FIRST REPORTED MARCH 26, 2022

REPORTED BY

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. 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 KILLINGWORTH, LESLY POMPY MD., NANCY SEEFEDLT, 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

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ARTICLE

BY

CaSonya Richardson-Slone

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The CDC Opioid Guidelines and Chronic Pain: A Widow’s Story

This article recounts CaSonya Richardson-Slone’s lawsuit against her late husband’s pain clinic, which she won after his suicide, triggered by a drastic reduction in his opioid prescription.

She argues that the 2016 CDC opioid guidelines caused widespread harm to chronic pain patients, and while she welcomes proposed updates, she remains concerned that they don’t go far enough to ensure adequate pain management. Richardson-Slone advocates for the FDA’s intervention and improved chronic pain care, highlighting the need for individualized treatment and accountability for pain clinics.

She urges others to share their stories to influence the CDC’s final guidelines. A supporting quote from Linda M. Dickson emphasizes the detrimental impact of restrictive opioid policies on pain patients and physicians.

A VIOLATION OF HUMAN RIGHTS

Hello, my name is CaSonya Richardson-Slone.

My late husband Brent Slone passed away on September 12, 2017, due to suicide that was brought on by his pain physician’s negligence when a nurse practitioner who treated my husband cut his Rx pain medication dose by more than half in a single visit.

I sued my late husband’s pain clinic for malpractice and won. I was able to turn my husband’s and family’s tragedy into triumph. I must share my late husband’s story so the decision-makers at the CDC can hopefully sympathize and understand what the chronic pain patient community is up against. 

At first glance, the proposed updated CDC Guideline for Prescribing Opioids for Chronic Pain is a sigh of relief and a long-awaited correction to the 2016 CDC Chronic Pain Opioid Guidance that caused widespread suffering and harm to chronic pain patients by their pain physicians who reduced or altogether stopped their necessary opioid pain medicine.

This was a violation of their human rights as citizens who put their faith in a flawed federal healthcare system that treated them more like drug-addicted addicts than vulnerable patients in significant physical pain. 

The misinformation written into the 2016 CDC Chronic Pain Opioid Guidance that many physicians and lawmakers interpreted as fact and influenced laws by various states, insurance companies, and pharmacies left many chronic pain patients without access to their prescribed pain medication and with little to no hope of living a standard pain-free quality of life.

“...Many conscientious doctors treat patients as distinct individuals. They used protocols that included various meds and a cautious approach to opioids...”

As a result, the harsh CDC recommendations left many chronic pain patients to suffer inhumanly and at the mercy of their chronic pain physicians and clinics without any realistic alternatives to their opioid pain medication to relieve their severe pain.

Many Chronic Pain Patient (CPP’s) pain prescriptions were reduced significantly without being tapered or stopped, and some patients were discharged from their pain clinics altogether because their chronic pain treatment required more than the CDC-recommended 90 months to relieve their pain symptoms realistically. 

After reviewing the proposed updates, I worry that many chronic pain patients will continue to be forced to endure their pain and have their cries silenced by an agency that has no business implementing drug administration guidance and recommendations. Let alone continuing to suggest dosing recommendations to patients in chronic pain, especially already existing long-term CPPs such as my late husband.

I applaud the obvious suggestion of individualized patient care, which has been long overdue because pain varies from person to person, and their medical treatment should mirror that. I’m also delighted to see that slow tapering is still highly recommended for long-term chronic pain patients on higher levels of opioid pain medication. 

Many conscientious doctors treat patients as distinct individuals. They used protocols that included various meds and a cautious approach to opioids.

However, I worry that the suggestion of using opioid pain medications as a last resort will continue to leave many patients in significant pain. I’m all for nonopioid pain treatment options. However, I feel they should be used in conjunction with opioid medications if a patient is expressing significant pain, as well as patients who have already tried nonopioid pain relief options but are still suffering. 

What is chronic pain, and how prevalent is it?

According to The New York Times, a January 8, 2025 article by Jennelle Khan explores the widespread chronic pain issue, affecting up to two billion people globally.

