her patient’s severe pain from prostate cancer, which had spread to his bones. Feeling ashamed after the pharmacist called him a “drug seeker,” he went home, hoping to endure his pain. Three days later, he tried to kill himself. Fortunately, McAneny’s patient was discovered by family members and survived.

This story has become all too familiar to patients who legitimately use opioid medication for pain.

Since the Centers for Disease Control and Prevention published its guideline for prescribing opioids for chronic pain in March 2016, pain patients have experienced increasing difficulty getting needed opioid medication due to denials by pharmacists and insurance providers.

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More troubling are recent press reports, blog posts, and journal articles that describe patients being refused necessary medication or those dismissed by their treating physicians, who practice in fear of regulatory reprisal. At the interim meeting, the AMA responded to these developments, passing several resolutions against the rash of laws and mandatory policies that limit or prevent patient access to opioid painkillers.

The CDC designed its guideline as non-mandatory guidance for primary care physicians. But legislators, pharmacy chains, insurers, and others have seized on certain parts of its dosage and supply recommendations and translated them into blanket limits in law and mandatory policy. Today, in more than half of U.S. states, patients in acute pain from surgery or an injury may not by law fill an opioid prescription for more than three to seven days, regardless of the severity of their surgery or injury.

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Although many of these laws exempt patients with chronic or cancer pain, in practice they often affect those with long-term pain, like McAneny’s patient. Some insurance companies and major pharmacy chains, like Walmart, Express Scripts, and CVS, also have mandatory restrictions on the opioid prescriptions they will fill. In addition to imposing supply limits, insurers and pharmacies are increasingly using the CDC’s dosage guidance (the equivalent of 50 to 90 milligrams of morphine a day) as the basis for delaying or denying refills for long-term pain patients, even though the CDC guidance is intended to apply only to patients who have not taken opioids before.

The Drug Enforcement Administration and some state medical boards are also using this dosage guidance in ways that were never intended, such as a proxy or red flag to identify physician “over-prescribers” without considering the medical conditions or needs of these physicians’ patients. As a result, some physicians who specialize in pain management are leaving their practices, while others are tapering their patients off of opioids, solely out of fear of losing their licenses or criminal charges.

The laudable goal of these laws and policies is to stem the tide of unprecedented overdose deaths and addiction in the U.S. But here are three interesting facts: Opioid prescribing is currently at an 18-year low. The rate of prescribing opioids has dropped every year since 2011. Yet drug overdose deaths have skyrocketed since then.

Recent data from the CDC suggests that illegally manufactured fentanyl, its analogs, and heroin are responsible for well over half of all overdose deaths. Stimulants like cocaine and methamphetamines are responsible for another third. Deaths related to prescription opioids come next in line, although many of those who died were not the intended recipient of the prescribed medication. In addition, most deaths involve multiple substances that are used in combination, often including alcohol.

The vast majority of people who report misusing prescription opioids did not get them from a doctor under medical supervision, and as many as 70 percent reported prior use of substances like cocaine and methamphetamines.

Conflating the misuse of opioids with their legitimate medical use, and treating all opioids — illegal or prescription — alike is stigmatizing patients for whom opioid painkillers are necessary and medically appropriate.

There’s no question that taking opioid medications carries risks: The CDC places the risk of addiction with the long-term use of opioids at 0.07-6 percent. The risk of addiction justifies judicious prescribing, trying other forms of treatment before prescribing opioids, and carefully screening patients for a history of addiction and mental health issues when opioids are being considered.

But most patients who use opioid medication for pain do not become addicted, although they may develop physical dependence. Addiction is the compulsive use of a substance despite adverse consequences. Appropriate medical use is just the opposite, use on a set schedule as prescribed with benefits to health and function.

Nearly 18 million Americans currently take opioids long-term to manage pain; many of them have complex medical conditions. When appropriately prescribed opioids are denied, patients whose pain has been well-managed by them may experience medical decline, lose the ability to work and function, and resort to suicide. Denying opioids to patients who have relied on them — sometimes for years — may cause some to turn to street drugs, thereby increasing their risk of overdose.

