60-Minutes: FDA Wrong To Allow Long Term Use Of Opioids Says Ex-Commissioner

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CBS 60 Minutes plans to air its interview with a former FDA commissioner that the agency was wrong to allow long term use of opioids for chronic pain treatment.

Dr. David Kessler said the FDA inappropriately extended the market for opioid use in the 1990s despite a lack of studies on safety for long-term use for patients with chronic pain. The former commissioner now says Purdue Pharma, the owner of OxyContin, needs restrictions.

In the realm of take-backs, how long do you think we will need to wait for VA to admit its own culpability in the expansion of opioid use? Some of you may recall the Tomah VA Candyland scandal a few years back that forced VA to flip from excessive and careless opioid use to one that dropped veterans off their prescriptions without tapering.

One thing seems clear, when it comes to policing pharma, our federal agencies seem completely clueless when heading off problems with deadly implications.

RELATED: President Trump Supports Opioid Replacement Research

Here is an excerpt:

The change in the FDA’s labeled indication for opioids such as OxyContin to long-term use gave big pharma a green light to push opioids to tens of millions of new pain patients nationwide. “You have a system of pharmaceutical promotion that changed the way medicine practiced and no one, all right, stopped it,” says Kessler. The marketing led to an over-prescribing of the dangerous drugs and a river of pills fueled the deadly epidemic, as companies were allowed to sell more and more pills at higher and higher doses. Kessler speaks to Bill Whitaker for a 60 Minutes report to be broadcast Sunday, February 24 at 7:00 p.m., ET/PT on CBS.

In 2001, after Dr. Kessler left the agency, the FDA officially relabeled the powerful opioid OxyContin to be used for an ‘extended period of time’ by chronic pain suffers. Originally approved based on science that showed it safe and effective only when used “short-term”, the label was changed without adequate scientific study. “We don’t know whether the drugs are safe and effective for chronic use,” Kessler says. “The rigorous kind of scientific research the agency should be relying on is not there.” The right to market for the new indication was ultimately granted to a whole class of opioids.

Dr. Andrew Kolodny, an addiction specialist at Brandeis University, has been trying to get the FDA to change the label and limit the marketing of opioids since 2011. He tells Whitaker opioids are essential drugs for pain management at the end of life and for short-term pain needs. “[But]If you’re taking them around the clock…you become tolerant to the pain-relieving effect…you’ll need higher and higher doses,” he says. “The treatment becomes more dangerous and the risk of death goes up,” says Kolodny.

Over the weekend, I watched an interesting piece from Democracy Now about the opioid crisis and the secretive Sackler family that owns Purdue Pharma. A link to that short piece is linked at the top.

What do you think about opioids and the role of big pharma in our every day lives? What will be the next opioid crisis?

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35 COMMENTS

  1. “[…What do you think about opioids and the role of big pharma in our every day lives? What will be the next opioid crisis?]”

    1) Tomah VA Candyman Dr Houlihan—‘nuff said.

    2) Next opioid crisis and only time something truly is done to combat this crisis, will be when a gaggle of these self-serving greedy pricks looses family memembers to the very poisons they candycoat, and can’t happen soon enough.

    3) It’s too late because bad ass opioid genie has left the bottle.

    4) Canabis is much more full spectrum helpful, legalize it Federally and watch big Pharma die.

  2. Hmmm. Ben. Not getting updates, your site is a no-show on my FB page. FB community policy is deleting some of your info/articles in “messenger” too stating police wrongs or copyright violations.

    Love the word play most are using… “opioid” this, opioid that, cliche the word, the need to cease all pain meds, evil opioids, blah blah blah. Entire communities and areas going through total shut-downs on pain med prescriptions but the propagandist keep claiming MDs still handing them out like candy and writing scripts??? Bull shit. Then here comes more laws, more over-sight, more laws, more fascism/tyranny, etc. While so many vets are treated differently and some have seen no change in their meds at all. Odd? Or while the elite and connected can still have theirs or all the Valium and such they want. Oh and exemptions from those vaccinations. Crickets and attacks from the Kool Aid drinking sheep and attack agents. Media totally silent about some facts and reality… censor, ban, and attack are the words for today, and everyday for people like me.

    Weed nor CBD oil is the helper or cure for all of us out here. If anything does help or heard to help like Kratom, etc., is made illegal over-night. But anything to help vets being attacked or ignored goes on to suffer the systems for years till they die.

    Or maybe those who have dealt with addictions in their family are led or think everything should be banned and we all put under the close watch of da law and Big Bro/Sis. More BS.

