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Sufferers of chronic pain and the government’s war on OxyContin

Our understanding of severe pain is inadequate


 
The latest opium war

Giulio Sarchiola/Contrasto/Redux

“Chronic pain is even worse to live with than lung, cardiac or liver disease. Bad chronic pain is connected with the worst quality of life. People don’t realize that it is a disease on its own, not just a symptom.”

That’s a pain warrior talking, a warrior who has been in the battle against pain for over 25 years. Dr. Mary Lynch’s new patients wait more than two years to see her because of her renown as an unusually empathetic physician who understands the complexities of living with pain, day in, day out, year after year.

In 2010, she co-authored a brief to the parliamentary committee on palliative and compassionate care, as did Margaret Somerville, an ethicist at McGill University, who stated a now-classic credo for pain-management workers: “People in pain have a right to fully adequate pain relief treatment. Physicians should not fear that giving adequate pain relief treatment is unethical or illegal; in fact, they should fear the ethical and legal consequences of not doing so.”

Ethical? Legal? These are not concerns that should afflict a fight to ease people’s suffering, yet they are. In pain treatment, there is an elephant in the room as old, if not older, than the dreaded opium dens of China’s dissipated Qing Dynasty.

The most effective drugs today for severe and chronic pain are based on opium, or chemicals with the same structure, all potentially addictive. So, on the one hand, you have pain specialists like Lynch, a past president of the Canadian Pain Society and a professor at the Queen Elizabeth II Health Sciences Centre at Dalhousie University in Halifax, on the front lines with patients in pain, who talks with fervour of “fulfilling” the United Nations Universal Declaration of Human Rights; on the other hand, you have doctors who specialize in addiction who say prescribing opioids can contravene a doctor’s duty to do no harm by creating addicts. Some doctors steadfastly refuse to prescribe opioids, even when their patients are in severe pain. That, in its starkest terms, is why we now have a modern-day opium war.

“The OxyContin disaster.” “Ground Zero for opioid use and abuse in Canada” “The country needs a national strategy to tackle the widespread abuse of painkillers.”

For evidence of the war, look no further than the rhetoric trumpeted in the media in the immediate aftermath of Ontario’s announcement in mid-February that it would no longer pay for a leading brand of potent painkillers. As of March 1, the province delisted OxyContin and its replacement OxyNeo. Any doctor who wants to prescribe the long-acting oxycodone to new patients will now need to prove another attempt at long-acting pain treatment has failed.

Nova Scotia is following suit, limiting the drug to use for cancer-related pain and palliative care. Prince Edward Island already had strict criteria for OxyContin prescriptions and will not pay for the new, safer replacement.

The war on this drug—no other opioid is being delisted—is driven by what editorialists describe as “an epidemic of opioid addiction,” fuelled by stories about pharmacy break-ins, inquests into prescription-drug deaths and tragic tales of lives undone. The focus of it all is the prevailing connection of opioids to drug addicts and accidental deaths, with little consideration for their proper need and use as painkillers.

“The popular scare comes from the deaths,” says Dr. Peter Selby, clinical director of the addictions programs at the Centre for Addiction and Mental Health in Toronto. “My personal opinion about OxyContin is that it was designed to be addictive. Thirty-five per cent of the drug is immediate release for a fast effect.”

Not all deaths involving OxyContin are accidental. According to Lynch, doctors who want to ban or severely restrict medical use of opioids ignore that “a significant number who died from overdoses, from 15 to 25 per cent, was not accidental but suicides because people are in such bad pain they want to kill themselves. Even with drugs, pain patients often don’t get the care they need. In these drug deaths, only one side of the story is told.”

The issue is complicated and multi-faceted, and hugely susceptible to easy, headline-grabbing accusations. For starters, the best drugs for pain—codeine, morphine, Demerol, ratio-Oxycocet, for example—are all addictive by nature. Before prescribing opioids, doctors are obliged to make sure their patients are not at high risk for addiction. Beyond what doctors prescribe, however, the reality is that OxyContin has replaced crack and heroin as one of the most popular street drugs. When the police manage to clean up this market, another substance will take over as the drug du jour.

Meanwhile, burglaries in pharmacies have become so frequent that many drugstores haven’t been keeping OxyContin in stock, ordering it in for each prescription. Not only do pharmacists fear violent, irrational thieves, but insurance companies can charge over $10,000 a month even if a pharmacy did as little as $1,000 worth of business in opioids. And since it has become an increasingly popular drug—more than 20 per cent of North Americans now report having suffered from chronic pain—there is lots left in family medicine cupboards.

“These days kids have ‘pharming’ parties,” says Dr. Roman Jovey, medical director of CPM, Centres for Pain Management. “They throw all the pills they can find in a bowl, take a handful and down it with alcohol. They see their parents take them, so they underestimate their strength. All youth will experiment with drugs but now there is a blurring of the margins of prescription drugs and illegal street drugs.”

Like most wars, ideology and money are key elements, and innocent citizens, particularly those disabled by pain, are the victims in the new opium wars. Jovey talks about a “societal historical fear of opioid addiction,” a sort of love-hate relationship. “Addiction to opioids seems to occupy a special obsession when alcohol and smoking are even more harmful,” he says.

But abuse is a particularly apt term when discussing oxycodone addiction. “When oxycodone came out, we never even thought of crushing it and snorting it or injecting it. The reason I can still sleep at night when I prescribe OxyContin is that street use is so relatively small compared with therapeutic use,” says Jovey.

Purdue Pharma LP first marketed a time-release form of oxycodone called OxyContin in 1996. Its strength is that it gradually releases its painkilling medicine. The aim is to keep pain at a low level all the time, to avoid the spikes of pain requiring higher doses of fast-acting pills.

Trouble soon followed OxyContin. In 2001, West Virginia claimed Purdue Pharma violated that state’s Consumer Credit Protection Act, antitrust statutes, and created a public nuisance because its aggressive marketing led to “excessive, inappropriate and unnecessary prescriptions.” Purdue settled three years later for US$10 million. In 2007, it paid US$19.5 million to 26 states and the District of Columbia to end their complaints. Also that year, Purdue paid more than US$600 million and pleaded guilty in federal court to resolve criminal and civil liabilities “in connection with a long-term illegal scheme to promote, market and sell OxyContin,” the U.S. Food and Drug Administration announced. While Purdue Pharma Canada is associated with, but independent from, the American company, the impact has been felt here, too.

In a rare interview, pharmacologist Cornelia Hentzsch, head of Purdue Pharma Canada, explained OxyContin was actually developed “as an alternative to MS Contin, which had morphine as its main component.”

Many people cannot tolerate morphine but can take other opioid drugs with fewer side effects. Feedback from doctors and patients indicated the need for a combination of fast- and slow-acting drugs in one pill. Pain-management practice accepts that a strong dose of painkiller as soon as possible reduces the amount of drug required in the long run.

“In its warnings, the publicity inadvertently gave information on how to abuse it,” said Hentzsch. “We’re worried we may have to take it off the market when it is such an effective pain control drug.”

After the American scandals, Pharma’s Canadian salespeople were instructed not to promote OxyContin, but rather just point out to doctors the drug’s dangers and how to detect potential addicts.

“People think I’m crazy,” says Hentzsch. “They see me going around doing a negative sales campaign. But I’m shocked by the lack of monitoring of patients. We’re trying to increase controls through professional associations. I’ve been to [Health Canada’s] Office of Controlled Substances asking for limitations on the numbers of high-dose tablets. We’ve been constantly searching. You don’t solve the problem of substance abuse by removing one particular substance. It is something deeply ingrained in our society.”

Ironically, the provinces have taken matters in hand, just when OxyNeo, impossible to snort, inhale or inject, makes a much safer drug available.

Fear of addiction may be deeply ingrained, but our understanding of severe pain and its consequences remains inadequate, and much of it recent. Pain begins with birth for mother and child. Doctors circumcised babies with no analgesic at all, apparently thinking they didn’t feel pain despite their screams. Premature babies who spent months in hospital before even coming home were put through hundreds of procedures, even excruciating ones like spinal punctures, without anaesthetics. Fortunately, pediatricians now know better, but only within the last 20 years.

Many adults still have trouble getting pain treatment—even before the delisting. One of Jovey’s patients was turned down by more than 20 doctors when looking for a new general practitioner to replace a retired one. It takes patience, extra work, and even some courage to take on a patient with chronic pain: in addition to the mountains of paperwork behind prescribing opioids, and the omnipresent fear of onerous inspection by the provincial colleges of physicians and surgeons, there’s just too much time required to deal with the complicated issues of chronic pain which—even on a good day—cannot be cured, only managed.

With many family doctors reluctant to deal with patients requiring long-term opioid use, the inevitable result is a small number of doctors come to be known as good “pain” doctors. Then, anti-opioid lobbyists criticize them for either over-prescribing or prescribing carelessly. In fact, most pain specialists say the biggest problem in Canada for pain patients is the under-prescribing of drugs.

“I have a whole caseload of nerve-damaged patients. Most of them are in terrible pain and they aren’t properly medicated,” laments therapist Carol Moore of Toronto. She specializes in patients who have gone through severe neurological trauma, like car accidents. Most of them live reduced lives with permanent brain damage and physical handicaps, and have gone from being healthy one day, to being in a wheelchair or worse the next.

