Discussion for article #245071
With friends like these…who needs enemas?
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It sounds as if Dr. Califf might not be the right person for this position – but, as a life-long sufferer of chronic pain, I take issue with the idea that the FDA, DEA or any other organization need to step up their game with regards to the use of opiate painkillers, etc. Pain management is not close to being perfect and requires a very individual plan between a patient and his/her Primary Care Physician, surgeon, etc., and the Palliative Care Physician. After the last big crackdown (less than a decade ago), the state of Virginia came down very hard on pain management doctors, surgeons and the like – so much so that many stopped writing ANY scripts for narcotics and similar medicines. I have been fairly fortunate, myself, but I knw of others who haven’t fared so well and have been forced to endure agonizing physical pain.
This nation does need to re-think how we treat persons going through horrid, agonizing, wretched physical torture – and it is sometimes torture what I go through – and just what our goals are to be. Yes, it is true there will always be some who abuse their medications–and I fully understand the need to try and avoid such an outcome–but, at the same time, some of the policies that are forced upon the treating doctors and affected patient are too harsh and cause not only physical agony but mental agony as well. I would much rather we treat folks through their physicians who are trained for palliative care than having draconian policies that force many to abuse street drugs, risking them using/abusing substances that are not true pharmaceutical grade as well as forcing many others to just endure needlessly. Draconian policies lead to more deaths and severe agony than not.
The U.S.A. is better than this – we have the ability to be far more compassionate than we currently show ourselves to be. At minimum, would you rather force a small but still solid number of “abusers” onto the street where it’s very difficult to keep track of not only the pain sufferer but of what substance they’re using to treat themselves and the effects on their families and communities … or keeping most of them in some sort of system where it’s easier to track them and know what they’re ingesting, possibly being able to reach them mentally so as to be able to get them in recovery of some kind as well as actually properly treating those of us who need it now and likely will always need palliative care?
This issue is not cut and dry, black and white. There are so many shades in between, and so many elements involved that go to make up the patient and his/her situation. I can tell you from personal experience that I’d much rather have a more lax attitude (that doesn’t mean less-documented) and policy than the scary cop with a control attitude and the inevitable suffering. No matter what, you’ll always have a few who abuse anything – but that’s true of everything in life. I believe America currently gives the pain sufferer short shrift in attempt to crack down on the abusers.
Thank you.
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Thoughtful people understand this. However, it is well documented that opioids are overprescribed in the U.S. with overdoses from them now equalling overdoses from heroin. And while it’s a given that a portion of the abuse is attributable to the “black market,” the lack of centralized record keeping for controlled substance prescription is equally at fault. Nothing very nuanced about that, especially as it’s the kind of thing that’s gone on for decades and really shouldn’t any longer with computer data bases. Think of elderly people seeing different doctors for different ailments and there being little or no communication between them and what they may be prescribing.
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Meh…At least he has a legitimate issue he’s trying to force to be addressed.
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Sen. Lisa Murkowski, R-Alaska, has also placed a hold on the nomination. At the vote, she said she wanted reassurances that FDA will write rules for labeling genetically modified salmon. She has said the engineered salmon approved by the FDA last year could be harmful to her state’s wild salmon industry.
And a perfect example of why these should be two different entities. If something ought to be combined it would be rolling the Food part into the Department of Agriculture.
