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Pain Crisis in Mohave County and America

I'm Afraid History is Repeating It's Self Read this 1996 Kingman Daily Miner Article and the 2017 Article

The article in this post is a Kingman Daily Miner article about my fight for pain relief back in 1996. I fear history repeating it's self.

This is a LINK to a February 2017 Kingman Daily Miner article the Politics of Pain 


1996
This is the original 1996 article Kingman Resident in Tough Battle for Pain Relief, Hist Rock Wall was written by Abbie Gripman a staff writer for the Kingman Daily Miner at the time. 

WARNING Counterfeit Opioid Tablets Contained Fentanyl Found in Arizona

Deadly synthetic opioids found in several Arizona cities

Several law enforcement agencies across Arizona, including Phoenix, Tucson and Yuma are alerting the public that street drugs containing deadly synthetic opioid fentanyl and carfentanil have been showing up across the state.

According to the national institute on drug abuse, fentanyl is 50 to 100 times more potent than morphine. Carfentanil is a sedative used for very large animals, such as elephants.

These pills may be sold on the street as oxycodone, and can be deadly. White Mountain Independent Link to Article 

If you have pills you think may contain Fentanyl or Carfentanil please contact Dusti at Kingman Harm Reduction 3505 Western Ave 

She's open Wednesdays 12-7:30 and Fridays 8:30-3:30 and has test strips for Fentanyl or Carfentanil as well as Naloxone and other supplies.  

NASA space suit on-the-move

SHOW LOW — Pictured is an actual NASA space suit worn by an …

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Lane restriction on SR 277 through Nov. 1

Drivers who use State Route 277 between Snowflake and Heber should plan for co

Doctors Urge CDC to Clarify Rx Opioid Guideline in Letter

Doctors Urge CDC to Clarify Rx Opioid Guideline in Letter

Hundreds of doctors and healthcare professionals have written a letter to the CDC, asking the agency to make a "bold clarification" of its controversial 2016 opioid guideline. 

They believe many chronic pain patients have suffered under the CDC guideline because it has led to widespread tapering and discontinuation of opioids. 

Read the Whole Story on The Pain News Network

The FDA is requesting comments concerning abuse medical usefulness of marijuana and 16 other substances

The Food and Drug Administration (FDA) is requesting interested persons to submit comments concerning abuse potential, actual abuse, medical usefulness, trafficking, and impact of scheduling changes on availability for medical use of 16 drug substances. 

These comments will be considered in preparing a response from the United States to the World Health Organization (WHO) regarding the abuse liability and diversion of these drugs. 

WHO will use this information to consider whether to recommend that certain international restrictions be placed on these drugs. This notice requesting comments is required by the Controlled Substances Act (the CSA)

Food and Drug Administration Comments Here

If You Have Chronic Pain You Need to Know About Trigger Points

I just learned about trigger points and WOW they really work.

My new pain doctor told me about trigger points and how he could inject a small amount medicine and relieve some of my pain. I love my doctor and trust him 100%, but I hate needles..... That's when he told me that I could get temporary relief using pressure on the trigger points. 

One night when I was hurting we printed the anterior trigger points. My wife didn't have much problem finding #1 and #5 on the chart as they were pretty tender. She used her elbow and pressed as hard as she could counting out 30 seconds. Then she moved on to the next trigger point and did the same thing.

When I got up off the bed I couldn't believe I didn't hurt, at least not as much. It had relieved about 80% of the pain. I could even stand up straight and walk without much pain.

Now when I get that pain down the back of my leg and it's hard to walk, my wife uses her elbow on #1 and #5 for 30 seconds, and it's much better.

If you have chronic pain look into the trigger point links below they can really make a difference. I was surprised how something so simple could make such a difference...

Locations are where you'll find sore spots or small muscle knots
Referrals are where pain may refer when a trigger point is pushed

Links
Anterior Trigger Point Locations
Posterior Trigger Point Locations
Anterior Trigger Point Referrals
Posterior Trigger Point Referrals

Great Page on How Trigger Points Work

HHS Recommendations on Chronic Pain Due Late October MUST READ

This is a must read article for pain patients in 

The National Pain Report

HHS Recommendations on Chronic Pain Due Late October

You have another chance to tell the Department of Health and Human Services your story...