Moore is an old pro but she loses her professional veneer when the subject of pain comes up. “They’re only given Tylenol 3 and they are suffering!” One of Moore’s patients suffers from a neurological disorder caused by a minor, low-impact collision when she pressed back her thumb on the driver’s wheel. The result has been complex regional pain syndrome; her entire arm, up to her neck, is in agony. From an ordinary healthy existence, her life has changed irrevocably. She needs to take so many opioid medications to deal with the pain that she once didn’t realize a fire alarm was screaming above her head in her own room. She didn’t even realize she should vacate her apartment immediately. As a result, she has had to accept 24-hour care, which costs her dearly. In addition to the medication, once a month she goes in for a nerve block, a surgical injection of steroids and anaesthetics that dulls the nerve paths in her arm. As the days of the month go by, waiting for that next stab of relief, her arm feels increasingly like it is immersed in boiling oil.

Because nerve blocks become less effective with repetition, she can’t have them too frequently. Her whole life centres around her caregivers and surviving until the next nerve block, the daily pain somewhat relieved by regular long-acting opioids, and extra, fast-acting ones for even more pain than usual. At least she has doctors who understand her need for pain control and give her more than Tylenol 3. People like her don’t get much mention in the media. The fact that the suicide rate of people suffering long-term chronic pain may be twice as high as the normal population isn’t mentioned either.

Opioids don’t get rid of chronic pain and for the most part, the medical system does not accommodate the myriad other treatments that should accompany these drugs. Nevertheless, many people find that these opioids just help them get through the day with less debilitating pain. They may be able to look after their children again, without collapsing in tears of frustration. Or they may be able to sleep through most of the night, again with the help of opioid medication, along with all the other pain-management exercises and paraphernalia.

What is clear is that the scaremongering often distorts figures and the response. It makes people in pain fear taking what can help them. It makes doctors reluctant to prescribe drugs their patients need, and it distracts attention from the real need for education in the field of pain management. The first reason people see their family doctor is because of pain. No medical school in Canada offers a specialized degree in pain management—even Dalhousie, where Mary Lynch fights on in a war where the battle lines keep changing.


 

Sufferers of chronic pain and the government’s war on OxyContin

  1. This is an amazing article. I don’t know how many doctors have refused to prescribe me meds that I need, instead accusing me of being a “drug seeker”. One PA actually told me to take the max dose of naproxyn, acetaminophen, and ibuprofen every 4 hours instead of prescribing me 2 painkillers a day! Good thing I didn’t listen or I would have ODed on tylenol. Chronic pain is so hard to live with, but the stigma and disbelief attached to it makes it so much worse!

    • Yes, especially when it comes from your doctor.  Trying to describe what you are feeling and describing your pain is so frustrating.  Some have abused it so much that when the true people who are actually in pain, they are not taken seriously.  So you try to move forward and try to live like you used to which is worse. 

    • Doctors who refuse to prescribe adequate pain relieving medications for patients, or doses of opioids insufficient to deal with the patient’s pain can create a condition known as “pseudo-addicton”.  The patient displays characteristics of opioids addiction such as drug seeking, not because they are addicted, but because they are being inadequately treated, and are suffering pain.

  2. I have watched this issue as my son passed away from cancer. Every time his pain increased and he suffered his medication would be increased, but first he had to suffer, over and over and over again. Imagine being a righteous politician and judging genuine pain management as a secondary issue compared with the possibility someone may get to enjoy themselves abusing a medication. Ah, life must be simple for the righteous.
    And to those few brave doctors that stand up against this heinous machine and provide patients what they need, thank you.

    • I agree with what you’re saying, but don’t think that “politicians” are at issue. 

      These are medical decisions made by professionals and presented to politicians for implementation.  Based on my experience in Canada’s health care systems, I think that public health suffers from a bureaucratic disease that frequently improperly makes individual medical decisions based on potential general consequences (e.g., to avoid generally “creating addicts”, your terminally ill son was required to suffer).  In other words, the care is not patient-centric and the patient is not properly treated as a result.  This raises ethical issues – ones that I assume Dr. Somerville is busy attacking.  There is a whole mindset that needs to change within the healthcare industry.  I would agree with you, however, that politicians ought to be part of that solution.

      •  Very well stated matt, I am not sure the medical practice boards that establish guidelines for physicians are entirely free of political influence or at least do not consider political positions and views when making decisions. I can’t imagine where else this thought process would originate.
        Every study I have read on pain and pain management since the mid 1990’s shows whether client controlled via say a morphine pump or doctor directed, larger dosages at the onset of pain results in patients using less medication over time, and they are free of pain medication use in a shorter time frame. To me this indicates being free of pain while it is present reduces stress and speeds healing.

    • Right on!

  3. I have Rhuematoid Arthritis and have days that are near impossible to walk as it is attacking my ankles and knees. The arthritis drugs make me feel ill and sick and I have to go get tests and bloodwork so often that I feel nervous about the side effects of something that the doctor agrees only works somewhat on a small percentage of people. I am expected to still work and feed my family as I, one, am not eligible for disability because the doctor watched me on a good day and said I can still walk, therefore must be fit enough to work and two, disability does not pay enough to live on anyhow. (I’d rather be productive)
    But taking the very smallest dose possible of oxy allows me to work, bring home enough money to feed our family and still get around. I dont tell anyone, and try to function as normal as possible. The worst part is the stigma of our population. The criminal element. And the fact that my doctor is retiring this year and my new doctor says he will not prescribe me this any longer. I will try but I know my body and my limitations. Why cant I be relieved of this crippling pain? Isnt that the idea of our advanced medical knowledge. The government needs to make medicine availble to those who need it and lock up those who are stealing and abusing it. Make the laws stiffer for those who attack and rob pharmacies.

    •  Thank you for being so right.

    • I also have the same condition, RA, but I also suffer from Fibromyalgia, chronic migraines, Epstien Barr, sock and glove neuropathy, and a myriad of other conditions which were discovered by my previous Pain Management doctor.  He was in fact a neurologist and also a psychologist, in addition to the pain management specialty.  The best doctor I ever had because of this combinations of specialties.  If I only I could find one here in the state I am now in.  He was the one who discovered some of my conditions because he listed to the patient….the WHOLE patient.  Not just the pain I was in, but also what was going on in my life.  But when I was in pain, and it was a new pain, he sought to find the cause, not just dismiss it, or just give me another pill for it.

      I agree that people in Chronic pain need their pain meds.  Without them, many (including myself) cannot lead a productive, or even semi-productive, life.  That needs to be addressed most of all.  So many people want to be productive, but because they can’t receive their pain medication, they file, and get, disability.  I know too many people who have done that, simply because their doctors wouldn’t listen and prescribe what they need. Anyway, I understand you don’t want to have to fight for your disability like everyone else who became disabled because of a sudden onset of a chronic condition.  You want to still feel useful.  I feel that way everyday.  However, my body will not let me work, even when I was on high doses of Oxycontin and Oxycodone.  They help you get through the day, but if you overdo it all, you suffer for the next day, possibly the next week.  But this war on pain meds, especially those derived from opium, has to find a middle ground.  I have a current pain management doctor, who is actually lowering my doses because he thinks I should be on no more than 60mg a day of pain meds.  That is 1/6 of what I used to take.  I do not agree with him and am finding I am in more pain as he continually decreases the dose, regardless of what I am telling him.  I think it has a lot to do with the fact that they are monitoring his prescriptions so much.  But he would rather prescribe Morphine than Oxycontin. But, because of this, he refuses to listen to me about my pain levels and where my pain is and what it is doing. He just keeps lowering my dosage.  I would rather he listen to “Please find out what is causing this and if we can, stop it, don’t mask it.”  That’s what I want.  I know my RA is chronic and will never go away, but there are other parts of me that aren’t connected with that that can be helped, and I want that.  However, no such luck.I wish you luck with your RA and are able to continue working.  Mine stopped me working after just 2 1/2 years after diagnoses.  I really hope you last much longer.

      • Your doc is scared. An arbitrary dose has nothing to do with the patient – it has to do with pleasing or avoiding the DEA. You need another doc as well, or it sounds like that to me. What he’s doing to you is called medical abuse, but it’s not really illegal when it comes to opiates. Rather, it is, but they’ll never prosecute him for it. The Medical Standard of Care says that the correct thing to do is first, find an opiate that works FOR YOU. Then titrate it upwards until the pain is under control. add breakthrough meds to a time-release form that gives you the dose that worked, and you should be okay. According to the W.H.O., the World Health Organization, “The right dose is the one that works.”

        A note: I’m not a doctor or even degreed in anything. I was avy Hospital Corps, a Paramedic and did some other things in medicine.In self-defense I still keep up, and read everything I can get my hands on. There are also doctors I talk to when I can. Anyway, the medical field, driven by the insane and profit-hungry DEA, is getting more and more draconian. If I could I’d head for another country, at least S.American, like maybe Panama. They’re more reasonable about medications there, and figure you know your own business best. Unfortunately I’ve been unable to work for almsot three decades, and I couldn’t put a down payment on a free meal.

        Anyway, talk to your doc, TELL HIM honestly what he’s doing to you – he’s crippling you, and if he refuses to try to help you, start looking for another PM doc. (pain management)

        I wish you all the good fortune in the world

        Ian

        • As the Clash sang “I’m so bored with the USA!