Dr. Terri Lewis, a researcher and rehabilitation specialist, recently conducted a nationwide survey of 3,000 pain patients. More than half of those surveyed (56 percent) reported disruptions in care or outright abandonment by their physicians. Among those reporting disruption or abandonment, many experienced adverse health consequences (55 percent) as well as hopelessness or thinking about suicide (62 percent) as a result. In other surveys, physicians said that they were prescribing fewer opioids or ceasing treatment of pain patients altogether because of regulatory scrutiny, even in cases where they believed that doing so would harm their patients.

The CDC guideline and its progeny of laws and policies have created chaos and confusion in the medical community. Some physicians are telling their patients that changes in the law are the reason they are tapering them to a preset dosage of opioids or off of opioids altogether. Yet the specific dosage thresholds in the CDC guideline were never intended to apply to patients currently taking opioids. Indeed, nothing in the current legal or regulatory environment justifies forcibly tapering a patient off of opioids who is doing well, and there is no solid evidence to support such a practice.

Some physicians are also using the CDC’s dosage thresholds, or simply their patients’ use of opioids, as a reason for abandoning them. Abandoning pain patients out of fear of regulatory reprisal may violate a physician’s ethical duty to place a patient’s welfare above his or her own self-interest. If serious harm results from abandoning a patient’s care, it may also serve as a basis for discipline or malpractice claims. In addition, physicians and pharmacies have responsibilities under the Americans with Disabilities Act not to discriminate on the basis of a patient’s condition, including chronic pain, or a perceived condition, as when a person with pain is erroneously regarded as a person with opioid use disorder or addiction when there is no clinical basis for that perception.

The AMA’s recent resolutions formally push back against what the AMA calls the misapplication of the CDC’s guideline by regulatory bodies, legislators, pharmacists and pharmacy benefit managers, insurers, and others. The resolutions underscore that dosage guidance is just that — guidance — and that doses higher than those recommended by the CDC may be necessary and appropriate for some patients.

The AMA also took issue with the recent practices of regulatory bodies that subject physicians to oversight and potential sanction solely because of the opioid dosages they prescribe. Medicine involves treating patients individually, and weighing the specific risks and benefits of treatment in each case. Taking this capacity away from physicians hamstrings their ability to treat their patients — as does requiring them to practice in an environment of fear.

Epidemics instill fear, but physicians have a responsibility to rise above fear and advance the interests of their patients. The AMA’s action in advocating for patients and for the right of physicians to practice individualized care is an important effort in beginning to rebalance the scales in the joint goals of reducing pain and opioid addiction.

Kate M. Nicholson, J.D., is a civil rights and health policy attorney who served for 20 years in the Department of Justice’s Civil Rights Division, where she drafted the current regulations under the Americans with Disabilities Act and managed litigation nationwide. Diane E. Hoffmann, J.D., is a professor of health law at the University of Maryland School of Law, director of its Law & Health Care Program. Chad D. Kollas, M.D., chairs the American Medical Association’s Pain and Palliative Medicine Specialty Section Council and is the medical director in palliative and supportive care at the Orlando Health UF Health Cancer Center.

  • New scientific study:

    Alternative treatments are often better for noncancer pain, the study found.
    The study examined more than 26,000 people experiencing chronic pain.
    Opioids were only marginally better than placebos at treating pain and improving physical functioning.
    It’s estimated that at least 2 million Americans have opioid use problems.

    “our results support that opioids should not be first-line therapy for chronic noncancer pain,” lead study author Jason Busse, an associate professor and researcher at McMaster University’s Michael G. DeGroote Institute for Pain Research and Care.

    The study was published today (Dec. 18) in the journal JAMA.[America’s Opioid-Use Epidemic: 5 Startling Facts]
    ————-

    Lawhern, PhD you need to further study your clinical trial.

    • T. Trust,
      There are all kinds of ‘studies” like that, only becasue they are funded, get promoted by mass media, and reinforce the current narrative. They are mostly deceptive. People are being hoodwinked by unscrupulous scientists.

  • Doctors are suffering from the same diseases they are treating, should be the next article on Statnews. What can we do?