It’s going to be the end of October before we see the set of draft recommendations of The Pain Management Best Practices Inter-Agency Task Force. Once the recommendations are released, there will be an extensive public comment period where the patients, providers, and policy makers can weigh in.

The Article Say's

 "Tellingly, the Task Force will recommend against imposition of any mandated numerical daily dose threshold. This position in effect contradicts much of the CDC Guidelines and State regulations based on them".

"It will be interesting to see if the final report extends this principle to 2019 rule changes of HHS/CMS authorizing “soft” and “hard” edits of prescription plans at 50 and 200 Morphine Milligram Equivalent Daily Dose levels".

"Mandatory or coercive tapering of high dose legacy patients is unjustified and risky unless some condition in the individual patient’s health justifies such action". 

The 90-day comment period will trigger a process that will result in a final report to Congress in May 2019.

LINK TO ARTICLE: National Pain Report Article

When Will We Learn?

When will we learn that drug abuse like alcohol abuse is a medical problem, not a law enforcement problem. Like I've said so many times, we can not arrest our way out of this.... 

Over the past 50 years our nations war on drugs has failed it's intended goal of reducing drug use. Today drugs are more potent, cheaper, and easier to get than when we started 50 years ago. 

This is a time our nation is threatened by terrorists and others who would want to damage America. This is a time we need to come together as a nation and not be divided by something as simple as a plant or pill. 

Hubert Humphrey told us “There are not enough jails, not enough policemen, not enough courts to enforce a law not supported by the people”. 

Covert operations the use of undercover officers, informants, and snitches have destroyed the trust between law enforcement and many communities.

I learned this from the damage I did while working undercover. Something I tried to make up for as a speaker for LEAP for the past 15 years. I still have problems talking about the damage I caused even today. I did talk about it in this 2006 documentary Damage Done the Drug War Odyssey 

Sadly nothing has changed.... America the home of the brave and land of the free still imprisons more of it's own citizens than any other country. While the United States has about 4.4 percent of the world's population, it houses around 22 percent of the world's prisoners. More of our own citizens than countries like Thailand, Cuba, Rwanda, and Russia. Really..   Prison Populations by Nation 

Now President Trump is ramping up the war on drugs again. As War on Drugs Again Declared Failure, Trump's UN Event Dismissed as 'Splashy' Backward-Thinking

I use a couple lyrics from the 1984 song Smugglers Blues to point out that sadly nothing has changed.

You see it in the headlines, you hear it every day

They say they're gonna stop it, but it doesn't go away

They move it through Miami and sell it in L.A. 

They hide it up in Telluride, I mean it's here to stay

It's propping up the governments in Columbia and Peru You ask any D.E.A. man, he'll say there's nothing we can do

 From the office of the president right down to me and you Me and you

It's a losing proposition, but one you can't refuse. 

It's the politics of contraband, it's the smugglers' blues Smuggler's blues

In the same 50 years we have reduced tobacco use by half. Cigarettes used to be everywhere in American society. Fifty years ago, 42.4 percent of U.S. adults smoked. Since then, that figure has declined by more than half, reaching a record low 17.8 percent in 2014.

We did that without SWAT teams, without putting anyone in prison, without destroying any lives or families. We did it by making it not socially acceptable......

We need to stop all this madness? When will we learn that drug abuse like alcohol abuse is a medical problem, not a law enforcement problem. When will we look at history as well as science and learn from both.

Like I've said so many times, we can not arrest our way out of this.... 

Free Naloxone From Sonoran Prevention Works Kingman Dolan Springs White Hills Meadview Chloride

Sonoran Prevention Works Kingman Harm Reduction Program is in the Mohave Mental Health Building at 3505 Western Ave Suite B in Kingman.

They have free Naloxone info on the Fentanyl laced street drugs and other services for the community.

It doesn't matter if you take prescription opioids from your pain doc, or if you abuse street drugs please keep Naloxone on hand just in case.

If you can't get into Kingman message me or Facebook and I'll get some to you in Dolan.

Jay

Now is Your Chance to Tell Congress How Chronic Pain Affects You and Your Life

Pain Management Best Practices Inter-Agency Task Force Second Meeting

September 25, 2018 - September 26, 2018

Now is your chance to tell Congress how pain affects you and your life...