    • The new doc will cripple you. From your description, the damage, and so the pain, will get worse, and when the nerves have been changed by outof-controlled pain, they transmit pain all by themselves and recruit other nerves. You need to find a real PM – Pain management – doctor if you can. Opiates don’t eat holes in your stomach, they don’t cause ANY sort of permanent damage. They’re actually the safest drugs on the market as long you’re not stupid with them and take them correctly. NSAIDs are the killers, like naprosyn, motrin, aspirin etc. The “buzz” initially, if any, goes away in days and you just lose the pain. It lowers testosterone but that can be supplemented, and thickens mucus in the mouth and causes cavities, which can also be handled. And it causes constipation. Senna tea, docusate sodium (or docusate potassium if sodium is a problem) is a stool softener, and Miralax when necessary hand;es that pretty well. So does a decent diet with the fiber you need and plenty of water. Something else that can be helpful is a natural for of MSM, the active ingredient in DMSO. It’s a form of sulfur, and it delivers oxygen to cells that don’t usually get enough. I’m about to try this one myself, but I’ve read a LOT about it in the past and there are some incredible stories about it. I hope it works. I’ve been a CPP for almost 29 years now. I suspect that the next time my meds get pulled I’m dead. Anyhow, here’s the URL for that sulfur:
      http://www.sulfurforhealth.com/ORGANIC-SULFUR.html

      It’s not expensive, and I figure it can’t hurt.

      Luck to us all. We’ll need it.

      Ian

      • You are correct and a smart man!

        • Thanks Johnathan, but I’ve had almost three DECADES of chronic in which to learn all this! I was a medic in the military, then civilian paramedic and I’ve kept up with the medicine. And I’m in chronic pain – always. Six back operations, now two more to go – if the V.A. ever pulls it’s head out. Anyhow, I hope my info helps someone, and if it does, great!

          Ian

          • Thanks for the reply Ian, I too have had multiple orthopedic surgeries including lower back. I am very knowledgeable in pain medicines as I have been taking them for 29 years, I have been in chronic pain for this time and am lucky to have found a Doctor who treated me properly and thus my medical records reflect my being bona fide. Even though I understand that opioids are serious stuff I just get frustrated that abusers ruin things for those of us that need treatment, pain patients should be treated as such and law enforcement should deal with those who bring in a criminal element which makes prescribers hesitant to treat pain sufferers, which in my opinion is not fair nor the right way to go about stopping abuse. At least in Canada they allowed generic Oxycodone CR to be allowed back on the market for those who could not tolerate the reformulated product (OxyNEO), I think it was a great move by the Canadian Government, because abusers just find a way to beat the reformulated product or will just move on to another product that is not formulated to be tamper resistant. In my opinion most prescription drugs on the street comes from those who work in the field, whether manufacturing or medical professionals, not patients. Most not all. Good Doctors should not have to worry about issues that law enforcement should be dealing with. 99 people should not be denied opioids because of 1 person misuses or diverts it, in my opinion. I also didn’t realise how old these posts were when I first replied. Purdue Pharma should be ashamed at saying their reformulated OxyContin should be the only brand on the market when it is clear it was their way of getting market exclusivity for a new patent, if they were truly altruistic why do they not reformulate all of their opioid products? Canada’s Health Minister should be applauded for letting Health Canada do its job without political interference in regards to generic Oxycodone CR.. Regards and good luck.

  4. Thank you for your timely article.  Politicians,and the general public need to be educated about the lives of those suffering every single day of their lives with chronic pain.  We aren’t on the street looking for our next high; we are trying to relieve our pain, at least to the point where we can get through the day.

    • Linda,

      What we need to do to fix this is get the blasted cops OUT of the medical field, specifically the DEA. They are the ones who are actually deciding on treatment standards! sadly, we’re so profitable to them, they’ll fight to keep their place in medicine. They taught nothing about it, but they see money, drugs, so there must be crime. After that, they’re willing to manipulate the evidence and the witnesses as much as necessary, and so is the DoJ, which only wants convictions. They have something like a 99% conviction rate. That’s because they lie and cheat, and they can attack forever, while no one can defend forever, especially when all savings, investments and everything has been stolen through misuse of the via civil forfeiture laws.

      Ian

  5. I had a brief pain flare from an old injury. My doctor said (offhand) that she’d prescribe morphine, but not Oxycontin, to patients. She said the practice was going Oxycontin-free. I’m grateful to this day that I never got the stuff. Heroin orally is probably safer.

    • I was prescribe Demerol after a surgery long ago.  Funny didn’t get addicted.  I took it the proper way for my pain.  As I healed, the necessity of taking Demerol reduced to the point where I didn’t need them anymore.  No addiction there.

  6. My doctor says that he has given me all the medications that he can for my chronic pain.  He is now even thinking of giving me ‘depression’ pills as that would make me relax more and would indirectly reduce the pain.  That’s bull.  Depression pills only make you into a zombie and if you’re not in a depression, what good is taking pills that are not for the problem at hand.  Fibromyalgia and Chronic Fatigue Syndrome (name considering being changed as it doesn’t define the exact diagnosis of chronic pain as you’re not ‘tired’, just in pain) are pains that can’t be diagnosed with MRIs, Scans, blood tests or other tests.  I can understand a person going into depression because the pain is so delibitating, however, frustration and being tired are side-effects of chronic pain.  Therapeutic massages only can do little.

    It would be nice to find the cause of the pain, but at least in my pain, there is no test.  So what is a person to do?  When a doctor fears giving out the proper medication that could work just because some have taken it to get high is terrible.  What is a person to do when pain takes over one’s life?  No one wants that kind of pain and no one asks to be in pain constantly. I don’t want to take pills the rest of my life, I just want my life back pain-free.

    • Good old fibro and CPS, easy to claim yet so hard to disprove.

    • The “depression pills’ your doctor wants to put you on are likely a SNRI (Serotonnin-Norepinephrine reuptake inhibitor).  These medications have been shown to lesson the symptoms of Fibromyalgia….google it and it will lead you to the research.  The medication does not make you feel a zombie.

    • My goodness, your story sounds identical to mine. As you noted, there is no cause for the pain. Our brain’s pain mechanism has basically short-circuited and no longer functions properly. I am told that I will not be like this forever, that sometimes the brain can sort itself out and get back to some semblance of normalcy. I am just so thankful that the whole issue of chronic pain is coming out of the closet. We all must make our voices heard. I urge everyone to contact their local MLA and/or our Health Minister. One out of five people are afflicted with some type of chronic pain. Only one out of 20 marriages survives when one spouse is afflicted. The ripples run far and wide and must not be ignored.

    •  Princess, I’m going to quote some article that are pretty recent, most of them. Or paraphrase, if I msy. First, the active components of SSRI’s are fluoride compounds. Fluoride is poison. It also has a sedative effect, but it causes damage, and it’s very, very hard to STOP taking. Some people CANNOT stop. In part, the withdrawal symptoms are the the symptoms people took them for in the first placve, but even more intense, plus other, physical discomforts, panic attacks and so on.The doctors look at this and say, “Well look – you’re relapsing but you’re even worse off now than you were! You NEED this medication!” Also, if you’re young enough to have a child, it causes problems there as well.

      The Nazis used fluoride to help pacify the prisoners in the death camps; then the Russians used it the same way in the gulags. It does work, but not as Big Pharma says it does. They’ve done a lot of hiding of studies and have been caught repeatedly falsifying studies and evidence. SSRI’s are dangerous and bad for your health. Your doctor may not even know. In fact, the psych drugs are not well understood, they’re just used anyway. The brain is a super-complex device, and when something goes wrong, they’ll often tell you that you lack this substance and the pill is just replacing it. Well, whatever the brain uses, I promise, it isn’t fluoride! And the brain uses TARGETED neurotransmitters. SSRIs just saturate the brain. They’ve also been linked to suicidal/homicidal ideation and actions, as well as gabapentin/Neurontin, anticonvulsants. These dangers are especially high for young people. The Columbine-style shootings that have happened have, as far as I know, always been done by kids who were taking SSRIs or anticonvulsants or SSRI’s like Paxil, or they were withdrawing from them. As for the opiates, your doc is simply afraid to prescribe more. “The right dose is the one that works.”

      The diagnoses used by the psych community are, as far as I’m concerned, spurious.They’re made-up diseases that they vote on in a big meeting, and if enough agree, they enter a set symptoms and call it a disease. Your doctor is willing to drug you to the gills, just not with substances that might attract the attention of the DEA. The pain will cause you enough damage. PLEASE – look into any other medication he wants to use! When a doctor is prescribing for HIS COMFORT and not for YOUR HEALTH, as far as I’m concerned it’s totally unethical.

      Here are some article URLs:

      “Antidepressant Studies Unpublished”
      http://www.truthout.org/issues_06/011708HA.shtml

      The makers of antidepressants like Prozac and Paxil
      never published the results of about a third of the drug trials that they
      conducted to win government approval, misleading doctors and consumers about the drugs’ true effectiveness,
      a new analysis has found.