    • T. Trust, (link provided below)
      Watch the clip and tell me again that their is no pain scale of 10. And tell me what your pain scale would be without your pain medicine. Alternately, the 0 to 10 is not the only scale to rate pain. I am suppressed you are not aware of it.

      https://youtu.be/QL6z1DnoJao

    • To bobbie in this youtube video and other sufferers, I cry for you.
      We know that these kinds of nerve pain are absolute murder. I pray that you all have an caring, understanding doctor like I do who says to call if there is anything else I need.

  • to DMN ok so you are a pain specialist ok I went to one who says the same thing you are saying I am sorry for your pain but remember everybody else is suffering all kinds of ways that leaves people they feel useless wow thanks for calling us liars. If that’s what you think of us then I don’t want to here your excuses. After that so called Dr. saw me he laughed at me would not even look at my x-rays and threw me out and ask for blood. I told my Drs. and told them never to send me to him ever again. I have a rare disease that destroys my body the ligaments and everything on top of that the government forced me to have 4 surgery’s in one month. Discover I might have the disease but didn’t say a word. One year later the rods put in had to be removed because you could see them under the skin but see them anyways. He was gone so someone else had to take out the top of each rods. now I am still going over and have sever pain from all the ribs being removed bone from the leg being put in lungs collapsing 2x . then years later I fell down 7 stairs and broke the bone from my leg in a v shape heading for my heart if I fall one more time bye cruel world. Now with severe pain in bed for hours. my tolerance to pain is high so how can you say that I don’t feel pain you and the other dr. sorry don’t get it. My doctors have detoxed me 4 times I guess they don’t seem to care after doing all the urine test and all requirements and the hospital say we don’t want you here. nice hah This is sick I feel for everyone and please understand every ones pains are bad and hurts them to suicide measures. Many diseases are rampart in this world help don’t scream at suffering patients . They don’t deserve it nobody does.

  • I wish to comment to DMN, I am so thankful to hear from a pain Doctor who really understands what it is like to be in pain. Dr.DMN, it sounds like you have some of the same problems I have I hope you will please help me understand some of the things I have been told as I have Dr,s telling me different things. I have no cartilage left in my neck, herniated disc , T3 and T4, L4,L5, and S1 also was told years ago at C7, is it still herniated if the cartilage is gone? I also understand what you are saying , when you advise others not to say the pain level is 10+. But I hate trying to give a number on the pain scale, to anyone who hasn’t been through pain that felt like torture to them. I worked as a aerospace machinist, 7-8 years longer than I could have if it were not for taking meds. I am sure you understand all this did not happen to my body overnight. First I was told I had bulging disc. What the final nail for me was the herniated disc I believe it is the L5,or S1, the one that causes shooting pain down your legs. I could not stand to move, I could not straighten up, lie down or sit. I was bent over holding on to the arms of a recliner trying to get in it, when my boy friend (we were never married but I hate using that word at my age) came home from work. I said I have to go to the hospital. He took me it was probably about 6pm when we got there. I was crying like a baby, I could not stand to move any part of my body. That was the worst pain I have ever had in my life, so I use it as my 10 on the pain scale. If I had been told I had to live in that amount of pain or die. I would have said please let me die. It took until 1am with them giving me drugs ( I am not sure what) to stop my crying and get me into a bed. I was still in pain though until morning, 6-7 am I think. Then a doctor came in and gave me a epidural , oh my God I was so thankful. I want to tell you I am not a wimp. I had two children and I had been hit by a car went up on the hood and was then thrown onto the street, all before this. Then in December 2012 I was a passenger in a car hit by a semi truck the car did a 180 spin slamming me into the concrete medium. I had rotator cuff surgery nerves burned in lower back 2x right knee 1x. I can not even guess how many steroid shots I’ve had in my right shoulder, hand, knee, neck, hip and back. Now an oral surgeon tells me the shots will cause bone loss and make me worse. I also had months of PT. every year since that wreck. I feel I need the shots and the pain meds both, if I am to have any kind of normal life. I am one of those now told I am to be weaned off the pain meds. I told the doctor I am not a damn baby nor am I a dope addict. I can either take the meds and do a few things like go out to the grocery store etc. or not take meds and lay on the couch watch TV. go on my laptop and wait to die. I will not say my pain is a ten if I sit and don’t move, it is maybe 3-5. But if I try to wash dishes, walk in a store etc. it can get 7 to 9. so I lay on the couch most of the day. I don’t know what to do. Should I have more shots I feel they do ease the pain, even though I still need the meds. I have been on the same dose for years and have not ever ask for more. Now from what I have read I know it is even lower than the CDC guide lines. But I am miserable because I have pain all over my body I am afraid to leave the house it hurts so much to walk. I am not taking the meds I have because I fear the pain will get worse and I will not have anything, so I am living in constant pain. I try to save the meds for times I have to go out and I only go out if I have to. This is not living it is existing. I was told to put my cat down because it had no quality of life and that broke my heart. Well I feel I have no quality of life now. So why is it inhumane to not let your pet live when you love it like a baby. If I had a baby that was in pain no one would say that. I cannot help feeling angary and asking how is this humane. It is BS. I worked hard for years. I was on my own at 17 years old and have been independent ever since. Now I am 68 this is what they call my golden years. Well I would call them rust. I do not enjoy anything, I cannot even do what needs to be done. If you are a pain doctor, I am asking you PLEASE speak out, I have a herniated disc pressing on my spinal cord, you know what it is like. I have been told surgery won’t help. I don’t know what to do anymore. I know I have written a lot here I truly thank you if you take time to read it and I will appreciate any advise you may give me, for I am feeling hopeless and lost. Carol