Link to Pain Management Best Practices Inter-Agency Task Force Meeting

• 
  September 25, 2018 | 8:30 am - 4:30 pm EDT
• September 26, 2018 | 9:00 am - 12:00 pm EDT

Prescriber Checkup Check Out Your Physician

ProPublica Prescriber Checkup lets you see how your pain doctor stacks up prescribing opioids, billing patients, and money they receive from drug companies.... 
ProPublica Prescriber Checkup

On Fentanyl: Congress Must Avoid Another Drug War

From the LEAP Blog On Fentanyl: Congress Must Avoid Another Drug War

Congress and the American public had agreed that incarcerating tens of thousands of Americans for nonviolent drug offenses is cruel and ineffective, and does nothing to stop drug use. Then fentanyl arrived.

And We Wonder Why Kids Use Drugs

The government does study after study spending millions of dollars doing studies on why kids use drugs... 

Let me make it simple for them...

We give kids Adderall (amphetamine) in the morning to get ready for school, they take a Vicodin (opioid) after school for a sports injury, then use medical marijuana in the evening to relax and finally they take a Xanax (benzodiazepine) at night to get to sleep. All prescribed by their family doctor. 

And We Wonder Why Kids Use Drugs? Really

The Role of Suicide in the Opioid Crisis

Must Read Article The Role of Suicide in the Opioid Crisis from The Pain News Network

By Roger Chriss, PNN Columnist

Suicide is an under-appreciated factor in the opioid crisis. Media reports rarely mention it, and pundits and politicians often ignore it. But the reality emerging from experts and a careful study of drug deaths shows that it is very important.

“We’ve done preliminary work suggesting that 22 to 37 percent of opioid-related overdoses are, in fact, suicides or suicide attempts,” Bobbi Jo Yarborough, PsyD, an investigator at the Kaiser Permanente Center for Health Research, told HealthItAnalytics.

Complications of Uncontrolled, Persistent Pain

My heros these days are physicians like Dr Forest Tennant who stand up for their patients. Dr Tennant wrote this article in Practical Pain Management on the complications of uncontrolled persistent pain. 

If you or a family member suffers from chronic pain you need to read this article. Most patients and many physicians don't understand how many ways chronic pain adversely affects the human body. 

Complications of Uncontrolled, Persistent Pain

Persistent, unremitting pain may adversely affect the body’s endocrine, cardiovascular, immune, neurologic and musculo-skeletal systems and require aggressive treatment of the pain as well as the resulting complications.

To the unfortunate patient who is afflicted and the practitioner who treats it, incurable, persistent pain is truly its own disease regardless of its underlying cause.1-3 Persistent pain, which is also often characterized as chronic or intractable, has all the ramifications of a disease in that it may have pre-clinical and overt phases.4-6 It may be intermittent or constant, as well as, mild, moderate, or severe. The most unappreciated clinical feature of persistent pain, however, is the plethora of complications that may result — particularly if the pain is constant and unremitting.

Here's the rest of the Article Complications of Uncontrolled, Persistent Pain

I Didn't See One Mohave County Pain Doctor at PainWeek?

PainWeek was an amazing gathering of 2000 medical professionals with an interest in pain management, but I couldn't find one Mohave County physician was listed as attending.

You would think physicians like those in Kingman, BHC, and LHC who treat pain but are not board certified in pain management, would take any opportunity they have to get the latest training.

Far too many physicians in Arizona hang out signs saying "pain management" "pain specialist" or "pain institute" that make patients believe the physician is actually a pain specialist... They're Not.

Arizona needs a law that requires any physician who hangs out a shingle saying  "pain management" "pain specialist" or "pain institute" actually be a board certified in pain management.

Until pain patients contact their legislators and tell their stories, nothing will change...

PainWeek 2018 WOW

PainWeek 2018

I was lucky enough to spent several days at PainWeek 2018 and it was amazing. Pain specialists from all over the US and the world came together in Las Vegas to share their knowledge and experience.

Over 2000 physicians, nurse practitioners, pharmacists, and other health care providers came together to share the best ways to provide pain relief for patients while lowering overdoses.

It's going to take me a few days to process and share what I learned in the CME courses. I hope what I learned can help other patients, physicians, and families understand the changes in pain management.

