2017 in review … what killed us

Today is 11/20/2018.. who will not be here tomorrow

2016 in review … what killed us

6775 Americans will die EVERY DAY – from various reasons


140 will be SUCCESSFUL – including 20 veterans

270 will die from hospital acquired antibiotic resistant “bug” because staff won’t properly wash hands and/or proper infection control.

350 will die from their use/abuse of the drug ALCOHOL

1200 will die from their use/abuse of the drug NICOTINE

1400 will contract C-DIF from Hospital or Nursing home because staff doesn’t properly wash their hands are adhere to infection control  

80 WILL DIE mostly elderly.

850 will die from OBESITY

700 will die from medical errors

150 will die from Flu/Pneumonia

80 will die from Homicide

80 will die in car accidents




Here is the list from the end of 2016 if interested in comparing
United States of America
from Jan 1, 2017 – Dec 31, 2017 (11:36:39 AM)

Abortion*: 1090465
Heart Disease: 613479
Cancer: 590862
Tobacco: 349505
Obesity: 306566
Medical Errors: 251098
Stroke: 132915
Lower Respiratory Disease: 142741
Accident (unintentional): 135861
Hospital Associated Infection: 98860
Alcohol: 99859
Diabetes: 76380
Alzheimer’s Disease: 93409
Influenza/Pneumonia: 55149
Kidney Failure: 42702
Blood Infection: 33417
Suicide: 42713
Drunk Driving: 33760
Unintentional Poisoning: 31713
All Drug Abuse: 24970
Homicide: 16775
Prescription Drug Overdose: 14979
Murder by gun: 11477
Texting while Driving: 5981
Pedestrian: 4993
Drowning: 3909
Fire Related: 3495
Malnutrition: 2768
Domestic Violence: 1458
Smoking in Bed: 779
Falling out of Bed: 598
Killed by Falling Tree: 149
Lawnmower: 68
Spontaneous Combustion: 0

Totals of all categories are based upon past trends documented below.



I am being completely weaned off my meds, & suspect I will kill myself with the amount of pain I am in, & will be by the time this is over (the wean that is). Already can’t function.

My husband committed suicide after being abandoned by his pain dr.

Please pray for me as I am on the brink of suicide! I don’t want to die but can’t handle the pain anymore! The doctor that I am currently seeing will not give me enough pills to last all month every month… I have to wait until Oct to get in with a pain management doctor whom I already know by others that I know sees this doctor that he will help me, need prayer to hold on until oct… I keep thinking of my family who needs me hear.

“We just lost another intractable member of our support group two nights ago. She committed suicide because her medications were taken away for interstitial cystitis (a horribly painful bladder condition) and pudendal neuralgia, both of which she had battled for years

D D., journalist and prescribed fentanyl patient for a dozen years joined me on air last weekend with her husband and spoke of her suicide plan should the only relief from constant agony be heavily reduced or taken away.

I was told last Friday that my Dr. will be tapering my meds again . When I told him I didn’t think my body could take another lowering he stated ” it wasn’t my
License on the line”, I stated ” no , but it’s my life on the line”!!!!! I can not continue to live this way . I can not continue to suffer in agony when my medications and dose where working just fine before and I was a productive member of society . I can no longer take this. I have a plan in place to end my life myself When I am forced to reduce my Medications again . I just can’t do it anymore .

On Friday at around 9 p.m. U.S. Navy veteran Kevin Keller parked his red pickup truck in the parking lot at the Wytheville Rite-Aid, walked across the grass and stood in front of the U.S. Veterans Community Based Outpatient Clinic next door.

Sick and tired of being in pain, he pulled out a gun, shot a hole in the office door, aimed the gun barrel at his head and ended his hurt once and for all.

As a longterm pain patient with a current unsupportive pain dr, I just thought I’d share the reality of the position I’m in right now…

I’m in very bad pain all the time for very legit and well documented reasons. My pain dr however never gives me enough meds to help me. He just keeps reducing them, which is causing me to be in even more pain and suffer so much more. My quality of life also continues to go downhill at the same time. I was just given a letter by him recently too about some study indicating an increase in deaths if you take opioids and benzos. It stated he’s no longer going to give pain meds to anyone who is taking a benzo. I take one, because I have to, for a seizure disorder, not because I want to. He told me to pick one or the other though, plus went ahead and reduced my pain meds some more. He doesn’t seem to care the least bit. I’ve looked hard and so far I can’t find another one to get in to see near me at this time, but I’m desperately still trying. Unfortunately, they’re few and far between here, in addition to the wait for an appointment being long. I’ve even called hospice for help. So far, they haven’t been of much help either, because I don’t have a dr who will say I have six months or less to live. I told them either choice my pain dr is giving me is very inhumane, so I’d rather just quit eating and drinking, to the point where I pass away from that, while I get some kind of comfort care from them. I don’t really want to though, although I do have a long list of some very bad health problems, including a high probability that I have cancer and it’s spread. Am I suicidal? No. Will I be if my pain and seizure meds are taken away. Highly likely. I never ever saw this coming either. I don’t have a clue what to do and the clock is ticking, but I’m still fighting for an answer. So far, I can’t find not even one dr to help me though. Not one. I know my life depends on it, but at what point will these drs let my suffering become so inhumane that I just can’t take it anymore. I just don’t know right now. It’s a very scary place to be in for sure. That I do know.

The patient was being denied the medicine that had been alleviating his pain and committed suicide because, “he couldn’t live with the pain anymore. He could not see a future. He had no hope. He had no life.”

I am a chronic pain patient who has been on fairly high doses of opiates for about nine years now. My dose has been forcibly reduced since the cdc guidelines. I moved to Oregon from Alaska and can’t find a doctor to prescribe my medication. I pray I have the strength not to take my own life!

Zach Williams of Minnesota  committed suicide at age 35. He was a veteran of Iraq and had experienced back pain and a brain injury from his time in service. He had treated his pain with narcotics until the VA began reducing prescriptions.