  • I’ll die before I take to the streets, I’ll not stop until there is justice. Prop and cdc what goes around comes around and best bet people like myself won’t stop until it does!

  • A (hopefully final) word about acupuncture, please. I have no problem with the statement that this kind of therapy is helpful for some people, some of the time. Where I differ is with unsupported generalizations or claims that acupuncture can substitute for analgesic or anti-inflammatory therapy. We really don’t know that in any definitive way.

    The Agency for Healthcare Research and Quality published a Systematic Outcomes Review last June, in which they reviewed almost 5,000 trials reports for non-invasive, non-pharmaceutical therapies in five categories of chronic pain. Only 218 of the reports survived rigorous quality review and also followed patients for at least 30 days following therapy. The following are direct quotes from their report:

    ===============
    Chronic low back pain: At short term, massage, yoga, and psychological therapies (primarily CBT) (strength of evidence [SOE]: moderate) and exercise, acupuncture, spinal manipulation, and multidisciplinary rehabilitation (SOE: low) were associated with slight improvements in function compared with usual care or inactive controls. Except for spinal manipulation, these interventions also improved pain.

    … For acupuncture, there was no difference in pain at intermediate term, but a slight improvement at long term (SOE: low).

    Chronic neck pain: At short and intermediate terms, acupuncture and Alexander Technique were associated with slightly improved function compared with usual care (both interventions), sham acupuncture, or sham laser (SOE: low), but no improvement in pain was seen at any time (SOE: llow). Short-term low-level laser therapy was associated with moderate improvement in function and pain (SOE: moderate). Combination exercise (any 3 of the following: muscle performance, mobility, muscle re-education, aerobic) demonstrated a slight improvement in pain and function short and long term (SOE: low).

    Fibromyalgia: In the short term, acupuncture (SOE: moderate), CBT, tai chi, qigong, and exercise (SOE: low) were associated with slight improvements in function compared with an attention control, sham, no treatment, or usual care. Exercise (SOE: moderate) and CBT improved pain slightly, and tai chi and qigong (SOE: low) improved pain moderately in the short term. At intermediate term for exercise (SOE: moderate), acupuncture, and CBT (SOE: low), slight functional improvements persisted; they were also seen for myofascial release massage and multidisciplinary rehabilitation (SOE: low); pain was improved slightly with multidisciplinary rehabilitation in the intermediate term (SOE: low). In the long term, small improvements in function continued for multidisciplinary rehabilitation but not for exercise or massage (SOE: low for all); massage (SOE: low) improved long-term pain slightly, but no clear impact on pain for exercise (SOE: moderate) or multidisciplinary rehabilitation (SOE: low) was seen. Short-term CBT was associated with a slight improvement in function but not pain compared with pregabalin.
    =================
    A further acknowledgment is also buried deeply in the report. The investigators could not document the nature of “usual therapy” in even the reports that survived quality review. They also “assumed” that the non-drug therapies were used in addition to usual therapy, not as replacements.