The author details her own experience with debilitating arm pain to highlight the often-overlooked problem and the lack of effective treatments. 

Chronic pain is persistent pain that lasts for months or even years, often defying typical medical explanations or treatments. It is prevalent, affecting as many as two billion people globally. Unlike acute pain, which serves as a warning sign of injury, chronic pain can be considered a disease in its own right.

It is characterized by sensitized nerves that continue to send pain signals even after the initial injury has healed or without any clear initial injury. This highlights that pain is not simply a symptom but can be a complex condition needing specific attention and treatment.

IT’S TIME THE FDA STEP IN

Unless significant changes are made at the federal level, CPPs will continue to be at the mercy of federal agencies, harsh state legislation, misguided and/or neglectful pain physicians, and misinformed public opinion. Changes have to be made at the federal level before insurance companies and pharmacies will update their guidelines and practices.

I feel it’s time that the FDA steps in and makes the necessary changes, considering opioid drug overdoses are at an all-time high when opioid pain medication prescribing has been at an all-time low for some time.

The federal government now has proof that the opioid crisis is not a result of the overprescribing of opioid pain medications but is mostly due to illegal drug abuse and/or fake fentanyl being sold to addicts and used to lace other street drugs. 

Last but not least, my late husband Brent Slone and many CPPs have, and continue to be taken advantage of by neglectful and cruel chronic pain practices by pain physicians who do not have their best interest at heart but instead continue to be driven by building their patient count in their practices for revenue.

This conflict of interest and lack of regulation has caused many patients to receive lower standards of quality care and left them vulnerable to medical mistakes, as in my late husband’s case. 

Patients with chronic pain need and require specialized and individualized quality care. Chronic pain physicians should also be required to see their patients in a realistic, timely manner and on a routine basis instead of contractually obligating patients to see physician assistants and nurse practitioners more often than not.

MEDICATIONS CUT IN HALF IN A SINGLE VISIT

My late husband and I advocated fiercely for him to receive timely, quality, and compassionate care, but his pain physicians’ lack of respect, empathy, and neglect cost Brent his life.

The nurse practitioner who mistakenly cut my husband’s pain medication by more than half in a single visit was a new nurse practitioner at the pain clinic who had never seen or treated my husband before. My husband had requested numerous times to see his actual pain physician, but his requests were often ignored.

During the trial, this nurse practitioner admitted not knowing what a high or low dose of MME pain medication was. Before trial, my husband’s physicians testified under oath in their depositions to not knowing why the nurse practitioner cut his pain medication by more than half and made no mention of purposely cutting his pain medicine in half due to any concerns about his current pain medication dose being too high.

Under oath, they acknowledged that if a nurse practitioner cut my husband’s pain rx by more than half in a single visit, it would be considered a medical mistake because a nurse practitioner by law can’t write an Rx for a schedule 2 narcotic that’s prescribed more extended than 72 hours.

Linda M Dickson:

“There’s a War on Pain Treatment and Doctors who provide Rx. There seems to be an ongoing genocide of both. It’s bigger than just the USA. It’s a scary time! The statistics on suicides & overdoses show an absolute failure of the War on Drugs. To continue doing the same thing (essentially causing a prohibition on treating pain w/ a potent RX) and expecting different results, I’ve heard, is the definition of insanity! 

Doctors are healers, not dealers. Patients want relief, not a high. The prohibition results are so bad that it feels negligent for the powers that be not to revert to considering pain as a fifth vital sign. 

If the goal were to stop stealing pain meds, a lockbox would’ve been a good solution. It feels like a monetary motive behind all the harmful decisions on our medical treatments.“

By the time we went to trial, my husband’s pain physicians stories had changed, and they argued that one of the physicians in the office purposely cut my husband’s pain medicine by more than half in a single visit because they were concerned about his rx pain dose he was currently taking was too high.

However, there was no evidence to prove this; their previous deposition testimony and trial testimony contradicted one another.

Thankfully, the jury that heard my husband’s story at trial and reviewed all of the prosecution’s evidence turned our family’s tragedy into triumph by making sure his pain physicians and their practice were held accountable on all counts! 

