Living with a Beast

Living with a Beast

July 13, 2018

By Cathy Kean, Guest Columnist

I am living with a beast who is cold, heartless, unmerciful, uncaring and cruel. Always lurking around me, making my life so challenging, so exhausting, and so painful. Not only physically, but mentally, spiritually and emotionally.  

This beast has taken so much from me, I hardly remember how it was before it came into my life. Of course, I had challenges and difficult times. But I was functional and happy. And I could cope! I could manage!  

Now I have had to deal with this evil and vindictive beast.  I live day in and day out in my cave (my bedroom), lying in bed. I rarely venture out anymore.  I’ve become isolated and alone; so different from the life I used to live.  

I wish that I had swallowed and drunk up and absorbed the greatness and beauty of the life I had before, and not taken it for granted. What I wouldn’t do or give to go back to that time! 

I mourn me. I miss me. I know my kids and my grandchildren miss me. The woman I used to be was energetic, vivacious, outgoing, industrious, loving and friendly. There wasn’t a person that could walk by me without me engaging in some kind of banter.  I loved life so much more then!

Now I am attacked when I least expect it. I have no way of knowing how or when, because the beast is always present, always lurking around. It has hurt my family, my career, my outlook and my sense of self. I am followed everywhere.

When the beast is angry, my days are hell and my nights sleepless. It is behind me, beside me, everywhere, every day.  I truly cannot remember a time that I lived totally out of its grasp.

This fiend’s name is PAIN.

bigstock-Business-person-afraid-of-a-bi-187536745.jpg

Pain is brutal, savage and barbaric at times. Pain cares little for family occasions, social events or holidays. Pain forces me to stay home, ensuring I don’t forget its brute presence for a second. The beast has been a silent witness to some of the most extraordinary and excruciatingly painful moments of my life.

There are so many who live with this insidious beast, just like I do. We do our best to keep on living, despite pain’s germinating presence. You never become immune to the torturous, aching, stabbing, aching and suffering that pain brings, regardless of how long you live with it.

I am trying to learn that this is my new normal and I must continue with my life. I try to smile, laugh and engage, despite the struggle, strain and toil it causes. But I feel like I have been robbed!

I need to tell those who do not have chronic pain a little secret.

It hurts all day, every day, 24/7. 

365 days a year.

It never stops.

It never ends.

You eat, it hurts.

You sleep, it hurts.

You just exist, it hurts.

You rest, it hurts.

You breathe, it hurts.

Every single aspect of every single day, it hurts.

And now without my essential tools (my medications) that gave me functionality, my quality of life has diminished 98% due to CDC guidelines. I truly don’t know how much longer I can stay in this fight, this madness, this torment and this torture.

Constant and chronic pain isn’t something you can deal with for a long period of time. My organs are starting to shut down. I am blacking out constantly. I am having cardiac issues. I am in so much pain, I pray to God to take me!

I have begged my adult children to please not be angry with me if I take my life. I want to be here! I want to see my grandbabies grow up. I want to engage in life again! 

I made a difference in peoples’ lives. I used to be a parent’s last hope for true help and success when I had access to my medications. I was a special education advocate and I was good! I knew those feelings of desperation, not knowing where to turn or what to do for your child.

I just wish the government, our families, friends, and society would see us as human beings with value. Please be more compassionate, more loving and more accepting of our limitations.

No one would ask or want to live with this beast, this madness! I promise you

https://www.painnewsnetwork.org/stories/2018/7/13/living-with-a-beast

Do You Think The Government Is Trying To Get Rid Of Us?

Media is participating in this! Have you noticed the clear theme spreading misinformation pertaining to this so-called “Opioid Crisis”, is the MEDIA!!!

Media bias dates back to the early days of the newspaper and continues to this present day. Media affects our daily lives in numerous ways – from television, radio to print. Sometimes these media avenues persuade our opinions on certain issues – such as same-sex marriages, abortion, homosexuality, politics and our views on opioids!

Many people in America today are not even aware the media is manipulating their way of thinking, while some media bias may be a simple matter of attracting readership by sensational headlines,
funding sources are likely a contributing factor.
Today I read a story, “Stop the anti-doctor media bias, by
Rebekah Bernard, MD Physician May 2, 2019, published by Kevinmd.com.
Rebekah Bernard, MD wrote, “Doctors feel like they just can’t win. But worse, when physicians face excessive media criticism, patients also lose.
The media bias against physicians has inspired a public distrust of doctors. Most physicians are dedicated individuals who hold patient care as sacrosanct. But patients rarely hear stories of these doctors in the media. Instead, they are barraged by terrifying stories of the occasional bad actor.

This may cause patients to become fearful of all doctors and lead to a delay in seeking necessary medical care.”
The media has a responsibility to present fair and unbiased information to the public, and that includes accurate reporting about physicians and intractable pain patients. Patients and physicians must hold media organizations accountable by speaking out against this ongoing assault and misinformation being forced on to the public by these inaccurate biased news reports!
Mainstream media inundate the general public, our legislators 24/7 with headlines of, “Prescription opioids are killing thousands, millions expected to die”, Take one opioid pill and you will become an addict… what??? Okay, I am exaggerating a tad bit. But, it is crazy how the media has contributed too, fueled and the more sensationalized the story the more attention said publication gets!