    I’ll put it in a question a person told me some time back, a reversal. “Is it because we are addicted to some level of pain management we can handle problem free like many do/did, past tense, or, is it because we are addicted to being pain free, more mobile, which is interpreted as being addicted to a pill three times a day or twice?” Trying to paraphrase. He is now dead by suicide I am told. Happy FDA, AMA, VA, legal beagles, etc?

    Big Pharma, LEOS, DHS, DoD, FDA, many others need to stay out of our lives or what we do with or put in our own bodies, period. Too many actors want or demand the Gov, colleges, media, Hollywood, to special interest groups to rule over our lives. To save us all from some tragedy, harm or from ourselves. Big money and more restrictive laws for the control freaks out there. I was with Ron Paul. Legalize it all, be responsible for thy self or face some consequences. You swim with sharks and get ate… suffer and deal with it choices were made and not appease some grieving mommy or actor on TV over something. Same thing with legal booze, gambling, soda drinking addictions, eating Bon Bons and just watching Oprah for a Gov check until they die. Whatever it is there are still those out there that is gonna make big money from our suffering, medical game playing with shit that has been tried and doesn’t work, to big money from our deaths.

    Death rate and amount of suffering today is? Oh, all that is secret and not for public consumption.

    • Yes, Facebook did not let me post this the way I normally would. Had to manually load the article. Also, good to know that Facebook is also blocking my links citing copyright… I anticipate this might be in the run-up to make health care mandatory via inoculation for all children in all states. The Constitution goes out the window when corporations are allowed to secretly limit the free flow of ideas in this way.

      Let’s not forget Facebook and Google are now wading into the health care waters themselves to in turn broker all your data back to Big Pharma for a fee… and then to sell ads from Big Pharma back to you of the newest this or that to treat an ailment you did not know you had.

      • Hey, Ben could you do a Review of the Effects of Using CBD oils and uses that has helped and is helping several people around the world…
        Thanks…

      • Breach of data requirements goes way back. I just now, within the last 5 minutes, discovered that the Vietnam Memorial requested a copy of my military record signing my name in August of 1995. I was using a National Parks Permit to man a booth overlooking the Vietnam Memorial from the Grassy Knoll on the DC Mall at the time. No one ask for my signature and a B G Burkett signed the letter of request as though I had signed him up to be my VSO Representative. Even in the days of signature requirements breaches were easy.

        I can understand why a Veteran’s authinicity might be questioned but they could simply have ask for my VA card at the time. Why the behind the back effort? My records were all ready in my VA C&P file so the National Military Records Center in ST Louis didn’t have them to pony up a copy. But the effort was made without authorization.

    • T, Thank you. This PHONY Opioid Crisis is killing people daily. Not to mention the TORTURE being imposed on MILLIONS. I have been on Opioid Therapy for more than 25 years. I take a prescribed, have not asked for more because of tolerance. These weak ass people that are “Addicted and overdose” are predisposed to addiction anyway, Most of them. Most deaths are due to mixing other things with opioids. I know I would be DEAD by now if not for Compassionate doctor,(at my VA). I have anxiety every month, wondering when I will be cut off, COLD TURKEY. Like so many people I know. The CDC has even come out and said their OD numbers were WRONG, High about 40%. That Jackass Kolodney is NOT a medical doctor. He is a top leader in the company that makes the drug to get you off of opioids, and is leader of SEVERAL drug treatment companies ( late night commercials). HIS bottom line is all he is concerned with. As far as weed, well it does help some people with pain. NOT ME. After smoking weed for 40 years I gave it up 4 years ago after failing VA drug test. I had to choose, Pot of Pain meds. I chose the meds. If weed works for you then fine. But don’t take my pills. I put the Weed legalization issue at the TOP of why the DEA is so damn hell bent on prosecuting doctors for Opioids. They are fixing to be MOR Useless than ever. They won’t have that Evil Weed to combat, so they need something to justify their budget. I am Sick and Tired of my govt. sticking their nose in EVERY aspect of my life. Supposedly to make it better. I am a big boy and have lived through a lot of shit, even their war. Damn rapist and murderers are getting away with shit by saying they were addicted to Opioids. What a crock. All this shit has done is cause more suicides due to non treatment of Intractable pain, or forced GOOD people to the streets to try and find relief. Most of them have NO IDEA about street dealers or street drugs. So they end up dead. I just wish we could find a lawyer with some BALLS to fight for the Chronically Ill Americans that are being tortured by it’s govt. But hell no. Lawyers don’t want cases they have to really work at. They all want the easy settling cases. I wish I had been young enough to use my GI Bill to go to college and get Lawyer degree. Hell, have VA Comp. benefits to live on. I would do nothing but represent the powerless in our midst against the power brokers. But NOOO. These lawyers now refuse to help the poor and week in our society. It doesn’t fill their bank accounts. Enough. Hell my BP through the roof, just thinking about how so many people are being TORTURED because of some weak ass rich kids made a bad choice and died as a result. What about the kids that make the choice to JOIN our All Volunteer military, and DIE as a result. ??!! PEACE TO ALL!!

