Posts Tagged With: standards

It seems to me an uncivilized and insane notion that just because someone in current moderate to severe pain had a history of an alcohol or drug problem, or even a current substance abuse problem, that you would deny them opioid therapy if that was the best medication to relieve their suffering. But this seems to be a point of confusion that increasingly comes up from patients, doctors, and regulators alike. So, in this post, let me make the medical standard of care in this situation perfectly clear. [...]

***Pain Relief Network files State Tort Claim vs. WA State***; Laura Cooper, Esq.; [Pain Relief Network][prn]; 2008/07/08. [**Full text PDF**] **Permalink:** http://doctordeluca.com/wordpress/archive/prn-tort-claim-vs-wa/ **See also:** [**PRN Complaint for Declaratory and Injunctive Relief, and Damages**][d1] – 2008 and, [**WA's Interagency Guideline on Opioid Dosing for Non-Cancer Pain**][d2] – 2007 —- SUMMARY: Nature of Relief Sought: This lawsuit is the result of grossly misinformed prejudices about opioid(1) pain medications held by high-level Washington public health officials. Those prejudices are identified in medical literature …

The nonprofit Pain Relief Network (PRN) says the guidelines for prescribing narcotics, written by the Washington state Department of Health and published in March 2007, have influenced pain treatment across the country and have made doctors afraid to give opiate prescriptions. Siobhan Reynolds, PRN president, says the group decided to target WA because the state has been a leader both in pain treatment and in restricting doctors’ prescriptions of pain relief medication. [...]

Dr. Schneider’s pretrial motions to dismiss on constitutional grounds, and his motions for abstention have been filed, as has the Government’s opposition to those motions, and Dr. Schneider’s response to the Government’s opposition. As I understand it, now we wait for rulings by the Judge. The relevant briefs, and the Order releasing Dr. Schneider on bond and setting conditions on that release, are linked to, below.

Talk given by Frank Fisher, M.D.; Drug Cops and Docs, Cato Institute Conference; 2005-09-09. Introduction — The undertreatment of chronic pain is an ongoing public health disaster. The means to reverse this disaster is a class of medications known as opioid analgesics. The pain crisis exists for just one reason. Physicians don’t prescribe enough of these medications. I’m going to explain why we don’t. — The war on drugs has become a war on legal drugs. This exposes physicians to the risk of unwarranted prosecution. In response to this threat, the academic pain establishment has developed a set of standards …

Excellent article by Dr. Forest Tennant explaining and demystifying chronic opioid therapy for chronic pain.

Associated Press article about injunction filed in State Court by the patients of the federally indicted Dr. Schneider; judge to hear PRN’s Temporary Restraining Order, Friday Feb. 29, 2008.

Associated Press article about PRN\’s lawsuit against the State of Kansas, the Kansas medical board, and Attorney General Mukasey and the Department of Justice. The article focuses on the continuing plight of the legitimate pain patients of federally indicted and imprisioned Dr. Schneider. The patients claim no local doctors or hospitals will treat them properly for chronic pain out of fear of becoming targets of drug war zealotry, like Dr. Schneider.

Chronic pain patient experience of abuse and neglect from a medical system distorted by drug war law enforcement imperatives placed on physicians.

Blog post about the case of U.S.A. v Dr. Rosa Martinez by Dr. Alexander DeLuca, defense medical expert. Case involves federal overreaching, and groundless charges that Dr. Martinez was drug criminal instead of the caring family doctor caring for her chronic pain patients entirely up to the medical standard of care for pain management.

Blog entry about the distortion of medical ethics and of medical practice of pain management using opioid therapy by drug war imperatives on physicians to value catching drug abusers over providing compassionate and rational medical care to their patients.

Blog post about a Continuing Medical Education (CME) course based solely on one interesting and flawed article about the prevalence of addiction in primary care chronic pain patients treated with chronic opioid therapy.

Dr. Fisher last practiced medicine some eight years ago. In the interval he has been criminally prosecuted for murder, civilly sued for wrongful death, and administratively prosecuted by the State of California medical board and stripped of his licenses to practice and prescribe. “I call it triple jeopardy,” he says. “That’s why doctors won’t treat [chronic pain].” All of this because he presumed to treat poor people to the medical [standard of care][soc] for chronic pain, which is opioid titration to analgesic effect or to untreatable side-effect. [...]

Blog post about: Dr. William Mangino remains incarcerated awaiting sentencing which is scheduled for August 8th in Newcastle, PA. Contact information: 1) Address to write to Mangio in jail provided; 2) address and instructions to contribute to Mangino Defense Fund provided. In my next post on the Mangio case, I want to consider in more depth issues raised by the defense’s Omnibus Motion, entitled, Motion For a Directed Verdict of Not Guilty Or In the Alternative, Request For Additional Jury Instructions, especially the section of that document that addresses the Jury Instructions given at trial.

Blog post about: Aberrant Drug-Related Behaviors (ADRBs), which are commonly referred to in slang vernacular as ‘red flags.’ Excerpt: “In summary, in opioid-treated chronic pain populations, ADRBs are very common, addiction as a consequence of treatment is very uncommon, undertreatment of chronic pain is very common, and pain experts lack uniformity in interpreting the relative importance and significance of various ADRBs.”

TOC: Intro — Opiophobia and Opioignorance — Risk of Addiction in Chronic Opioid Therapy — Treatment and Outcomes — Undertreatment of Pain is a National Scourge — Footnootes

First of a series of blog posts regarding the trial of pain doctor William Mangino. Excerpt: “The prosecution asked only one question on cross examination of defense expert Dr. Tennant. The prosecution brought forth no further expert testimony. The defense felt Tennant’s testimony was sufficiently strong and his credibility and professional stature so huge relative to the prosecution expert, and that the prosecution had failed to make it’s case. And so on 2007-07-03, the defense choose not to call it’s second defense expert (myself) and choose not to put Dr. Mangino on the stand, and rested.”

The House Judiciary Committee, Subcommittee on Crime, will be holding hearings on DEA oversight Thursday, July 12, 2007. As a result of my visit to DC in early June, the recent New York Times Magazine Cover article, and the assistance of many good friends on and around Capitol Hill, I (Siobhan Reynolds, President, Pain Relief Network) have been invited to represent the pain issue. The House staffer we are working with is developing the roster and we are supplying her some excellent suggestions for patients, doctors, and lawyers. There will be a couple of other issues represented but it seems …

Blog post reviewing the bizarre developments in Salt Lake City in the wake of the federal raid on Dr. Warren Stack. Much effort is being put into registering “addicts” into government clinics. Zero effort has been made, or concern expressed, for the abandoned pain patients who are to be treated as “prescription drug addicts who could turn to heroin at any time” according to the District Attorney.

Excerpt: “Veterans in chronic pain average less than 4 Percosets a day from the compassionate care-givers of the Veterans Administration… [Such low-potency opioids] are indicated for mild to moderate acute pain, not chronic moderate to severe persistent pain… Oxycodone is a short acting opioid in this preparation, with an effective duration of action of about three hours. One pill every six hours of oxycodone/acetaminophen for chronic pain guarantees that the patient will be in unacceptable pain 50 percent of the time, at best. That’s not treatment, it’s under-treatment; it could not possibly be adequate.”