Ryan Trunzo committed suicide at the age of 26. He was an army veteran of Iraq. He had experienced fractures in his back for which he tried to get effective painkillers, but failed due to VA policy. His mother stated “I feel like the VA took my son’s life.”

Kevin Keller, a Navy veteran, committed suicide at age 52. He shot v after breaking into the house of his friend, Marty Austin, to take his gun. Austin found a letter left by Keller saying “Marty sorry I broke into your house and took your gun to end the pain!” Keller had experienced a stroke 11 years earlier, and he had worsening pain in the last two years of his life because VA doctors would not give him pain medicine. On the subject of pain medication, Austin said that Keller “was not addicted. He needed it.”

Bob Mason, aged 67, of Montana committed suicide after not having access to drugs to treat his chronic pain for just one week. One doctor who had treated Mason was Mark Ibsen, who shut down his office after the Montana Board of Medical Examiners investigated him for excessive prescription of opioids. According to Mason’s daughter, Mason “didn’t like the drugs, but there were no other options.”

Donald Alan Beyer, living in Idaho, had experienced back pain for years. He suffered from  degenerative disc disease, as well as a job-related injury resulting in a broken back. After his doctor retired, Beyer struggled without pain medicine for months. He shot himself on his 47th birthday. His son, Garrett, said “I guess he felt suicide was his only chance for relief.”

Denny Peck of Washington state was 58 when he ended his life. In 1990, he experienced a severe injury to his vertebrae during a fishing accident. His mother, Lorraine Peck, said “[h]e has been in severe pain ever since,” and his daughter, Amanda Peck, “said she didn’t remember a time when her dad didn’t hurt.” During the last few years of his life, Peck had received opiates for his pain from a Seattle Pain Center, until these clinics closed. After suffering and being unable to find doctors who would help with his pain, Peck called 911. Two days later, Peck was found dead in his home with bullet wounds in his head. A note found near Peck read: “Can’t sleep, can’t eat, can’t do anything. And all the whitecoats don’t care at all.”

Doug Hale of Vermont killed himself at the age of 53. He had experienced pain from interstitial cystitis, and decided to end his life six weeks after his doctor suddenly cut off his opiate painkillers. He left a note reading “Can’t take the chronic pain anymore” before he shot himself in the head. His doctor said he “was no longer willing to risk my license by writing you another script for opioids”  (see attachment A for details of the problem as relyed by his wife Tammi who is now 10 months without a husband as a direct result of the CDC guidelines to prevent deaths)Bruce Graham committed suicide after living with severe pain for two years. At age 62, Graham fell from a ladder, suffering several severe injuries. He had surgery and fell into a coma. After surgery, he suffered from painful adhesions which could not be removed. He relied on opioid painkillers to tolerate his pain, but doctors eventually stopped prescribing the medicine he needed. Two years after his fall, Graham shot himself in the heart to end the pain.

Travis Patterson, a young combat veteran, died two days after a suicide attempt at the age of 26. After the attempt to take his own life, Patterson was brought to the VA emergency room. Doctors offered therapy as a solution, but did not offer any relief for his pain. Patterson died two days after his attempted suicide.

54-year-old Bryan Spece of Montana  killed himself about two weeks after he experienced a major reduction in his pain medication. The CDC recommends a slow reduction in pain medicine, such as a 10% decrease per week. Based on information from Spece’s relative, Spece’s dose could have been reduced by around 70% in the weeks before he died.

In Oregon, Sonja Mae Jonsson ended her life when her doctor stopped giving her pain medicine as a result of the CDC guidelines.

United States veterans have been committing suicide after being unable to receive medicine for pain. These veterans include Peter Kaisen,Daniel Somers, Kevin Keller, Ryan Trunzo, Zach Williams, and Travis Patterson

A 40-year-old woman with fibromyalgia, lupus, and back issues appeared to have committed suicide after not being prescribed enough pain medicine. She had talked about her suicidal thoughts with her friends several times before, saying “there is no quality of life in pain.” She had no husband or children to care for, so she ended her life.

Sherri Little was 53 when she committed suicide. She suffered pain from occipital neuralgia, IBS, and fibromyalgia. A friend described Little as having a “shining soul of activism” as she spent time advocating for other chronic pain sufferers. However, Little had other struggles in her life, such as her feeling that her pain kept her from forming meaningful relationships. In her final days, Little was unable to keep down solid food, and she tried to get medical help from a hospital. When she was unable to receive relief, Little ended her life.

Former NASCAR driver Dick Trickle of North Carolina shot himself at age 71. He suffered from long-term pain under his left breast. Although he went through several medical tests to determine the cause of his pain, the results could not provide relief. After Trickle’s suicide, his brother stated that Dick “must have just decided the pain was too high, because he would have never done it for any other reason.”

39-year-old Julia Kelly committed suicide after suffering ongoing pain resulting from two car accidents. Kelly’s pain caused her to quit her job and move in with her parents, unable to start a family of her own. Her family is certain that the physical and emotional effects of her pain are what drove her to end her life. Kelly had founded a charity to help other chronic pain sufferers, an organization now run by her father in order to help others avoid Julia’s fate.

Sarah Kershaw ended her life at age 49. She was a New York Times Reporter who suffered from occipital neuralgia.

Lynn Gates Jackson, speaking for her friend E.C. who committed suicide after her long term opiates were suddenly reduced by 50% against her will, for no reason.  Lynn reports she felt like the doctors were not treating her like a human being (Ed:  a common complaint) and she made the conscious decision to end her life.

E.C. committed suicide quietly one day in Visalia California.  She was 40.  Her friend reported her death.  “She did not leave a note but I know what she did”.  The doctor would only write a prescription for 10 vicodin and she was in so much pain she could not get to the clinic every few days.   We had talked many times about quitting life. Then she left.  She just left.

