One of my readers forwarded this to me… it was a email sent out by PROP (Physicians for Responsible Opioid Prescribing)
Dear Friends and Colleagues,
Here’s the latest from PROP:
- Jane Ballantyne to become next President of PROP
- September 28th FED UP! Rally on the Mall and march to the White House
- The battle to up-schedule hydrocodone combos is over – Public health trumps special interests!
- Chewable OxyContin is back with a new name- Targiniq ER
Dr. Jane Ballantyne to become next President of PROP
We are proud to announce that Dr. Jane Ballantyne will become the next President of PROP. The changing of the guard will occur on September 27th at the National Press Club in Washington, DC at the FED UP! Pre-rally reception (more about FED UP! Rally below).
Dr. Ballantyne received her medical degree from the Royal Free Hospital School of Medicine in London, England. She trained in Anesthesiology at the John Radcliffe Hospital, Oxford, England, before moving to the Massachusetts General Hospital (MGH), Harvard University in 1990, where she directed the Pain Center for 20 years. Dr. Ballantyne is UW Medicine Professor of Education and Research and has editorial roles in several leading journals and textbooks, and is a widely published author.
She was among the first prominent pain specialists in the country to sound the alarm about high dose chronic opioid therapy risks and lack of efficacy. She has an outstanding international reputation and is highly regarded for her research, writing, and professionalism. PROP is very lucky to have her as our next President!
In case you’re wondering… I’m not going away. On September 27th, I’ll become the Director of PROP, which allows me to remain actively involved in our advocacy and educational efforts.
Sunday, September 28th FED UP! Rally on the Mall and march to the White House
In case you haven’t heard, thousands of people from around the country will descend on Washington for a rally on the National Mall & a march to the White House. Together, we will call for an immediate and coordinated federal response to the opioid epidemic. The event was organized by a coalition of organizations (including PROP). If you’re feeling “FED UP!” with the tragically ineffective federal response to the opioid crisis, please try to be there and/or please spread word about the event.
To learn more about the FED UP! Rally and Platform, and to register please visit: www.feduprally.org
The battle to up-schedule hydrocodone combos is over – Public health trumps special interests!
On October 6, hydrocodone combos (i.e. Vicodin, Lortab & Norco) will move from C III to C II. PROP began advocating for this change when we first formed. This was a long hard fight against vested special interest groups and the FDA. We would not have won without the help of Congress (especially Senator Manchin) who passed legislation requiring FDA to hold an advisory committee meeting on the subject (the committee voted overwhelmingly in favor of the change). And we would not have won without support from the many medical experts and consumer advocates who submitted comments to the federal docket and gave testimony before the FDA advisory committee. THANK YOU!!!
It will take a few years before the impact of this change can be measured, but I’m hopeful it will mark a turning point in the opioid addiction epidemic. Up-scheduling will, no doubt, lead to a sharp decline in prescribing of hydrocodone combos, which in turn should lead to a sharp decline in new cases of opioid addiction (among both pain patients and recreational users). Preventing opioid addiction is a must if we hope to bring the epidemic under control.
Chewable OxyContin is back with a new name- Targiniq ER
Last month FDA approved Purdue’s new extended-release opioid called Targiniq ER, which contains oxycodone combined with naloxone. FDA is allowing the drug to be marketed as “abuse-deterrent” because the naloxone may deter misuse by injection and snorting. However, naloxone has no effect on the brain when taken orally. This means that when chewed, extended-release Targiniq ER tablets will immediately release the entire dose of oxycodone – the naloxone will have no effect.
An FDA advisory committee (AC) would probably have voted against Targiniq ER approval because it has the same active ingredient (oxycodone) found in crush-resistant OxyContin but it’s obviously more dangerous. Rather than bringing it to an AC for a vote and risking another Zohydro fiasco, FDA bypassed its outside advisors and approved the drug without a vote. Purdue Pharma will once again have an easily chewed extended-release oxycodone product on the market.
If this has you feeling fed up with FDA, I hope we see you in Washington, DC for the FED UP! Rally. It will be very hard for the administration to ignore thousands of people marching from the National Mall to the White House, calling for a change at FDA and for an immediate and coordinated federal response to the opioid crisis.
