I am writing to you on behalf of the 50 plus million Chronic Pain Patients in the United States, Debilitating pain is a widespread problem with half if not more being consistently under-treated
February 24, 2007 (Press Release) --
It Is Time For Our Government To Protect America's Most Vulnerable Citizens Government has failed to address the needs of the patients in pain. Over 50 million Americans needlessly suffer from disabling pain. Patients in the worst pain, those with the highest dose requirements, cannot get care because their doctors are afraid of prosecution from the DEA, Federal & Local Government, Police, etc..
The ethical duty to relieve pain is well established. The Agency for Health Care Policy and Research (AHCPR) founds its pain management guidelines on this principle: "The ethical obligation to manage pain and relieve the patients suffering is at the core of a health care professionals commitment."
Health care professionals offer many reasons for the under-treatment of pain, and an effective response to the problem requires an effort on several fronts. Health care professionals require much more effective education and training in the treatment of pain. Institutions must remove unnecessary institutional barriers to pain relief and should ensure that effective pain management is an institutional priority. Payment systems should realize the costs of pain and adequately support pain control. Patients and caregivers must also be informed and assured that pain relief is to be expected and that fears of addiction are unfounded.
One source of the problem, according to physicians, is the threat of legal sanctions for treating patients in pain, especially when that treatment must rely on the use of controlled substances. Doctors have reported that they under-treat for pain, in part, from fear of legal penalties, especially disciplinary action. In a California survey, 69 percent of respondents said that the potential for disciplinary action made doctors more conservative in their use of opioids in pain management, and a third reported that their own patients may be suffering from untreated pain. Another review of published research on the under-treatment of pain concluded that "available data suggest that medical decision-making regarding the use of opioids continues to be unduly influenced by regulatory policies and fear of regulators."
Doctors' fears of disciplinary action and criminal prosecution are justified. There is no evidence that large numbers of physicians are sanctioned for their treatment of patients in pain, but the impact of the process on those physicians who are only investigated, or only charged but not disciplined, or only warned or cautioned but not penalized is severe. The prosecutorial stance stimulated by a "war on drugs" and by increasing public scrutiny of disciplinary agencies may unintentionally interfere with adequate pain relief because it has intensified and criminalized investigations and later proceedings. Descriptions of the investigation of physicians engaged in the treatment of pain patients with controlled substances present a scenario that would easily intimidate most people. Some evidence also suggests that many state medical boards have not adapted to more current approaches to the use of controlled substances in pain management and that they may rely solely or too heavily on dosage and length of treatment as indicators of inappropriate and illegitimate prescription practices. Greatly increased enforcement efforts in Medicaid programs may also have an impact on prescribing practices in the treatment of pain, though these are still being evaluated.
Needless human suffering from untreated but treatable physical pain is caused by a number of factors influencing health care professionals, health care institutions, payment systems, and patients and families themselves. Fear of legal sanction is one reason for neglect of treatment.
It is important that the provider who more aggressively treats patients in pain consistent with newer standards of care be evaluated only by professionals who themselves are knowledgeable about effective pain relief and not the Drug Enforcement Agency who has never been schooled in appropriate medicine but rather only in the law.
Many doctors are afraid to prescribe adequate pain medication for fear of prosecution.
"Unbalanced and misleading media coverage on the abuse of opioid analgesics not only perpetuates misconceptions about pain management; it compromises the access to adequate pain relief sought by over 50 million Americans living with pain.
"In the past several years, there has been growing recognition on the part of health care providers, government regulators, and the public that the under-treatment of pain is a major societal problem.
"Pain of all types is under-treated in our society. The pediatric and geriatric populations are especially at risk for under-treatment. Physicians’ fears of using opioid therapy, and the fears of other health professionals, contribute to the barriers to effective pain management."
Opioid analgesics are extremely useful in managing severe acute pain, including postoperative pain, and chronic pain, including cancer pain. They are often underused, resulting in needless pain and suffering, because the required dosage is often underestimated, their duration of action and risks of side effects are overestimated, and physicians and nurses often have unreasonable concerns about the development of addiction. Although physical dependence occurs in virtually all patients treated for chronic pain with opioids for a long time, addiction is extremely rare in patients without a history of substance abuse and should not be considered in the decision to begin or to increase doses in patients with severe pain.
It is time to let the Doctors decide what is the appropriate treatment for patients in chronic pain and not the DEA or any other Government Agency. It has been stated regularly in many medical circles that pain management is one of the most problematic areas for prescribing because the symptoms are very often not detected by standard medical tests, pain sometimes cannot be seen by the human eye but yet it is there. Further, there are so many legal regulations faced by physicians that pain medications are very often under prescribed.
After reviewing the case law involving disciplinary actions against physicians for their prescriptive practices it also reveals that the disciplinary process is not entirely successful in distinguishing between "good doctors" who are providing effective medication to patients experiencing pain and "bad doctors" who are providing controlled substances to patients when it is not appropriate.