  3. Absolute lie that opiates do not work for long term chronic pain. I have been on Oxycodone for 10 years and the same dose for the past 6. Without them I would put a bullet in my head. Living with severe chronic pain is unbearable at times, now the clowns at the CDC cut all pain patient doses in half thinking it will save the drug addicts on the street. Insanity. Now that they were caught in lies about pain meds not working long term through their bogus 6 week study by anti-opiate doctors, all pain patients are forced to suffer. Not one drug addict has been saved by this “feel good” harassment of pain patients. Suicides by innocent pain patients are up 38%? Why? Drug addicts don’t give flip about anyone but themselves… Selfish POS…

    • Nick, Thank You! I have been on Opioid Therapy for over 25 years. And. like you, I would have been GONE a long time ago without. These idiots ack like Opioids just came along 10 or 15 years ago. Opioid has been used for pain since the beginning of time. This is just making Kolodny rich from sales of Suboxone. He owns majority of company that makes it. And studies have shown, it is worse than opioids. Thanks for bein g a person of sense. Hard to find any more.

  4. Yes he was wrong. But the medical and government communities didn’t force drug companies to find CURES for aliments or other solutions that keep people from pain. Instead the FDA allowed symptomatic drugs to be used that never took the person out of pain and cured illness. This is their job and they failed miserably. You want people off opiates – then find cures and get them out of pain. Short of that people are allowed to have a comfortable life and not be in pain – period.

  5. Lets see how many disabled veterans and others we can force over the edge and into no longer being a drain on our society ( the words of a REDpublican Cresent Hardy, Nevada state senator, 2015) and let them suffer or join the 22 SUICIDES a day among veterans. That as high as 38% of ALL suicides are now lack of proper pain control related (state of Montana) and the ONLY pain control option available that is as strong or stronger than a narcotic ( Ziconotide/Prialt )requires the installation of a Morphine/Insulin pump to even try leave alone actually use… The Nazi’s STARTED by tossing the disabled into the ovens…. Why bother with cyanide when you can force the desired goal by simply withholding relief…

  6. Even more stupid is not treating pain at all? How about the VA policy No joint replacement until after 50? How about using your bad knee and ankle till the tibia and fibula fused together? What about kept working and walking with a gait change? Do you realize that your comments are asinine? When walk with a bad joint it forces your body to guard causing other joints to fail? Does he know when have a complete ACL that it tends you fall? My spine has numerous discs bad from cervical to S-1, shoulder impingements both side, tissue torn and tendinitis. Carpel tunnel in both wrists, but believe neurological. I have impingements in both hips, bursitis and arthritis. Left knee reconstruction with almost no cartilage, right knee has a torn meniscus and both with patella maltracking and I have widespread arthritis. Need 2 hip, 2 knee and left ankle all need joint replacements. Then get into Chronic pain, depression and anxiety disrupt my daily life. If they take meds from it would be homicide. I believe that when you get an injury and correct in a timely manner it is far better, but where’s the pool and all that is needed for rehab. When you don’t do in a timely manner and you leave me no options and must work it grinds your joints and losing stability that it too causes additional injuries from falls. Yet you and the VA believe no opioids knowing what would happen leaving me to die. It’s ridiculous to treat all under your and others under one umbrella, you and peers can have dez nutz and GFY

    • Broken, that is exactly what the VA and now the civilians have done to those like you and me with multiple issues from head to toe to contend with. And they think it’s something to smile and laugh about. Needless to say I like others have tried everything out there but just wasted tons of money and dashed hopes. Acupuncture needles are even illegal to purchase here, or told illegal to purchase minus a script in the states to get.

      Ya get too old with our many many issues once ya hit around the sixty mark they all refuse to try to mend torn rotator cuffs too. Claiming it won’t turn out well, having to spend like six months in a nursing home due to the casts and care required, then the rehab. Told the cast don’t come off for months leaving a person one armed for that time. Elbow sticking straight out with a side brace, and looking goofy.