Sincerely,
-Andrew
Andrew Kolodny, MD
President,
Physicians for Responsible Opioid Prescribing
www.supportPROP.org
Chief Medical Officer/SVP
Phoenix House Foundation
164 W. 74th Street
New York, NY 10023
T 347 396 0369
F 347 396 0370
akolodny@phoenixhouse.org
Filed under: General Problems
@Coonhound..yep cant wait for all the new addiction diagnoses additions and discontinuation of all the chronic pain diagnoses and ruined reputations of patients when this diagnosis becomes “public” among the patient’s other healthcare professionals.
Propagandist, DOES IT TAKE ONE TO KNOW ONE [?]
Kolodny, other psychiatrists, and alarmist’s cries over the marketing practices by Big Pharma in relation to the management of pain (and the current opioid ‘epidemic’) is rather ironic as the same practice was used (still used) in relationship to Big Pharma and treatment of mental illnesses and the medications used to treat them. The only discernible difference is that pain falls outside their scope of their expertise (hint, addiction does not). As far as a lack of evidence showing positive effects of long term opioid therapy? One could ask the same about the use of antidepressants, the THEORY of a ‘chemical imbalance’, and the treatment of depression.
How many medical studies have proven the relationship between a ‘chemical imbalance’ (serotonin or norepinephrine) and depression? Answer is………NONE! NADA, ZIP, ZERO. It is a THEORY that has been repeated so often it is now taken to be gospel. Some experts say they do more harm than good (sound familiar?)
Has a similar lack of evidence (so often touted as reason against the use of opioids for >90 days) hindered psychiatrists from prescribing risky and dangerous medications to treat depression and other mental illnesses, which have less (actually almost NO solid medical proof) to substantiate their diagnosis than >90% of those w/ chronic pain?
In most patients with pain there are tests, imaging, and symptoms to guide treatment, Where is the hard proof in the diagnosis of depression, anxiety, and other psychiatric conditions? Are there antibodies present like in AI disease? How about MRIs or CTs like those showing spinal and other degenerative issues? EMG/Nerve conduction studies for diagnosing neurophy? How about biopsies? I believe the answer is an emphatic NO! Just SYMPTOMS my friends, self reported ones at that!! Now who is being irresponsible with prescribing practices here? Pain doctors look extremely thorough when compared to psychiatrists when it comes to prescribing practices and diagnosing the causes of chronic pain.
http://www.antidepressantsfacts.com/Biochemical-Imbalance.htm
http://wellnesswordworks.com/by-erin-hebler-the-chemical-imbalance-theory-an-unprovable-yet-highly-marketed-scam/
*I would like to know the % of patients who leave an initial appt w/ a psychiatrist with a benzo or amphetamine (usually the coupe-de-grace in many opioid overdoses, though rarely mentioned), after simply telling the doctor they have symptoms of anxiety or ADD. Then compare it to those who see a pain doctor and receive opioid medications. i’m going to guess that the number weighs heavily on the side of psychiatrists giving out scheduled meds more often on initial visits than PM docs.
The invasion into the treatment of pain is the next logical step for the promotion of their psychiatric drugs (now promoted for pain and quick to point out in direct to consumer ads that they are NOT a NARCOTIC, followed by a soothing voice that mentions use of the drug can cause increased risk of suicide among other disturbing side effects). There are serious adverse effects of these drugs which were proven not much more effective than placebo in most trials yet they are prescribed on an ongoing basis just like COT.
from the link:http://www.biopsychiatry.com/bigpharma/drugcompanies-doctors.html
“four researchers who, using the Freedom of Information Act, obtained FDA reviews of every placebo-controlled clinical trial submitted for initial approval of the six most widely used antidepressant drugs approved between 1987 and 1999—Prozac, Paxil, Zoloft, Celexa, Serzone, and Effexor.[10] They found that on average, placebos were 80 percent as effective as the drugs. The difference between drug and placebo was so small that it was unlikely to be of any clinical significance. The results were much the same for all six drugs: all were equally ineffective. But because favorable results were published and unfavorable results buried (in this case, within the FDA), the public and the medical profession believed these drugs were potent antidepressants.