VICTORY IN COURT

This groundbreaking victory in court was a game-changer! It proved that pain clinics and physicians can and should be held accountable for their neglect, medical mistakes, and poor standards of care. I hope the verdict encourages you and your loved ones to advocate for yourselves and fight for your rights so your voices can be heard.

I understand it’s not easy, but it’s necessary to see real changes, and it’s long overdue! I highly encourage you and your loved ones to send your personal stories and comments to the CDC no later than the April 11, 2022 deadline. It’s so important that the final draft reflects the needs and support that the chronic pain patient community has gone without for far too long. 

In this together,

Sonya Slone

FOR NOW, YOU ARE WITHIN

THE NORMS

CREDIT TO:

Founder/Doctor-Patient Forum/Don’t Punish Pain: RIH5247-S384/author
cmerandie@gmail.com

REFERENCE:

Chronic Pain, Opioids, and the CDC Guidelines

Study Guide: Chronic Pain, Opioids, and the CDC Guidelines

Quiz

1. What was the primary cause of Brent Slone’s death, according to his wife CaSonya?
2. According to CaSonya, how did the 2016 CDC opioid guidelines negatively impact chronic pain patients?
3. What is CaSonya’s opinion on the proposed updates to the CDC opioid guidelines, and what concerns does she express about them?
4. Why does CaSonya believe that the FDA needs to get involved in regulating pain management?
5. What does CaSonya suggest is the actual cause of the opioid crisis?
6. According to the text, what care do chronic pain patients need and require?
7. What medical error occurred in Brent Slone’s case, and what were the consequences?
8. According to Linda M Dickson, what is the relationship between doctors and pain patients and the war on drugs?
9. What contradictory statements did Brent Slone’s physicians make during their depositions and the trial?
10. What was the outcome of the legal case brought by CaSonya Slone, and what does she hope this outcome will accomplish?

Quiz Answer Key

1. Brent Slone’s death was due to suicide brought on by his pain physician’s negligence when a nurse practitioner cut his pain medication dose by more than half in a single visit.
2. The 2016 CDC guidelines caused widespread suffering by leading physicians to reduce or stop necessary opioid pain medications for chronic pain patients, violating their human rights and creating a lack of access to prescribed medicine.
3. CaSonya is relieved at the proposed corrections to the 2016 guidelines but worries that the suggestion of using opioid medications as a last resort will still leave many patients in significant pain. She also worries that the CDC has no business making such medical recommendations.
4. CaSonya believes the FDA needs to get involved because opioid overdoses are at an all-time high while opioid pain medication prescribing is at an all-time low, indicating that the crisis is due to illegal drug abuse, not overprescribing.
5. CaSonya argues that the opioid crisis is mostly due to illegal drug abuse and/or fake fentanyl being sold to addicts, not the over-prescription of opioid pain medications by doctors.
6. According to the text, chronic pain patients require specialized and individualized quality care from physicians who see them on a routine basis promptly.
7. A new nurse practitioner at Brent Slone’s pain clinic cut his pain medication dose by more than half in a single visit, a medical mistake because a nurse practitioner can’t write an Rx for a schedule 2 narcotic that’s prescribed more extended than 72 hours.
8. According to Linda M Dickson, doctors are healers, not dealers, and patients want relief, not a high. She also believes that the war on drugs has led to a failure to treat pain properly and that there is a financial motive behind the war on drugs.
9. Brent Slone’s physicians initially testified under oath to not knowing why his pain medication was cut, but later, during the trial, claimed one of them purposely cut his pain medicine, claiming his current dose was too high.
10. CaSonya won her malpractice suit against her husband’s pain clinic. She hopes that the verdict encourages others to advocate for themselves and fight for their rights and that it shows that pain clinics and physicians can be held accountable.