      Medical care in this country has turned to shit and left many of us out here like you, and me, screwed, needy, or like me and others in my group dropped from pain meds, play the VA game, or told to hit the street corners for Heroin, crack or told if alcoholic ‘go back to drinking.’ Read nice people at the VA to drop vets picking names out of a alphabetical hat to appease the stats that so many pain scripts have been purged from each PCP or clinic. Sure made the politicians and others smile doing their photo ops on TV and bragging bout making drastic changes in our health care.

      Oh and one Tramadol tablet about gave me a heat attack and had to lay in bed for a couple days. Did nothing for pain but created a stir when I didn’t get the second script filled and how to prove why I threw the other full script away in the yard. Bastards. Now thanks to the VA and others retaliation and politics game I still can’t find good health care or get my civy files released, but told it’s all legal.

      • Damn it man. My Dad is 84, Retired Marine M/Sgt, having Rotator Cuff repair next Thurs. Said he be down about 14 days then start PT and be good as new inside 6 months. Tricare for Life at civilian facility. Not VA. Just wanted to toss that out there. Hate to hear about your issues. I know though. 3 spine surgeries so far myself. Last in Aug.2015. Titanium plate and screws through entire Cervical spine, C2-C7. Done at Civilian also, through Choice. That doc. said he didn’t see how I wasn’t paralyzed from the damage. Took 2 MRIs and about 14 months to get approves. Funny thing, VA and Health Net didn’t pay the bill of $104,000. So I am being sued. Think I could find a lawyer to help with that too? NOPE! Ha Ha. Oh well. All I got is my ass and my hat. And they both got holes in them. Neither worth shit . So??!! PEACE BROTHER and good luck.

      • R. Michael Maddox
        Thank you and all the best back at you and for yours. I really hope and pray your Dad’s surgery goes well. Keep me/us informed on that, please. 2019, the info age and we still can’t get straight answers to second opinions, or three, or more, that match up and can be trusted. Minus all the side and assorted BS. Like dealing with the VA, politicians, families, med boards, et all, isn’t bad enough, piss off the local herds around here they will attack in any way imaginable to protect their own including trying to burn me out while being community wide black-balled or called nuts. With Indiana being so bad and corrupt to the core no-one, no media, cares to come here to reveal some truths and realities of life in some areas.

        Gotta give Kudos and thanks to Ben because at least he’s given us a forum of sorts and he took on one monster of deceit… Voc Rehab. And points fingers to other problem issues too. No-one else is doing that. One office or one person can only do so much and take on so much. Some of us know just how dangerous it is to step on so many toes in this country today too considering all the nepotism and connections. I figure considering it all plus a aneurysm or a “may-pop” on top or the rest of everything I am a walking dead-man anyway so all threats or being kept from acceptable MD care isn’t bothering me much. Sixty six years old and tired of all the BS and corruption. Like I’ve stated before I am damn good at suffering. Political or activist or union styled threats don’t bother me. Cops don’t care about the phone harassment or death threats, fine, ain’t gonna bother me much either. But just bring it and get it over with cause I am not shutting up or going away like so many desire or told me to do. LOL Kinda like a coming to Jesus moment or ‘give me liberty or give me death’ scenario or thinking. Also why it didn’t bother me much to post my FB page out here. Didn’t do much good but picked up a couple understanding vets and tons of enemies. lol Got me banned, blocked and ignored all over the nation. lol

        Got over twenty five or so years in recovery programs and helped run a club here for the addicted or out-casts and such. So they can’t shock me or tell me how all these addictions offices springing up or local mental wards isn’t all about facade and money, it is. Or how great the VA is about so professional, perfect and better trained than all the rest, they are not. So “they” can’t pull their normal propaganda and facade on me. Worn too many hats, seen too much, know too much, not part of any herd or fancy uppity cliques or out to just save my ass. Once awake to many things there is no giving up or falling back to sleep to appease all the corrupt and uncaring buttwipes out there.

        All try to have a good day out there today.