When compared to psych ‘researchers’ from major universities and other study centers, pain advocacy groups and PM doctors (targeted w/ criticism for fueling the Rx ‘epidemic’) appear almost saintly. This practice by big pharma of using psychiatrists, and more recently GPs as well, continues unabated. Example: Take Eli-Lily and its promotion of Zyprexa for off label uses, knowing full well that it is illegal to advertise off label use of a drug.
http://www.justice.gov/archive/opa/pr/2009/January/09-civ-038.html
Over the last couple decades psychiatrists (w/ help from big pharma) have labeled many (most?) of life’s problems and natural emotions as mental illnesses in need of psychiatric care, while raking in the $$. Shyness=social anxiety disorder, short attention span (often aided by too much caffeine/sugar)=ADD/ADHD, nervous disposition=general anxiety disorder, the list goes on.
The following statement from: http://www.biopsychiatry.com/bigpharma/drugcompanies-doctors.html
“Given its importance, you might think that the DSM represents the authoritative distillation of a large body of scientific evidence. But Lane, using unpublished records from the archives of the American Psychiatric Association and interviews with the principals, shows that it is instead the product of a complex of academic politics, personal ambition, ideology, and, perhaps most important, the influence of the pharmaceutical industry. What the DSM lacks is evidence. Lane quotes one contributor to the DSM-III task force:
There was very little systematic research, and much of the research that existed was really a hodgepodge—scattered, inconsistent, and ambiguous. I think the majority of us recognized that the amount of good, solid science upon which we were making our decisions was pretty modest. Lane uses shyness as his case study of disease-mongering in psychiatry. Shyness as a psychiatric illness made its debut as “social phobia” in DSM-III in 1980, but was said to be rare. By 1994, when DSM-IV was published, it had become “social anxiety disorder,” now said to be extremely common. According to Lane, GlaxoSmithKline, hoping to boost sales for its antidepressant, Paxil, decided to promote social anxiety disorder as “a severe medical condition.” In 1999, the company received FDA approval to market the drug for social anxiety disorder.
Perhaps the real ‘epidemic’ isn’t prescription drug abuse at all but the over-diagnosis of mental illness (including ADDICTION) as evidenced by an ever expanding DSM and “treatment” by psychiatrists with their cure-all drugs including SSRIs , SNRIs, ER ADD/ADHD meds, and newer atypical antipsychotics like Abilify and Seroquel, and Zyprexa. [atypicals having black box warnings]
SO, where do legitimate patients with pain fit into all this babbling and posturing by idiots like POOPs Kolodny? Exactly like a piece to a puzzle it seems………
* DSM 5 “would expand the list of recognized symptoms for drug and alcohol addiction, while also reducing the number of symptoms required for a diagnosis.” This raises for Urbina the concern that there will be an expansion in both “rehab” style and pharmaceutical treatments, a clearly money-making motivation for, and consequence of, the DSM’s revision. Urbana indicates in his article’s lead paragraph:
“In what could prove to be one of their most far-reaching decisions, psychiatrists and other specialists who are rewriting the manual that serves as the nation’s arbiter of mental illness have agreed to revise the definition of addiction, which could result in millions more people being diagnosed as addicts and pose huge consequences for health insurers and taxpayers.
http://www.huffingtonpost.com/stanton-peele/addiction-dsm_b_1512528.html
COULD RESULT IN MILLIONS MORE BEING DIAGNOSED AS ADDICTS?…………seems to ring a bell but I just can’t place it………………….
Perhaps Kolodny and other like-minded psychiatrists, who seem to know what is best for the disabled with moderate to severe chronic pain (or simply narcotic addicts) and their treatment (labeled addiction), should get their own house in order before stepping into an arena (pain management) in which they are woefully under qualified to critique.