    Thus my reading at this stage, is that there is some evidence of low quality that acupuncture can be a useful addition to drug therapies for common types of moderate to severe pain. But improvements in pain level observed so far are relatively slight, and impossible to generalize to replacement of drugs. In fairness, the same is true of other non-pharmaceutical treatments.

    These findings are summarized in an article which I co-authored with Stephen Nadeau, MD, in the October 2018 edition of *Practical Pain Management*. The title was “Behind the AHRQ Report – Understanding the Limitations of Non-Pharmacological, Non-Invasive Treatments of Chronic Pain”. Dr Nadeau has a record of over 100 papers published in medical literature under peer review.

    Regards,

  • Now, I’m going to try and keep this little story short. Two years ago, at 55 years old, I was diagnosed with some very rare autoimmune diseases that have been aggressively destroying my spine and all that works from it in my body. I am the proud owner of two pages worth of spine and autoimmune diseases including Late Stage Lyme Disease which is the gift that keeps on giving. One disease it gave me is early onset of Osteoporsis. Without even getting out of bed yesterday I knew it was going to be a bad day. Pain in my spine is a given, never goes away, but yesterday I was not prepared. From my lumbar, right hip, S Joints and Sciatica I live with everyday and am usually a level 7 or 8 on any given day. Yesterday, I was a level 10+. Medication wise, I’m almost down to the guideline limit from 255MME for the past 12 years. Nothing I tried helped with the pain, but I was determined to get my four foot vintage tree decorated. After getting the lights on (I found out the longest pre-lit trees lights work is 2 years) and garland, I took a couple of steps and the pain I endured inside my femurs and the outside sciatica brought me to the floor screaming in pain. But I didn’t try to get up because through my own tears my first thought was about a little girl whom I’ve known since the minute she was born. She has lived with Osteogenesis Imperfecta aka Brittle Bone Disease her entire life. All I could think of was by four years old she’d already had over 40 broken legs and the pain she must endure on the inside of her bones everyday and barely takes any medication for the pain because “she’s used to it.” For years now, I’ve been saying the same thing about my pain until yesterday. I crashed down to the floor. I wanted to die. Nothing worked for this pain I was suffering in my spine, arms and legs it was more than I ever have before and by nightfall all I could think of was the pain because this time I wasn’t “used to it.” Well, that little girl is almost 29 years old now and has suffered through just about every bone broken in her body, going to the hospital 3 days a month for special bone treatments, surgeries, rods, severe scoliosis so she has so many screws holding her spine together, but she’s a survivor and a warrior. She will be walking down the aisle on her father’s arm this coming September and I will be in the congregation so proudly watching her marry the love of her life. She’s a beautiful, remarkably talented woman who sings with the voice of an angel. She is my hero. I’m also double her age now and sometimes I forget that she knows how I feel and worse in her 29 short years on this earth. So, it’s the holiday season and I really have nothing to celebrate this year, but I’m not going to feel sorry for myself, I’m going to keep going like I always have. I’ve been a crafter my entire life and now I have many days when I can’t even hold a pencil, but when it’s this time of year I always think of those I love and for those who also suffer more than I do and we are fighting for them too!

    At this time of year we often forget about others when we are dealing with so much ourselves. We have enough problems trying to get our medications and we suffer, but sometimes, I like to humbly remember that there are those who fare far worse than I.

    • I am a physician who specializes in chronic pain management. I also suffer from chronic pain due to four herniated cervical discs, one herniated and three bulging lumbar discs, with multi-level moderate and severe central canal and bilateral foraminal stenosis, resulting in spinal and radicular pain. I believe everyword of your story. Almost. You undermine your credibility when you claim to have “level 10+” pain. There is no such thing. Ten is the absolute maximum. That is broken glass ground into your eyes, cutting off your leg with a chainsaw, crushing your hand in machinery, etc. – whatever is the worst possible pain that you can imagine. However you define it, there is no “+” that can be added to your worst possible pain. Again, I believe you have significant pain issues. But as a pain management phyician, I caution you that by claiming to have a level of pain that simply does not and can not exist, you risk having yourself lumped in with the drama queens and drug seekers, and you may not get the best possible care as a result.