  7. Good Ole Nice Jew(ish) Boy Sackler Family up to 2016 when I heard about them had made over 14 Billion, like always the Veterans will or have been the guinney pigs of these harmful Drugs. I don’t take any of these Bullshit Drugs they give me I just put them in my cabinet. I’m a little more pro-active than the average bitch and moan vet who blindly and ignorantly takes these drugs without knowing the side effects of them. I always look for alternative methods for my conditions period…

    • Must not be much wrong with you in the pain category, You stupid Fuck how do you know how much pain someone else is in You act like I don’t need it so know one else does either… Your sounding like a politician that sat on his ass all his life and says I feel good so you should to. Or I was there and there’s nothing wrong with Meeeeeee……..Stupid Lifer, Now go shine your boots, Fuck stick

      “I always look for alternative methods” LOL Like your the only one that does.
      Opioids are the only answer to real pain, But you don’t know what that Is

      • Thanks OM. Saved me from dropping some well meaning F-bombs myself. “Bitch and moan vets”? Wouldn’t say that to my face…. for F-ing sure.

        Told by experts and specialist not to do over the counter meds along with other killer meds or OTC types. Now we hear still how so much damage and harm is being done by the OTC dope but some will still claim they’ve been eating Tylenol and other stuff by the hands full and had no problems. YET. I was told to never stray from narcs, period.

        Bit my tongue, ate some Crow, and joined up with another local Legion to get some community and vet news since the area lost it’s last open chat forum. So its go out and gather info or get fed from the MSM, censoring social media, Freak Book, and town communist.

        Been floating around questioning more vet groups too. Telling my story and asking about the censoring, pain pill issues, VA retaliations, their thoughts on vast amounts of law breaking by professionals to no ethics, their evil ways and cover-ups and many other others in a short time. The unanimous consensus from them all is … ‘don’t want involved or associated with such major contradictory issues.’ ‘Know it’s happening but not their agendas or works.” Known about but have to play the symbiotic political games for the ole quid pro quo and pretending to be all caring and shit. Wouldn’t discuss it and swiftly walking out of the meetings at the end. To just bragging about their riders or how great their vet groups and such are, according to the liaison person present. To basically and frankly… not giving a flying F at a rolling doughnut and does not care what other vets are going through.

        There is also chronic drops in memberships full circle and in many areas and states. Locals going the way of the worthless groups like CVA that isn’t crap or care about local issues at all. Oh but we are supposed to support the biker groups just worried about looking cool, riding and not much else unless it’s support for the animal shelters or women’s groups, etc.

        Worries about not many showing up for V day parades….which is sad and doesn’t speak well for the public and locals in any area dealing with that. Parades in some areas may come to an end. But TV shows everything is all patriotic and loving, totally accepted and attended. HA, lies. Low attendances, not much concern, very low funding, volunteer and admin/officer shortages, having to pacify local councils, special interest groups to the cliques. Legions and groups closing down all over. Seems much is going to hell fast. And I guess no time to deal with censoring, those in chronic pain and being illegally treated and attacked. Community black balling to ignoring major issues is okay too. No one wants involved in any VA issues or the rest.

        And all those that claimed their needs for pain meds were getting theirs no problem. Also in good with all the lefties, the corrupt, and cliques. How nice.

    • “I’m a little more pro-active than the average bitch and moan vet who blindly and ignorantly takes these drugs without knowing the side effects of them.” Fuck off asshole. You don’t know shit about most Vets, their conditions and pain level. You are a typical ignorant pain med hater.

  8. Almost got caught up in that with Tramadol. Fortunately I couldn’t get it in Japan and had to go back to T3 or hospitalization with controlled minimum time between shots.

  9. This is true. Opioids are not appropriate for long-term use for chronic pain.
    I broke my neck and damaged my spine in 2000. I used OxyContin, oxycodone, and methadone, variously and in combination, doctor-prescribed, to combat the pain.
    The longer I used them, the less effective they became.
    By 2014 I was at the maximum prescribed limit and still in daily intractable pain, and the decision was made to switch to Celebrex, a powerful anti-inflammatory. I gradually reduced the opioids. It took me six months to fully detox.
    I still have daily chronic pain, but it is more manageable than it was on opioids and decidedly safer.

    • Edwin
      Good for you but we are still individuals with varied experiences. Don’t try to speak for all of us like so many want to do or make claims for all across the board.

      Celebrex huh? That was the first med that gave me severe NAFLD (non-alcoholic fatty liver disease). Gave me some feel good for a month then lowered it’s real effectiveness on pain. Wow, lets all do the collective punishment thing and do Celebrex and anti-depressants and Gabapentin for pain. Or we can all go back to Grannies moonshine remedies. Let’s force the DC an Congress crowd to do that too. Oh, let us eat cake/bread and do without which is the plan.

      For many years I had my migraine meds, standard pain meds and those for break-through pain. No problem. Saved me money and stupid trips to the emergency where it’s a toss up whether you’d get sterile water or Dem or Morph. I would also constantly check my tolerance and back off them all every few months for up to a week and endure the pains for my own observations or exploring. Then that became illegal too.