Jessica, a patient with RSD/CRPS committed suicide when the pain from her disease became too much for her to bear. A friend asserted that Jessica’s death was not the result of an overdose, and that “living with RSD isn’t living.”



















Aliff, Charles

Beyer, Donald Alan

Brunner, Robert “Bruin”

Graham, Bruce

Hale, Doug

Hartsgrove, Daniel P

Ingram III, Charles Richard

Kaisen, Peter

Keller, Kevin

Kershaw, Sarah

Kimberly, Allison

Little, Sherri

Mason, Bob

Miles, Richard

Murphy, Thomas

Paddock, Karon

Patterson, Travis “Patt”

Peck, Denny

Peterson, Michael Jay

Reid, Marsha

Somers, Daniel

Son, Randall Lee

Spece, Brian

Tombs, John

Trickle, Richard “Dick”

Trunzo, Ryan

Williams, Zack

Karon Shettler Paddock  committed suicide on August 7, 2013  http://www.kpaddock.org/


Jessica Simpson took her life July 2017

Mercedes McGuire took her life on Friday, August 4th. She leaves behind her 4 yr old son. She could no longer endure the physical & emotional pain from Trigeminal Neuralgia.


Another Veteran Suicide In Front Of VA Emergency Department

 Depression and Pain makes me want to kill self. Too much physical and emotional pain to continue on. I seek the bliss fullness of Death. Peace. Live together die alone.

 Dr. Mansureh Irvani  suspected overdose victim  http://www.foxnews.com/health/2017/08/18/suspended-oral-surgeon-dies-suspected-overdose.html

Katherine Goddard’s Suicide note: Due to the pain we are both in and can’t get help, this is the only way we can see getting out of it. Goodbye to everybody,”   https://www.cbsnews.com/news/florida-man-arrested-after-girlfriend-dies-during-alleged-suicide-pact/  

Steven Lichtenberg: the 32-year-old Dublin man shot himself   http://www.dispatch.com/news/20160904/chronic-pains-emotional-toll-can-lead-to-suicide  

Fred Sinclair  he was hurting very much and was, in effect, saying goodbye to the family.  http://www.pharmaciststeve.com/?p=21743

Robert Markel, 56 – June 2016 – Denied Pain Meds/Heroin OD  http://www.pennlive.com/opioid-crisis/2017/08/heroin_overdose_deaths.html

 Lisa June 2016  https://youtu.be/rBlrSyi_-rQ

Jay Lawrence  March 2017  https://www.painnewsnetwork.org/stories/2017/9/4/how-chronic-pain-killed-my-husband

Celisa Henning: killed herself and her twin daughters...http://www.nbcchicago.com/news/local/Mom-in-Apparent-Joliet-Murder-Suicide-said-Body-Felt-Like-It-was-On-Fire-Grandma-Says-442353713.html?fb_action_ids=10213560297382698&fb_action_types=og.comments

Karen Boje-58  CPP-Deming, NM

Katherine Goddard, 52 –  June 30, 2017 – Palm Coast, FL -Suicide/Denied Opioids  http://www.news-journalonline.com/news/20170816/palm-coast-man-charged-with-assisting-self-murder

https://medium.com/@ThomasKlineMD/suicides-associated-with-non-consented-opioid-pain-medication-reductions-356b4ef7e02aPartial List of Suicides, as of 9–10-17

Suicides: Associated with non-consented Opioid Pain Medication Reductions

Lacy Stewart 59, http://healthylivings247.com/daughter-says-untreated-pain-led-to-mothers-suicide/#

Ryan Trunzo of Massachusetts committed suicide at the age of 26  http://www.startribune.com/obituaries/detail/18881/?fullname=trunzo,-ryan-j  

Mercedes McGuire of Indiana ended her life August 4th, 2017 after struggling with agony originally suppressed with opioid pain medicine but reappearing after her pain medicine was cut back in a fashion after the CDC regulations. She was in such discomfort she went to the ER because she could not stand the intractable pain by “learning to live with it” as suggested by CDC consultants. The ER gave her a small prescription. She went to the pharmacy where they refused to fill it “because she had a pain contract”. She went home and killed herself. She was a young mother with a 4 year old son, Bentley. Bentley, will never get over the loss of his mom.

Suicides: Associated with non-consented Opioid Pain Medication Reductions

“Goodbye” Scott Smith: Vet w/PTSD committed murder/suicide. Killed his wife then himself today 11/27/2017


Pamela Clute had been suffering from agonizing back problems and medical treatment had failed to relieve pain that shot down her legs While California’s assisted suicide law went into effect a couple months before Clute’s death, the law only applies to terminally ill patients who are prescribed life-ending drugs by a physician. Clute wasn’t terminally ill

Kellie Bernsen 12/10/2017 Colorado suicide

Scott Smith: Vet w/PTSD committed murder/suicide. Killed his wife then himself today 11/27/2017

  Michelle Bloem committed suicide due to uncontrolled pain

John Lester shot himself on Jan. 8, 2014.

 Anne Örtegren took her life on Jan. 5  

 Debra Bales, 52 – Civilian – January 10, 2018 – Petaluma, CA – Denied Pain Meds/Suicide

 Aliff, Charles – Could not locate info!
He may be able to help! Charles Aliff – https://www.facebook.com/profile.php?id=100009343944744…

Brunner, Robert – Could not locate info!

Cagle, Melvin – http://www.objectivezero.org/…/The-Veteran-Spring-Why-a…


Harold Hamilton – http://www.dispatch.com/…/chronic-pains-emotional-toll…

Hartgrove, Daniel – http://www.legacy.com/…/name/daniel-hartsgrove-obituary…

Ingram III, Charles – http://www.pressofatlanticcity.com/…/article_b7a4a712…

Jarvis, Michael http://www.chicagotribune.com/…/ct-indiana-doctor…


Kevin Keller, 52 – US Navy – July 30, 2014 – Wytheville, VA

Kershaw, Sarah – https://mobile.nytimes.com/…/sarah-kershaw-former-times…

Kimberly, Allison http://feldmanmortuary.com/…/Allison…/obituary.html…

Lane, Keith – Timothy Shields
August 8, 2017 · Colon, MI I would like you too include Kieth Lane . US Army , Vietnam in country , combat wounded . He died recovering from ulcers surgery of a stroke and heart attack in Battle Creek VA medical center in Michigan .