No one knows how media can spin this, “Fake, false propaganda, the false narrative machine of judgment, misunderstanding, bias better than “We the intractable pain patient/community”! And usually, in editorial, there is a picture with prescription opioids and syringes? Go figure, I have never shot up my medication would not even know how to?

Media has been plagued with all sorts of problems scandals about manipulation including, sliding profits, plagiarism, propaganda just to name a few! They are trying to sell this false narrative, “Fake Opioid Crisis/Epidemic”, but why?
More on that later.

News is often written and used to manipulate, advertise, create fear among the populations or to follow a certain media ideology or agenda.

A functioning democracy needs to know and be able to count on media giving factual information out vs. lies, manipulation, and biased information!

We must stand up and make these agencies, journalists, and reporters do their due diligence in making sure they research and exhaust all avenues making sure of its authenticity!
Those with power and influence know that media control and influence is crucial for their agenda to be recognized and supported!
Did you know that today’s mass marketing is owned by only five major corporations giants which control 90% of media?

As of 2018, the largest media conglomerates in terms of revenue rank Comcast, The Walt Disney Company, AT&T
CBS Corporation and Viacom per Forbes.
Additionally, they are not defined as, “news organizations” where there would be certain laws they had to abide by for the public’s best interest.

The purpose of these corporations is to maximize profits, which often includes exploiting negative externalities so they can pass costs off to society!
These clever profit-maximizing corporations use the terminology of the 1970s,
“free press”/“journalists”, to give them the air of credibility to their operations. These corporations monopolizing the market, it reduces the diversity of media voices and puts tremendous power in the hands of just a few companies. These news outlets have holdings in many industries, conflicts of interest inevitably interfere with newsgathering.

Outside Nations described as authoritarian, whose media ownership is very close to this model completely control all information put out to their citizens directly or indirectly.
This amount of control can be problematic for a variety of reasons…

The democratic role of the media in news is further getting clouded with these gigantic mergers mainstream media is increasingly blurring the lines with the economic and political power further limits the spectrum of viewpoints that have access to mass media.
Independent, aggressive and critical media is essential to an informed democracy. But mainstream media who increasingly partner with the economic and political powers they should be reporting on.
Because of mergers in these new industries this further limits the spectrum of viewpoints that have access to mass media. With U.S. media outlets overwhelmingly owned by for-profit conglomerates and supported by corporate advertisers, independent journalism is in trouble of extinction.

These Corporate elites determine what ordinary people do not see or hear in-depth let alone problems real people face every day. Sponsors have a disproportionate amount of influence over what people get to see or read too.
These corporate executives main goal is increasing profit and raising their share price.

Could this have anything his could what is contributing to lack and/or misinformation being regurgitated pertaining to this false narrative, propaganda Fake prescription opioid epidemic/crisis???

Its painfully clear that Congress- and each of its members is not fit to serve the people in pain. Congress lacks the heart that cares and it is clear they have been brainwashed in their beliefs about the pain that have done great damage to the lives of people in pain. Congress is simply morally, ethically, intellectually, and politically unfit to serve people in pain.

The clear evidence of the government’s long-standing prejudice and neglect of its people in pain as well as they’re against people in pain-
has to lead many individuals including myself to think how remarkably similar this seems to Hitler’s 4 step Process for dehumanizing the Jews…
We are/were living longer, drawing on Social Security, Medicare, Medicaid Benefits, Disability, etc…
We are looked at as a liability.

Our Government looks at Pain Patients as being a huge cost factor… What if the #CPPS were gone, eliminated or thinned out…
It is being done by the United States government and outside agencies to completely eradicate the Intractable pain community or make it impossible for them to get the medications (opioids) that they have used in the successful management of their pain for decades!

What a genius idea Straight From The Archives of Hitler.
As reflected in an article by Jaine Toth, Hitler’s 4-Step Process for Dehumanizing the Jews https://bahaiteachings.org/hitlers-step-process-dehumanizing-jews
“The Holocaust didn’t occur suddenly or spontaneously—it required a conscious process. If we study the process, we might prevent future genocides.
Toth says, even before they took power in 1933, Hitler and the Nazi government set about implementing a series of four specific steps designed to result in the complete and total dehumanization of Europe’s Jewish population”,
1. Prejudice- The Nazi government actually fostered and promoted prejudice. According to the dictionary definition, prejudice is comprised of “unreasonable feelings, opinions, or attitudes, especially of nature, regarding an ethnic, racial, social or religious group.”
2. Scapegoating
The Nazis scapegoated the Jews, blaming them for every societal problem in German society. They published an enormous quantity of propaganda that blamed the Jews for the wrongdoings, mistakes, or faults that plagued “civilization;” and declared Jews and others Untermenschen, or sub-human.
These Nazi scapegoating tactics carried prejudice to the next step—from bigotry and bias to blaming.
3. Discrimination 
In the case of the Jews, the Nazi’s prejudice against them made them easy to scapegoat. This naturally led to discriminatory laws by the government and caused violent acts against them that individuals could perpetrate with impunity.
4. Persecution
Persecution of minorities isn’t new. The persecution of the Christians by the Romans is one Jews were forced from their homes, their valuables confiscated, crowded into ghettos, homes, businesses.