      I was given Fentynal patches at the VA. Didn’t do shit. People didn’t believe me so I made a call to a local MD, I got a friend to drive me to a local E room and I slapped FIVE on my arm… nothing. No over-dose, no pain relief why? Pharm sealed packets and boxes. Got one like mine from a dying C patient while caring for him and had to pull that dude off my arm it was so intense. Again, why? Sure as hell wasn’t all in my head. Like getting pain shots in a E room and not getting any benefit at all from it or another one. But had to lay there for four freaking hours to appease them and not call the cops in for non-compliant and possibly driving with sterile water on board. Yeah, right.

    • Study links Celebrex, heart valve calcification after earlier research declared drug safe.
      A well-known, four-year study found popular arthritis drug Celebrex no more dangerous for the heart than older drugs in its same classification – commonly called NSAIDs. Now, a big-data analysis of patient records at Vanderbilt University has found a link specifically between Celebrex and heart valve calcification.

      W. David Merryman, professor of biomedical engineering, and Ph.D. student Megan Bowler started out by testing celecoxib, the active compound in Celebrex, on valve cells in an effort to see if it could double as an aortic stenosis therapy. It made the problem worse.

  10. Oh Ben, many other vets are being banned or deleted on FB. Can’t remember her name but you were on her radio show and FB. She pops in and out and is also seemingly, obviously, being censored. Last pop up from her on my FB notifications said something about her trying to read posts then it disappeared. Still can’t get yours on. Guess we are headed for a total shut down and fascist game. Just a FYI.

  11. 02/24/2019

    Dear Benjamin Krause.

    You stated: “One thing seems clear, when it comes to policing pharma, our federal agencies seem completely clueless when heading off problems with deadly implications.”

    After the 1960s no American is stupid to drugs.

    Congress passed The Comprehensive Drug Abuse Prevention and Control Act of 1970; President Nixon and the Drug Czar Robert DuPont called it a “War on Drugs.”

    After the 1980s every banker knew what Cocaine was; especially, every dollar bill had cocaine on it.

    All businesses were warned not to aid the “Drug” industry in the late 1980s, and the Bankers were told to monitor the withdraws and the deposits.

    The Federal Government was making too much money to interfere [Cardinal Health; McKesson; AmerisourceBergen; Sacklers; etc…], especially after Enron [Kenneth Lay, Jeffery Skilling].

    The policy was to make money anywhere you can, no matter who gets in the way…according to Joseph Rannazzisi [a former top DEA supervisor]…and Congress cannot stop it according to Dr. Carmen Catizone National Association of Boards of Pharmacy [NAP] Executive Director; “We agree, the laws are not working”—replying to my old U.S. Senator Diane Feinstein [December 12, 2017—The Senate Judiciary Committee held an oversight hearing on the Ensuring Patient Access and Effective Drug Enforcement Act].

    Talking about turning a blind eye to the deaths of so many Americans, many whom are Veterans.

    In the last three years the captured Fentanyl would have killed the United States.

    Our problem starts here at home; it starts in Arizona, goes to Mexico, then to China, and back to the U.S. so our kids will die before they can become adults.

    So who hates us in Arizona???

    Sincerely,

    Don Karg

  12. I have to disagree with the ex-FDA commissioner and with those who assert that Narcotic analgesics are the root of (many) evils.

    I sustained one GSW, two mTBI (no brain-through-the skull), splinters (“shrapnel”) wounds, an injury to my knee (concurrent with a mTBI and the splinter wounds), and a penetrating injury to the ball of my foot. Later, as a civilian, I survived a late-Stage III Testicular Cancer after four rounds of chemotherapy and surgeries. Fifteen years after that, the GSW “residuals” caused an anoxic trauma that further added to my troubles.

    I spent 25 years rotating through “short-term” narcotic analgesics, with all the struggles that led to—choices about what to do, how often, etc—while my children grew up with me as their only parent.

    From 2000 until 2010, I took the same dose of sustained release narcotic analgesics. Despite that, once the pendulum swung and the same people who had approved SR Narcotic Pain meds started railing against them—they’d been tricked!—I was one of the ones who paid.

    The facts are that these medications made my life livable. Full Stop. I was a good patient, careful to use breakthrough medication only for pain well above what I normally tolerated—because I didn’t ever get “complete relief” from my Pain Management, I balanced relief with other factors, like operating a vehicle safely, or being able to watch a movie.