http://psychcentral.com/blog/archives/2013/02/11/the-problems-with-the-u-s-addiction-treatment-system/
http://blogs.psychcentral.com/addiction-recovery/discuss/677/
Coonhound
hey, i just found this site, I am curious. Well, I have a long history of being involved in the drug war debate/drug war community, especially online where I am apart of some of the active communities. To be totally frank, in recent times, disillusionment and other things have caused me to drastically cut back on my involvement but for a very long time I was involved on a daily basis and in the most humble way possible i had lots of calls to start my own site etc. because what I’d been saying was popular and popularly debated/hated too… what it is is that I am a very proud, very boisterous opiate lover. I absolutely hate the 12 step community root and stem everywhere in every form. I feel the same way about the drug war, about the so called rehab business and I’ve been very vocal about loving drugs and drug use, even though at times, I maintain, that prohibition has rendered me utterly destitute, literally homeless in the streets of NYC (bond st, great jones and others, to be specific if anybody here is from NYC.) Well after almost 13 years of daily involvement in the amateur pharm world if you will, one becomes a bit of a amateur pharmacist, though I understand the potential harms in that, nevertheless it’s all very fascinating to me. I found this particularly page on this blog because of a search on Targiniq. I just heard about targiniq today. For the longest time I’ve often said how to me one of the most disgusting inventions ever created in this war on drugs has been buprenorphine aka suboxone/subutex. I mean, I hate methadose/methadone with a passion too but there is nothing quite as dispicable and horrible and repugnant as bupe.
I had the great fortune once to be briefly seeing a doctor who was prescribing me roxicodone and at the same time suboxone. I never took the subs she was providing me and the fact of the matter is, she was prescribing me about 600-800 mgs of Roxi that was to last a month but would not last me a day. It was totally not worth the cost of seeing the doctor. The thing people dont generally know is that there are opiate maintenance programs in the world that are actually opiate maintenance programs, NOT BOGUS ones like our American methadone program but programs in Europe and England that actually give the patient heroin / diacetylmorphine. Not some bogus oral heroin but pre-ready injectable ampules of diacetylmorphine and if youre preference is to smoke it for your pain relief or emotional relief or both well the idea out there is that they actually give the patient what the patient prefers. However, it is difficult to get into the heroin program, however, it is much easier to get into a morphine/oxycodone/oxycontin/hydrocodone/dilaudid etc. maintenance program. You see in America we have this thing where a doctor would be committing a crime by knowingly prescribing a narcotic to a so called “addict” (boy do i hate that word) to treat the addiction. This is a unique thing to America. It is called the Harrison narcotics act. Before it came about we actually had Heroin maintenance clinics in America. It was a half a decade period but it existed. Anyhow, the point is, other countries dont have that restriction which is why you can get a daily dose of morphine/opiates ive listed and not be a criminal. The results for using the real opiates vs our ridiculous methadone clinic / buprenorphine model is incredible. A 92% success rate vs often 64% for methadone and lower for bupe. There are even studies, easy to find with google, comparing morphine or diacetylmorphine vs methadone or buprenorphine and the subjects using the heroin or morphine always do much better than their counterparts.
The big thing about it all that needs to be understood is that the AVERAGE dose of opiates that you get on these programs, is actually 500 milligrams PER DOSE PER DAY up to 4x a day, sometimes only 2x though. The thing is, my doctor here in America was prescribing me like i said 600-800mgs FOR A MONTH, 500mgs being the average dose per day, well, no kidding things didnt work out. No kidding we have this misguided concept so often said by so called experts that the “opiate addict is never satisfied” well if the body requires 500mgs of something, and you are given a script for a vicodin 5mg pill 1x every 6 hours, well no kidding somethings not freaking gonna work. No kidding theres a problem here and how wrong they all are about “fine line between restricting abuse and giving access to patients who need.” lol. this whole opiate situation is a nightmare. the war on drugs is a nightmare. I love pharmacists, thank you for your involvement in the worlds most beautiful profession. be well.
cj
Take away all migraine treatments from chronic migraine sufferers…BARBARIC!!!!
I cant function
I wonder who the reader was that Dr. Kolodny sent this email to.
Its amazing that Dr. Kolodny would relinquish his presidency of this group PROP to Dr. Ballantyne. She must not know of the FDA Citizens Petition that Dr. Kolodny sent to the FDA in 2012 and was shot down on all three subjects he asked to change along with his fellow doctor signers.
Dr. K. wanted Moderate Pain stricken from ever getting treated with opioid medications and we all know moderate pain will soon become SEVERE if not treated in a timely manner. Next he wanted no one chronic pain suffer to receive
anymore than 120 mgs of morphine a day and the equivalent ,again turned down by the FDA.
And last the treatment period must not exceed 90 days and we all know chronic pain comes with a lifetime guarantee.
