A SUMMARY PAIN OF CARE LITERATURE
NORMAN J CLEMENT RPH., DDS, NORMAN L. CLEMENT PHARM-TECH, MALACHI F. MACKANDAL PHARMD, BELINDA BROWN-PARKER, IN THE SPIRIT OF JOSEPH SOLVO ESQ., INC.T. SPIRIT OF REV. IN THE SPIRIT OF WALTER R. CLEMENT BS., MS, MBA. HARVEY JENKINS MD, PH.D., IN THE SPIRIT OF 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., JULIE KILLINGSWORTH, RENEE BLARE, RPH, DR. TERENCE SASAKI, MD LESLY POMPY MD., CHRISTOPHER RUSSO, MD., NANCY SEEFELDT, WILLIE GUINYARD BS., JOSEPH WEBSTER MD., MBA, BEVERLY C. PRINCE MD., FACS., NEIL ARNAND, MD., 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 NJOKU, BS., RPH., IN THE SPIRIT OF DEBRA LYNN SHEPHERD, BERES E. MUSCHETT, STRATEGIC ADVISORS
“…it bothers me that this kind of evidence can send a person to prison for as long as this has been going, some many, many years, but in any event, that that is the sort of evidence that is the basis for criminal liability…“
“The US Drug Enforcement Agency proposed in April 2018 to change its own charter to permit the Agency to scale back production of opioid pain reliever drugs, if they find reason to believe these essential medications are “diverted.” DEA offers no explanation for how they proposed to determine diversion.”
richard “red” lawhern ph.d
DEA and HHS Joint Letter on Medications For Opioid Use Disorder (MOUD)
“DEA’s Diversion Control Division is pleased to post this joint letter from DEA and HHS supporting the expansion of Medications for Opioid Use Disorder (MOUD). DEA and HHS support the expansion of MOUD especially in rural or underserved areas.
“…DEA does not act as the Federal equivalent of a state medical board overseeing the general practice of medicine and lacks the authority to issue guidelines that constitute advice relating to the general practice of medicine...”
DEA is asking its registrants to ensure an adequate and uninterrupted supply of MOUD products when appropriately prescribed and asks distributors to examine any quantitative thresholds they established to ensure that individuals with OUD are able to access buprenorphine.
Expanding access to MOUD is one more way to assist patients with OUD during the Opioid Public Health Emergency.”
Thomas W. Prevoznik, DEA Deputy Assistant Administrator Diversion Control Division, LETTER To: Richard A. Lawhern, Ph.D. DATED FEBRUARY 12, 2021
“One of the most important principles underlying the CSA and its implementing regulations is that to be valid, every prescription for a controlled substance must be based on a determination by an individual practitioner that the dispensing of the controlled substance is for a legitimate medical purpose in the usual course of professional practice. United States v. Moore, 423 U.S.C. 122 (1975) and 21 CFR 1306.04(a).
Federal regulations do not define the term legitimate medical purpose, nor do they set forth the standards of medical practice. It is up to each.
DEA authorizes DEA-registered practitioners to do so, to treat patients according to his or her professional medical judgment under a standard of medical practice that is generally recognized and accepted in the United States.
While DEA is the agency responsible for enforcing the CSA, DEA does not act as the Federal equivalent of a state medical board overseeing the general practice of medicine and lacks the authority to issue guidelines that constitute advice relating to the general practice of medicine.”(1)
Effectiveness of Long-Term Opioid Therapy for Chronic Pain in an Outpatient Palliative Medicine Clinic
Clinical setting and guidelines for pain care
Over four years, the cohort received palliative care longitudinally at a hospital-based outpatient palliative medicine clinic embedded within a regional cancer center on the central campus of Orlando Regional Medical Center (ORMC), an 808-tertiary hospital in downtown, Orlando, Florida.52 All patients were referred by oncologists or hematologists to manage chronic pain, with most coming from Orange, Seminole, Lake, and Osceola counties, a population of >2.5 million people.53
Clinical encounters were conducted face-to-face between an attending clinician and the patient and/or any family members in the outpatient palliative medicine clinic. We established individualized goals for pain care through informed discussions that emphasized patient autonomy and balanced benefits and risks of opioid therapy.