      Eli Lilly Lied About Prozac, Hid Suicide Evidence, Charges Harvard Psychiatrist

      http://www.naturalnews.com/003201_Eli_Lilly_Prozac.html

      There are countless articles like this. Big Pharma hides a LOT of evidence of danger, even fatalities, about new drugs to get them approved. When there’s enough power behind it or there’s an industry lobbyist in charge of the par of the FDA that vets new drugs or other things, they tend to get approved anyway. You will not likely find a doctor who will prescribe what you actually need ntrol the pain so you can function as close to normally as you could. If you do., you almsot certainly won’t keep him because the DEA will put him in prison. Study, look things up, be informed! Do all you can because you will usually be your best and only advocate! Meanwhile, I would look for another doctor if I was in your place. This is oen too concerned abouthimself and too cavalier about your life.

      Ian

    • If by “depression pills” you means SSRIs like Paxil, I’d leave ’em alone! They are based on fluoride, which is a poison in any form, any combination. Also, the withdrawals when people decide to go off these zombie pills include a depression that’s worse than the depression they started you on the stuff for! That way the doc can say. “Wow, look! They WERE helping! And your depression has become so much WORSE! You’d better go back on it – at a higher dose than before, of course.” And gabapentin is another problem causer. I’m unsure if suicide is only with children, but from what I’ve read, ALL of the Columbine-style shootings involved kids who were either taking or withdrawing from SSRIs and/or gabapentin.

      CPPs don’t NEED “mood elevators” if the pain is properly treated. It’s just that the DEA is making so much money by attacking doctors and using civil forfeiture laws (wrongly) to bankrupt them (also so they can’t afford to defend themselves), so that doctors, in addition to being hit with medically incorrect propaganda about pure opiate agonist drugs like morphine (and sorry but there’s nothing that special about oxycodone – that’s just the active ingredient in Percodan – “percs” – remember those?), are often having to talk with retired cops now working for the DEA as “inspectors” who are keeping an eye pain docs. They’ve got the government breathing down their necks, crawling up their butts and hiding in their closets and under their beds. Or they may as well be! It just doesn’t pay to be a Chronic Pain Patient. Not in these insane times!

      Ian

  7. It is refreshing to see that there is at least some good doctors willing to help these people. I have become an advaocate since contracting chronic pain myself and after watching my grandmother suffer for all those years. I decided to not let myself suffer since there are effective medications to treat it. It absolutely horrible for any country or state to let citizens suffer when there is something that can help with some quality of life. We have to now fight our rights to have pain care and this is unhumane to the human race because of a few addicts. Addicts have been around forever and they will not stop because these meds are taken away, only chronic pain pain suffers will be effected by this. What is wrong with govts? Is it that they can’t fix all the other problems that they want to control all of lives people? There will be many suicides if they take away effective pain medicines like oxycontin. The new formula is not as effective and takes a much longer time to do anything.
    People need to fight harder and not give up, no matter what. Keep fighting people!

  8. People that live through dibilitating pain are far more likely to be killed by law enforcement, homelessness, jail rape or underlying illness than the medecines themselves. In many cases it is the only way they can try to survive a hellish nightmare that people who do not live in such pain use to control, and in through outright lies and misrepresentation and deception line their own pockets or justify their own employment. People living in severe pain are simply easy targets and should be protected not prosocuted. If you disagree try taking a 1/4″ drill bit and drill it repeatedly into your arms, shoulders, hammer a couple of ten penny nails into your lower spine, wiggle them around, suck the cartililege and bone marrow out of your bones with a pump using an 3/8″ tube and bash your ankles together with a slegehammer simultaneously while standing wet and naked in a freezer and tell me then why anyone that DEMANDS that you suffer even further would not look like Adolf Hitler or Charles Manson in your eyes?

    To their credit there are some Doctors that do care about their patients and organizations that do promote sanity instead of suffering.

    • Advocacy isn’t good for people either. Siobhan Reynolds cost the DoJ a LOT of extra money and effort in busting another pain treating doctor as a “pill mill doc”. The DoJ bankrupted her, tried to have a gag order put on her and couldn’t, so instead tried to subpoenaed absolutely EVERY phone record, her film that she’d made – she demanedd everything but the woman’s underwear! Siobhan refused, and the DoJ destroyed her financially (with the help of an ignorant judge who right in line with the DoJ), and destroyed her blog as well, the Pain Relief Network – PRN. We’d saved a number of lives with that blog over a few years that I was there, I know. So that was all down the tubes.

      During the trial, sitting in the audience a DEA agent she had met sat RIGHT behind her clicking his revolver open and shut, open and shut, and spinning the chambers (carousel?) – during the trial! As the audience got up to go, he said to quietly, “You WILL pay for EVERYTHING you’ve done!” Well, she was about to marry one of the volunteer ACLU lawyers – they’d fallen in love – but that wasn’t to be either. The very following Christmas Day, Siobhan, Kevin and his 74 year old mother died in a small plane crash, leaving Siobhan’s teenaged son Ronin with her sister. (Also leaving her book that was almost ready to publish unfinished). Somehow Kevin had tried to land on a road that ran parallel to the runway about 150 feet away from it. No one knows why, and old friends said that he was an EXCELLENT pilot, and the most careful man they knew, absolutely paranoid about following ALL the rules for safety when he flew.

      Another unsolved mystery.

      Ian

  9. I have degenerative discs in my neck and lower back and fibromyalgia. The pain manager I see explained to me that the normal drug therapy for Fibro patients is anti depressants, sleeping pills and and muscle relaxers. Also long lasting pain killers are given but to a lesser extent because they supposedly do more harm than good for Fibro patients. However, with those cut with a double edge sword such as I am with the effects of degenerative discs the OxyContin is what works.

    When I first saw him I was started out on 6 OxyContin a day. I was a zombie! And I was still in pain! I ASKED to be cut back on the pain pills and try something else. But that was also when they realized it was Fibro. So I was put on that regimen and I’m down to 3 OxyContin a day. I’d gladly get off of it if I could do it without being in constant pain. That isn’t going to happen!

    Someone said they had a hard time explaining their Fibro pain. I just had to explain mine to a friend yesterday. I told her to imagine that you have fresh very bad bruises all over your body. Or if you’re lucky it is only one area at a time. But it is like fresh bruising that it hurts to even touch your skin!

  10. I’ve now been switched from my oxycontin to a different, less effective drug. I have never abused this drug or sold this drug. I take the doses to the exact prescription and see my doctor every 3-4 weeks to discuss how I am doing. 

    This drug is an EFFECTIVE drug for people with chronic pain. Don’t punish the people who actually need it because of some junkies. 

    The regulations surrounding OxyNEO is extreme and very expensive. I will not be able to afford this drug, even with private coverage (which may or may not even cover OxyNEO!)

    People who want to abuse these drugs are going to abuse these drugs no matter what precautions are taken. 

    I am hurting. I am in pain. My bones and muscles hurt daily. I’ve tried so many other drugs over the last 2.5 years and none have been as effective as oxycontin. 

    So until my doctor and I find a new drug that will make getting through a day more tolerable, I will be in more pain than I normally have, I will not eat as well as I should because the idea of chewing and swallowing is enough to make me gag, I will not sleep more than 2 hours consecutively and I will move slower than normal and I will be sketchy and unable to focus.

    To all of the “Concerned Mother” groups, the “keep our streets safe groups” and any other groups that made it impossible to get true relief from my pain:
    Fuck you. You have no idea what you’ve done.

    • I sympathize with you.  I’m wondering though which new drug you’ve been placed on.  The replacement for Oxycontin, OxyNeo, is exactly the same price.

      • I’ve gone from 80mg/day of OxyContin to 140mg/day of Morphine.  According to my pharmacist, the pills are not the same price and most private insurance companies will not cover this drug for me. =(

        • Morphine is very inexpensive.

          • And not as effective. At all. The side effects are so incredibly bad. 

  11. I am a pain specialist and see patients in severe chronic pain every day. They are referred to me by their family physicians, orthopedic surgeons, neurologists, psychiatrists, often having spent many frustrating years being told by the health care system that their problem is all in their heads and that they should “suck it up” and get on with their lives.  Nothing could be further from the truth.  I am a big fan of my colleague, Mary Lynch, and think that this article by Elizabeth MacCallum is the most balanced, compassionate piece of reporting i have ever seen on this subject.  Bravo!  I watched the recent Fifth Estate show on Oxycontin, and would be shocked if most people didn’t walk away believing that everyone who takes Oxycontin abuses it, gets addicted and that their lives go straight to hell. Completely untrue.  Interviewing mostly addiction specialists is an open invitation to biased reporting.  Of course, since all they see are people who have abused opiates, they are likely to feel that opiates are bad, all the time. It would have been more appropriate if the addiction issue had been put into perspective.  While opiates can be highly addictive, and potent opiates like diacetylmorphine [heroin], morphine, oxycodone [including Oxycontin], hydromorphone and fentanyl are particularly risky, weaker opiates like codeine and tramadol are less risky, and methadone and buprenorphine can reduce the risk that opiate addicts in treatment will inject opiates, thereby reducing their risk of HIV/AIDs, hepatitis B and C, and serious bacterial infections. I wish the media would learn the difference between physical dependence [being unable to stop a drug suddenly without suffering withdrawal] and true addiction [a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.]. Everyone who takes any kind of psychoactive drug [e.g. antidepressants, alcohol, cocaine,marijuana, tranquillizers, some blood pressure pills, sleeping pills, opiates, nicotine, caffeine] for more than a few weeks will experience unpleasant withdrawal if the drug is taken away suddenly. Withdrawal can be prevented most of the time by gradual reduction of the drug dose, but this can take months, and even years, in some cases. Many addicts continue to take their drug of choice because it makes them feel “normal” and , when they miss a dose, they no longer feel “normal”.  This is often the primary motivator that keeps them using or promotes their return to drug use. Most of the people interviewed on the Fifth Estate were addicted. Research suggests that most chronic pain patients, in the absence of serious pre-existing risk for addiction, will never become addicted to the opiates they are prescribed [addiction liability is estimated to be between 0.2 and 3.5%].  Misuse, on the other hand is a problem, with up to 11.5% of chronic pain patients prescribed opiates displaying what are called aberrant drug behaviours [self-dosing, borrowing or buying extra drug, early refills, using illicit drugs such as marijuana or cocaine, drug diversion]. A very large study on  heroin and cocaine put addiction prevalence at 23% and 17% of users, while nicotine comes in at 32%. That means that most users of these highly addictive drugs never become addicted. Interesting, eh?  There is a major overlap between chronic pain and addictions, and we [especially health care and mental health workers] all need to become better educated in order to help sufferers better manage these serious health issues.