Essay Questions

1. Analyze the arguments presented in the text regarding the role of the 2016 CDC opioid guidelines in the treatment of chronic pain. Consider both the intended and unintended consequences.
2. Discuss the various perspectives on the opioid crisis, as presented in the text, contrasting the views of CaSonya Richardson-Slone and the official narrative surrounding the issue.
3. Examine the ethical considerations surrounding the treatment of chronic pain, focusing on issues such as patient autonomy, physician responsibility, and the role of government regulation.
4. Explore the interplay between healthcare providers, regulatory bodies, and insurance companies in determining patient care, using the case of Brent Slone as a specific example.
5. What do the experiences of Brent Slone and his wife tell us about the importance of patient advocacy? In what ways can patients and their families effectively advocate for better health care?

Glossary of Key Terms

• CDC Opioid Guidelines (2016): Federal recommendations intended to address the opioid crisis by guiding opioid prescribing practices, particularly for chronic pain.
• Chronic Pain: Persistent pain that lasts for three months or more.
• Opioid Pain Medication: A class of drugs, such as morphine and oxycodone, that are used to treat severe pain.
• MME (Morphine Milligram Equivalent): A standard used to compare the potency of different opioid medications, allowing healthcare providers to understand the equivalent dosage of opioids being prescribed or consumed.
• Tapering: The process of gradually reducing the dosage of a medication over time, often used to avoid withdrawal symptoms.
• Nurse Practitioner (NP): A registered nurse with advanced education and training who can provide primary care and, in many states, prescribe medications.
• Physician Assistant (PA): A healthcare professional licensed to practice medicine under the supervision of a physician.
• FDA (Food and Drug Administration): A federal agency responsible for regulating and supervising the safety of food and drugs in the United States.
• Human Rights Violation: Actions that infringe on the basic rights and freedoms of individuals, as protected by international law and treaties.
• War on Drugs: A term for the U.
  . government campaign of prohibition of drugs and the prohibition of the medical treatment of pain that came as a result.
• Fentanyl: A powerful synthetic opioid that is often illegally produced and is a primary driver of the current drug overdose crisis.

Okay, here’s a briefing document summarizing the key themes and ideas from the provided text, incorporating quotes for emphasis:

Briefing Document: “THEY KILLED “MY HUSBAND BRENT DAVID SLONE:” 2016 CDC OPIOID GUIDELINES”

Date: October 26, 2023

Subject: Critique of 2016 CDC Opioid Guidelines and Call for Reform

Prepared for: [Intended Audience – e.g., policymakers, healthcare advocates, etc. – Please Specify if Needed]

Executive Summary:

This document analyzes an article by CaSonya Richardson-Slone, who details the tragic death of her husband, Brent Slone, following a drastic reduction in his prescribed pain medication, which she attributes to the negative impacts of the 2016 CDC Opioid Guidelines.

The article argues that the 2016 guidelines led to widespread harm for chronic pain patients, who were often treated as drug addicts rather than legitimate patients in need of pain relief.

Richardson-Slone also expresses concern that the proposed updates to the guidelines may not fully address the issues and calls for more action by the FDA to regulate pain clinics and protect chronic pain patients. The piece also strongly suggests that restrictions on opioid prescriptions have not solved the opioid epidemic, suggesting the crisis is driven more by illegal drug use than by prescribed pain medication use.

Key Themes and Ideas:

1. Devastating Impact of 2016 CDC Guidelines:

• The 2016 CDC Opioid Guidelines are blamed for causing widespread suffering among chronic pain patients (CPPs). Richardson-Slone states, “This was a violation of their human rights as citizens who put their faith in a flawed federal healthcare system that treated them more like drug-addicted addicts than vulnerable patients in significant physical pain.”
• The guidelines were “misinterpreted as fact” by many physicians and lawmakers, leading to restrictive laws, insurance policies, and pharmacy practices that limited access to prescribed pain medication.
• “The harsh CDC recommendations left many chronic pain patients to suffer inhumanly and at the mercy of their chronic pain physicians and clinics without any realistic alternatives to their opioid pain medication to relieve their severe pain.” This indicates that these patients were often left with no recourse or other alternatives for adequate pain relief.
• Many patients had their prescriptions significantly reduced or stopped abruptly and were sometimes discharged from clinics entirely.