How this is playing out in intractable/chronic pain patient community!
1. Prejudice-
According to the dictionary definition, prejudice is comprised of “unreasonable feelings, opinions, or attitudes, especially of a hostile nature, regarding an ethnic, racial, social or religious group.”
Intractable pain patient- The United States government has actually fostered and promoted prejudice.
Is an effective feeling towards a person or group member based often on that person’s group membership (tribal behavior). The word is often used to refer to preconceived, usually unfavorable, feelings towards people or a person because of their political affiliation, sex, gender, beliefs, values, social class, age, disability, religion, sexuality, race/ethnicity, language, nationality, beauty, occupation, education, criminality, sport team affiliation or other personal characteristics. In this case, it refers to a positive or negative evaluation of another person based on that person’s perceived group membership. Wikipedia
Equating intractable/chronic pain patients to drug addicts, drug seekers, lazy, etc…

2. Scapegoating-Intractable pain patient– The United States government and other governmental agencies scapegoat the Intractable pain/chronic pain patient, blaming them for all societal problems with overdoses in American society. Much has been published an enormous quantity of propaganda that blamed the intractable/chronic pain patient and doctors for the wrongdoings, mistakes, or faults that plagued “civilization;” and declared Intractable/chronic pain patients and others Untermenschen, or sub-human.
Scapegoating is the practice of singling out a person or group for unmerited blame and consequent negative treatment. Scapegoating may be conducted by individuals against individuals, individuals against groups), groups against individuals., and groups against groups. Wikipedia

3. Discrimination –
In human social behavior, discrimination is treatment or consideration of or making a distinction towards, a person based on the group, class, or category to which the person is perceived to belong. These include age, color, criminal record, height, disability, ethnicity, family status, gender identity, generation, genetic characteristics, marital status, nationality, race, religion, sex, and sexual orientation. Discrimination consists of treatment of an individual or group, based on their actual or perceived membership in a certain group or social category, “in a way that is worse than the way people are usually treated” Wikipedia
the unjust or prejudicial treatment of different categories of people or things, especially on the grounds of race, age, or sex.
Intractable pain patient– In the case of the Intractable/chronic pain patient, the prejudice against them made them easy to scapegoat. This naturally led to discriminatory laws by governmental agencies and states pertaining to tapering, mme dosage, prescription refills so on and so forth.!

4. Persecution – is the systematic mistreatment of an individual or group by another individual or group. The most common forms are religious persecution, racism and political persecution, though there is naturally some overlap between these terms. The inflicting of suffering, harassment, imprisonment, internment, fear, or pain are all factors that may establish persecution, but not all suffering will necessarily establish persecution. The suffering experienced by the victim must be sufficiently severe. The threshold level of severity has been a source of much debate.

The persecution of the Intractable pain patient has led to doctors abandoning their practices, being falsely accused and prosecuted! Patients losing access to their doctors and essential medications and medical treatment for sustaining health and livelihood. The patients able to keep their doctors have been severely tapered off their medications resulting in a community who are suffering and held hostage by the very government sworn to protect and serve our best interests!
Many have committed suicide not able to live with the torturous, caustic, disabling, never-ending, 24/7 incessant, insidious, unbearable, relentless intractable pain!
Other intractable pain patients have succumbed to the complications of untreated or undertreated pain.
Intractable/Chronic pain patients are often treated as a special class of patient/citizens, often with severely restricted liberties – prevented from consulting multiple physicians and using multiple pharmacies. In many cases have little say in what treatment modalities or which medications will be used. These are basic liberties unquestioned in a free society for every other class of sufferer. These attitudes and judgments cause the intractable pain patient much distress, sadness, anger, and depression. When confronted with severe life-threatening events many will not go to the emergency room were more likely than not treated as if they are a “drug seeker”,

In the past few years, chronic pain patients are often seen by medical professionals primarily as a prescription or medication problem, rather than as whole individuals who very often present an array of complex comorbid medical, psychological, and social problems.
Intractable/chronic pain patients are often seen by medical professionals/community primarily as prescription/medication problems, rather than individuals who very often present an array of complex comorbid medical, psychological, and social problems.Ui

According to Alexander DeLuca, Senior Consultant, of Pain Relief Network in an article titled, Why Untreated Chronic Pain is a Medical Emergency, 2008-02-28… These complex general medical patients are ‘cared for’ as if their primary and only medical problem was taking prescribed analgesic medication many are treated as if they were a drug seeker, addict!

Chronic pain is probably the most disabling, and most preventable, left untreated, and inadequately treated severe pain can cause long-term damage to their system, painful trauma or disease, chronicity of pain may develop in the absence of effective relief. A continuous flow of pain signals into the pain-mediating pathways of the dorsal horn of the spinal cord alters those pathways through physiological processes known as central sensitization, and neuroplasticity. The end result is the disease of chronic pain in which a damaged nervous system becomes the pain source generator separated from whatever the initial pain source was.

Aggressive treatment of severe pain, capable of protecting these critical spinal pain tracts, is the standard care recommended in order to achieve satisfactory relief and prevention of intractable chronic pain.
Medications represent the mainstay therapeutic approach to patients with chronic pain syndromes… aimed at controlling the mechanisms of nociception, the complex biochemical activity along and within the pain pathways of the peripheral and central nervous system (CNS)… Aggressive treatment of severe pain is recommended in order to achieve satisfactory relief and prevention of intractable chronic pain.