Many people have had no choice but turn to the Internet for pain relief, with these places that help manage a patients pain there are guidelines, for instance they must have your medical records and they must clearly state your diagnosis and that it is a chronic pain diagnosis, proof that the patient has been prescribed the medication before, they must have a physical, they must have the patients identification as well, these medical records must also be updated each year for the telemedicine doctor.. These places do have licensed Doctors who do preform a consult with the patient and then the Doctor will write a prescription if they feel the diagnosis warrants a prescription. The problem with these telemedicine places that want records and consult with the patient via phone is that they are constantly getting different regulations that they must comply with and these regulations change day to day. Now these places which are in many cases the only form of pain relief for many are being taken away by the DEA too, it is bad enough that you cannot get pain relief from a local doctor but now the Chronic Pain Patient cannot even get relief from what may be the only place that gave them pain relief and gave them a somewhat normal life back.
Also I read all over the Media about kids/adults and how easy it is to get scheduled II meds over the Internet. I think you will find that even you were to Google: "buy Oxycontin online", that if you did a bit more investigation into this area and actually tried to go to one of these websites and actually tried to order a scheduled II medication from these places that you would either find that these places do not exist or if they do have a website I would bet you would find that you may pay for something that you will never receive, it simply is not available online.
I would also like to state the fact that what works for one person may not work for another, every single person has different pain receptors as well different opioid receptors. For example take two people with the same exact injury and the same exact pain levels given the exact same pain medication with the same exact directions for use: For patient "A" perhaps those 4 tablets of pain medication works fine while patient "B" gets hardly any relief of any from the same dose taken at the same time and my require higher doses of pain medications. But the Doctors are sanctioned by the DEA, DOJ, FDA and other Government Agencies on what they feel is appropriate dosing for opioid pain medications, this is something that needs to stop.
Also I find that many patients in chronic pain are constantly prescribe the medication Hydrocodone and that medication is for Acute Pain and not Chronic Pain, but due to so many fears Doctors are afraid to prescribe a medication specifically for Chronic Pain. Another point about a patient who suffers everyday with Chronic Pain is the fact that these patients are not addicts, yes a Chronic Pain Patient will be dependant upon the medication to live a somewhat normal life but the the chances of the patient becoming addicted are very low, this can be proven by the studies that have already been done.
Public awareness needs to be raised and an attempt to remove of the barriers of stigmas placed on people who suffer in pain and to correct the damaging myths that surround pain and pain management for the 50 plus Chronic Pain Patients who need medication in which to live a somewhat normal life .
The DEA prosecutes Doctors for believe it or not:
PILL MILLS
We want you to know that 2004 will show American taxpayers coughing up a whopping $120 million dollars to be used by the DEA to target other doctors who prescribe legal drugs to ease pain.
Money well spent?
We don't think so either.
Physicians in this country today are up against Government Policy that is filled with so much danger, it's changing the very standards of WHAT IS and WHAT IS NOT the proper way to treat pain.
The ethical duty to relieve pain is well established. The Agency for Health Care Policy and Research (AHCPR) founds its pain management guidelines on this principle: "The ethical obligation to manage pain and relieve the patients suffering is at the core of a health care professionals commitment."
Health care professionals offer many reasons for the under-treatment of pain, and an effective response to the problem requires an effort on several fronts. Health care professionals require much more effective education and training in the treatment of pain. Institutions must remove unnecessary institutional barriers to pain relief and should ensure that effective pain management is an institutional priority. Payment systems should realize the costs of pain and adequately support pain control. Patients and caregivers must also be informed and assured that pain relief is to be expected and that fears of addiction are unfounded.
One source of the problem, according to physicians, is the threat of legal sanctions for treating patients in pain, especially when that treatment must rely on the use of controlled substances. Doctors have reported that they under-treat for pain, in part, from fear of legal penalties, especially disciplinary action. In a California survey, 69 percent of respondents said that the potential for disciplinary action made doctors more conservative in their use of opioids in pain management, and a third reported that their own patients may be suffering from untreated pain. Another review of published research on the under-treatment of pain concluded that "available data suggest that medical decision-making regarding the use of opioids continues to be unduly influenced by regulatory policies and fear of regulators."
Doctors' fears of disciplinary action and criminal prosecution are justified. There is no evidence that large numbers of physicians are sanctioned for their treatment of patients in pain, but the impact of the process on those physicians who are only investigated, or only charged but not disciplined, or only warned or cautioned but not penalized is severe. The prosecutorial stance stimulated by a "war on drugs" and by increasing public scrutiny of disciplinary agencies may unintentionally interfere with adequate pain relief because it has intensified and criminalized investigations and later proceedings. Descriptions of the investigation of physicians engaged in the treatment of pain patients with controlled substances present a scenario that would easily intimidate most people. Some evidence also suggests that many state medical boards have not adapted to more current approaches to the use of controlled substances in pain management and that they may rely solely or too heavily on dosage and length of treatment as indicators of inappropriate and illegitimate prescription practices. Greatly increased enforcement efforts in Medicaid programs may also have an impact on prescribing practices in the treatment of pain, though these are still being evaluated.
Needless human suffering from untreated but treatable physical pain is caused by a number of factors influencing health care professionals, health care institutions, payment systems, and patients and families themselves. Fear of legal sanction is one reason for neglect of treatment.