Lichtenberg, Steven – http://www.dispatch.com/…/chronic-pains-emotional-toll…

Markel, Robert – http://www.pennlive.com/…/08/heroin_overdose_deaths.html

Miles, Richard – Could not locate info!

Murphy, Thomas – http://www.objectivezero.org/…/The-Veteran-Spring-Why-a…

Paddock, Karon http://www.kpaddock.com/

Denny Peck, 58 – Civilian – September 17,2016 – Seattle, Wa https://l.facebook.com/l.php…


Peterson, Michael – https://l.facebook.com/l.php…

Reid, Marsha – https://www.painnewsnetwork.org/…/daughter-blames…

Simpson, Jessica – https://www.facebook.com/photo.php?fbid=1616190951785852&set=a.395920107146282.94047.100001848876646&type=3&hc_location=ufi

Daniel Somers, 30 – US Army – June 10, 2013 – Denied Pain Meds/Suicide http://gawker.com/i-am-sorry-that-it-has-come-to-this-a…

Son, Randall – http://www.wpsdlocal6.com/…/woman-says-marion-va…/…

Bryan Spece, 54 – USMC – May 3, 2017 – Great Falls, Montana – Denied Meds/Suicide https://www.painnewsnetwork.org/…/patient-suicide…

Tombs, John – http://www.objectivezero.org/…/The-Veteran-Spring-Why-a…

 Jennifer E. Adams age 41 of Helena  December 20, 1976April 25, 2018


Jay Lawrence  March 1, 2017  on the same bench in the Hendersonville, Tennessee, park where the Lawrences had recently renewed their wedding vows, the 58-year-old man gripped his wife’s hand and killed himself with a gun.

suicide due to pain video  https://youtu.be/CSkxF1DMQws

Eden Prairie Aug 2018 handwritten note, which stated she “could not endure any more pain and needed to escape it.” http://www.fox9.com/news/charges-eden-prairie-man-helped-wife-commit-suicide

Raymond Arlugo  August 29th 2018   https://hudsonvalleydoctorskilledmybrother.wordpress.com/2018/09/14/suicide-over-pain-telling-my-brothers-story-because-he-cant/amp/

Kris Hardenbrook   Oct 2018   What is the difference between patient abandonment and a FIRING SQUAD ? – NOT MUCH ?

Robert Charles Foster,65 Nov 3, 2018 Chronic pain pt …SUICIDE BY COP https://theworldlink.com/news/local/crime-and-courts/suspect-dead-after-officer-involved-shooting-in-bandon/article_182bfafd-5e6d-539f-b366-0f9a00b7dc85.html


I reserve the right of editorial censorship

It looks like the political “mud slinging” has already started – IMO – worse than the national election two years ago… I am taking a stand – in particular – against “slanderous name calling”  directed toward specific politicians, particular political parties and/or specific people.  I don’t mind political debate – based on FACTS… when the debate drifts off the road based on FACTOIDS, FAKE NEWS, opinions stated as FACTS.. is where I am going to draw the “line in the sand” and delete comments that go down that path.

While personally, I am not a big fan of our political/bureaucratic system.. IMO.. it is too self serving… Admittedly, politically I tend to lean to the POLITICAL RIGHT but that is because the Libertarian party is seemingly always kept in their place by our dominating “two party system”.

I have belonged to a national pharmacy association for 35 yrs… that promotes the saying “get into politics … or get out of pharmacy ..” If you don’t attempt to influence politicians… someone else will…. and IMO this saying applies to those in the chronic pain community and/or pts who are dealing with subjective diseases.  Legislatures, bureaucrats are doing things that are adversely effecting the quality of life of those pts.  As long as those being affected continue to lack unity and/or a large segment chooses to stand on the sidelines, whoever is successfully “bending the ear” of these politicians … they will continue to do so because they have  little/no concern about the consequences and/or collateral damage that they cause to those suffering and dealing with subjective diseases.

I am sure that the vast majority of my readers will understand and cooperate…those who try to challenge this policy…  It is THREE STRIKES and you are out/banned… and WORDPRESS gives me your IP ADDRESS attached to your comment(s)… Once banned, just posting under a different name – WILL NOT WORK !  Everyone needs to “play nice “

Lastly, please do not post anything promoting a particular vendor or any entity or person selling a product/particular service. Because some may perceive/believe that they have my endorsement which may or may not be the case. Anyone posting a link to a professional selling a product/service will be edited out

Image result for Play Nice in the Sand Box


One of 22/day: Man dead from self-inflicted gunshot wound inside Nashville VA

Man dead from self-inflicted gunshot wound inside Nashville VA



Metro Police have confirmed a man is dead from a self-inflicted gunshot wound inside the Nashville Veteran Affair’s Medical Center.

It happened just after 9 a.m. Friday inside the main lobby of the facility at 1310 24th Avenue South.

The victim was transported to the Emergency Room at Vanderbilt University Medical Center.

Police have since confirmed the victim, an adult male, has died.

Investigators remain on scene.

If you or someone you know needs assistance in preventing a crisis or suicide, call the National Suicide Prevention Lifeline at Call 1-800-273-8255.

Metro Police are responding to a self-inflicted gunshot wound at the Nashville Veteran Affair’s Medical Center.

It happened just after 9 a.m. Friday inside the main lobby of the facility at 1310 24th Avenue South.

The victim is being transported to the Emergency Room at Vanderbilt University Medical Center.