In modern imaging studies of a maladaptive and abnormal persistence of brain, researchers are seeing activity associated with loss of brain mass in the chronic pain population. Atrophy is most advanced in the areas of the brain that process pain and emotions. In a 2006 news article, a researcher into the pathophysiological effects of chronic pain on brain anatomy and cognitive/emotional functioning, explained:
“Because of this constant firing of neurons in these regions of the brain it could cause permanent damage, Chialvo said. “When neurons fire too much they may change their connections with other neurons or even die because they can’t sustain high activity for so long,” he explained.
Intractable pain patients have to jump through a variety of hoops in order to receive the small amount which is barely able to manage their pain medications. They must sign a patient contract with Pain Management Clinic and agree to submit to drug tests, see only one doctor, only fill prescriptions at one pharmacy, many have had their contracts amended that they will not drive any longer additionally. Intractable pain patients have lost their 1st Amendment right in the doctor’s office and medical community. Afraid to speak up and lose access to their medications has silenced them which can lead to horribly, horrific consequences. When they start experiencing systems that are of concern many do not feel like they can freely bring them up. Which can have disastrous results!


Allison Kimberly was a friend of mine she was a beautiful, supportive soul. I knew her from Instagram she was part of the #CPP Chronic Pain Community.

ALLISON KIMBERLY JACOBS
Age: 30
A post from Facebook:
Allison Kimberly, age 30, of Colorado was denied treatment for her intractable pain from interstitial cystitis, and several other painful conditions. Interstitial cystitis can end in suicide from the failure to treat it properly as it is an extreme form of agonizing discomfort. It is said the University of Colorado emergency room in Aurora refused her treatment for her pain. Allison posted on Instagram describing how she was treated like an addict and sent away without pain medicine.

“I was rushed to the ER because my pain was so out of control I couldn’t take it anymore, I got ZERO help. After 7 hours I was discharged. The nurse has the nerve to say that my kind of pain shouldn’t be that bad and basically, I was faking for medication. I am so beside myself I am shaking as I type this. Screaming and begging in pain, needing any kind of help they’d give me and I was just sent home. As soon as I am able I’m reporting my whole experience”

Allison did not have time to file a complaint against the hospital as she violently ended her life while her mother walked her dog, the animal companion that had made her anguish less lonely. No doctors appear to have been charged. The Colorado Hospital Association was in the process of piloting a no-opioid policy for the state. She died in June 2017

Link to obituary:
http://www.legacy.com/obituaries/denverpost/obituary.aspx…
More and more patients will die if our government continues its brutal War Against Chronic Pain Patients. We take daily opiates not because we want to, but because we have no other choice. Without proper pain management, our lives are over. More and more of our brothers and sisters will continue to commit suicide if our pain is ignored and untreated. We deserve better than this.
Don’t let the death of our sister go unanswered!!
Tell the government we are #PatientsNotAddicts and we have rights too!!
#CNN #CNNHealth #SuicideDue2Pain #POTUS #OpiateEpidemic#ChronicPain #WarOnDrugs #FLOTUS

From post found on Facebook:
To whom it may concern,
I have CRPS/RSD and am currently seeing a doctor that monitors my progress and medications. I was diagnosed in June of 2010. After trying every treatment modality including physical therapy, anti-seizure medications, biofeedback, etc. I was put on OxyContin. After having 8 brachial plexus nerve blocks and 5 lumbar nerve blocks, my neurologist/ pain management doctor kept upping the dosage of it because I was getting no relief and we could not figure out why. He ended up upping the dosage so much I was only experiencing side effects, no pain relief. I decided to leave my pain management doctor at UCLA and seek out another doctor that could find out why I wasn’t getting any pain relief. I finally found a doctor that did many tests on me including Neuroinflammation blood tests, Genetic malabsorption blood work-up. My doctor was able to figure out that I cannot absorb oral opioids due to a genetic malabsorption defect. He put me on a trial of subcutaneous dilaudid. I had experienced instant pain relief and received my quality of life back. I have been on this medication for two years with no side effects. This medication has to be compounded, which my new insurance will not pay for. Dr. Tennant has saved my life and given me my life back. You must understand that we chronic pain patients cannot be punished for the people that use opioids illegally. None of us “want” to be on these medications, but have no choice. After trying everything, we just want quality of life. The restrictions that are already put in place are making it harder and harder for the legitimate chronic pain patients to get the medications that give them the quality of life. Please consider that we are carefully monitored by our doctors and take our medications as prescribed only.

We should not be punished for the street abusers that only want a “high”. I have never experienced a “high” from my pain medicine. There are studies in the process that have to do with different medications to help us, but it takes an extremely long time to get the FDA approved. In closing, I hope you will kindly consider our circumstances, that we have families, and only want to be able to participate in daily activities without suffering inhumanly.
Thank you,
Michelle Bloem
Michelle died directly because of the policies and practices of people like @AndrewKolodny, The CDC, Organizations like #PROP, and the policies of people like Chris Christie and the #POTUS@realDonaldTrump. Chronic pain patients are dying because of the policies our government imposes to curb the illegal use of opiates. Just because we suffer from chronic, debilitating pain does not make us criminals. We take medications, under the supervision of multiple doctors, to improve our quality of life. Chronic pain patients are being forced to take their lives as their only means of pain management. Please stop the genocide of chronic pain patients!!
#SuicideDue2Pain #PatientsNotAddicts#DisabledAmericans4Change #CNNHealth#OpiateEpidemic #GivePainAVoice #ChronicPain#POTUS #FLOTUS
Many are committing suicide due to their pain…

Pain is relentless
Pain is cruel
It doesn’t discriminate it could happen to you.
Everyone is just one car accident, surgery, illness away from living the rest of their lives in torturous, stabbing, aching, insidious, disabling intractable pain! Believe me, this is a Journey you do not want it is literally hell on earth!