Seems this guy has a narcissistic personality disorder characterized by the patient’s overestimation of his own appearance and abilities and an excessive need for admiration.
Well all good things must come to a end and it was best Dr. Kolodny relinquish his presidency of such a popular group, after all he has made a fool out of himself so far. I don’t know what this group FED UP is all upset about wanting to
put a end to opioid medications all together. Most all in this group have had a tragic experience with these medications and lost a loved ones who abused these medications. Must we all pay for the mistakes of those that needed direction and made a tragic error in judgment , I don’t think so ,may God be with them and may they rest in peace.
Last I thought of different things to compare to taking away opioid medications that help those in chronic intractable pain live a somewhat normal life and what it would be equal to , this is what I came up with and you can add to this if you like.
Taking away opioid medication from those truly suffering chronic pain is equal to,
1. Taking away antibiotics from those with a serious infection.
2. Taking away blood pressure medication from those with high or low blood pressure.
3. Taking away blood thinners for those with heart problems.
4. Taking away cholesterol medication from those with clogged arteries.
5. Taking away insulin from those with diabetes.
6. Taking away Viagra from those with , well you know.
7. Taking away Dilantin from those that have a seizure disorder.
8.Taking away ace inhibitors from those with heart problems.
9. Taking away Prilosec ,Zantac from those with chronic heartburn.
10. Taking away sleep medication from those with insomnia,,, really cruel.
11. Taking away Kaopectate from those to treat sudden diarrhea,,, more cruel
NEED I GO ON ,,, MUST PEOPLE THAT TRULY SUFFER EACH DAY FROM NEVER ENDING CHRONIC PAIN CONTINUE TO SUFFER.
I PRAY NOT.
CAN ALL OF US JUST PLEASE GET ALONG .
the only thing these people are accomplishing is hurting the legitimate people who are already in enough pain.what right do they have to take away medication from people who really need it.it really is time for people who are clueless to the needs of someone in chronic pain to educate themselves with real facts and not just media hype.
i agree 100%
Just what exactly is it that these folks want? It seems to me that their campaign to help citizens ‘caught up’ in the prescription drug abuse ‘epidemic’, or reign of terror/intimidation/descrimination (depending on one’s point of view) has been extremely successful in restricting access to pain medication for both addicts and legitimate patients despite having well documented injuries and disease states
Just off the top of my head here……….PDMP are installed in every state now save for one, MO. Four make a check mandatory prior to writing an Rx.This has and can continue to be an effective tool against ‘doctor shopping’ with many states communicating w/ each other along the borders so addicts cannot exploit geography to fill from multiple physicians in different states.
New rules for pain management clinics and their ownership along with more oversight has resulted in a large number of ‘pill mills’ being closed down. Another restriction is their ability to distribute medications on site (a few days rather than the whole month).
FDA/DEA has rescheduled hydrocodone combos from III to II. They have shut down pill mills and internet pharmacies. Then there is REMS. Patients, even the disabled are drug tested, pills counted, forced to sign away basic rights in order to receive treatment (opiate contracts), etc, etc. It is humiliating to be treated like a child who has misbehaved, you have to prove your innocence. Even the disabled with extensive documentation are having a hard time finding a doctor who will write an Rx for an extended period of time. When and or IF they do there is generally a long waiting period for an initial appt.. Collateral damage? Seemingly unimportant to them. Any simpleton could tell you that the number of pain clinics is woefully inadequate when compared to the number of legitimate patients with chronic pain who invariably will be referred by chickenshick PCPs who don’t feel ‘comfortable’ writing for schedule II meds. If they aren’t frightened enough by DEA vagueness and empty reassurances many simply prefer not to deal w/ the extra hassles involved in treating someone w/ a chronic condition in need of prescription opioids on a regular basis.