    • This article was very interesting and thank you everyone in pain who shared their stories in this thread.

      PainDoc65 and anyone else reading this, I am hoping you can provide some guidance for me as I am considering becoming PainDoc66 :)

      I am a medical student at a Canadian university currently considering my options to apply for residency.  I am considering pain medicine as a way to palliate (i.e. treat symptoms when cure is impossible) those without life-threatening conditions who could potentially have much better qualities of life indefinitely if treated well (I am also interested in palliative care for patients in the last stage of their lives as well). 

      My background is in philosophy, and I am learning to understand the vast potential of human thought, aspiration and feeling — and on the other side, with each patient encounter, I am learning of the hurt; the fear of what could come next (or if there will even be a ‘next’); the limitations on actually being awake and alert, thinking clearly, enjoying the things one used to enjoy and hoping for some occasion or growing in the future.  And I am beginning to understand the frustration: not most of all at the situation but rather at the lack of understanding; not the futility of fighting something that can’t be changed, but of being left alone to deal with it when support is most needed; and not the feeling of systemic injustice but rather the failure of humanity additive in each encounter.

      PainDoc65, would you recommend your line of work? What is your background, if you don’t mind my asking? I am thinking that anesthesiology would be a good (albeit long way) to get into the field.  I enjoy working with my hands, and anesthesia would give me some opportunity to do that and use my mind to think through physiology and complicated medical problems at the same time. 

      Thank you again everyone for sharing on this message board,

      Yours,

      –?FuturePainDoc66

    • Well said, doc. TV shows and articles about oxcontin so often fail to make clear the difference between using the amounts of the medication prescribed, and the method prescribed for pain management versus taking the wrong amounts in the wrong ways (ex. crushed) for a high. These are different sets of people with different sets of intents, and should not be tarred with the same brush.

  12. Finally, an article that tells it like it is. I am one of those patients whose life has been completely changed from Complex Regional Pain Syndrome. I went from living an active life, working full-time at a good paying job, going to the gym 4-5 days a week when, after what seemed to be a minor ankle sprain, my whole world changed. I went from a full life to a world of pain which has put a stop to almost every activity I enjoyed. I was not prescribed OxyContin, but I do take an opioid-based medication. This was a last resort medication for me. I tried everything else, and out of shear desperation my doctor and I agreed to try it. It was and continues to be the only medication that brings my pain to manageable levels. It does not take it away, but it gets me to the point where I can function a bit. What I have learned through my pain journey is that no one can possibly understand what it is like to live with chronic pain unless they are afflicted with it. It is disgusting that we have a medical system which sees veterinarians getting more education on pain management then physicians. I guarantee that if the policy makers and doctors who are trying to cover their own butts were to spend 24 hours inside my body without the benefit of opiod medication, they would have a radically different view on things. If they had to care for someone suffering from chronic pain, they would be fighting for their right to proper pain management It is so easy to make policies and decisions at arm’s length, from a nice safe distance where they don’t have to deal with the fall-out.

    Because of policy makers and bureaucrats unwilling to deal with the real problem of drug abuse, I live in fear that the medication I take will be next on the chopping block. I live in fear that if my insurance plan decides not to cover my medication, that I won’t be able to afford to take it. I know what awaits me if I am unable to take my medication and it terrifies me. 

    I looked up the definition of psychological abuse. Justice Canada has set out a number of examples that fall under the category of psychological abuse including:
    http://www.vchreact.ca/read_psychological.htm 
    –  Threatening to abandon
    –  Making them fear that they will not receive the food or care they needI hear from people who live in excruciating pain because their doctors can’t or won’t prescribe the medications they need; people reaching desperation. To deny people medication that can give them some quality of life is both cruel and abusive. What makes matters worse is that many people living with chronic pain simply don’t have the physical capacity to fight for their rights. This simply cannot be tolerated.

  13. A Snap shot of a real pain patient, a real story, not from a textbook. Please read on for my life in a paragraph. Thank you.

    I was born with roto-scoliosis and bi-lateral phocomelia , both brought
    me pain all of my life. The really strong pain began 1 year prior to
    puberty ending. I noticed I could not stand 8hours at a time while I was
    a Manager at McDonalds (18-21 yrs) and went to high school f/time.

    I was placed on anti-muscles spasm pills and lost my hair in 6 months. 
    Never took any pain meds. I worked out and Rollerbladed 16km -20km per
    day and swam, walked, hiked, etc… ate well. Then the pain began to get
    worse. I drank socially, and always held f/time highly successful high
    paying jobs and was lucky enough to work with a major bank that paid my
    University education.  I never did drugs.

    So, here we fast forward to my 30th b-day ..living in pain , not taking
    anything to help, I began to stop working out, stopped all physical
    act’s as my back was swollen on 1 side double the other side. The pain
    caused me to lay down at nights and not do anything, prepare for going
    to school full time + work part.  ~  my co-workers would walk by my
    office and tell me to shut the fuck up as they could hear me moan from
    next door offices. After a phone call or meeting I moaned and complained
    like an red faced old irish man who drank scotch all night and awoke in
    cold sweats early every day, sick, in pain. Nauseous.  But not from the
    booze. I quit years back. 

    At 34 I could no longer work,  my Type~A personality was put behind bars
    , some friends stopped calling, years of snowboarding, skiing weekly on
    the coldest -35deg nights and days hours on end stopped, travelling on
    my own dime stopped. I lived at home and supported all of my endeavors. 
    Very impressive. We would head to the ski hill EVERY weekend as long as
    there was snow.  Traveled all of Europe alone, been to 20+ places. All
    over. Barbados to Croatia.  Smart guy…. experienced.  I was going
    places, FAST.

    Your comments and article are moronic. Ill informed. at the very least.
    You obviously are biased and have no experience yourself. the proof is in the pudding. you should be ashamed. Seriously.

     I tried every pain med and nothing helped. I could no longer type
    emails this long until I began taking Oxycontin.  So at 300mg per day
    recently I was abruptly taken off and my doc switched me to Morphine ER
    and it almost killed me, I had all of the textbook side effects. Lost
    another week of my life. Showered 2 times a week, could not reply to
    emails, the pain was simply too great. Too much. Then to Hydromorphone,
    all the side effects subsided, but the pain was back, in force. I
    dropped my phone , could not bath myself, dressing was a stress, I
    stayed home, layed on sofa and watched T.V all day waiting for the hours
    to pass. The pain is too much.  Even at reduced amounts of Oxyneo ~
    200mg, and dropping I am able to function at some level. I may not work
    ever again as per my spinal cord and nerves in my hand are too damaged
    but at least I am able to take care of the basic human needs.

    This taper and switch occurred in the past 2 weeks from this email being
    written.

    It really shows just how little some docs know. Not much at all.

    Sad.
     

  14. Good article, should be sent to every doctor and health care people. Lumping addicts in with people who are in pain is a problem and it is true doctors want nothing to do with pain. I wish there were some of these lawyers or human rights people who would take this on. I got in contact with the government to not pay doctors who do not actually treat a person in pain, they said no we pay the doctor for the visit , if you show up he gets paid. Once all the liver problems start showing up from desperate people taking tylenol , tylenol with muscle relaxent, Ibuprofem and all the other over the counter stuff that does not work, maybe then doctors will start treating patients again.

  15. I had recently come out of a kidney surgery and had to have a stent in place. For those of you who do not know a stent is a sort of plastic tube that runs from kidney through ureter and into bladder. I was in constant pain- or if not, constant burning discomfort. BUT I was still much better off (millions of times better) then most of the people commenting here. But even those eight weeks brought on depression, fights with my partner, and a feeling of overwhelming weight. After crying for two days straight and having no sleep I was finally prescribed morphine and percocets. I felt guilty for straight out asking for pain killers. I felt like a junkie! I was embarrassed for properly taking prescribed medications. That’s not how it should be. Now I’m back to work, obviously I’m not continuing with meds as they’re not needed. But because they were prescribed to me I could get the rest I needed to heal my body stress free. Thank you doctors who understand! 