TO: All State and Federal Elected Officials & Government Agencies

RE: An Open Letter From a Severe Intractable Pain Patient Regarding The Unintended Consequences Harming Legitimate Pain Patients in the Wake of the Illicit Drug Overdose Epidemic


Do our leaders have the mental capacity to comprehend the gravity of what people living with constant, unrelenting pain have to endure on a daily basis? Aside from the physical symptoms, the emotional and mental repercussions are unfathomable to most.

Our bodies are riddled with physical intractable pain and insurmountable limitations, but does anyone consider the mental aspect of living in a constant state of anxiety, depression, and fear of losing our doctors and our medications?

I’ve had the unfortunate reality of living with several horrendously painful, incurable diseases and illnesses for over 25 years. I’ve undergone close to 20 surgeries and tried every last modality, treatment, and non opioid medication under the sun to no avail. I made an informed decision to begin a strict opioid pain medication management regime approximately 20 years ago which had been a Godsend for me and afforded significant pain control & a moderately functional quality of life.

However, as a result of our government’s attempt to combat the nation’s OVERDOSE crisis, my nightmare began in February 2018 when my doctor was forced to reduce my pain medications by more than HALF, and has decreased it every month since then. This drastic measure has ripped away the only relief I was able to achieve, which has left me mostly bed ridden and home bound.

Every week, we hear our Government Agencies boast about the DOJ/DEA raiding, shutting down, or sanctioning several reputable doctors across our country leaving thousands of patients scrambling to find another doctor to take over their pain management which is next to impossible.

Unfortunately, my doctor of 10 years was among the growing list of targets and was shut down in August, leaving his patients including myself with no meds and no doctor. This inhumane practice is happening to countless prescribers and pain patients across the country. We are being discounted and overlooked for no justifiable reason and through no fault of our own. Why are we being continuously ignored and left out of the conversation?

My Questions:

Does anyone at the State or Federal Level realize the amount of damage and needless suffering these draconian, inhumane policies are causing and forcing upon millions of chronically ill Americans?

Where’s your OUTRAGE & FERVOR over protecting our rights?

Why is no one standing up and mobilizing, protesting, shouting, chanting, or speaking out about the atrocities being inflicted upon those of us in the pain community who are suffering in silence?

Pain does not discriminate. It affects people from ALL walks of life and can strike any one at any time. I wouldn’t wish this agony and torture on my worst enemy.

So, why is it that not ONE single elected official is willing to CHAMPION our cause and fight for the lives of cancer patients, chronic intractable pain patients, disabled veterans & wounded warriors, post surgical, trauma & accident patients, or palliative care & hospice patients?

Our government does NOT belong in our Doctors office and shouldn’t meddle with our health care decisions or treatment period.

Let’s make one thing clear…pain patients and prescribers are NOT the problem!

The overdose crisis is being fueled by ILLEGAL drugs including heroin laced with deadly (IMF) illicitly manufactured Fentanyl, Carfentanil (aka elephant tranquilizer), its analogs, and black market counterfeit look alike pills — NOT by legitimate doctors or pain patients diverting our opiate pain medication.

We have no CHOICE, unlike so many others who CHOOSE to abuse whatever substance is available to them. If we want pain relief, we must follow a maze of invasive procedures and excessive rules every month and jump through voluminous hoops just to obtain our legally prescribed pain medications in order to have a somewhat normal, bearable quality of life.

We take our pain medications responsibly as prescribed & directed without issue. However, there is no proverbial box that each and every one of us fit into, and our doctors should not be limited to prescribe a maximum, arbitrary dosage because every patient has various illnesses and different, complex needs.

Yet, after going through this seemingly endless merry go round each month, our choices are narrowing and our rights dwindling with every new regulation, restriction, and arbitrary attack on our doctors’ ability to prescribe our life saving, necessary pain medication.

Please leave our doctors alone and allow them to prescribe opioid pain medications for chronically ill patients as they see fit. Anything beyond that is a blatant infringement on the sacred doctor patient relationship.

Government/Law Enforcement Agencies should pursue ILLEGAL drug dealers, traffickers, producers, suppliers, and cartels. They should not be wrongfully and deceitfully targeting, surveilling, sanctioning & prosecuting physicians and prescribers for doing their job which they’ve been thoroughly trained and schooled to do.

If this cruel and INHUMANE behavior is allowed to continue, it will go down in history as the darkest, most flagrant violation of the rights of MILLIONS of Americans who are among the weakest, most vulnerable segment of our society!

We are terrified, our lives have been turned upside down because our government is instilling this unjustified fear in legitimate doctors and pain patients like myself. We are already suffering from unimaginable pain, and now we’re being looked down upon by society and instantaneously judged by our families and friends because of preconceived notions about weakness, inability to “fight through” the pain, and of course, subjected to the irresponsible myth and stigma being perpetuated by the mainstream media who refuse to acknowledge the difference between “addiction” vs. “dependence” on opiate pain medication to have a decent quality of life.

How much longer do we have to suffer the consequences and prove ourselves to the entire chain of command until we are taken seriously and afforded the same rights and respect given to the miniscule faction of our population who suffer from addiction? Are our lives not just as important and deserving?

Why should we be punished because of people who make a CHOICE to abuse legal and illicit/illegal substances for non medical purposes?

We have no CHOICE in the matter.

We were never given a CHOICE to begin with.

We comply with the OUTLANDISH rules & regulations created by government entities in order to receive our pain medication.

However, we are growing weary because of the exhaustive and inhumane conditions we are forced to suffer through just to survive another hour, another day, another week, another month….

How many more innocent lives need be lost until our government decides that enough is enough?

We are being thrown to the wolves and feel expendable and worthless leaving many to make drastic choices out of desperation to escape the debilitating pain.

I’ll admit that the thought of suicide has crossed my mind like thousands of others, and I’m terrified that I too will become a statistic of collateral damage. But our fight here is too important, so I continue to push myself each and every day to advocate for those who cannot advocate for themselves. However, I’m not sure how much longer I can stay in this fight. My body is getting weaker and is beginning to shut down.

