PART-3, OF THE DASGUPTA, BELETSKY, CICCARONE PROTOCOLS
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
KIMBERLY SMITH RN
I completely understand. I’m a disabled RN, who once cared for others but not once thinking I myself would end up being a chronic pain patient. Now new doctors in medical school are being instructed not to treat chronic pain. No one asks for chronic pain! Chronic pain can happen to anyone in an instance.
I too have written Governor Desantis at least 2xs. He sent my 1st response to the health department. Please know that you’re not alone. There are millions of chronic pain patients.
As with previous drug crises and the HIV epidemic, root causes are social and structural and are intertwined with genetic, behavioral, and individual factors. It is our duty to lend credence to these root causes and to advocate social change.
People behind the scenes are fighting for us. I too am trying my best to fight for chronic pain patients. Opioids have been used for centuries to treat pain. Alternative treatments will not help incurable painful conditions.
THE DASGUPTA, BELETSKY, CICCARONE PROTOCOLS
” Alas, the US health care system is unprepared to meet the demands elucidated by a structural factors analysis. Even at the patient level, the intersection of social disadvantage, isolation, and pain requires meaningful clinical attention that is difficult to deliver in high-throughput primary care. Some providers struggle with addressing complex, chronic medical conditions requiring regular follow-up, especially with limited recourse to nonpharmacological alternatives and the predominantly urban concentration of specialty services.
Patient contracts, urine drug tests, and prescription monitoring can generate mutual distrust in the provider–patient relationship when applied inconsistently, giving rise to uneven care delivery and inducing perceptions of intentional mistreatment.66
In Wisconsin, the prescription drug monitoring program includes patients’ convictions and suspected drug violations, straying into ethically hazy realms of social control. Patients suspected of drug-seeking behavior are “fired” instead of receiving enhanced care, as compassion would dictate.67 Institutional, legal, and insurance architecture have robbed clinicians of time and incentives to continue care for these patients.
Access to evidence-based treatment for opioid use disorder, such as methadone and buprenorphine, must be rapidly improved. The hardest hit states, such as West Virginia and Kentucky, prohibit Medicaid coverage of methadone maintenance, and insurance preauthorization prevents low threshold access among privately insured patients.
The Appalachian Regional Commission recommended economic development strategies in addition to increased access to treatment services, prevention, and overdose medications.68 Yet, proposed federal health care reforms threaten to further exacerbate existing service gaps.69
Although national policy emphasizes medically assisted treatment, the social stigma of these treatments is widespread, carrying unrealistic expectations for quick fixes and a pervasive belief in “detox,” as exemplified by television shows popularizing coercive interventions.
“Suffering” may be a better focus for physicians than “pain.”70 Others have argued for “compassion.”67Health care providers have a role in reducing suffering historically and ethically. We have lost the commonsense imperative to engage those who use opioids in comprehensive care, especially during periods when access to opioids may be fluctuating. These tenets also may justify limited regimes to treat acute pain for veritable patient need.
The social determinants lens lays bare the urgency of integrating clinical care with efforts to improve patients’ structural environment.71 Training health care providers in “structural competency” is promising,72 as we scale up partnerships that begin to address upstream structural factors such as economic opportunity, social cohesion, racial disadvantage, and life satisfaction. These do not typically figure into the mandate of health care but are fundamental to public health.”
Kimberly Smith, RN concludes;
CHRONIC PATIENTS ARE FORCED TO LOOK TO THE STREETS
All of Florida Senators don’t care either. All Florida Senators and Ron Desantis want to be the next president. I will not vote for someone who doesn’t work for the people!. Hang in there sir. I’m so sorry for your suffering. I’d like to thank you for your service to protect and serve.
Hang in there I know that we will win! It just doesn’t work and the opioid crisis isn’t safe pharmaceutical drugs it illicit illegal drugs. Kids think it’s easier to get drugs off the streets than going to a doctor. Chronic pain patients are looking to the streets for pain relief or killing theirselves by suicide sadly. We can’t lose people!
Kimberly Smith, RN, A Chronic Pain Patient and A Human Being
FOR NOW, YOU ARE WITHIN
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69. Young K, Zur J. Medicaid and the opioid epidemic: enrollment, spending, and the implications of proposed policy changes. Available at: https://www.kff.org/report-section/medicaid-and-the-opioid-epidemic-enrollment-spending-and-the-implications-of-proposed-policy-changes-issue-brief. Accessed October 9, 2017. Google Scholar
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