  16. I suffer from chronic pain and have for almost 8 years now! I have never had a pain free day in all these years. I was on percocet and OxyContin at the same time years ago, it didn’t really help! The doctor I was seeing at that time prescribed these drugs as he had no idea about pain management. He just upping the dosages on both drugs! Then the doctor left and another doctor didn’t believe in either of these drugs! I had to be put methadone so I wouldn’t go through major withdrawal! Now I have a new doctor who has prescribed a form of morphine as my pain med! The dosage is not strong enough so I am in constant pain 24/7! She does not want to up the dosage as she fears that I will get addicted! Mean while I am in constant pain! I have no real quality of life as the pain is so horrible that I can barely do anything! Horrible way to exist as I am not really living due to the pain!

  17. Oxy doesn’t work for me, my physical system seems to block most pain drugs…I’ve been on Lyrica for awhile now, along with advil type of meds…going to take myself off those and see if the Lyrica works just as well on it’s own…it’s a brain inhibitor…I started get electric shocks from my neck to out both elbows and running down my legs while working at a job…couldn’t work for months afterward and WSCC/WCB wouldn’t have given me anything because it was a pre-existing condition – the disks in my neck and lower spine have both degenerated rather a lot…it’ll be a nice day when more people realize that constant pain is extremely dibilitating…I’m only 45 and I have lost 15 lbs so far and have another 15 to go before I hit my old normal weight…I’m doing this to take unnecessary pressure off my disks…I also suffer from tendonitis in both elbows and both wrists because of sports injurys…good luck everyone

    • If your current treatment regime is working, you might not want to mess round with it unless the side effects are very troublesome.  Otherwise you might find that you start experiencing excruciating pain and you won’t be able to fix it by simply going back to your old regime.  Discuss this plan you have to ‘take yourself off your NSAIDS” with your doctor before you do it.

      • NSAIDS will kill your stomach and impair your kidneys.

  18. When I was a student I went to a pain seminar…extremely enlightening.  These seminars should be manditory for all health professionals….unfortunately, they are not and infact, the one I attended, people had to pay for, including students so that doesn’t really encourage wide attendance.  I would advise anyone suffering from chronic pain to ask their physician for a referral to a chronic pain clinic.  There you will be cared for by people who specialize in this area and you will received comprehensive care from a whole team, including psychologists and physiotherapy.  The next step is to put your trust in this team because although they might make recommendations to you that make you skeptical, you have to take a leap of faith and realize that the team works from a place of research-based knowledge.  They chose this specialty and ridding you of pain is their only goal.

  19. Eric Arzoumani
    Amazing article thanks to Andy Paras for recomending the link,Matt i agree with you specialy part of bureaucratic disease which is a real diseas in our system,any way my friends it is much to be regretted that with all this progress still ther are millions people sufferingof chronic pain.ofcourse chemists are trying to find cure to rescue human life and as you say polititicians are ought to be
    part of solution .onlyarmorys are trying to invent better weapons to kill.(and monkeys are laughters)
     
     

  20. ALL Chronic pain sufferers should try taking a look at a more natural solution, i know how much pain people go through, but i also see how much Cannabis has naturally helped so many people with no bad side effects. It is beneficial to most diseases and is actually proven to shrink and sometimes cure forms of cancer, including lung cancer.

    Believe me its worth if nothing else looking into and asking questions.

    if you have any doubts, watch a documentary done on it to explain all sides of everyone’s opinion, with specialists, lab researches, and patient tests,

    http://www.youtube.com/theunionmovie

    take the bad effects out of medicine, keep your money for you, and not the pill companies with 600% mark up.
    The only reason your doctors and politicians dont like Cannabis is it takes away their narcotic funding from almost everything on the market because you can now make your medicine at home. just need 2 ingredients.. so as long as you can somehow come up with some dirt (from anywhere) and some water (im sure you can figure something out)

    Hope this can help :)

  21. As an ED physician, I can speak first hand of the deadly effects of this addiction.  Opioid overdose has replaced cocaine, heroine, and methamphetamine as the leading cause of drug related death in my practice.  Clearly, the harm-to-benefit ratio of Oxycontin has exceeded ratio of any other drug that I can think that has been commonly prescribed in the past 20 years.  I commend politicians who recognize the epidemic of deaths and loss of human potential associated with prescription drug abuse.  

    • While you commend politicians who recognize the epidemic of deaths and loss of human potential associated with prescription drugs, you also place a whole segment of the population in an epidemic situation.  These are people in chronic pain who, at the moment, are given very few alternatives for their pain. I consider them to be in an epedemic situation because 1 in 5 Canadians are suffering from chronic pain.  Doctors need to see both sides of this problem and instead of just looking at the deaths from abuse of this drug, also see the responsible use of this drug by people who are able to lead useful lives because of if. You don’t see them in the ER because they are able to function in society when taking this drug. You may begin to see more of them as they come in with excruciating pain and no solution.  I would also like to see some statistics on the number of chronic pain patients who will no longer be able to take this medication and who will simply give up and take their own lives instead of suffering this pain on a daily basis.

    • “Clearly, the harm-to-benefit ratio of Oxycontin has exceeded ratio of any other drug that I can think that has been commonly prescribed in the past 20 years.” (Your quote, above, ER Doc.) Your statement provides no stats or hard data. Let’s see some figures on chronic depression, job-losses, poverty, family break-up, child-neglect and suicides prompted by inadequate treatment of persons suffering chronic pain. I endure agony from spinal injuries and arthritis. My family and fore-bearers have not died from narcotic drug addiction, but from chronic ulcers, hemorrhages, stomach cancer, and impaired kidney function — all due to the vile NSAIDS that MD’s have dispensed like candies (in lieu of safer opioid alternatives that would have addressed chronic pain more more successfully.) The culprits? Vioxx, Celebrex, Naproxen and their cousins, which MD’s have been all to eager to prescribe to patients over the last several decades. Re: Medical marketing: A product suddenly becomes “dangerous” around the time it’s patent expires. It is replaced by “newer, safer, better” alternatives that cost twenty times more. Compare the cost of a bottle of plain old codeine pills with the new super-drug your MD (or MP) want you to take!

    • I am extremely sick and tired of being sick and tired! I, also, believe that there are lots of other people out there suffering needlessly from severe and unrelenting chronic pain!

      Why did the Government 15 years ago, not introduce the legislation concerning opioid pain relievers and tightening up the use and control of these drugs instead of letting doctors’ hand them out like candy?

      Why was Oxycontin singled out? Because it worked for us chronic pain patients and was the leading No. 1 painkiller available to us! Unfortunately, like anything else there are people continually on a quest to escape reality! If there is anything out there to be abused these people will find a way to abuse it!

      I NEVER ABUSED ANY OF MY MEDICATIONS, AND THE ONLY PAIN PILL THAT WORKED FOR ME AND OTHERS WAS OXYCONTIN! Yes sure you might say there are other pain reliever, they continue to forget that most of us chronic pain patient’s have tried the others, and have had severe, debilitating side effects.

      I was a victim of severe physical abuse as a child and the injuries that I incurred have come back to haunt me in the form of “SEVERE ARTHRITIS” in nearly all of my joints and degenerative disc disease”!

      I was on many different medications until 2001 when I found “OXYCONTIN”,It was the only pain reliever that did not rob me of all my energy, did not upset my stomach. It actually gave me my life back!

      Then on the return from a trip to South America, I was told by my doctor that it had been taken off the market due to drug abuse!

      First, he put me on “OXYNEO’, It gave me severe cramps and stomach trouble, etc. Then I tried “MS CONTIN’, it made me so tired, I could not think straight or drive. Then these so-called generic OXYCONTIN’S became available, I tried them whatever else they put in it made me severely ill, both physically and mentally. I had to stop them immediately.

      I am now in pain, 24/7, I feel forgotten about! Ignored by everyone, the Health Care system, isolated, in my bed, afraid to stand up! I literally scream the pain is so bad! To be honest, sometimes I am so depressed, I would like to throw myself under a bus!

      Please is there anyone out there that cares? I am at the end of my rope, I am now on OXYNEO, i suffer with severe nausea, IBS from what I suspect is from the plastic in this medication.

      Now, I hear that in my little town, they are chewing and smoking the FENTANYL PATCH! Say what you got to be kidding me, until “I read that an 8 year old boy died from chewing on one; another died from an overdose of smoking one. Will they ever stop? Is the PATCH NEXT TO GO!. Oh yeah, I also read that there has been an influx of “HEROIN” on our streets. That is totally unheard of here in our town and region, it was never heard of before!

      Yes, I am deathly afraid for our young people, we need to look after them and educate them. But why am I being punished? I feel totally abandoned, I am lost and alone. I am confined to my bed! The pain is that bad and the pain is so very “REAL”.

      I guarantee if you or a government official, lawmaker, doctor spent one day or even a few hours in my body they would be ‘SCREAMING TO GET OUT”!

      Please, please give me back my life and others like me. Help us before it is too late!

      Is there any compassion or empathy out there!

      SIGN ME ALL ALONE AND HURTING! GIVE ME BACK MY LIFE’

      From a little town called Fort Erie, ON

  22. Good article. It’s scandalous that a policing problem– criminal addicts — should interfere with good medical practice. By the way, it isn’t only those who suffer injuries who are in chronic pain; millions suffer from intestinal disorders that are essentialy chronic pain, and can be utterly debilitating. 