1. Personal Tragedy as an Example of Systemic Failure:

• Brent Slone’s case highlights the devastating consequences of these policies. His medication was cut by more than half in a single visit by a nurse practitioner, leading to his suicide.
• Richardson-Slone successfully sued her husband’s pain clinic for malpractice, a victory demonstrating that pain clinics and physicians can be held accountable for substandard care and negligence. “This groundbreaking victory in court was a game-changer! It proved that pain clinics and physicians can and should be held accountable for their neglect, medical mistakes, and poor standards of care.”
• This case underscores the human cost of the issues with the guidelines, highlighting the lack of adequate monitoring of patient care and suggesting that patient advocacy can lead to positive change.

1. Critique of Proposed Updated Guidelines:

• While the author acknowledges some positive changes in the proposed updated guidelines (such as a call for individualized patient care and slow tapering), there are ongoing concerns that the new guidelines may still be inadequate.
• The suggestion of using opioid pain medications as a last resort is a worry for Richardson-Slone, as she believes that these medications should be used in conjunction with other treatments if needed. “I’m all for nonopioid pain treatment options. However, I feel they should be used in conjunction with opioid medications if a patient is expressing significant pain, as well as patients who have already tried nonopioid pain relief options but are still suffering.”
• She believes that changes need to be made at the federal level first, before insurance companies and pharmacies update their guidelines and practices. “Unless significant changes are made at the federal level, CPPs will continue to be at the mercy of federal agencies, harsh state legislation, misguided and/or neglectful pain physicians, and misinformed public opinion. Changes have to be made at the federal level before insurance companies and pharmacies will update their guidelines and practices.”

1. Call for FDA Intervention and Focus on Patient-Centered Care:

• The author argues that the FDA should step in to make necessary changes, noting that opioid overdose deaths are rising despite a decline in opioid pain medication prescriptions. “I feel it’s time that the FDA steps in and makes the necessary changes, considering opioid drug overdoses are at an all-time high when opioid pain medication prescribing has been at an all-time low for some time. The federal government now has proof that the opioid crisis is not a result of the overprescribing of opioid pain medications but is mostly due to illegal drug abuse and/or fake fentanyl being sold to addicts and used to lace other street drugs.”
• She highlights the conflict of interest within some pain clinics, where revenue is prioritized over patient care, leading to reduced quality of care and medical mistakes. “my late husband Brent Slone and many CPPs have, and continue to be taken advantage of by neglectful and cruel chronic pain practices by pain physicians who do not have their best interest at heart but instead continue to be driven by building their patient count in their practices for revenue.”
• She calls for chronic pain physicians to be required to see patients on a routine and timely basis, rather than relegating them to physician assistants and nurse practitioners. “Patients with chronic pain need and require specialized and individualized quality care. Chronic pain physicians should also be required to see their patients in a realistic, timely manner and on a routine basis instead of contractually obligating patients to see physician assistants and nurse practitioners more often than not.”

1. Critique of the “War on Drugs” Approach:

• Linda M Dickson is quoted within the piece describing the state of pain treatment as “a war on pain treatment” and also suggesting that the current approach is not working and that the pain of patients should again be considered a fifth vital sign. “There’s a War on Pain Treatment and Doctors who provide Rx. There seems to be an ongoing genocide of both. It’s bigger than just the USA. It’s a scary time! The statistics on suicides & overdoses show an absolute failure of the War on Drugs.”
• She also suggests that the motive behind many of the harmful decisions on medical treatments may be a monetary one, rather than a genuine desire to help patients. “It feels like there’s a monetary motive behind all the harmful decisions on our medical treatments.”
• The article suggests the failures of the “War on Drugs” model highlight the need for a different approach in healthcare, one that prioritizes patient well-being and acknowledges their right to pain relief.

Conclusion:

The article is a powerful indictment of the negative consequences of the 2016 CDC Opioid Guidelines, using a personal tragedy to illustrate the broader systemic failures in pain management. Richardson-Slone calls for more meaningful federal-level changes, patient-centered care, and a re-evaluation of the approaches used to deal with the opioid crisis in the USA. The piece stresses the importance of patient advocacy and holding healthcare providers accountable.