Suicide due to pain videos I have 7 more plus I have to make so many more… #suicidedue2pain
Due to this to memorize our brothers and sisters in #CPP Community


We have tried numerous times to set the record straight explaining that addiction and dependence or completely different concepts as Dr. Thomas Kline explains in this screenshot below.
Many physicians are telling their patients they need to switch to suboxone is there an alternative motive for this? That will be discussed in my next piece!
(Buprenorphine/naloxone), From Wikipedia, the free encyclopedia
is a combination of medication that includes buprenorphine and naloxone. Which is a medication used to treat opioid use disorder? Buprenorphine/naloxone is available for use in two different forms, under the tongue or in the cheek. Buprenorphine binds strongly to opioid receptors and acts as a pain reducing medication in the central nervous system (CNS). It binds to the μ-opioid receptor with high affinity which produces the analgesic effects in the CNS. It is a partial μ agonist and it is a weak κ-opioid receptor antagonist. As the dose of buprenorphine increases, it’s analgesic effects reach a plateau, and then it starts to act like an antagonist.[20][21] As a partial agonist, buprenorphine binds and activates the opioid receptors, but has only partial efficacy at the receptor relative to a full agonist, even at maximal receptor occupancy. It is thus well-suited to treat opioid dependence, as it produces milder effects on the opioid receptor with lower dependence and abuse potential.

In an article Sept. 26, 2017 PRNewswire — The mental health watchdog group Citizens Commission on Human Rights (CCHR) International warned that a drug being used to treat the opioid crisis in the United States could be like “switching seats on the Titanic.” A prescription drug, buprenorphine-naloxone, described as the gold standard treatment for opioid addiction, carries a warning in its Medication Guide that it contains “an opioid that can cause physical dependence.”[1]

A Florida psychiatrist warns using this drug could be trading one addiction for another and that it is estimated to be 25 to 40 times more potent than morphine.[2]
Watchdog Warns About Replacing Opioid Epidemic With a Psychotropic One?”Like Switching Seats on the Titanic,” CCHR says
in 2016, an article warned that buprenorphine-naloxone abuse is now an epidemic, based on 2013 statistics reported in The New York Times.[5] Between 2009 and March 2013, an estimated three million Americans were treated with the drug.[6] A report by the Substance Abuse and Mental Health Services Administration (SAMHSA)found a ten-fold increase in the number of emergency room visits involving buprenorphine. Over half of the 30,000 hospitalizations in one year were for non-medical use of the drug.[7] Approved to treat opioid addiction in 2002, it now sells illicitly on the streets for anywhere from $5 to $35 a pill.[8] Long-term users of buprenorphine-naloxone say it is more difficult to get off than painkillers or heroin because, unlike an intensely painful five to seven or even fourteen-day detox from opiates, a buprenorphine-naloxone detox can last weeks or even months.
Dr. Steven R. Scanlan, board certified in general psychiatry and addiction medicine, says psychiatrists and doctors that prescribe the drug can charge $200 to $300 monthly, per patient, for a 5-to-10 minute checkup to renew a prescription. He warned that the lucrative nature of the drug “on a maintenance basis creates a disincentive to tapering the drug and its income-generating potential,” according to Bloomberg News. Withdrawal can cost $5,000 because it may take “four to five months, incorporating about 10 different drugs to detox the patient successfully,” he said.
So why the big push for buprenorphine/suboxone?
Is media contributing to this false narrative, propaganda intentionally?
I will explore that in the next piece!
Cathy Kean

Medical Society of Virgnia Guidelines for the Use of Opiates in Chronic, Non-Cancer Pain

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American Society for Action on Pain
“MEDICAL SOCIETY OF VIRGINIA’S GUIDELINES FOR THE USE OF OPIOIDS IN THE MANAGEMENT OF CHRONIC NON-CANCER PAIN”

Note from the ASAP President: We can thank the courage of one compassionate doctor who has so far given up a year and a half of his income to help make this happen, and 5 people who paid with their lives to bring about this new day for Pain Patients in Virginia.  If Dr. William Hurwitz had not have “done the right thing,” these guidelines would not be here in the way they are now written.  We must also thank all the lay-people who wrote to the Governor and those Pain Patients who never gave up doing their best to bring about change in a barbaric system.  As you will see, Virginia has made a 180 degree turn, and now ANY doctor can practice Pain Medicine without fear of being brought into a Medical Board Hearing, costing him tens of thousands of dollars, and a years salary to help those suffering with non-cancer chronic pain.

Skip Baker, ASAP.

REPORT OF MEDICAL SOCIETY OF VIRGINIA
    PAIN MANAGEMENT SUBCOMMITTEE

PREFACE TO THE MEDICAL SOCIETY OF VIRGINIA
PAIN MANAGEMENT SUBCOMMITTEE REPORT

Recently, there has been increasing interest on the part of physicians, regulatory agencies, legislators, the public, and patients for the proper diagnosis, timely workup, and state of the art treatment for acute, cancer, and non-cancer, chronic pain conditions. While there is widespread agreement among health care providers concerning the treatment of acute and cancer pain with opioids (also known as
narcotics)–as exemplified by Federal Clinical Practice Guidelines published by the Agency for Health Care Policy and Research, U.S. Department of Health and Human Services–there has been a lack of consensus, misunderstanding and hesitation among health care providers (physicians, nurses, pharmacists), regulatory agencies, patients, and third party providers concerning the use of these same agents in the management of chronic, non-cancer pain.