  23. I have been given all kinds of drugs or pain including Oxycontin, Fentanyl, Morphine, Neurontin, anti-depressants….I found the Oxy made me too dopey, the anti depressants made me sad and out of touch, Neurontin made my mind very foggy and very forgetful and gave me unusual twitches and while all of these could address some of the pain, the worst of it, the nerve pain could never be addressed. That is until I tried using cannabis medicinally. Because of it I was able to get off of most of the other drugs and now take 1/3 of what I used to. It is the only thing that has has any effect on the nerve pain yet it remains illegal in both Canada and the US. Nobody has ever overdosed on Cannabis yet this safer option is being kept from most of us.

    •  well said! as i mentioned in my post, its worth everybody in pain to try for a week, 95% will not regret it and the other 5% will say “it made me paranoid” – but the paranoia comes from the government making it illegal, you can be prescribed this to be legal and then you have no worries to be paranoid about…
      An effective medicine with the only real side effect: Government Misinformation
      I can offer a probable positive solution but only you can do the research to learn about it and help yourself, if you wont even try to help yourself i have no sympathy

      Thank you Diane for telling your experience, and helping let those who need it know the truth!

      if you haven’t already please watch this documentary to learn the facts that will answer any concerns you have, and how it benefits more than just people with pain, but everybody – and not how you would think! It can also be used to reduce or eliminate polution, save our forests, run our cars and power, can make bio plastics out of resins, car bodies, clothes and that doesnt even scratch the surface.
      This plant can replace most of our harmful medicines and save the economy at the same time. Please just watch, for the good of everyone in the world, look into the facts and truth, and talk to your doctor.
      http://www.youtube.com/theunionmovie

  24. It’s much more than just propaganda. The DEA pushes that very deliberately, btw, but they don’t stop there! It’s very profitable, for them, for police and other City and County agencies who get some of the swag from forfeitures. That is spread all over the place. Good pain-treating doctors are busted all over the country. Every time a clinic is busted, it starts with a big Media Event – another Pill Mill Doctor bust! The doctor is convicted in the media instantly, and citizens climb on the bandwagon like ants on a birthday cake. People with exculpatory evidence or even a different opinion with some experience to back it, however, are enjoined not to speak to the media – it might contaminate the jury! Hundreds, sometimes over a thousand patients are instantly thrown out on the street without meds, and the DEA, having stolen the medical files, refuses to give even copies to the patients, so doctors elsewhere have another excuse to refuse to see them. Patients can’t get seen even for insulin or heart meds within two states in all directions because doctors are afraid it might attract the predator: the insane DEA. Having made sure there are no nearby doctors who will treat pain, they classify as likely addicts/drug abusers any patients “who drive long distances to see a doctor”. 

    At the trial, juries are mis- orsimply not informed as they should be. Terms like “dependency” and “addiction” are regularly and repeatedly conflated. Exculpatory evidence is withheld. Patients are often blackmailed. the investigation usually consists of about two years of attempting to get the doctor to give even one small prescription of opiates to an undercover cop who has been coached by a doctor on how to fool another doctor. That one script can send a doctor to prison, can precipitate a SWAT raid on a clinic that is open to the public. That is used to fan the flames of fear and ignorance that is the DEA and DOJ’s bread and butter. The doctor’s savings, investments, homes and other property is all confiscated via civil forfeiture before he’s even charged. That way he – or she – is unable to afford a decent defense. I’ve written thousands of words on in many articles. It’s changed nothing at all, and the handful of people who have lost a relative to drugs – or to pain, but they never see a difference – always have FAR more of a voice than the 116 MILLION of us who try to get the truth out there. I’ve been in crippling pain for almost 29 years. After a decade of trying desperately to find a diagnosis and being thrown out of clinics, VA hospitals, after unbelievable medical abuse including screaming doctors, snide, humiliating nurses, and after 6 back operations for the pain so many were certain I was faking – along with the sky-high BPs and all the rest after an athletic, active life, I’ve STILL been cut off from the medication that gave me back enough function for me to live a decent life. Almost; I still couldn’t work. Any doctor I see can be imprisoned at any time. What I have can be taken away again whenever another cop needs a promotion, or a judge wants to go into politics, or some agency needs more funding.

    We hurt, so we’re guilty. There is no appeal, and there’s generally no help or even belief either. This is never going to change as long as it’s so profitable. It’s corrupt as Hell, and it’s business as usual. We age too fast, die too young, and too often of suicide. Why not? We’re just a bunch of addicts. Right?

    Ian

  25. I am a psychiatrist and must express my outrage at the Colleges of Physicians and Surgeons in this country who persecute, prosecute and destroy many good physicians who do their very best to help people in pain. The guidelines have everything to do with bureaucracy and nothing to do with patient care.  I shit you not. These colleges, the worse being the the CPSOntario, have heavy hands and use ignorant ex police offices to investigate. How dare they cause patients pain and suffering. If society wants to get rid of drug problems then legalize the whole kit and kaboodle.Use the money saved from prisons to help treat the ill. We have 3 million addicts in Canada. We have less than 5000 treatment beds for addiction–and I’m not even speaking of tobacco.These colleges are unprofessional disreputable dishonourable dishonest draconian. They do not care about patients-they have no knowledge of the massive amounts of pain and suffering which exist in this country.PAIN requires treatment. TREATMENT  requires that physicians are safe from the colleges, insurance companies and their agents. Why am I not signing this letter? Because to do so means my license would be revoked. As Ripley said, believe it or not.

  26. I think it is sick how people with real chronic pain are being treated I am one of them!!! Join my group on FACE BOOK search Michael Gesy or maddonna3536@1a0d0e004636b12c60d920d244a4832a:disqus hotmail.com join my group we all must fight together!!!! THERE IS HOPE

  27. OxyNeo, impossible to snort, inhale or inject, makes a much safer drug available.!?!!That is NOT correct at all!!!! People figured out(very fast) if you grind it up place it in microwave or oven until it turns a golden brown color then cool it in freezer it is VERY snortable!!! In this day and age NOTHING is impossible to alter.What a crock of sh***it

  28. Drug addicts (coke/crack-heads, etc.) are entitled to have their habits facilitated via “safe” drug injection sites and needle-exchange programs available in some major Canadian cities (funded by taxes, of course.) Sick people, however, must fight a nightmarish daily battle of unending pain without the benefit of the very medicines that could restore a bit of dignity and quality of life to their daily grind of disability and physical anguish. This is worse than the policy of Prohibition, which treated every human as a potential addict. At least no one NEEDS booze for health reasons. Those who battle severe and/or chronic pain, however, NEED pain meds in order to live something which approximates a normal life. MD’s, treating me like a hot potato, have passed me from pillar to post, avoiding responsibility for providing me with MODERATE pain treatment for spinal injuries and arthritis. Yet doctors are all happy to prescribe fistfuls of NSAIDS (Vioxx, Celebrex, and their descendents) without first reviewing my personal and family history of stomach bleeds and kidney impairment triggered by such drugs. Enough!

  29. I live with pain every moment of every day. I have a type of leukemia that has caused my immune systen to go crazy. Consequently all my joints are inflamed with a form of Rhumatoid arthritis, when you add in degenerating discs in my back and other issues, Im a mess. I am lucky enough to have 2 very compassionate doctors that want me to have a quality of life. However when I became stuck out of town due to my mothers death, I was terrified. When I tried to get my Oxycontin and dilauda refilled you would have thought I was trying to get a gun. Doctors I phoned refused to see me, lucky enough a very kind pharmacist helped me. If I didnt have any pain relief , my life would be over. Polititions and the police should stay out of medicine. Patients with real medical issues shouldnt be left in pain to combat drug abuse. Thats the dumbest reasoning Ive ever heard.

  30. Do they teach even bedside manner in medical school? I would rather be “addicted” to an effective opiate than be in pain, and would even be okay to die addicted. That’s fine with me. If we don’t hear a flippin’ alarm and that’s how we go, I think that would be fine with me as well. Take that one day at a time and deal with it pain free as best we can. Just my opinion. It’s my choice. Pain sucks. Great article. Pray it makes a difference.

  31. I find it very discouraging that there should be so little buzz about medicinal uses for cannabis in Canada, especially when it’s about chronic pain. This article and most of the comments don’t help with my discouragement.

    I am firmly convinced that a good majority of folks affected by pain, and specifically chronic pain, would see the quality of their lives greatly improved by the use of orally ingested, smoked, vaporized or topical cannabis.

    Cannabis will help you sleep, it will help your appetite, it will help your bowel movements, it will help your mood, it will help your sore muscles, it will help your brain cope with the horrors of chronic pain, it will help you sleep and function when you don’t. You can drink, eat, chew, smoke and vap it. The spectrum of cannabis products (oils, tinctures, edibles, drinks) makes it accessible to most people who need it. More often than not it does not interfere with the rest of your life. It won’t make you stupid, or slow, or anything but that which you choose to use it for.

    You can have cannabis prescribed by a doctor. Not all doctors prescribe, not all conditions are equally persuasive to those who do. But if you don’t try, you’ll never know. And if you tried once, or know someone who tried once, and failed, believe me, it is worth trying again and again.