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In today’s world with electronic records, there’s not much of an excuse to continue a policy of forcing the patient to obtain a written script (for narcotics and similarly controlled substances) from their treating physician to physically take to a pharmacy. This past week is a good example. I am a lifelong pain management patient. Additionally, I am currently recovering from another cervical spine surgery. My normal meds ran out last week and required another written script to have filled by a pharmacist… Besides being homebound due to surgery recovery, add in the winter blizzard. Early last week, I did what I do nearly ever four weeks – I phoned my Pain Management doctor to request a script to be mailed to me so that I can physically take it to pharmacist. For whatever reason, there was a day’s delay in their response. I spoke to the nurse in my doc’s office. She mailed script. Script didn’t arrive in my mailbox until Friday after 4pm. I have no way to get the script to the pharmacy. There are two pharmacies I deal with that my doctor’s okay with. One of them stopped delivering narcotics and related meds due to, I’m guessing, their insurance. The other pharmacy is closed on Sundays. Luckily for me, I was able to have pharmacy #2 come pick up script late Friday with understanding to deliver meds Saturday. Enter huge snowstorm. Pharmacy #2 closed not only Saturday but Sunday – and they have the script. If I hadn’t had an emergency stash of a few pills, I would have been going through withdrawal starting Saturday night into today, Monday evening (they literally just delivered them at 6:45pm). Withdrawal symptoms are the worst psychologically/physical torture events to wish upon someone. This sort of timing problem happens a few times a year due to doctor review of requests, sometimes doc-on-call is not familiar with your case, mailing times, etc. It is an burden to have to juggle this.
I have never in my life (50yo now) abused medications. I have been on narcotic-type treatment since early 2000s. I will never be able to be free of them. I swear, I am a model patient–pissy at times, but model in way of jumping through the right hoops, peeing in the right cup, seeing the doc when requested, blah, blah, blah. That said, I have–due to circumstances out of my control, usually meaning the mailing of a physical script–been forced to endure withdrawal symptoms more than a couple of times. I wanted to kill myself. If I hadn’t had it in my head that it was just a matter of time–perhaps that day but soon–before I was able to get the script filled and suck down that first dose so as to relieve not only the excruciating pain but the psychologically-awful withdrawals. When a person has reached that stage, they need help getting the script filled. Thank whatever god is out there for my mother. When I lived in my hometown (not near my docs) and was forced to wait for that script, my mother was a lifesaver. She took the script, had it filled, waited, then ran immediately home to get me started on them again. Currently, I live in Charlottesville, very close to the docs and not with my family nearby. I live by myself. I rely on no kinks in today’s idiotic system of paper-written script, mail, physically handing it to a pharmacy (only one in town who will come pick up the script or deliver the meds – and they are closed Sundays). I have no family or close friends here to help me out (no close enough friends to trust, etc.). My story is rather simple but shines a light on how fucking dysfunctional it is – it treats me like a damned criminal.
I did not go through withdrawal this weekend, though, I would have, because I have cut some pills in half throughout the month so as to be able to save a few for emergency situations like this. Years ago, I approached m current docs about giving me a separate script–or just add a few days’ worth–so I can keep them aside for such situations – they all said NO. This was during that huge crackdown I mentioned. Even today, they won’t consider it. Keep in mind, I am quite happy with my pain management docs - they’re top-notch and we get along pretty well. That said, there isn’t any room in their minds for what I just described. I’m guessing they expect patients to do just what I said – but it’s against the rules and against the written “contract” they force you to sign.
I am not an abuser – they know this a thousand times over. I am not a fucking child – but the system as it’s set up treats us ALL the same.
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Tennessee Sen. Lamar Alexander, the Republican chairman of the Health, Education, Labor and Pensions Committee, is supporting the nomination.
I suppose Sen. Alexander needed to be queued up before President Obama even rolled out his nominee, but this does give me some small pause. On the other hand, what will be more or less effective at addressing the issues present at the FDA over the next year, a Secretary that’s not perfect, or no Secretary at all?
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All I can say is hurry up and appoint a Democrat to head the FDA before my sister gets the job. Hard telling what she’d do if she got the job plus she’s a rabid Republican. No marking GMO food if she can help it.
The FDA is under staffed and doesn’t have enough people to do the job properly.
Boy howdy.
My online friends in the UK are bewildered by our refusal, e.g., to allow the use of diamorphine (which we call heroin) for terminal patients with intractable pain. We save zero lives that way, but we greatly increase their pain and suffering before death puts an end to it.
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