  • I am amazed whenever MD or PhD are doing scientific study about Acupuncture Medicine and seems not to realize that acupuncture is a complete set of medical field. It consists of procedures and TCM. It is invasive and non-invasive. Acupuncture is good for pain management, diseases management and prevention. You either embrace it or not, but it is good to the point WHO, AMA, NIH and others have concluded that acupuncture is good for well-beings. I understand that people are suffering, but Doctors’ oath is to do no harm. They cannot prescribe opioids unless the risk outweigh the benefits.

    Patients, Advocates, and Doctors should work together for the benefit of good. There are a lot of treatments for pain. There are different types of pain. Please speak to your practitioners and seek the best result for you.

    • No Jorge! I don’t wish pain on anyone. Words did not come out right. I would hope that the cdc and people in government would just listen to people like Dr. Lawhern and Tim here, who would have good, solid information for them to consider. Chronic pain patients are dying and this is totally unacceptable! I speak out of anger sometimes about this issue and I need to stop.

    • None of those agencies listed by T. Trust have endorsed Acupuncture. It was a grave mistake to allow the NIH to fund these pseudo science studies or allow these unscientific and often deceptive studies to be included in their publications. Every single attempt to quantify these acupuncture studies, shows that almost none were done scientifically. The conclusions of these studies are mostly over-hyped or deceptive. Not one of these studies showed anything more than amplifying the Hawthorne Effect, or the Placebo effect.

      In spite of no reliable findings, these studies were picked up acupuncture marketers, and science deniers to prove nothing. The result was that useless studies were presented as fact or science. The highly profitable CAM practitioners, and other unscrupulous health marketers, along with willfully ignorant people who don’t understand science, continue to peddle misinformation and lies across the internet.

      T. Trust either has a financial stake in trolling sites like this, or they are a true believer. Greedy and unscrupulous people view the scourge of the so called Opiate Epidemic, as an opportunity to peddle their wares. spreading misinformation and doubt is profitable. that is how this problem started in the first place, Pharma Marketing. Mainstream Media portrayed pharma and the treatment industry as a good investment, plying both sides. The device industry saw the demonization of pain medication, and pain patients as a way to sell more dangerous devices.
      Trolls following the Facebook Model of targeted adverting descend on these sites, to prey on vulnerable sick people. A recent study showed that cancer patients were more likely to die earlier if they used alternative medicine, yet these unscrupulous marketers persist. Science has been warped and undermined by marketers. There is no way to measure the damage, by design. The market suppresses any information that shows the facts. Facts are not good for profiteering. We can measure the number of deaths, the suicides of chronic pain patients, or deaths due to the epidemic of despair. Physicians jumped on Acupuncture, Chiropractic or other quackery, so they could dump people with chronic pain. Science tells us that none of this is working, but industry insiders at the NIH,the CDC and other agencies are profiting from the misinformation, and deliberately misinformation the public. After all they failed to identify the problem, they re-framed it several it several times over the last 2 decades, too protect the profiteers. The Market mentality created this miasma and every single “solution” was designed to enrich some industry.

      Advertising health claims used to be illegal in the US. Quacks have gotten around the few remaining laws, by trolling sites like this.

    • Davidson,

      You know more than the NIH, WHO, and AMA.

      Please let me know when you run one of these organizations. After all, your arguments do not base on facts. Please don’t paste a website as usual with their deprive informations.

    • Sorry T Trust, the only qualifications for these positions are a billion dollars in the bank, and an insider position at a corporation that could benefit from the decisions. I guess you have not been paying attention to the news, and the appointments of incompetents to the US agencies.

      It is relatively easy to backtrack industry ties online, and fact check, before posting nonsense. These agency appointments have no credibility. If they did they would have immediately cracked down on marketing, instead they allow more violations of the laws. They view healthcare as a “Market” so when someone dies, from spending their life savings on acupuncture, or spreads the flu, becasue they don’t believe in flu Shots, that is alright, because the Market is all that matters.