We sought a goal-concordant reduction in pain intensity sufficient to allow for patients’ participation in their desired activities with minimal side effects from pain care, including opioid therapy. The time between clinical encounters varied somewhat, but patients visited the clinic at least every three months, if not more frequently.
Justice Potter Stewart: Supreme Court Of The United States OF AMERICA, CASE: 74-759 United States vs. Moore
“…And is it not true that historically most, if not all of the great breakthroughs and advances in medical science have been made by people who did not follow the conventional way of doing things. They followed a new way, their way, and most of the conventional physicians of their day would have disagreed with them because this is not the way it has always been done…”
Frontline Physicians Call on Politicians to End Political Interference in the Delivery of Evidence Based Medicine
Washington, DC (May 15, 2019) –
“Our organizations are firmly opposed to efforts in state legislatures across the United States that inappropriately interfere with the patient-physician relationship, unnecessarily regulate the evidence-based practice of medicine and, in some cases, even criminalize physicians who deliver safe, legal, and necessary medical care.
Our organizations represent more than 560,000 physicians and medical students serving on the front lines of health care. We care for patients in communities across America for their lives, including when they need to make critical decisions about their futures and families.
The insertion of politics between patients and their physicians undermines the foundation of trust this relationship is built on and inhibits the delivery of safe, timely, and comprehensive care. Outside interference endangers our patients’ health by limiting, and sometimes altogether eliminating, access to medically accurate information and to the full range of health care.
Physicians should never face imprisonment or other penalties for providing necessary care. These laws force physicians to decide between their patients and facing criminal proceedings. Physicians must be able to practice medicine that is informed by their years of medical education, training, experience, and the available evidence, freely and without threat of criminal punishment.
Our healthcare system faces many challenges. We call on policymakers to partner with us to advance policies that protect the sanctity of the patient-physician relationship, expand access to timely, evidence-based health care, and eliminate health disparities in our nation.”
How the buzzword “catastrophizing” stigmatizes people with chronic pain
“AND THIS IS NOT NEWS, CARL
Justice Potter Stewart:
“…And if that is the new — it bothers me that this kind of evidence can send a person to prison for as long as this has been going, some many, many years, but in any event, that that is the sort of evidence that is the basis for criminal liability? This man was a physician, he was not a fraud?..”
By US Pain Foundation | Jun 19, 2020 | Blog
By Gwenn Herman, LCSW, DCSW
“The first time I heard the word “catastrophizing” being used to describe the pain experience on a national level was at a chronic pain lecture at the National Institutes of Health. It sent shivers through my body.
After 25 years of living with chronic pain and 20 years working with the pain community as a clinical social worker, I have become an expert in the field and what it takes to fight to take back your life from intolerable, daily pain while creating a quality of life. I was horrified at the use of this pejorative word and voiced my reaction.
The response that I received was condescending and reflected zero knowledge of what it is like living in the body of someone with chronic pain.
Medical and mental health professionals in the field of chronic pain commonly use this terminology with each other and with their clients/patients. At best, “catastrophizing” is insensitive to patients’ very rational and reasonable response to the impact of pain on their lives. At worst, it perpetuates a harmful stigma and creates yet another obstacle to effective pain management.”
How did this happen?
Opioid Prescribing and Overdose Mortality – What Does the Data Show Us?
Richard A. Lawhern, PhD
March 6, 2024
This paper draws from work published in a mixture of peer-reviewed journal papers and mass media. It will also be posted on several social media platforms. The figures below were among those briefed in February 2024 to the healthcare staff of a US Representative.
This data is intended for use by other advocates. Attribution of the text to me by name would be appreciated but is not required.
“Alliance for the Treatment of Intractable Pain: is a collaboration of pain patient advocates and activists calling for the immediate withdrawal of the guidelines published by the US Centers for Disease Control and Prevention regarding the prescription of opiates to adult non-cancer, chronic pain patients. The grounds for this challenge include exceptionally poor science, professional bias, and known harm to patients and doctors in the arbitrary withdrawal of care.”
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