NADDI the National Association of Drug Diversion Investigators had maintained a training partnership with PainWeek for the preceding seven years, but choose not to attend this year. With all the changes in opioid guidelines, rules, regulations, and laws I was surprised NADDI choose not to assist physicians in understand the new changes. 

I was also surprised that with all the misunderstandings and confusion physicians in Arizona have about the CDC Guidelines and Arizona's Opioid Epidemic Act, I didn't see one pain management physicians from Mohave County at PainWeek.

Conferences like PainWeek give pain management physicians and other health care providers who treat pain the opportunity to receive continuing medical education credits known as CME's while learning the latest in pain management techniques.

More on PainWeek soon..........

Looking To The Future - Pain Treatment - Addiction - Overdoses - It's Time To Work Together

As PainWeek approaches physicians who treat pain and those who treat addiction come together to look toward the future of pain treatment. I'm sure there will be a lot of discussion on how to get patients the medications they need while lowering  the prevalence of addiction and overdoses.

It's going to take everybody and I mean everybody working together on this. Pain and addiction specialists, law enforcement, state and federal regulatory agencies, patients and the public must come together if we hope to find a solution to this complicated problem.

I hope PainWeek is a time for people from all these various specialities and agencies to come together and learn from each other.

Maybe it's time to think out of the box.....

As Medical Access to Opioids is Reduced Mexican Cartels Pick Up the Slack

As the government reduces access to pain medications for patients Mexican cartels are picking up the slack with fentanyl, pounds and pounds of fentanyl.

CNN is reporting Authorities in Arizona discovered $1 million in drugs during a traffic stop -- and officials say that led them to a nearly 600-foot drug tunnel that runs between a former fast food restaurant and a private home in Mexico.

Inside the containers, police found 239 packages of various drugs, including over 261 pounds of methamphetamine, 14 pounds of cocaine, 30 pounds of white heroin, 13.7 pounds of brown heroin and 6.8 pounds of fentanyl. The fentanyl alone "translates to over 3 million dosage units," Homeland Security Special Agent Scott Brown told CNN affiliate KYMA on Wednesday.

Unintended Consequences................. 

PainWeek in Las Vegas Sept 4th to 8th

I'm going to Vegas for a few days in September for PainWeek. It's a big deal in the pain management world. PainWeek.org say's PAINWeek is the largest US pain conference for frontline clinicians with an interest in pain management. PainWeek runs from September 4th to the 8th at The Cosmopolitan of Las Vegas.

I'm going to attend a number of training sessions on  interesting subjects like Pain Terminology: Knowing the Difference Makes a Difference, Full Metal Jacket: Examining the Psychedelic Side of Ketamine, and The Other Opioid Crisis: Fentanyl and Heroin.

There will also be programs by the American Pain Society, the American Society of Pain Educators, the International Pelvic Pain Society.

The National Association of Drug Diversion Investigators will have programs at PainWeek. It will be interesting to see what strategies the National Association of Drug Diversion Investigators have for dealing with the current opioid problem.

It's going to take everyone working together to solve this opioid problem. We need regulatory agencies, 
health care providers, patients, and law enforcement 
to work together in a spirit of cooperation rather than one of fear.

We need to find a way Do No Harm to current patients who've been on opioids for years without any problems, and set guidelines on prescribing opioids for future acute and chronic pain patients.

It should be an interesting week and I hope to learn a lot.

Suicide Watch - You need to Read This..

Need to read Pharmacist Steve's article Suicide Watch 

http://www.pharmaciststeve.com/?attachment_id=21115 

I am being completely weaned off my meds, & suspect I will kill myself with the amount of pain I am in, & will be by the time this is over (the wean that is). Already can’t function.

Why Are Dealers Mixing Fentanyl in Heroin?

We see or hear on the news about Fentanyl quite often these days. Most of the news is about people who overdosed on a mixture of Heroin and Fentanyl, or how many times more potent than Morphine Fentanyl is.

Drugs are about money, it doesn’t matter if its prescription drugs from your doctor, illegal drugs from the street or the money law enforcement receive in grants; drugs are always, about money.

In this case the new guidelines, regulations, and laws have helped both sides to make a lot of money. Drug Cartels found out Fentanyl was cheap and easy to make. According to Stratfor.com it costs about $3,300 to make a kilo (2,2 lbs) of Fentanyl.