We need a true HERO to sponsor and introduce a Pain Patients & Physicians Protection Policy and Bill of Rights. Will you be that HERO?

Or will you continue to sit on your hands, bow your head, and follow the herd by choosing to ignore the plight of millions of law abiding American citizens and beloved veterans?

Our time is running out….But YOU can be responsible for saving MILLIONS of innocent lives during this terrifying time of uncertainty. I respectfully request a meeting with you to discuss this matter further and offer some common sense solutions to this dreadful, yet preventable situation.

Will you please help us?

Thank you for your consideration.

Respectfully submitted, 
Andrea Patti 
Pain Warrior & Patient Advocate
War on Pain Patients: https://www.facebook.com/waronpainpatients/

this is what volunteering to help keep us free/safe … GETS YOU ?

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Ashlee Williams is with J.D. Williams.

Sooo… After 6 years, the Nashville VA Medical Center has made the determination that my triple amputee husband no longer needs a full-time caregiver. Effective immediately.

I mean… he IS pretty bada*s and all but it sure is a major blow that driving him everywhere is my “spousal duty” or helping him put his prosthetics on daily is a just a normal part of married life. Lifting wheelchairs 10+ times a day- yup, should have been included on the marriage certificate according to the VA.

Who at the VA made this decision you ask??… Wait for it…

A Women’s Health Doctor. An OB/GYN at the Nashville VA decided my husband doesn’t need me. Cool. 😐

Friends– I URGE you to PLEASE call your local and state representatives, E-mail them, GO visit them- this is INSANE. And unfortunately, I’m just a minuscule part of this MUCH Larger problem. I’ve only been lowered tiers as of now but chances are, I’ll likely be completely removed from the program when they receive my appeal as this just happened to my good friend Jessica Collins Allen who cares for her double amputee husband, Read her story here: http://bit.ly/2FrMNxT

Please, caregiver friends… prepare yourselves. You think you’re safe in the program. No one is safe!

*Edited to add- Feel free to share, I attempted to reach my CG “Support” Coordinator 6 times on Friday before posting this but with no success. So, as always Y’ALL are the BEST support.

**WANT TO HELP? Share & Help Bring awareness for the caregivers out there &
Click the ‘Town Hall’ Feature on your homepage to find your FEDERAL Representatives and give them a shout!

No matter my outcome, I’ll never stop fighting for caregivers to get the help they need. This is unacceptable.

Tonight (11/20/2018) 8pm est THE DOCTOR’S CORNER w/ DR. KLINE & JONELLE ELGAWAY

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Tonight 8pm est

Topic: How to deal w/ your illness w/out pain meds and questions from the audience.

Tune in on www.cawnation.com and click “Listen.”
Direct link: https://www.youtube.com/channel/UCQk7ewfPvTfo3pleSzvth7A

Call in w/ questions (415) 915-2291


Pained never killed anyone… just causes people to commit suicide.. no one charged with assisting suicide ?

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Kentucky: proposed bill would allow discrimination against smokers – what subjective disease is next ?



Bill would allow employers to discriminate against smokers

A state senator in Kentucky says companies should be allowed to discriminate against people who smoke.

Republican Sen. John Schickel of Union pre-filed his proposal this week. The bill would remove smokers from the protected classes outlined in Kentucky’s employment anti-discrimination law and allow employers to lawfully refuse to hire or terminate people who smoke.
Currently, state law protects smokers as long as the employee “complies with any workplace policy concerning smoking.” State law allows employers to offer stop-smoking incentives and a difference in employee contributions to an employer-sponsored health plan for smokers.
Schickel says smokers should not be a protected class.
The bill has not yet advanced in the Senate.


MAJORITY of addiction Physicians: favor INVOLUNTARY INSTITUTIONAL COMMITMENT for substance abuse disorder

Substance Abuse and Involuntary Commitment: Will It Work?


AUSTIN, Texas — A majority of physicians supported adult civil commitment for substance use disorder, according to a recent survey presented here.

From a national sample of 165 addiction physicians, 61% favored laws that permitted adult civil commitment for opioid and other substance use disorders, 21% were opposed, and 18% were unsure, reported Abhishek Jain, MD, of Columbia University in New York City.

Generally, respondents who spent more time with substance abuse patients were more supportive of civil commitment than those who were not, and the strongest support tended to be for opioid and alcohol use, he said at the American Academy of Psychiatry and the Law (AAPL) annual meeting.

However, the majority of physicians also reported that they were concerned with the amount of resources and facilities needed to impose this treatment, and said they generally supported having medication-assisted treatment (MAT) available if these laws were implemented.

“[The study] suggests that people oppose civil commitment for substance use more based on the lack of resources and the ability to pay for the commitment,” rather than other concerns such as losing rapport with patients, or that patients would need motivation for substance use treatment to be effective, Jain said in the talk.

Civil commitment allows family members, or others, to seek court-ordered treatment for individuals with substance abuse on the basis that they pose a substantial threat of harm to themselves or others. However, unlike being processed through a drug court, civil commitment does not require substance abusers to go through the criminal justice system, Jain explained. As of 2013, 32 states and Washington, D.C., had laws permitting civil commitment in these cases.

But he said the literature regarding civil confinement is often extrapolated from other international studies and that U.S. studies in this field tend to have small sample sizes and insufficient treatment details, making it difficult to generalize. The studies also have mixed findings. For example, in a 2007 American Psychiatric Association (APA) survey, just 22% of respondents supported alcohol or drug civil commitment, Jain added.

Those against the implementation of these programs argued that taking patients in against their will was a violation of a civil liberty, and that treatment imposed involuntarily may not be effective. Jain cited a 2017 study in which six of seven patients relapsed immediately after discharge.