    • How did this group go from the battle against the CDC Guidelines into a war of words amongst ourselves? We are here for support of each other. We are all suffering one way or another. It doesn’t matter what we are suffering from because we all have something in common by living with Chronic Pain and are needlessly suffering because of the government. The reason doctors are pushing procedures and Spinal Cord Stimulators (and yes they get kick backs) is out of fear because they are afraid to write prescriptions but still want to try and relieve a patient of pain. For me, over 30 procedures, 5 spine surgeries that included an SCS implant and removal due to a rare condition. These implants all have trials. At least, after you research your options, just do the trial and see if it helps. There are types that are MRI friendly, you can drive with it on and airport security stations are fine to go through now. What happened to me and the SCS is another story for another time but you do have choices, it’s just up to you to make your own decisions, but blaming the doctors who are innocent and does have your best interest at heart to try and give you some relief, he’s just as scared as we are. Has anyone ever have an appointment with his/her doctor and ever watch tears in his eyes because he knows how bad off you are and knows there is absolutely nothing he can do to help relieve your pain? I do, mine did and we both know that until the Guidelines are removed, there is nothing that can help me.

      Every modality or what people should try, have tried, or don’t want to try, it is their right to say no and not be pushed. When my kids were young and I would give them one of those “it’s time to learn about life” talks I told them two things to never forget. The first is that there is one thing no one can ever take from you; your opinion. The second is that you cannot take away another’s either. If you don’t like what they are saying, don’t listen, just smile and pretend you are, if you don’t like what they write, don’t bother reading it and skip over it. It’s that simple.

      Trust T. I love acupuncture and I had it done for a couple of years when I was in my early 30s long before I had any of my the illnesses and spine issues I’ve acquired over the past 22 years. In 1999, I decided to try it again after 3 years of failed physical therapy for the four herniated discs in my cervical spine stemmed from a car accident in 1996. Unfortunately, the acupuncture treatment only worked for one year. I had trigger point and botox injections at every appointment trying to stop the never ending spasms in my neck. They never worked and I am still spasming to this day but it’s all the muscles in my spine now. Acupuncture isn’t for everyone, especially those who don’t like needles, so don’t push it. Women over 50 have the highest rate of issues that cause chronic pain. Medicare does not cover Acupuncture so if you are on SSD or retired collecting Social Security and are on Medicare, your case goes down the toilet because it’s hard enough living off of Social Security and to try and pay upwards of over $120 per session three times a week…it doesn’t add up. Best to offer if asked, but don’t push acupuncture or anything else that many people can’t even dream of affording. Think about it.

      Before I became disabled in 2006, Research was a fundamental part of my career. I find myself always doing research. Everything from my illnesses and situations or to help others. Richard Lawhern is one of the most intelligent, well spoken, hard working individuals I’ve ever had the pleasure of knowing just through ATIP, our advocacy group he co-founded. Believe what he’s saying. Read the literature he’s either written himself or with others, it doesn’t matter because I know through working with ATIP. I know because it is all fact. This man has given his life to helping the chronic pain community, and he is not a chronic pain patient. It is because of Dr. Lawhern that there are so many positives beginning to surface against the CDC Guidelines so believe what he has written.

  • T. Trust, The last thing I want to say here to people like you is, until the day comes when you all have to deal with the pain that carol, kim, tim, lance, jorge, alice, myself and all the other suffering people who have commented on this site have gone through, you will never understand why we are proponents for opioid pain relief medications.

  • T. Trust, before you go touting all the so-called all natural alternatives, the FDA just recently disclosed that they found found over 700 supplements and other non-pharmaceutical products that contained various prescription drugs that were not listed on the labeling and therefore posed possible negative health consequences.

    • You nailed another one, Lance.
      I personally tried probably over 15 natural herbs, pill, cremes, lotions…ashwaganda, curcumin, st. johns wort, etc., for pain…
      Worthless! All of it. If fda wants to go after a corrupt, money making rackett, they should start with the ‘natural’ herbs and supplements, ripping people off.
      It’s really disgusting that the good doctor here would have to be defending himself against someone like a T. Trust, but he is typical of the people why we all have to deal with these problems we are facing every day.

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