NORMAN J CLEMENT RPH., DDS, NORMAN L.CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., IN THE SPIRIT OF REV. C.T. VIVIAN, JELANI ZIMBABWE CLEMENT, BS., MBA., IN THE SPIRIT OF THE HON. PATRICE LUMUMBA, IN THE SPIRIT OF ERLIN CLEMENT SR., WALTER F. WRENN III., MD., WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., RICHARD KAUL, MD., LEROY BAYLOR, JAY K. JOSHI MD., MBA, ADRIENNE EDMUNDSON, ESTER HYATT PH.D., WALTER L. SMITH BS., IN THE SPIRIT OF BRAHM FISHER ESQ., MICHELE ALEXANDER MD., CUDJOE WILDING BS, MARTIN NDJOU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
“WE ARE PHYSICIANS, PHARMACISTS, DENTISTS TREATING PATIENTS IN NEED OF PAIN CARE NOT STREET DRUG DEALERS AND TRAFFICKERS”
A Bibliography for Legal Defense and Appeal:
For Medical Professionals Persecuted for Prescribing Opioids
Richard A Lawhern PhD
It is now apparent that doctors, nurses, and pharmacists are being persecuted (not merely sanctioned) in a US national witch hunt by the Drug Enforcement Agency, Department of Justice, State Attorney Generals, and State Medical Boards, for the imagined “crime” of “over-prescribing” opioid pain relievers to patients in moderate to severe pain. This unjustifiable witch hunt is unsupported by science or ethics. But it has resulted in the departure of thousands of physicians from pain management practice. Millions of patients in agony have been denied access to community clinics, or force-tapered from opioid therapy that has been the only effective means of controlling their pain. The death toll in medical collapse and suicide from this campaign is rising.
This paper gathers recent references from the clinical and legal literature, which may prove useful in preparing legal defense and appeal actions on behalf of medical professionals. Unlike the paid opinions of Government expert witnesses, these references are firmly grounded on medical evidence and published data.
Permission is hereby granted for the use of this information without attribution to the author.
Stephen E. Nadeau, MD, Jeffrey K Wu, and Richard A Lawhern, Ph.D., “Opioids and Chronic Pain: An Analytic Review of the Clinical Evidence”, Frontiers in Pain Research, 17 August 2021 | https://doi.org/10.3389/fpain.2021.721357
We conducted an analytic review of the clinical scientific literature bearing on the use of opioids for the treatment of chronic non-cancer pain in the United States.
There is substantial, albeit not definitive, scientific evidence of the effectiveness of opioids in treating pain and of high variability in opioid dose requirements and side effects.
The estimated risk of death from opioid treatment involving doses above 100 MMED is ~0.25%/year.
Multiple large studies refute the concept that short-term use of opioids to treat acute pain predisposes to the development of opioid use disorder.
The prevalence of opioid use disorder associated with prescription opioids is likely <3%.
Morbidity, mortality, and financial costs of inadequate treatment of the 18 million Americans with moderate to severe chronic pain are high.
PAUL VOLKMAN MD., PHD., FEDERAL INMATE NUMBER 19519-424 RECEIVED MORE TIME THAN EL CHAPO AND THE UNI-BOMBER COMBINED
Because of the absence of comparative effectiveness studies, there are no scientific grounds for considering alternative non-pharmacologic treatments as an adequate substitute for opioid therapy but these treatments might serve to augment opioid therapy, thereby reducing the dosage.
There are reasons to question the ostensible risks of co-prescription of opioids and benzodiazepines.
As the causes of the opioid crisis have come into focus, it has become clear that the crisis resides predominantly in the streets and that efforts to curtail it by constraining opioid treatment in the clinic are unlikely to succeed.
James L Madera, MD, CEO American Medical Association “RE Docket Number CDC-2020-0029” Letter to Debra Houry, MD, Chief Medical Officer, National Center for Injury Prevention and Control, June 16, 2020, https://searchlf.ama-assn.org/letter/documentDownload?uri=%2Funstructured%2Fbinary%2Fletter%2FLETTERS%2F2020-6-16-Letter-to-Dowell-re-Opioid-Rx-Guideline.pdf
American Medical Association, “Report Shows Decreases in Opioid Prescribing, Increases in Overdoses”, [Press Release, with embedded references including https://end-overdose-epidemic.org/wp-content/uploads/2021/09/AMA-2021-Overdose-Epidemic-Report_92021.pdf ] September 21, 2021, https://www.ama-assn.org/press-center/press-releases/report-shows-decreases-opioid-prescribing-increase-overdoses
Alicia Agnoli, MD, MPH, MHS1,2; Guibo Xing, PhD2; Daniel J. Tancredi, PhD2,3; et al “Association of Dose Tapering With Overdose or Mental Health Crisis Among Patients Prescribed Long-Term Opioids” JAMA. 2021;326(5):411-419. doi:10.1001/jama.2021.11013 https://jamanetwork.com/journals/jama/article-abstract/2782643
Josh Bloom, Ph.D. “Opioid Deprivation and Suicide – Washington Post Weighs In”, American Council on Science and Health, September 14, 2021, https://www.acsh.org/news/2021/09/14/opioid-deprivation-and-suicide-washington-post-weighs-15807
Jeffrey Fudin, Jacqueline Pratt Cleary, Michael E Schatman “The MEDD myth: the impact of pseudoscience on pain research and prescribing-guideline development” Journal of Pain Research March 4, 2016, https://www.dovepress.com/the-medd-myth-the-impact-of-pseudoscience-on-pain-research-and-prescri-peer-reviewed-fulltext-article-JPR
Roger Chris, “The Myth of the Opioid Addicted Chronic Pain Patient,” Pain News Network July 25, 2017, https://www.painnewsnetwork.org/stories/2017/7/25/the-myth-of-the-opioid-addicted-chronic-pain-patient
Cinzano Cunningham, MD, “Observations of the Opioid Workgroup of the Board of Scientific Counselors of the National Center for Injury Prevention and Control on the Updated CDC Guideline for Prescribing Opioids”, NCIPC BSC meeting of July 16, 2021, https://www.cdc.gov/injury/pdfs/bsc/Observations-on-the-Updated-CDC-Guideline-for-Prescribing-6-30-2021-508.pdf
Chad D. Kollas MD, Terri A. Lewis Ph.D., Beverly Schechtman, and Carrie Judy, “Roger Chou’s Undisclosed Conflicts of Interest: How the CDC’s 2016 Guideline for Prescribing Opioids for Chronic Pain Lost It’s Clinical and Professional Integrity” Palimed – A Hospice and Palliative Medicine Blog, September 17, 2021, https://www.pallimed.org/2021/09/roger-chous-undisclosed-conflicts-of.html
FOR NOW, YOU ARE WITHIN
excellent piece,,sending to my medical boards in wisco,,maryw