For the current study, surveys were sent to addiction physicians actively practicing in the U.S. In addition to yes or no questions, the survey also asked respondents to submit their thoughts on adult civil confinement for substance abuse disorder. One respondent said involuntary treatment “treats addiction like a crime rather than a disease” and that, instead, “voluntary, low threshold treatment” should be made available. In contrast, another respondent reported, “I think all 50 states should have it.” However, it is important to note that these views do not necessarily reflect the formal position of any specific professional organization, he stated.

Part of the issue is that these commitment laws vary across states and jurisdictions, Jain said. Within some states with civil commitment legislation, for example, only certain individuals in the community are legally allowed to petition. In others, family members must submit a guarantee of payment stating they claim responsibility for the payment of treatment. Additionally, in some jurisdictions, civil commitment may only be offered for some, but not all, substances of abuse.

Debra Pinals, MD, of the University of Michigan in Ann Arbor, spoke during the session here and discussed her prior involvement in the Women’s Recovery from Addictions Program in Massachusetts, which provides women with substance use disorders who are civilly committed with a treatment program in a treatment setting instead of in a correctional setting. Although she acknowledged that the program is new so there is not yet data supporting its success, she said it has been examined as a model for similar developing institutions.

Pinals said many patients who may be subject to civil commitment for substance use disorders can have comorbid mental health disorders like depression and bipolar disorder that need to be addressed. Additionally, since substance use treatment typically utilizes strategies that focus on stages of change and aims toward engaging treatment into voluntary services, motivational interviewing can be helpful in facilitating patients to own their recovery in a personal way. In the civil commitment setting, patients are there involuntarily so there is a paradigm shift in how they get to these treatments, she stated.

Pinals said she was not presenting answers in terms of what best direction is regarding the complex issues surrounding civil commitment, but that more research is certainly needed. “I could certainly say anecdotally, I’ve seen some people do well, but I’ve also seen some people not do well,” Pinals said during her presentation.

Several policies need to be established where such civil commitment proceedings exist and where it is being established, Pinals said. For example, when a patient states their desire to leave the institution, or not adhere to the court commitment, what measures should be taken?

She also noted that licensure and funding needs to be considered where there are facilities or community-based services. Some AAPL attendees stated that in their states, programs have been designed to address treatment of pregnant women with substance use disorders, pointing out that these women, as well as other vulnerable populations, tend to require more complex treatment that would need to be built into programs that are developed.

When the pt’s QOL is no longer really part of any healthcare provider’s consideration

Medicare Rule Will Create New Challenges for Chronic Pain Patients


Last February, when the Trump administration announced new restrictions on opioid prescriptions covered by Medicare, the plan drew strong criticism from patients and physicians across the country. The proposed rule, which would have required insurer approval of prescriptions totaling 90 or more morphine milligram equivalents (MME) per day, generated nearly 1,400 online comments and they were overwhelmingly negative. 

“The 90 MME hard edit guidance was strongly opposed by nearly all stakeholder groups for a variety of reasons,” the Centers for Medicare and Medicaid Services (CMS) noted two months later, in April 2018. “Physician groups opposed the forcible/non-consensual dose reductions due to the risks for patients of abrupt discontinuation and rapid taper of high dose opioid use. Similarly, we received hundreds of letters from patients who have taken opioids for long periods of time and are afraid of being forced to abruptly reduce or discontinue their medication regimens with sometimes extremely adverse outcomes, including depression, loss of function, quality of life, and suicide.”

In response to the backlash, CMS changed the rule to require consultation between pharmacists and prescribers (a “soft edit”) instead of approval by insurers (a “hard edit”). That regulation, which takes effect on January 1, 2019, and does not apply to cancer patients or people in hospices or nursing homes, in theory provides more flexibility for chronic pain patients who reach or exceed the 90 MME threshold. But in practice, pain experts say, the new requirement, which CMS describes as “a tailored approach” to “address chronic opioid overuse,” is likely to further discourage prescriptions at or above 90 MME, even when they are medically justified.

Source: 123RF

The 90 MME limit, which comes from the opioid prescribing guidelines published by the US Centers for Disease Control and Prevention in 2016, is scientifically problematic for several reasons. It assumes that analgesic effect corresponds to overdose risk and that different opioids can be reliably compared to each other based on fixed ratios. It ignores numerous factors that affect how a patient responds to a given dose of a particular opioid, including obvious considerations such as the patient’s weight, treatment history, and pain intensity as well as subtler ones such as interactions with other drugs (which can suppress or amplify an opioid’s effects) and genetically determined differences in enzyme production and opioid receptors.

It is not even safe to assume that two physicians, or a physician and a pharmacist, will agree about whether a patient has reached the 90-MME threshold. Research by clinical pharmacist Jeffrey Fudin, PharmD, who specializesin pain management at the Stratton VA Medical Center in Albany, New York, and serves as PPM’s Editor-at-Large, has shown wide variation in MME estimates between medical professionals and online calculators. “There’s no consensus guideline,” says Dr. Fudin. “You can go to three different sources and get three different morphine milligram equivalents.” So the first problem patients may encounter under the new Medicare rule is that “a pharmacist’s calculation might be different from the physician’s calculation.”

The next problem is that the newly required discussion between the pharmacist and the physician may not be easy to arrange, especially if a patient is trying to fill a prescription after office hours or when the doctor is busy. “If it takes a day or two to get that prescription approved, that patient may go through withdrawal,” says Dr. Fudin. “Once the pharmacist gets approval, they don’t have to call every month. So at least the first time the patient should see if they can get the prescription early so this can all get ironed out.” Fudin says some doctors are willing to write prescriptions as many as five days early, but that practice would also have to be allowed by the pharmacy and the insurer.

Lynn Webster, MD, a former president of the American Academy of Pain Medicine and current vice president of Scientific Affairs at PRA Health Sciences, says advance notice to pharmacists also can help. If the doctor lets the pharmacist know that a patient on a higher dose will be coming in, that he considers the dose medically appropriate, and that the pharmacist can call if he has any questions, Webster says, that exchange might even qualify as the consultation required by Medicare.