Inadequate understanding about issues such as addiction, tolerance, physical dependence, and abuse has lead to unfounded stigma against proper opioid prescription. Fears of legal and regulatory sanctions or discipline from local, state, and federal authorities often result in inappropriate and inadequate treatment of chronic pain patients. Undertreatment or avoidance of appropriate opioid therapy increasingly has been reported by physicians, patients, and other health care team
members.

The discipline of pain medicine has produced a new awareness about the necessity of proper diagnosis, history and physical examination, and treatment planning for the patient with chronic pain. Unfortunately, the paucity of specially trained physicians in the field of pain management often precludes patient access to specialized pain treatment facilities. The treatment for these patients will appropriately fall within the realm of the primary care or specialty physician. Until adequate guidelines are made for prescribers of opioids for patients with chronic non-cancer pain, episodes of undertreatment of this deserving population will continue.

As a result of the efforts and recommendations of the Governor’s Joint Subcommittee studying pain, the Medical Society of Virginia’s House of Delegates, at the 1996 annual meeting of its legislative body, recognized the lack of national consensus as well as the need for parameters concerning the proper use of opioids for patients with intractable pain of non-cancer origin within the Commonwealth of Virginia. The following guidelines are presented with the hope that they will attenuate fears about professional discipline, encourage adequate and proper treatment of chronic pain with all appropriate therapies, and educate about and protect patients as well as the general public from unsafe or inappropriate prescribing patterns or abuses.

The Society believes that physicians have an obligation to treat patients with intractable pain and to lessen suffering and that opioids may be appropriately and safely prescribed for many acute, cancer, and chronic pain conditions as long as acceptable protocols and standards are closely followed. The Society feels that physicians should be encouraged to prescribe, dispense, and administer opioids when there is demonstrated medical necessity and proper indication for these agents without fear of discipline, excessive scrutiny, or remunerative or restrictive legal penalties. These guidelines should not be interpreted as absolute standards of care in the treatment of chronic pain patients, nor are they absolute directives for clinical practice. Rather, they are guidelines by which, all physicians may more safely and comfortably evaluate and treat this very problematic and needy group of patients.

MEDICAL SOCIETY OF VIRGINIA ‘S GUIDELINES FOR THE USE OF OPIOIDS IN THE
MANAGEMENT OF CHRONIC NON-CANCER PAIN

For the purposes of this document the following terms shall have the following definitions:

Addiction is a disease process involving use of opioid(s) wherein there is a loss of control, compulsive use, and continued use despite adverse social, physical, psychological, occupational, or economic consequences.

Substance abuse is the use of any substance(s) for non-therapeutic purposes; or use of medication for purposes other than those for which it is prescribed.

Physical dependence is a physiologic state of adaptation to a specific opioid(s) characterized by the emergence of a withdrawal syndrome during abstinence, which may be relieved in total or in part by
re-administration of the substance. Physical dependence is a predictable sequelae of regular, legitimate opioid or benzodiazepine use, and does not equate with addiction.

Tolerance is a state resulting from regular use of opioid(s) in which an increased dose of the substance is needed to produce the desired effect. Tolerance may be a predictable sequelae of opiate use and does not imply addiction.

Withdrawal syndrome is a specific constellation of signs and symptoms due to the abrupt cessation of, or reduction in, a regularly administered dose of opioid(s).

Opioid withdrawal is characterized by three or more of the following symptoms that develop within hours to several days after abrupt cessation of the substance: (a) dysphoric mood, (b) nausea and vomiting, (c) muscle aches and abdominal cramps, (d) lacrimation or rhinorrhea, (e) pupillary dilation, piloerection, or sweating, (f) diarrhea, (g) yawning, (h) fever, (i) insomnia.

Acute pain is the normal, predicted physiological response to an adverse (noxious) chemical, thermal, or mechanical stimulus. Acute pain is generally time limited and is historically responsive to opioid therapy, among other therapies.

Chronic pain is persistent or episodic pain of a duration or intensity that adversely affects the function or well-being of the patient, attributable to any non malignant etiology.

ASSESSMENT, DOCUMENTATION, AND TREATMENT

A. History and Physical Examination: The physician must conduct a complete history and physical exam of the patient prior to the initiation of opioids. At a minimum the medical record must contain
documentation of the following history from the chronic pain patient:

1. Current and past medical, surgical, and pain history including any past interventions and treatments for the particular pain condition being treated.

2. Psychiatric history and current treatment

3. History of substance abuse and treatment.

4. Pertinent physical examination and appropriate diagnostic testing.

5. Documentation of current and prior medication management for the pain condition, including types of pain medications, frequency with which medications are/were taken, history of prescribers (if possible), reactions to medications, and reasons for failure of medications.

6. Social work history.

B . Assessment: A justification for initiation and maintenance of opioid therapy must include at a minimum the following initial workup of the patient:

1. The working diagnosis (or diagnoses) and diagnostic techniques. The original differential diagnosis may be modified to one or more diagnoses.

2. Medical indications for the treatment of the patient with opioid therapy. These should include, for example, previously tried (but unsuccessful) modalities/medication regimens, diverse reactions to prior treatments, and other rationale for the approach to be utilized.