The solution according to PROP and other ‘reformers’ is that alternative treatments and pain clinics will replace the decrease in opioid prescriptions.The fact is that most patients who wind up in PM clinics are there because all these other treatments have proven to be inadequate, not covered by insurance, and are too costly for patients. Laboratories are certainly doing well given the inprcreasing numbers of UDT given, (My PM clinic went from 3-4x a year randoms to every visit since Sept ’13) and lets not forget how Big Pharma is still sitting pretty. They get to take effective, safe, and cheap medications like oxycodone, morphine, hydrocodone, etc and make new abuse resistant formulations further driving up the costs of treatment. It is looking to be a big racket where everyone benefits save the legitimate patient. The.Prison industrial complex, attorneys, law enforcement, labs, Big pharma, DEA/DOJ, state and local LE agencies, and other FED alphabet LE task forces, rehabilitation organizations [see kolodny’s Pheonix House] etc all look to make up most of the 10% (from your other thread) who think we are winning the drug war. I don’t know the exact figures (does anyone?) but with all the stories out about vast shipments of scheduled meds ‘lost in transit’ or embezzled by pharmacists and techs, or brought in across the border from Mexico, etc, why are the patients always the ones who are painted as addicts and assumed to be the root of all the prescription abuse in this country? Easy targets I presume.
Add to these impediments the cost of being treated at a real comprehensive pain clinic, that is if they are fortunate enough to be one of the few seen by one, and it its cost makes them out of reach for many who neecd it.
Increased urine screens (not cheap), monthly visits, other procedures (nerve blocks, Euflexxa, facet injects, TENS etc) help make PM clinics too expensive. Even if they weren’t and began being covered by many insurance companies they are not always going to be enough. I take many of these treatments and they are very helpful but the 70-80% of the relief I get for my pain comes from the medications I take (both opioid and adjunct meds and DMARDs for my autoimmune disease(s),
While on the issue of cost, one variable conveniently left out of much of the discussion surrounding pain management is fact that pain is but one symptom those of us with autoimmune disease face daily. My lupus overlap/MCTD and sarcoidosis are both incurable. They leave myself and other AI patients with many symptoms like nausea, dyspnea, frequent infections, autonomic nervous system dysfunction, joint, skin, muscle (think charlie horse but including most muscles not just your calf) involvement, endocrine problems requiring several meds to control thyroid, testosterone, and VitD/calcium dysregulation (D is a hormone rather than a vitamin). At any rate, the list goes on and on but you get the idea, they all need to be managed. They require many meds to do so 4 GI, 1 heart, 3 pulmo inhalers/neb meds, 3 DMARDs, etc etc. These symptoms are daunting enough by themselves but what happens when you undergo stress and strain from untreated or under treated pain? Most of these symptoms become more severe due sleep deprivation, anxiety, raised blood pressure, etc, etc.
I guess my point here (yes there is a point other than just venting)is that there have been so many obstacles (safety concerns) put in place for US citizens who need protection from themselves is this, when is enough enough?
Why cant these crusaders allow time for the new laws and regulations enacted to bear fruit before resuming the offensive against the use (yes just the USE) of opioid pain medications? I knew the pendulum was swinging back the other direction after years of more compassionate care but this is ridiculous. After all their ‘progress’ what exactly are they FED UP about that calls for a national rally in Washington DC?
*Kolodny: “In case you’re wondering… I’m not going away. On September 27th, I’ll become the Director of PROP, which allows me to remain actively involved in our advocacy and educational efforts”
*Hmmmm. I wonder. Why is this clown no longer president of POOP? Did Kolodny let his alligator mouth override his hummingbird hind end (see recent comments/threats to CLAAD concerning the IRS) http://paindr.com/claad-and-phoenix-house-square-off/
Just one example of many of his unsavory and outspoken foot-in-mouth moments. Perhaps he was kicked upstairs because he is too unstable and doing more harm than good for POOP in the spotlight so they kicked him ‘upstairs’.
Coonhound
Am I reading this right? This group.wants to decrease pain med use even in chronic pain patients where it is working just because it is their belief they are.prescribed too much. And rsis a pain specialist? Correct.me if I mis read this. Their whole thinking comes across as junk science regarding high dose risk and lack of efficacy…I personally know.people.on high doses and they are comfortable and functional
I strongly agree with the designation of this as propaganda. It’s bad enough that the Federal govt is limiting the availability of pain medication to those that truly need it but now we have physicians who feel that a rally will somehow curb the widespread use of opiates among those that don’t need them. The only thing it does is convince naive physicians that everyone seeking an opiate is doing it in order to abuse it. Again the legitimate pain patient is automatically categorized as an abuser and denied necessary treatment of their pain.