It is important that the provider who more aggressively treats patients in pain consistent with newer standards of care be evaluated only by professionals who themselves are knowledgeable about effective pain relief and not the Drug Enforcement Agency who has never been schooled in appropriate medicine but rather only in the law.
Many doctors are afraid to prescribe adequate pain medication for fear of prosecution.
"Unbalanced and misleading media coverage on the abuse of opioid analgesics not only perpetuates misconceptions about pain management; it compromises the access to adequate pain relief sought by over 50 million Americans living with pain.
"In the past several years, there has been growing recognition on the part of health care providers, government regulators, and the public that the under-treatment of pain is a major societal problem.
"Pain of all types is under-treated in our society. The pediatric and geriatric populations are especially at risk for under-treatment. Physicians’ fears of using opioid therapy, and the fears of other health professionals, contribute to the barriers to effective pain management."
Opioid analgesics are extremely useful in managing severe acute pain, including postoperative pain, and chronic pain, including cancer pain. They are often underused, resulting in needless pain and suffering, because the required dosage is often underestimated, their duration of action and risks of side effects are overestimated, and physicians and nurses often have unreasonable concerns about the development of addiction. Although physical dependence occurs in virtually all patients treated for chronic pain with opioids for a long time, addiction is extremely rare in patients without a history of substance abuse and should not be considered in the decision to begin or to increase doses in patients with severe pain.
It is time to let the Doctors decide what is the appropriate treatment for patients in chronic pain and not the DEA or any other Government Agency. It has been stated regularly in many medical circles that pain management is one of the most problematic areas for prescribing because the symptoms are very often not detected by standard medical tests, pain sometimes cannot be seen by the human eye but yet it is there. Further, there are so many legal regulations faced by physicians that pain medications are very often under prescribed.
After reviewing the case law involving disciplinary actions against physicians for their prescriptive practices it also reveals that the disciplinary process is not entirely successful in distinguishing between "good doctors" who are providing effective medication to patients experiencing pain and "bad doctors" who are providing controlled substances to patients when it is not appropriate.
Many people have had no choice but turn to the Internet for pain relief, with these places that help manage a patients pain there are guidelines, for instance they must have your medical records and they must clearly state your diagnosis and that it is a chronic pain diagnosis, proof that the patient has been prescribed the medication before, they must have a physical, they must have the patients identification as well, these medical records must also be updated each year for the telemedicine doctor.. These places do have licensed Doctors who do preform a consult with the patient and then the Doctor will write a prescription if they feel the diagnosis warrants a prescription. The problem with these telemedicine places that want records and consult with the patient via phone is that they are constantly getting different regulations that they must comply with and these regulations change day to day. Now these places which are in many cases the only form of pain relief for many are being taken away by the DEA too, it is bad enough that you cannot get pain relief from a local doctor but now the Chronic Pain Patient cannot even get relief from what may be the only place that gave them pain relief and gave them a somewhat normal life back.
Also I read all over the Media about kids/adults and how easy it is to get scheduled II meds over the Internet. I think you will find that even you were to Google: "buy Oxycontin online", that if you did a bit more investigation into this area and actually tried to go to one of these websites and actually tried to order a scheduled II medication from these places that you would either find that these places do not exist or if they do have a website I would bet you would find that you may pay for something that you will never receive, it simply is not available online.
I would also like to state the fact that what works for one person may not work for another, every single person has different pain receptors as well different opioid receptors. For example take two people with the same exact injury and the same exact pain levels given the exact same pain medication with the same exact directions for use: For patient "A" perhaps those 4 tablets of pain medication works fine while patient "B" gets hardly any relief of any from the same dose taken at the same time and my require higher doses of pain medications. But the Doctors are sanctioned by the DEA, DOJ, FDA and other Government Agencies on what they feel is appropriate dosing for opioid pain medications, this is something that needs to stop.
Also I find that many patients in chronic pain are constantly prescribe the medication Hydrocodone and that medication is for Acute Pain and not Chronic Pain, but due to so many fears Doctors are afraid to prescribe a medication specifically for Chronic Pain. Another point about a patient who suffers everyday with Chronic Pain is the fact that these patients are not addicts, yes a Chronic Pain Patient will be dependant upon the medication to live a somewhat normal life but the the chances of the patient becoming addicted are very low, this can be proven by the studies that have already been done.
Public awareness needs to be raised and an attempt to remove of the barriers of stigmas placed on people who suffer in pain and to correct the damaging myths that surround pain and pain management for the 50 plus Chronic Pain Patients who need medication in which to live a somewhat normal life .
The DEA prosecutes Doctors for believe it or not:
PILL MILLS
We want you to know that 2004 will show American taxpayers coughing up a whopping $120 million dollars to be used by the DEA to target other doctors who prescribe legal drugs to ease pain.
Money well spent?
We don't think so either.
Physicians in this country today are up against Government Policy that is filled with so much danger, it's changing the very standards of WHAT IS and WHAT IS NOT the proper way to treat pain.
Email
Print
SPAM
LEAVE A COMMENT