    Then…It Was Decided….that these medications Don’t Work. Even though, if taken properly, THEY DO. The State and Federal governments’ willingness to involve politicians in setting arbitrary limits which the DEA and FDA enforce—by taking your doctor’s license if they do not conform to the “suggested” levels—has meant disaster for people like me.

    Yes, there are instances where the drugs were over-prescribed and many more where patients were as careless with dosages as they are with any other medication. That is rightfully on Drs., who should have first ensured they educated themselves about these medications before prescribing them to patients.

    But it is not an issue for which sweeping decisions are a panacea—which is what politicians and TV wonks prefer. It requires Drs to actually practice medecine, rather than only write an Rx.

    I did my bit. I made my sacrifices. Yet instead of fighting for me, the VA abandoned me to the private sector (and as I am 100% Disabled and actually disabled, BOTH, that means my pension). My Pain Management Dr. is constantly being pressured by the DEA, FDA, and (believe it or not) the CDC, to cut “all opiod use” in their practice—as if the patients are stopping by to smoke opium and then wandering off. We aren’t “using” opium, we are taking a prescribed medication. We are not addicts. We probably are dependent (which many people confuse with addiction).

    Now they push is on again. Because the issue is polarised—one must either be in favour of all these deaths from the “crisis”, or be completely opposed to the irresponsible use (eg, any use) of opiods.

    Most of the deaths come from people who are addicts, which traditionally is not a result of proper Pain Management but of careless and indifferent Pain Management followed by the peasants and their pitchforks leaving people in pain with no good options.

    Pain Management needs oversight, but not arbitrary grandstanding. Those of us in serious, irremediable pain, need a means to live our life in a meaningful way. And as a person in pain, I can tell you that the reason these medicines are still around is that they work—and most of the others do not. Gabapentin is great for sciatica, but it doesn’t touch the pain of a brachial plexus trauma. Ibuprofen may help a sore back or knee, but it doesn’t touch the pain of movement in a joint that had a bullet blow it apart.

    Let’s just slow down and talk about what we mean to talk about, and not just scatter terminology like “opiod crisis” and “pain management”. Chronic Pain is a big bucket to describe everything from back agonies and destroyed knees to combat wound and severe disease residuals.

  13. SFH; Thank you Sir for well articulated response to this issue. I suffer similar to you and twice monthly must endure Anxiety when calling in for my pain medication renewals. Which I get from my VA PCP.(for now). I am Lucky enough to have the BEST doc. in the VA System, in my opinion, and others. Compassion is a virtue among providers these days. Too many just buckle under to the powers that be, instead of honoring their Hippocratic Oath. The politicians don’t care about patients. They are just climbing on the Anti Opioid Bandwagon, hoping for VOTES!

    • You are welcome, and fortunate. Here in Central Texas, the VAOPC asserts that they are prohibited by Federal VA Directives from prescribing narcotic analgesics for anything other than Cancer. Our “Pain Management Specialist” is in Temple at the Olin E. Teague hospital (90-odd actual road miles one way), and refuses to write ANY Rx—even ibuprofen! He believes Nerve Blocks solve all chronic pain. He avoids the issue of how that works out over an entire year, or the fact that they don’t. He “leaves it” to the PACT to write Rx; and they claim they are prohibited from doing so by the National VA.

      Because anyone who argues FOR the proper prescribing of narcotic analgesics in chronic pain management is cast as being in favour of drug abuse, addiction, and death, no sane conversations can take place, and no advocates exist for Veterans who suffered terrible wounds in war and are now being abandoned, because to take our side would tar them with the “pro-opiod” brush. As if wanting rational discourse and honest Pain Management is equivalent to arguing that everyone should have as much fentanyl as they want.

      When pharmaceutical companies in India (like Ranabaxy) were shown to have inexact standards for narcotic analgesic medecines, the FDA revked their approvals. When pharmaceutical companies in China do the same, we apparently just gnash our teeth, tear our hair, and blame-punish patients. Maybe we shouldn’t buy Chinese fentanyl if it’s so inconsistent.

      Maybe, just maybe, fentanyl should be the subject of the “regulation” discussion, as it is the drug that changed the landscape of Pain Management and patient abuse. Stop using “opioid” as a secret synonym for fentanyl when discussing abuse, overdose, and deaths. Write “fentanyl”. Or even “Chinese fentanyl”, if that’s the case. But in any event, let’s look at real, meaningful numbers.