CNN tells us recently Nebraska State Troopers seized 118 pounds of Fentanyl in a traffic stop. That amount is enough to overdose 26 million people. That amount cost the cartels $180,000 to make.

But this time we told then what the change in guidelines, regulations, and laws would do. After 40 years of the war on drugs we knew what the unintended consequences would be, illegal drugs would fill the void.

Heroin.net tells us the average cost of a single dose (0.1 g) of heroin purchased on the street has been reported as approximately $15–$20 in the U.S. state of Ohio.

So the 26 million doses would have been worth $390,000,000 street price to Cartels for that one shipment. And trust me cartels never put their eggs in one basket, how many shipments got past troopers that day?

Now cartels are manufacturing Carfentanil also called Carfentanyl.

According to Wikipedia Carfentanil is an analog of the synthetic opioid analgesic fentanyl. A unit of carfentanil is 100 times as potent as the same amount of fentanyl, 5,000 times as potent as a unit of heroin and 10,000 times as potent as a unit of morphine

The problem is how the drug world distribution works. At the top if you mess with quality you may not do well in the drug world. But as the something like Carfentanil with a potency 10,000 times that of morphine shifts down through the drug world, everybody is going to step on it. Imagine the profit for a drug dealer?

In 1mg of Carfentanil you have the equivalent of 10,000 doses of Morphine, wow. The problem for little Donny drug dealer is how to evenly distribute 1mg of Carfentanil into 9,999 mg’s of whatever little Donny drug dealer is using for cut.

If little Donny drug dealer makes a mistake and it’s easy when we’re talking about overdosing a little over 1/10,000^th of a milligram.

Prohibition doesn’t work…..

Wikipedia

https://en.wikipedia.org/wiki/Carfentanil

Heroin.net

https://heroin.net/about/how-much-does-heroin-cost/#streetcost

CNN

https://www.cnn.com/2018/05/25/health/nebraska-fentanyl-bust/index.html 

Stratfor.com

https://worldview.stratfor.com/article/mexicos-cartels-find-another-game-changer-fentanyl

Arizona Medical Board Doesn't Have a Plan for Pain Patients and It's Costing Lives

In 1990 Dr Albert Yeh of Golden Valley Arizona was arrested by DEA for over prescribing opioids, and another pain doctor just up and left Needles California. In 2009 there was also a significant spike in suicides in Mohave Counrt. I can't prove the coloration between the loss of two pain physicians and the increase in suicides, but someone might want to look into that.   

Dr Yeh was the type of bad physician DEA needs to go after. You'll understand about Dr Yeh when you read the the DEA special agents statement in the affidavit for seizure warrant below. 

Most physicians who treat pain and have problems with DEA do so because of technician violations of the law like medical records. I think most of these violations could be dealt with by education rather than arrest. 

On the patients side the Arizona Medical Board needs to have a plan in place on what to do if patients were to lose their physician who treats chronic pain with opioids..

Currently there is no plan for how to assist pain patients when a prescriber who treats patients with opioids should be arrested. 

Some of Dr Yeh's were people looking for drugs, and news spreads fast. That doesn't mean some of his patients have a legitimate need for opioid pain medications.

How many of Dr Yeh's patients committed suicide?
How many of Dr Yeh's patients turned to the street?
How many of Dr Yeh's patients overdosed because of unknown street doses?

What are WE going to do?

AFFIDAVIT FOR SEIZURE WARRANT

COUNTY OF MARICOPA

STATE OF ARIZONA

Your Affiants, Phoenix Police Detective Jamie Barilla and Erin Hager, a Diversion

Investigator with the United States Drug Enforcement Administration (DEA) Tactical Diversion Task Force, being first duly sworn upon oath depose and say:

On March 25, 2008, an Arizona peace officer acting in an undercover capacity posing as a new patient at Dr. YEH’s Golden Valley medical clinic met with Dr. YEH.

That agent, Arizona State Attorney General’s Office Special Agent (SA) Cheryl Thomas, was instructed by Dr. YEH’s staff at the clinic to complete paperwork entitled ‘Narcotic Contract’ which indicated that no early refills would be issued, and paperwork entitled ‘pain diagram,’ which was left blank by SA Thomas.