Dr. Fudin suggests that doctors prepare for possible gaps in medication by prescribing clonidine or lofexidine, which “will prevent, or significantly lessen, the withdrawal symptoms,” when taken as directed. Patients may be able to avoid that problem by forgoing Medicare coverage and paying for their medication out of pocket, assuming the pharmacist is willing to fill the prescription. That could cost as much as $800 for a month’s supply of a brand-name drug that’s still under patent, although the price could be less than $100 for something like generic hydrocodone.

The expense might be reimbursed by the insurer once the pharmacist has talked to the prescriber. Then again, insurers may impose their own requirements for opioid prescriptions, as they are permitted to do under Medicare regulations. Patients also should be cognizant of limits set by state law. For example, see the information provided by the National Conference for State Legislatures, or refer to pharmacy policies shared online by drugstore chains like CVS and Walmart.

Drs. Fudin and Webster both think the new CMS rule will have a noticeable impact on prescribing practices. Doctors undeterred by the soft edit may nevertheless switch to less expensive medications, which may be less effective or more easily abused, to reduce the burden on patients who end up paying out of pocket. Other doctors may decide to taper patients down below 90 MME, something that is already happening in response to the CDC guidelines, which are officially optional but have become increasingly mandatory as they are incorporated into laws, regulations, and insurance rules.

“This is such a hassle for both the prescriber and for the pharmacist,” says Dr. Webster, “that they don’t want to trigger some event that’s going to cost them money and time, so they’ll just keep the patients below 90 MME. It places the physician and the pharmacist in a confrontational position, and the patient is going to be the real loser, because neither of them wants to be in a confrontationtoo many chiefs and not enough Indians. They’ll basically abandon the patient’s needs. As with most of the policies to date, the people in pain who really suffer are the ones who are paying the price for the illegal use of the drugs that have been diverted.”

There is this old idiom …too many chiefs and not enough Indians”  which boils down to … ” in an organization, there are too many people in charge and not enough people doing the work”  In the new Medicare opiate guidelines that take effect Jan 1, 2019… we have too many people who perceive that they have some sort of “professional discretion” and/or some “professional obligation”

Their decisions may be based on personal opinions or biases. Corporate policies created that may have more to do with protecting the corporation from a legal perspective (fear of the DEA) , actions taken to enhance or protect the corporate bottom line or state edicts/laws that may or may not have certain exceptions for certain pts (cancer, hospice, nursing home).

The pt may be dealing with a multiple of subjective diseases (pain, anxiety, depression) where there is no objective test to have a bench mark to reach or maintain which is considered some sort of presumed “normal level”.

We have already seen where individual healthcare professionals, corporations, states have taken the 90 odd pages of the CDC opiate dosing guidelines and find one sentence or paragraph that they are found of and make it their entire policy when dosing opiates for pts in chronic pain.

As pointed out in this article, most of the opiate conversion programs may or may not agree with each other and at best these conversion programs are “CRUDE ESTIMATES AT BEST” and apparently with the likes of the DEA who seem to believe that these conversion programs are accurate and irrefutable.  What else would you expect out of agency that is made up of LAW ENFORCEMENT ?

Our country is a country of LAWS and our laws are out there with numerous INTERPRETATIONS, but opiate conversion programs and the appropriate opiate dosing to meet the needs of a pt.. should be done via a “cookie cutter formula” ?

My recommendations to pts is that it is legal by federal law – some states may have different limitations – for the prescriber to write for a 90 days supply of the pt’s opiates in December 2018 so to allow all the dust to settle before the pt needs their next new  order filled.  The last thing that a chronic pain pt needs is to need a fill their next controlled med Rx the first week of Jan 2019… the system is going to be full of unanswered questions and that means that when that happens.. the pt gets told – NO NOT TODAY !

Just ask any pharmacist that was around when the Part D program began in Jan 1, 2006.  All too many pts timed their refills so that they would be due the first week of Jan 2006 and the Part D billing system literately FELL APART and a lot of pts were told that their new Part D insurance would not approve the payment of their meds.  Personally, back then… I timed Barb’s refills for no earlier than Jan 15th, 2006 hoping that if/when the system didn’t perform as promised that there would be such an uproar by Medicare folks not getting their meds promptly paid for … that within 2 weeks … things would be straightened out… and when I went to fill Barb’s Rxs after Jan 15, 2006… the system was functioning as designed. 

This time, since controlled meds are involved.. I suspect that there will be no “I will lend you a few to get you by” like there was done in 2006.  You try to get your next controlled med Rx… the pt will either be told YES or NO…   Consequences to the pts being told NO… will not be a concern to all those involved… they will not FEEL YOUR PAIN !

AG Bondi: going to help assure that chain pharmacist stop filling opiates ?

Florida sues Walgreens, CVS alleging they added to state’s opioid crisis

CVS says Florida’s opioid claim ‘without merit’


FORT LAUDERDALE, Fla.Florida is suing the nation’s two largest drugstore chains, alleging they added to the state’s opioid crisis.

Attorney General Pam Bondi announced late Friday that she has added Walgreens and CVS to a state-court lawsuit filed last spring against Purdue Pharma, the maker of oxycontin, and several opioid distributors.

Bondi said in a press release that CVS and Walgreens “played a role in creating the opioid crisis.” She said the companies failed to stop “suspicious orders of opioids” and “dispensed unreasonable quantities of opioids from their pharmacies.”

CVS spokesman Mike DeAngelis issued a statement Saturday saying the company is “dedicated to helping reduce prescription drug abuse and diversion.” That includes training pharmacists and their assistants and public education efforts.

The nation’s second-largest drugstore chain says Florida’s lawsuit alleging that it helped fuel the state’s opioid crisis “is without merit.”

Walgreens declined to comment for this story.

The federal government says about 45 people die daily because of opioid overdoses.

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