      A report on PBS a month or so ago claimed Americans were now more likely to die of an “opioid” overdose than a car accident. While that makes a great headline, it’s complete bullshit. Far more Americans drive and ride in automobiles than take or mis-use narcotic analgesics. It’s a sleight of hand number game mis-representing statistical data for the sake of grabbing a headline or being “topical”. Inexcusable.

      But notice the silence. Even Mr. Krause is on the “opioid = bad” bandwagon (based on his post, above). This is the difference between people who are in chronic pain, and people who equate pain with a headache or a broken bone.

      • Steven Ford. Yes great spread of info, points, etc. There is a lot of discussions and stepping stones to other serious issues that should be discussed but is not.

        Consistency. Why one batch or a couple of scripts for Fent or something else is totally ineffective while from another source would knock your socks off.

        My last civy batch of Gout meds were three different sizes, shapes, and colors.

        Once I got a box of meds from Canada passed along by two other shipping differing VA state stamps along the way. Told it was because of severe shortages of available meds in the U.S. Then gas-lighted over that ordeal.

        There are those here that still get their meds mailed to them. Some claim they’ve had zero issues over pain meds and have been unchanged for many years. Others claim they have to play the VA game and sign over your entire lives to them with special secretive contracts like we were told to sign or else hit the street corner for pain dope. Others like in my groups were treated and talked to like crap, totally disrespected then threatened if we didn’t follow “orders.” For those like me that did not bow to them and complained get the VA retaliation game treatment. Totally different stories across the board but we aren’t supposed to question and VSOs run away from it all like the rest of society. Oh and due to HIPPA laws state officials, media to scum bucket politicians top t bottom can’t investigate this stuff. After we’ve signed all our info and life history over to many of them.

        Then the money games. All the re-testings, triple testings because they claim wanting their own test results. Big money and wastes of time going back over years of trial and errors, waste of time and great pains… head to toe. Orders to do their physical therapy (the new cure alls) and other countless games that have already been attempted and simply do not work. But we are expected to play the game to beyond any Medicare fraud. Expected to run gamut of each MD or clinics choices of care in their “associations.” Their people. $$$$$$$

        While all we get on TV or in public is the propaganda. Then the hard censoring to people fearing the establishments. Then the cops and many others getting big dollars for the war on pain meds, called ‘drugs.’ The war on “opioids.” Still having their informants out selling pain meds to catch evil doers wanting simple pain relief. Oh they are gunning for the “big dealers” alright. More BS. The set-ups. The need to fill jails and corporate prison systems. Now the need for larger jails and prisons. More need for rip-off recovery joints. Job security and big money for all concerned and law firms doing nothing but bankruptcies and drug court issues, big bucks. More going to their pals in so-called recovery companies or systems, etc. Then the grand game of civil asset forfeiture for the slightest infractions, big money there, and smiles at the goodies they all can attain. They protect their own and have no problems getting any kind of meds or care. Hint… “one of our own” they say. With many out there just wanting more laws to be passed like with the FDA, AMA even wanting to restrict vitamin use or wanting everything to be under prescription laws while like the CDC lying to us and allowing more poisons made legal, what is banned over-seas is legal here, etc. Never ending BS.

        Maybe they’ll do with a pain pill like with a small bag (4 Oz) of special anti-biotics to kill off a super flu case. Oh that will be 25 grand cash, insurance won’t cover that. We don’t keep that in stock and rarely made. No great need for it that much. Try it, buy it, or die.

  14. @T: I actually forgot about the VA’s “let’s just start over” rigamarole—thanks for bringing in that point, it is very important.

    The VA shares our single (now electronic) record with all VA Drs. The same information is available to all of them. Yet, any time one is assigned a new PACT Dr., that new Dr. is able to insist on the patient-Veteran being subjected to an entirely new set of tests, trials, and therapies BEFORE they will “agree” to write the same Rx that the patient-Veteran was receiving before they were paired with the new PACT Dr. IF A SPECIALISTS CARE DR. TRIED TO DO THAT, THE OPC DIRECTOR WOULD SHUT IT DOWN AS AN UNNECESSARY COST. Full Stop. But the VA systematically leverages the idea that no one can force a Dr. to write an Rx they personally don’t feel called upon to write.

    It’s yet another pin in the case for the Hypocritical Oath taking the place of that of the Hippocratic. “First, Save Your License; Never Admit Your Might Be Wrong; Always Do As You Are Told; Tell Anyone Who Asks Anything They Want; Ignore Your Patient, they are unimportant and easily replaced”. And of course, make money, act entitled, and make sure to insist people use “Dr.” instead of “Mr., Ms., Mrs.”.

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