SA Thomas informed Dr. YEH’s medical assistant she did not have a referral from another doctor, nor did she have any xrays with her. The only medical evaluation performed by the medical assistant consisted of placing what resembled a pulse oximeter on SA Thomas’s finger.

Without first introducing himself, Dr. YEH immediately asked SA Thomas what kind of pain she was having. SA Thomas responded that she didn’t feel good, that she had aches and a headache. When asked specifically if she had pain in her shoulders and arms, SA

Thomas replied “no.” Upon having SA Thomas stand on her toes and her heels, Dr. YEH told SA Thomas that, “You’re fine, what can I do for you, what can I do to make you feel better.”

SA Thomas told Dr. YEH she had taken Vicodin (hydrocodone) in the past. Dr.

YEH then issued SA Thomas one prescription for 120 Lortab tablets (hydrocodone – 30 day supply), one prescription for 120 Robaxin tablets (prescription-only muscle relaxer –30 day supply), and a third prescription for an X-ray of the spine.

How Many Times Do We Need to Read About Pain Patient Suicides

Even though pain is the most common reason patients see a doctor, pain wasn't treated in the 90's. Pain was undertreated and patients were committing suicide for lack of pain control. I carried a stack of death certificates from pain patients who took their life as noted in the 1996 article about the fight for pain relief below.
LINK to 1996 Article in Kingman Daily Miner  

There Are Two Side to Every Story.....
Pain and Suicide: The Other Side of the Opioid Story
Jack never said much during his office visits. He was
mostly silent and followed my instructions. But he did
quietly express fear of the pain if I continued to reduce his
pain medications. During the third clinic visit of this process, he said, “I can’t live like this, Doc.” I said, “It will get better,” hoping more than knowing my statement would be true. 

I counseled him that the pain may worsen for a while, but that—in time—this new regimen would be for the best. I heard his words but not his cry for help.

Three days later I got a call from his daughter. Jack had died from a self-inflicted gunshot wound. He left a note saying he couldn't live with the pain anymore. He could not see a future. He had no hope. He had no life. He loved her but felt he was of no value to her or to anyone.

These are more stories of patients who couldn't take the pain and the fight just became too much.....

How Chronic Pain Killed My Husband 

Sherri’s Story: A Final Plea for Help

Video: Lisa’s Story – FM Patient Commits Suicide

Some People Still Need Opioids 

When pain patients commit suicide if they leave a note everyone understands it was because of the pain. If they choose to end the pain by saving enough pills to overdose and don't leave a note, they're just another overdose.

If you are thinking about suicide PLEASE Call the National Suicide Prevention Lifeline 1-800-273-8255 and talk to someone

Physicians Who Do Harm to Patients MUST Be Held Responsible 

Good News Dr Vaipiani is a Board Certified Pain Specialist

Good News Dr Vaipiani is a Board Certified Pain Specialist. I want to thank Shawn at the Kingman Daily Miner for finding Dr Vaipiani listed in the American Board of Pain Medicine Director in Nevada.

I hope Dr Vaipiani lets the American Board of Pain Medicine know to also list him in Arizona. I didn't think to look in Nevada for an Arizona pain doc, and I didn't search by name, I looked at all the physicians listed in Arizona.

You can also find some information about the 2018 Arizona Opioid Epidemic Act and Arizona House Bill 2001 HERE

I don't know anything about Dr Vaipiani except what I've read. If any patients know how he is with patients, please let other patients know. Here or on Facebook. If you use Facebook please let me know.

Thanks
Jay

Update... Just My Opinion... July 19th 2018

In a 2017 article in the Kingman Daily Miner Dr Valpiani said, "in Mohave County, with its high percentage of the population on Medicaid, roughly half of the people on pain pills are abusing them".

The doctor patient relationship is built on trust. Trust that the physician will do what's best in the patients interest, and the patient is honest about their medical condition. How can a physician treat patients fairly if they believe half of the patients who walk through the door are lying to him. 

When treating pain patients most times there is objective evidence like MRI's and nerve conduction studies. 

Benjamin Franklin said, "it is better 100 guilty persons should escape than that one innocent Person should suffer". 

He was talking about the criminal justice system, but I think he would say the same about pain treatment today, that it is better 100 Patients should escape with pills than that one innocent Patient should suffer.