3. Updates on the patient’s status including physical examination data must be periodically reviewed, revised, and entered in the patient’s record.

C. Treatment Plan and Objectives: The physician must keep detailed records on all patients, which at a minimum include:

1. A documented treatment plan.

2. Types of medication(s) prescribed, reason(s) for selection, dose, schedule administered, and quantity.

3. Measurable objectives such as:
      a. social functioning and changes therein due to opioid therapy.
      b. activities of daily living and changes therein due to opioid therapy.
      c. adequacy of pain control using standard pain rating scale(s) or at least statements of the patient’s satisfaction with the degree of pain control.

D. Informed Consent and Written Agreement for Opioid Treatment: Written documentation of both physician and patient responsibilities must include:

1. Risks and complications associated with treatment using opioids

2. Use of a single prescriber for all pain related medications.

3. Use of a single pharmacy, if possible.

4. Monitoring compliance of treatment:

a. Urine/serum medication levels screening (including checks for non-prescribed medications/substances) when requested.

b. Number and frequency of all prescription refills.

c. Reason(s) for which opioid therapy may be discontinued (e.g. violation of written agreement item(s)).

E. Periodic Review: Intermittent review and comparison of previous documentation with the current medical records are necessary to determine if continued opioid treatment is the best option for a
patient. Each of the following must be documented at every office visit:

1. Efficacy of Treatment
      a. Subjective pain rating (e.g. 0-10 verbal assessment of pain)
      b. Functional changes.
      i. Improvement in ability to perform activities of daily   living (ADL’s).
      ii. Improvement in home, work, community, or social life.

2. Medication side effects.

3. Review of the diagnosis and treatment plan.

4. Assessment of compliance (e.g. counting pills, keeping record of number of medication refills, frequency of refills, and disposal of unused medications/prescriptions).

5. Unannounced urine/serum drug screens and indicated laboratory testing, when appropriate.

F . Consultation: Most chronic non-cancer patients, like their cancer pain counterparts can be adequately and safely managed by most physicians without regard for specialty. However, the treating physician must be cognizant of the availability of pain management specialists to whom the complex patient may be referred. The physician must be willing to refer the patient to a physician or a center with more expertise when indicated or when difficult issues arise. Consultations must be
documented. The purpose of this referral should not necessarily be to prescribe the patient opioids.

G . Medical Records: Accurate medical records must be kept, including, but not limited to documentation of:

a. All patient office visits and other consultations obtained .

b. All prescriptions written including date, type(s) of medication, and number (quantity) prescribed.

c. All therapeutic and diagnostic procedures performed.

d. All laboratory results.

e. All written patient instructions and written agreements.

SUMMARY AND CONCLUDING REMARKS

The treatment of patients with chronic, non-cancer pain should not be limited to pain specialists only. Because of complex social, regulatory, ethical, and legal issues surrounding the use of opioids in these patients, the physician who elects to help treat these patients may find it useful to utilize the guidelines and examples outlined in this document. While these guidelines do not define standard of care, it is the hope of the Medical Society of Virginia, working in close conjunction with the Virginia Board of Medicine, and the Commonwealth of Virginia’s Joint Subcommittee to Study the Commonwealth’s Current Laws and Policies Related to Chronic, Acute, and Cancer Pain Management, that physicians who do treat this very difficult and deserving patient population will find significant clinical benefit from this document and will be enlightened by the suggestions offered herein.

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— Read on druglibrary.org/schaffer/asap/virginia1.htm

CDC HAS BEEN SNEAKY…

CDC has been Sneaky, Shady, Underhanded, Corrupt, Fraudulent, in Skewing all these numbers!!!
CDC a Government Agency that is supposed to look out for the best interests of USA citizens is failing us all HORRIFICALLY!!!

As the nation’s health protection agency, CDC is supposed to save lives and protect people from health threats. To accomplish that the CDC conducts critical science and provides health information that protects our nation against expensive and dangerous health threats, and responds when these arise.

How does the CDC get funded?
As a private 501(c)(3) public charity, the CDC Foundation receives charitable contributions and philanthropic grants from individuals, foundations, corporations, universities, NGOs and other organizations to advance the work of the Centers for Disease Control and Prevention. The Centers for Disease Control and Prevention (CDC) is the leading national public health institute of the United States. The CDC is a United States federal agency under the Department of Health and Human Services and is headquartered in Atlanta, Georgia.

Can the CDC make laws?
CDC and other agencies implement public health laws passed by Congress through Federal Regulations. … The process of creating regulations or rules is called rulemaking. Jun 30, 2016


#CDC is responsible for deceitfully
allowing great harm to be inflicted onto/into intractable pain community/patients… 

2016 CDC guidelines are
causing millions to Suffer in relentless torturous Intractable pain,  because of their irresponsible, neglectful, ingenuous, lack of integrity and immoral standards of operating in the infamous “OVERDOSE” stats!

The CDC has been BS us all along. There recent cowardly admission of the fact that those numbers were grossly disingenuously counted incorrectly, the insidious horrific damage by these tremendously huge over-exaggerated numbers have been used to formulate these cruel, inhumane heartless,  POLICIES which is now plaguing, torturing,and SLOWLY KILLING millions of us.
The degree these overdoses were over counted is criminal …
According to Josh Bloom’s article,
“The CDC Quietly Admits It Screwed Up Counting Opioid Pills” he states that
“Based on all these adjustments, it would not surprise me in the least if 90% of opioid overdose deaths were a result of illicit fentanyl and its analogs, heroin, and the combination of pharmaceutical opioid drugs with other drugs of abuse.  Maybe more.
CDC EXAGGERATED OVERDOSE CLAIMS
“In 2016, 63,632 persons died of a drug overdose in the United States; 66.4% (42,249) involved an opioid.” 

