Archives for February 2016

Addiction Isn’t a Death Sentence

Drug and Alcohol Programs Secretary Gary Tennis of Pennsylvania is 100% correct. In a recent Reading Eagle article, he talks about changing our attitude about addiction to deal with the overdose epidemic. “The best cure for opioid addiction is seeing it as a disease,” says Tennis.

Yes.

Addiction is a Disease

We have to see addiction for the disease it really is. Since addiction is a disease, we need to move away from criminalizing people with the disease. Instead, as with all diseases, including cancer and heart disease, we have to move toward preventing and treating addiction.

This is How Heroin and Prescription Opioids Are Different

Patrick Clarke, of Rockville, is correct in his letter to the Washington Post‘s editor.

Heroin is not the same thing as prescription opioids.

There’s a huge difference. I’m not talking only about the pharmacology. I’m talking about the reasons why people use heroin and prescription opioids.

Heroin and Opioids Are Different

Heroin is most commonly used to treat mental pain, while prescription opioids are intended to treat physical pain.

Yes, there are people who use heroin for physical pain. But they are not doing so under any medical supervision, and many heroin users usually can sustain that use only for short periods of time. Then, ultimately, they overdose and die.

Lawmakers Are Looking in All the Wrong Places

In the movie titled with their names, Butch Cassidy and the Sundance Kid look back at an unknown posse that’s following them far more doggedly than the two outlaws would desire. At night, watching the lights of the oncoming riders, both men wonder aloud, “Who are those guys?”

The next day, from a bluff where they are again checking up on the progress of their pursuers, Butch says, “They’re beginning to get on my nerves.” And he repeats, “Who are those guys?” Despite their best efforts to throw off pursuit, the two men can’t shake the armed crew that’s hunting them down.

When to Say No

An article called “7 Words That Could Have Biotech and Big Pharma Very Worried,” written by Sean Williams and recently posted on The Motley Fool, tells both sides of the story.

Pressure on price for pharmaceuticals is a real concern. Affordability is important. A drug can only work if patients can afford to pay for it.

So, on the one hand, the price of drugs must be kept in check.

Biotech and pharma can’t just raise the price of a lifesaving drug by 5,500% overnight. That isn’t reasonable, and that isn’t a good decision for anybody.

OIC Is No Joke, Bill Maher

Those who live with chronic pain may suffer from OIC (Opioid Induced Constipation). That’s not a joke, and it doesn’t lend itself to satire. Yet after the Super Bowl ran a tasteful ad to raise awareness about OIC, Bill Maher weighed in with a tweet that was shameful and offensive.

These are people with serious medical problems. Which of my patients with chronic pain would Maher call a junkie? Would it be the child with bone cancer taking morphine who becomes seriously constipated? Or would it be the grandmother in her eighties who has had severe arthritis in her spine and joints and uses an opioid so she can walk?

Why Keep a Pain Journal

“Julie” mentioned that her doctor advised her to keep a pain journal, and she wanted some direction. She loves to write, but she wasn’t sure how to approach the task. Also, she was concerned that dwelling on her pain might make it worse. Wasn’t the goal to distract herself from the pain rather than to think (and write) about it?

Here’s my advice for Julie:

First, yes, I do think it’s a good idea to keep a pain journal. That will let you observe patterns of what seems to make pain worse/better so you can modify your activities accordingly.

Follow up to President Obama’s Opioid Funding Request

I blogged that President Barack Obama has requested that Congress earmark $1.1 billion to combat the U.S. opioid, and the fact that I support the president on that.

Yet the president made no mention the need to help people in pain. The CDC and Johns Hopkins issued opioid prescribing guidelines without out a peep of concern for the vast majority of people in persistent pain who could be harmed by the guidelines. This is where the national dialogue about opioid addiction is now.

President Obama Requests $1.1 Billion to Combat the Opioid Abuse Epidemic

President Barack Obama’s request that Congress earmark $1.1 billion to combat the U.S. opioid abuse epidemic has turned out to be controversial. That’s not surprising, since controversy infiltrates everything related to every president and every Congress. Nothing any president does is viewed by everyone as the right thing to do.

But, to me, there is no controversy here.

The request that President Obama made to Congress is wonderful news, in my estimation. I applaud the president for making it.

The country has a serious crisis with opioid addiction that must receive priority attention and funding. What the president proposes is largely focused on treatment, and we sure need better access to affordable treatment.

Will Cancer and Pain Melt Away?

Alec Ross, author of a book called Industries of the Future, writes that, in 20 years, cancer may be curable. We might just be able to “melt it away.”

Frequently, I compare pain to cancer. Believe it or not, pain is far more complex than cancer.

Cancer usually starts from a single DNA mutation. On the other hand, pain may involve multiple mutations that can influence each other and evolve depending on environmental factors.

Cancer involves a physiological process that has been disturbed. Pain involves multiple disturbed processes including cognition, emotions, social interactions, memories and physical stimulus. Genetic mutations that affect the expression and function of each of these areas can affect the dynamic experience of pain.

Shame on an Intolerant Firefighter

I was flabbergasted to read the comment made on Facebook by the firefighter in Weymouth, Massachuestts who said “we should just let heroin addicts die from overdose rather than give them the rescue antidote, naloxone.”

This would be like saying the obese diabetic should not be treated because they ate too much, or the disease of AIDS should not be treated because it was a self-inflected disease unworthy of treatment.

The stigma associated with addictions is almost as deadly as the disease itself because it is the reason for the firefighter’s intolerance. It’s also why we have punitive laws aimed at people who have a disease.