Jay

Know A Pain Patient Who Committed Suicide for Lack of Pain Management? Contact Me

If you know someone who committed suicide because their pain medications were lowered too far, please contact me.

Physicians take an oath to Do No Harm. But that's what they're doing to pain patients, causing harm, and some can't take it.

Back in the late 1990's I carried death certificates of pain patients who had given up and taken their life. Some were obvious suicides, others for various reasons like insurance or religion chose other ways not so easily identified.

Others were patients who saved enough meds to end the pain. Please don't write these patients off and count them as just another overdose. Some were involved in suspicious single car accidents, and one in Spokane was suicide by cop. That one screwed up a lot of lives including the officer who shot a guy with an empty gun.

So please... If you know someone who ended their life for lack of pain management let me know. I need to collect this information and share it with legislators. 

This 1996 article in the Kingman Minor talks about my fight back then... Kingman Resident in Tough Battle for Pain Relief, hits Rock Wall 

That was 22 years ago and it sounds too familiar... 

Send me a message if you know anyone who's committed suicide over pain control....

PLEASE Share

Jay

Governor Ducey says the Opioid Epidemic Act language was specifically designed to protect individuals with chronic pain

I contacted Governor Ducey's Office of Constituent Engagement about physicians cutting down the dose of current long time pain patients.

The Office of Constituent Engagement told me “It is important to note that language and features of the Opioid Epidemic Act were specifically designed to protect individuals with chronic pain”.

The email continued to say “The 5-day first fill limit does not apply to chronic pain patients already working on a pain management program”.

“Additionally, opioid dosage limits of 90MME day do not apply to individuals currently receiving a dose in excess of this amount”. "There is no requirement that individuals who take prescriptions above 90 MME taper down to a lower dose".

His office also included a link to information for patients including the full text of the Opioid Epidemic Act at: https://azgovernor.gov/sites/default/files/related-docs/arizona_opioid_epidemic_act_policy_primer.pdf.

And a PDF poster for physicians on how the plan protects chronic pain sufferers at https://azgovernor.gov/sites/default/files/related-docs/chronicpainweb_0.pdf.

I thank the Governor Ducey's Office and the legislature for trying to protect pain patients. But the Opioid Epidemic Act was written with stopping abuse in mind, not patients. It was designed to stop abuse, but has left pain patients suffering, and heroin cheaper and easier to get for addicts.

The Opioid Epidemic Act has a section on Prescriber Education that said, The Problem was many clinicians were trained at a time when the medical community was taught that prescription opioids were not addictive. 

NOTE: I can't think of any high school kid, let alone a physician who didn't know then or now that opioids (heroin) is addictive. Any Physician who would believe a drug company sales rep that all of a sudden opioids stopped being addictive should not be in practice. 

The Opioid Epidemic Act goes on to say, "since then, research has clearly proven that to be false. Training and updated education is essential for prescriber's to practice safe prescribing practices and identify substance abuse or drug dependence, but is not currently required by state law".

NOTE: I don't agree with the wording they use in this section of the Opioid Epidemic Act. It isn't specific in the wording on "drug dependence". 

Its important to understand the difference between Physical Dependence and Psychological Dependence. PLEASE Don't confuse Physical Dependence with Psychological Dependence or Addiction.

Physical Dependence is when your body builds a dependence on a specific medication (opioid). If the medication is abruptly stopped withdrawal symptoms will start. ALL Patients will be physically dependent on an opioid if taken for more than a few weeks. 

Psychological Dependence is similar to addiction but may occur with or without physical dependence and is conceptually characterized by impaired control over drug use, compulsive use, continued use despite harm, and craving for the psychic effects of the drug.

Addiction is 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. 

The Solution Codify the governor’s call for the medical licensing board to require at least three hours of opioid-related Continuing Medical Education (CME) for doctors who are licensed to prescribe opioids.

Require medical students to receive three hours of opioid related courses to ensure they are equipped with the most current information about prescribing opioids.

The Opioid Epidemic Act has provisions to protect patients, but physicians simply ignore the protections out of fear. This leaves patients suffering and patients no recourse except to file a complaint with the medical board. That works well, It's been a year since I filed a complaint and no end yet... A year?