But factoring in all the triple counts, inaccurate counts
Based on all these adjustments, it would not surprise me in the least if 90% of opioid overdose deaths were a result of illicit fentanyl and its analogs, heroin, and the combination of pharmaceutical opioid drugs with other drugs of abuse. Maybe more.
42,249 more like 4,249 a huge, gigantic difference it is CRIMINAL WHAT THE CDC HAS DONE!!!

It should be entirely clear that pain patients who use these painkillers correctly and responsibly are not the people who are dying from overdoses. But they are dying – slowly – from having to live in misery that we wouldn’t allow our pets suffer so horrifically 

the medicines they need to function are being forcibly taken away.
❌It is 2020 and this is the United States. How did we ever get here?”

All THIS SUFFERING,  SUICIDES DUE TO PAIN…

❌ ALL BECAUSE OF THE  ACTIONS  based on a bunch of lies many have resorted to
SUICIDE DUE 2 PAIN, Suicide due to pain

https://youtu.be/CSkxF1DMQws

https://youtu.be/0ACgV0aLIAk

https://youtu.be/hRGECrgVPsk

Because the pain is just to much! PAIN KILLS!

Pain is Relentless, pain is cruel, it doesn’t discriminate, it could happen to you, everyone is just one car accident, surgery, illness away from spending the rest of their lives in torturous,  incessant disabling 24/7 365 days a year every minute of every day… believe me this is a journey you do not want!

That paper analyzed 295 pages of text from 86 emails obtained by the public ⬇️⬇️ health group➡️➡️ U.S. Right To Know under the Freedom of Information Act. Of the non-profit’s 10 Freedom of Information Act ⬅️⬅️requests, three were still pending at the time of publication, five were rejected, and only three were returned.⬅️⬅️⬅️✔ U.S. Right to Know has sued the Centers for Disease Control and Prevention over the agency’s failure to comply ⬅️⬅️⬅️with the Freedom of Information Act (FOIA).⬅️⬅️

 In the letter, the congresswomen point to a couple specific examples from the published email exchanges, including one where Coca-Cola used self-funded⬅️⬅️ epidemiological studies to argue to CDC officials that “associations between⬅️⬅️ diet beverages and weight… [are] likely the result of reverse causality.”⬇️⬇️⬇️
The messaging coincides with the⬇️⬇️ corporation’s mission to shift blame ⬅️⬅️⬅️for the global obesity epidemic. Despite evidence that diet, rather than physical activity, is the defining determiner of obesity, Coca-Cola has a vested interest in arguing the opposite for the sake of their profit margins. Their attempts to obfuscate are a common theme of these email exchanges.

In reply to comments posted by Donna and Joe Lane: there were chronic pain patients who were properly titrated to a working dose by their specialist physician(s) [note: not general practitioner but a physician specializing in pain management]. These patients suffering from intractable pain were compliant in Rx treatment and were STABLE with their respective dosage; their use of opioid therapy was successful for their condition or diagnosed injury. There is research which substantiates that some patients require a higher dosage; it is a matter of genetics and DNA markers. We are all different with pain tolerance.

Perhaps in the next century our scientific community will determine a pain threshold “marker” just like the medical researchers discovered blood types (i.e. “A”, “AB”, “O”, “B” and whether the blood type is positive or negative). DNA and genetic profile is complex, and our researchers continue to discover new things about our bodies. Perhaps a pain profile test awaits.

But from a legal viewpoint, I am shocked CDC combined legitimate Rx opiate data analysis with illicit (illegal) drugs such as Heroin and offshore non-Rx Fentanyl to determine overdose death. 

Why did CDC fail to isolate Heroin and other illicit substances in their data classification? Why did CDC fail to create those street drugs as a subset cause of human fatality? 

Why force legitimate chronic pain patients and their specialist physicians into a living hell by reducing the dosage of legitimate pharmaceutical opiate meds? 

It seems that illicit drug death data should be separated.

This mistake by CDC harms diagnosed responsible patients suffering in pain because of degenerative disk disease, RSD, complex regional pain syndrome, arachnoiditis, spine injury – just to name a few causes of pain. It is also a HUGE insult to patients’ specialists who are skilled in diagnosing and treating the complexity of chronic pain.

Physicians, pharmacists and medical professionals raised the issue to CDC and CMS/HHS Medicare about the legal risk in “forcing” an arbitrary number of 90MED per day. Legal risk as in law suits, and the question becomes “What if a lawsuit is filed by an individual party’s undertreated/untreated pain”? Case law court past decisions were decided in favor of pain patient’s right to opiate treatment.

Let us not forget Skip Baker’s untreated pain in Virginia, the torture inflicted on him and his legal victory. http://druglibrary.org/schaffer/asap/virginia1.htm

Staying Organized

Who me? Organized? My husband might tell you otherwise, but I do find it hard to keep track of our weekly schedule. You know: school, swimming, grocery shopping, tidying up, paying bills, remembering appointments and so on. Fortunately, in our house we all pitch in. No one person does everything. But we do have a little secret that helps our day run more smoothly.

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