    One day we’ll look back in horror at how easily we looked the other way as those we love were using opioids while cannabis remained an option.

  32. This is exactly the situation i’m in.. its very heartbroken, feel so alone. Doctor only prescribe a certain maxium amount of oxycodone for me which i told him its not enough, then when i need to refill more, pharmacist refuse to dispense it because my prescribe last month should last me 2 more weeks. I try explaining when i need to take it i need to. No one understood, everyone just look at the numbers of pills and freak out. Everytime i need to fill a prescription either with a doctor or pharmacist, I’m very scared and angry because i feel scared that they won’t prescripe it, and exactly what i’m facing as I’m writing this. they make me feel like a drug addict, makes me feel so worthless. Its really heartbreaking for me… why do i have to beg just to make my pain go away…Everyone is worried about these drugs and makes me really sad that they are not looking deeply into people who legitimately needs it. I’m still waiting for a call back from pharmacist who is calling my doctor to get approval to dispense more refil. I’m really sad… so alone… fighting the pain is hard enough.. i have to fight doctor,pharmacist… not to mention because i’m taking oxycodone, i’m having hard time find life insurance who will cover me so at least i get a piece of mind if …. oh.. you know what i mean. This is so sad…. so alone… so difficult.

  33. Is Anyone Else going through this????? Very recently my Pain Management Dr. has come under investigation for prescrbing oxycodone… This Dr. is highly knowledgeable and respected yet the College Of Physicians and Surgeons of BC is forcing my doctor to reduce and eliminate narcotic pain medications with all patients regardless, even if it forces patients to live with severe pain. The ONLY reason the doctor is doing this is out of fear of the College and what they are capable of doing to this doctor’s career.
    Is anyone else going through this with their doctor?????

  34. I applaud Dr. Jovey for putting pain patients first, why should they suffer because of a few deceptive people who sell their medications? Studies in the US have shown that since Oxycontin was reformulated the abusers just turned to Heroin whilst the chronic pain sufferers have to take a reformulated drug that is not as effective because of the poisonous additives used to make the drug crush resistant. It should also be mentioned that since oxycontin was reformulated heroin overdose deaths have spiked upward. As well there are also a lot of other medications that are still oxycodone based and are crushable. By making Oxycontin the flavour of the month the news industry has damaged the reputation of a good medicine. Drugs like Fentanyl are abused more than Oxycontin but the news industry just seems stuck on one drug, very narrow minded and un Canadian. Thanks You Minister Leona Aglukkak and the Stephen Harper Government for letting Health Canada do its job without political interference and now Canada has cheaper old formulation generic Oxycontin again. A win for Conservative values, pain patients, it was the “Canadian thing to do.” Let’s hope addicts will just stick to their more dangerous, and illegal Heroin so Oxycontin does not get an undeserved negative response. Alcohol kills more people and is more harmful than opiods, when the opioids are used as prescribed. Let’s hope law enforcement concentrates on unscrupulous Doctors who profit from bogus prescriptions and leave legitimate Doctors and pain patients to get on with their lives. As well if Purdue Pharma has reformulated their Oxycontin and renamed it OxyNEO why don’t they reformulate their other long acting opioids instead of whine about cheaper generics that work better? Why did Purdue Pharma wait until their patent was about to run out on Oxycontin before they reformulated it, it was to give themselves market exclusivity of a newly patented pain tablet. It is called ever greening their drug and Health Canada saw it for what it was and along with the Harper government allowed pain patients to receive a better, cheaper, product. Purdue Pharma did not do any of this altruistically and even are now whining about their OxyNEO being delisted. Soon the Provinces will re list the cheaper, better working generic Oxycodone product and Purdue’s plan will have backfired. The hardening agent in OxyNEO is called BHT for short and is a known carcinogen, it is poisonous, but Purdue does not care as long as they sell it. Way to go Ms. Aglukkak, you were courageous and did chronic pain patients a good deed. History will prove this. Anybody wonder why Purdue plead guilty to criminal charges in the US and paid 634 million dollars US in fines? Because they acted criminally by claiming it was less addictive when they knew it was not. However, when used properly, is it not better to be pharmacologically dependant than be in so much pain that you cannot work or drive, I think not. Remove the criminal element and Oxycontin will be a good thing and save lives. Given this, there are always going to those who want Oxycontin banned because a loved one overdosed. Remember it was the person who overdosed that made the decision to take the pill, the pill did not have any input in the decision, people need to be responsible and not blame their problems on a pill that their loved one(s) misused. MADD does not blame alcohol or call for its banning, they blame the people who misuse it, and then kill someone, just like how it should be. People who take Oxycontin with authorisation and or sell it should be dealt with by the judicial system, and people in pain should be able to use it as prescribed. The WHO states that an opioids should be dosed until pain is relieved and side effects are at an acceptable level, no matter how high the needed dose is. The amount that someone who is tolerant can take could be enough to kill someone who is not tolerant, and that is why people should never give their medications to another person, when this happens there will be casualties. As well, this medication should be kept out of reach of others to prevent this. Mitigate your pain but be safe and follow your Doctor’s directions.

  35. Used properly opioids including Oxycontin are life savers. What would help is less sensationalized reporting about abusers who make bad decisions.

  36. Anti depressants are bad for you, opioids are not if used for pain. NSAIDS ruin your stomach. Get the puritans out of the FDA.

  37. Are you suggesting that new born babies be administered oxy?? I am not sure what this is promoting but I have a very clear understanding for what I’ve seen as I worked in a pharmacy and have deal with a mild form of fibromyalgia but oxy to me means the more you have the more you want pain tolerance becomes higher=more oxy…. I’ve seen people turn against their family just to get an extra dose of this drug and many people OD’ng on this drug mainly because the high is so good the take extra pills… I don’t expect anyone on this forum to agree with me but I for sure hope the government puts a limit to this ridiculous drug…

  38. I had a doctor who prescribed almost a full bottle of extra strength aspirin a day. You have no idea what it can do to your stomach until after a few weeks when the pin in your gut is worst that the pain you are trying to relieve. Finally when I started to bleed internally did I change doctors. This new one prescribed an opioid but only after a full workup, I was fortunate he did not prescribe Oxi but started me on a more traditional older form of medications. I still take it today and have managed to keep the medication dose as low as possible. This means however, I have to tolerate some pain on a daily basis. Without my medications I would be in a world of pain 24 hours a day 7 days a week. I don’t like to take the meds but realize they are the only way for me to lead a somewhat normal life.

    The reason I try to take the minimum is I am relatively young at 58 and will be taking these medications for the rest of my life. I fully expect my pain to increase as I age. the same problem I dealt with aspirin and non-opioid pills until I could no longer stand the pain. As a man of 52 years old I actually cried in my Doctors office from the pain I was in. That was the day our relationship changed and to this day I bless the god that allowed me to meet such a calm and humane individual. He talking about retirement and I am afraid I am going to be left out in the cold looking for a new doctor who appreciates what chronic severe pain really is and how it affects someone life.

    Most doctors are reluctant to prescribe opioid’s and treat you with great suspicion especially if you have to end up in the ER. clearly pain education is not a priority in medical schools. It should be one of the most important classes.

  39. 不喜欢这篇文章,大半夜还得总结什么文章大意

  40. The abuse of opoids can be a real problem, but itsnt anywhere near as tragic as the abuse of patients by a government that is preventing doctors to releive their suffering. Patients who truly are “drug seeking” and plan to abuse the medication are doing so on their own free will. If unable to get the drugs from the docyor they will likely turn to other sources. Some will develop severe addiction and could possibly someday overdose which is tragic, but in most cases the only real “side effect” is euphoria. The real tragedy is denying releif those who did not voluntarily seek their suffering. If preventing ten junkies from getting approved for pain drugs means denying releif to one person who is honestly suffering, it is not worth the cost. this war on drugs has had far too much colatteral damage. I think the denial of needed medication should be grounds for medical malpractice lawsuits. Doctors shouldnt have to fear prescribing these drugs, they should fear the consequences of the uncompassionate withholding of them. The are very safe when taken as directed. No one will overdose on the amount needed for releif. By current logic all drugs should be resricted because one could surely overdose on nearly anything if he ground up an excessive amount and injected it. Taking oxycodone off the street will only open a bigger market for heroine which is far mor dangerous due to uncontrolled doses.

  41. Good to see an alternative view to balance out stigma that all strong pain management meds should be avoided. Obvs better to decrease pain through combo of exercise, rest, avoid stress and ensure a balanced diet where possible to help, but sometimes the support of stronger pain meds is also needed to promote a normal active lifestyle, provided managed intelligently and monitored. The view that under medicating patients with chronic pain is also in humane is a valid one! GPs need to take a balanced view vs just being scaremongered into avoiding anything that makes them liable. UK view on this seems far more conservative than French view that eliminating pain quickly is key to avoiding chronic pain probs developing in longer term! All about a balanced view. Also worth noting that addiction to these kind of drugs amongst patients with chronic pain is around 0.1 percent and rates of suicide linked with the drugs are often due to patients living with significant pain being under medicated. All about prescribing based on overview of multiple factors and acting intelligently. Rant over!

  42. this situation is pathetic ,its pretty sad when you to buy meds on the street at street value that should be prescribed so my mother doesnt have to suffer

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