Author of The Painful Truth
According to Scientific American, there are approximately 6,800 rare diseases, most of which have no approved treatment. To be considered a rare disease, it must affect fewer than 200,000 Americans. Most rare diseases have limited treatment options. Unfortunately, many types of chronic pain are considered rare diseases for which there are few effective treatments.
If you’re a fan of television’s “Star Trek: The Next Generation,” then you’ve seen virtual reality (VR) at work in the episodes that featured the holodeck. In the series, the holodeck was used mostly to entertain the Starfleet crew. While the holodeck is still science fiction, a goggles-based form of virtual reality has been around for some time and now is being used to treat pain.
Some people may be surprised that the therapeutic value of VR has been researched for more than 20 years. There have been at least 120 papers written about how virtual reality may reduce pain.
Several lawsuits have been filed against several opioid manufacturers, distributors, and physicians for participating in what was allegedly a scheme to cause incalculable harm for profit. I am one of the physicians named as an alleged “conspirator.”
The opioid lawsuits are far more than legal matters that involve the defendants. They also have serious implications for people in pain.
The opioid crisis and resulting lawsuits have significantly impacted regulatory scrutiny of prescribing, which in turn has had a chilling effect on physicians who are increasingly unwilling to treat people in pain for fear of losing their license. Unfortunately, the lawsuits and the hyperbolic charges they contain fail to recognize the scientific, medical realities of chronic pain patients.
Most people in pain do not like talking about their pain problem with others. When they do mention it to friends and family, they generally are disappointed at the responses. People are well intended, at least initially, but they can be insensitive. Fundamentally, they fail to understand what someone in pain is experiencing, so they can only provide a limited amount of support.
On her web site, bestselling novelist Amy Tan shares her belief that she has late-stage neuroborreliosis, or Lyme disease. She suspected she might have Lyme disease because of her mysterious symptoms that included migrating aches and neuropathy, a racing heart, hallucinations, getting lost in familiar places, difficulty talking, plunging blood sugar, insomnia, and fatigue. She finally found a doctor who was able to confirm the diagnosis. After years of expensive treatment, Tan can now manage her symptoms, but she doesn’t expect to ever be cured.
On September 29 of this year, the Food and Drug Administration (FDA) published a notice — Opioid Policy Steering Committee; Establishment of a Public Docket; Request for Comments — in the Federal Register, The Daily Journal of the United States Government.
The FDA is seeking comments from members of the public, including chronic pain patients and their families, healthcare professionals, academic institutions, and industry relative to the FDA’s new Opioid Policy Steering Committee (OPSC).
FDA Commissioner Scott Gottlieb, M.D. has expressed his commitment to confronting the opioid crisis and reducing the possibility of opioid addiction. He established the OPSC, and charged the committee with seeking input from the public.
It began just about a year ago, when the CDC Guideline for Prescribing Opioids for Chronic Pain provided “recommendations for primary care clinicians who were prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care.” The emphasis is mine. The goal, as the CDC’s web site stated, was to improve “… the way opioids are prescribed through clinical practice guidelines” and to “ensure patients have access to safer, more effective chronic pain treatment while reducing the number of people who misuse, abuse, or overdose from these drugs.”
According to Martha Bebinger of WBUR, “About 75 percent of the state’s men and women who died after an unintentional overdose last year had fentanyl in their system, up from 57 percent in 2015 (PDF). It’s a pattern cities and towns are seeing across the state [of Massachusetts] and country, particularly in New England and some Rust Belt states.”
This article was originally published in the Salt Lake City Tribune.
Gary developed excruciating pain in his shoulder and arm following a cervical disc herniation several years ago. He was athletic and otherwise in good health, but the pain is now disabling.
For years, Gary was prescribed pregabalin for this condition. It provided him substantial pain relief until he changed insurance companies. The new insurance company sent Gary and his physician a letter indicating that before they would pay for pregabalin, Gary first had to try two generic drugs that were less expensive. This meant that Gary had no choice but to endure excruciating pain, once again, so that he and his doctor could prove to his insurance company that these medications were ineffective and that he required pregabalin.
On the one-year anniversary of the Centers for Disease Control and Prevention’s (CDC) opioid prescribing guideline, an online survey of patients, doctors, and healthcare providers conducted by Pain News Network and the International Pain Foundation (iPain) found that the guideline has “harmed pain patients, reduced access to pain care, and failed to reduce drug abuse and overdoses.”