Category: Opiophobia

I am republishing these “Principles of Opioid Management of Pain“, by Dr. Joel Hochman, et al., because of the explosion of deeply flawed and misguided “Guidelines” for pain management in recent years. This document stands alone in meeting the (textbook, ‘responsible physician’) for pain management while not violating core ethical obligations of the doctor-patient relationship and is useful, I think, for comparison when studying promulgated Guidelines. [See also: The Distortion of Medicine and Confusion of Standards]

Unrelieved pain has a devastating impact on the physical, emotional, social, and economic well being of patients and their families. Diagnosing and treating pain is, therefore, fundamental to the public health. Terminology is review, myths identified, and medical understanding is stated.

I spoke to Billy’s wife briefly, recently, and am very happy to be able to report that Dr. Hurwitz is no longer in federal prison. He is currently in a half-way house in D.C. and will be transitioning to house arrest as part of his parole and probation requirements… He is in a sort of “titration to house arrest” best I understand it. Meaning, he is starting to get overnight visits with his family – YEA! – and more and more of that till he sort of “stabilizes” on a regimen of maintenance house arrest. (Is house arrest a substitution therapy for …

Update on the case of USA v Dr. Martinez in Washington state. Martinez has been acquitted of all drug crime charges. The fraud charges remaining after her 2007 fed trial have also been dismissed, but the govt can bring the fraud charges anew. Also examined is a recent Yakima Herald article announcing “new” charges that are not, in any reality-based sense, “new” at all.

The article well describes the public health chaos this is the predictable consequence of clinical and public health authorities abandoning their real mission to uphold the medical standard of care for their citizenry, and instead focusing exclusively on the policeman’s agenda which prioritizes ‘catching a few addicts’ over providing adequate pain management for legions of innocent patients.

Excerpt: “As usual, the academics ignore the elephant in the living room. Regarding review articles that wring their hands about the lack of long term evidence of the safety and efficacy of opioid analgesic therapy, they never discuss the impossibility of measuring the efficacy and safety of a therapy that almost no physician is comfortable doing properly. For an excellent analysis of what we might call the “new academic opiophobia,” see the Pain Relief Network’s 2008 “WA State Tort Claim” pages 34 – 37.”

*__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. [...]

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.

AP news article about Dr. Schneider, who remains in jail awaiting the outcome of legal wrangling regarding conditions of his release on bond.

This Resource Is an article discusses the failure of the ‘barriers to pain care’ literature to analyze those barriers from an ethical POV. The author relates this to ‘the collective failure of the profession to recognize the ethical implications of undertreated pain.’

Network, protesting a scandalous article by the paper about PRN’s involvement in the Dr. Schneider case. Excerpt: “In our movement to reestablish rule of law and to normalize the doctor-patient relationship, we are constantly faced with desperate patients who ask us what do after they have been turned away from care dozens of times. I explained to the reporter that these people were once prosperous, had full lives, and dreams and hope. But merely by suffering a crushing accident or a cancer diagnosis, they find themselves in chronic severe pain and in need of ongoing opioid therapy. They then find …

Blog post about an example of war on doctors Trash Journalism, which is analyzed. Excerpt: “So what is the message? Well one clear message to me is that the line between pain patient and ‘addict’ – that pitiable dregs of humanity; the walking dead; that criminal scourge; is thin and vague. In fact it is presented as the slippery slope if not an inevitability – people on chronic opioid therapy are, or will become, addicts. Pain patient, drug addict, who cares? Drug are bad, people who use them are bad, you and I are better than that; they deserve what …

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.