The Deception: Tylenol, Opioids and the DEA

The Deception: Tylenol, Opioids and the DEA; Alex DeLuca; Addiction, Pain and Public Health website; Date. Source

We are in the midst of a fascinating media firestorm, an ejaculation of drug war Trash Journalism brought about by a veritable perfect storm of events including:

  1. The rediscovery by the FDA that acetaminophen (Tylenol) and NSAID (aspirin, ibuprophen, naprosyn, Vioxx, etc) toxicity are serious public health problems;
  2. A focus on “Vicodin” and “Percoset” as representatives of the class of low-potency opioid formulations which include Tylenol, and widespread calls for banning these medications;
  3. A very recently released medical guideline document from the American Geriatrics Society (AGS) entitled: Pharmacological Management of Persistent Pain in Older Persons – 2009 Guideline Recommendations, which (finally!) states the true medical standard of care for pain management: “All patients with moderate-severe pain, pain-related functional impairment or diminished quality of life due to pain should be considered for opioid therapy.”; and finally,
  4. New DEA revelations that “Most obtain the drugs by stealing them, hooking up to false Internet pharmacies or from friends and relatives.” Wow, and for the past decade they’ve been identifying and targeting bad doctors and bad pain patients as the primary source of diverted drugs fueling a “prescription drug abuse” crisis (for which scant scientific evidence exists);

[The 2009 AGS Pharmacological Management of Persistent Pain in Older Persons][agsindex] – index page with links to the Executive Summary, full text of the Clinical Guideline, press release and related resources. These guidelines are very refreshing and represent the medical standard of care for pain management. The “strong recommendations“

VIII. All patients with moderate-severe pain, pain-related functional impairment or diminished quality of life due to pain should be considered for opioid therapy.

X. Clinicians should anticipate, assess for, and identify potential opioid-associated adverse effects.

XI. Maximal safe doses of acetaminophen or NSAIDs should not be exceeded when using fixed-dose opioid combination agents as part of an analgesic regimen.

XII. When long-acting opioid preparations are prescribed, breakthrough pain should be anticipated, assessed, prevented and/or treated using short acting immediate release opioid medications.

DEA recently weighed in regarding the (presumed overdose) death of celebrity Michael Jackson:

“Most obtain the drugs by stealing them, hooking up to false Internet pharmacies or from friends and relatives.”[US agency renews warnings on drug abuse]

Right – DEA has known this for a long time; and done everything possible to not release the database they were finally forced to release due to a Freedom of Information Act petition, that proves they knew. But go back and read the yearly White House Drug Strategy for, say, 2000-2005. [These historical ONDCP reports can be found at the National Criminal Justice Reference Service; and here is the current, 2009 President's National Drug Control Strategy

What you will find is a focus on physicians and prescribing - bald statements that the primary source of abused meds is criminal doctors and criminal patients. Essentially, they are now acknowledging that they purposefully mislead us and lied to us and imprisoned us even though they knew the bulk of the real diversion problem lay elsewhere. [US agency renews warnings on drug abuse] That’s what happens when you put 18 billion in the hands of cops under a “drug czar” to manage a public health problem for you.

Footnotes

[agsindex]: http://www.americangeriatrics.org/education/pharm_management.shtml “AGS Clinical Practice Guideline: Pharmacological Management of Persistent Pain in Older Persons – American Geriatrics Society, 2009″

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1 Comment

  1. Comment by:
    Mary

    F*#$ Michael Jackson normal people in thie world need help and every time some star O.D's and dies we have to pay for it. I have 88 year old mother that I care give for and the Doctor constantly is worried about his own a$$ he will insist on things like Reclast which could kill my Mother but to give her give her some Lorazepam so she can sleep becuse of her Osteoporis and her pains God forbid and its hard to start over with another Doctor at her age. Very upset and sad the way things have become.

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