OMG: I got this unsolicited email in my inbox today… a Chronic pain pt living in MO and on Medicaid… may have a problem

From a short websearch – MO Healthnet – seems to be the state of MO Medicaid program.  Will many of the practitioners in MO just pull out of the Medicaid program or will they end up just applying Medicaid prescribing rules to all their pts…  so that they will not accidentally exceed the dosing limit on Medicaid pts ? with this and the other post from today that applies to SC and Arkansas  New law lets South Carolina providers deny care that conflicts with personal beliefs Is it time for some law firms that deal with civil right violations to step up to the plate ?

Steve Corsi, Psy.D., Director of Department of Social Services
Randall Williams MD, Director of Department of Health
Mark Stinger, Director Department of Mental Health

This message is intended to reach the people listed above as the heads of their respective Departments. If they have since been replaced please forward it to the new Director(s). No disrespect to anyone else that may read this, but I need to reach those with the power to effect change. Since the website for the Great State of Missouri is extremely difficult to navigate, I am sending this to the address listed on the March 9, 2018 letter to prescribing physicians. At the end of this message I will attach the response that I have already received from the Administrator of the MO Bureau of Narcotics and Dangerous Drugs. In his letter he was clear that doctors should use their best medical judgement in prescribing and that the CDC Guideline does not hold the effect of law. What it has done is frightened physicians to the point of abandoning, forcing tapers and refusal to accept any new pain patients.

As you are well aware on March 9, 2018 physicians that accept MO HealthNet were issued a letter that can only be described as a direct threat to their livelihood, ability to properly treat patients, and even their freedom in the form of incarceration if they did not dramatically reduce the doses of chronic pain patients on opioids to an arbitrary amount of 90mmed. There is no medical evidence that this threshold in anyway protects the lives of chronic pain patients as we are the most responsible patients a doctor could have. It also discounts the fact that the enzymes in the livers of each individual metabolize opioids at extremely different rates so much so that a dose of 50mmed in one patient may suppress their pain, but another patient may require 1,000mmed or more to control the same amount of pain.

This has forced doctors in MO to taper their patients that have been on high dose long-term opioid pain medications, sometimes for decades, against the patients wishes and their thoroughly considered medical decisions. This has been disastrous for Missourians and across the country where this guideline has been applied as policy or law. Whether your intent was to force doctors to do this it has been the effect. My personal physician has received regular visits by the BNDD to monitor the tapering of opioids of legacy patients. It is impossible that an agency that denies this guideline has the force of law, would take it upon themselves to do these edits without being directed by one of your Departments.

Factors you may not be, but as a governing body should be aware of, is that the authors of the CDC Guidelines were from a radical group of anti-opioid crusaders known as PROP physicians for responsible opioid prescribing, or as many in the industry call them PROPaganda. (They will be mentioned again in this letter many times) In 2012 PROP petitioned the FDA, which is the appropriate regulating agency for prescription drugs in the United States, with the very recommendations they later used as the anti-opioid guideline. The FDA of course rejected their petition because it was not based on solid science. The FDA did agree with them in part and introduced new labeling requirements. Again this is the ONLY measure that was approved by the FDA, which again is the governing and regulating body for all prescription drugs. The buck stops with them.

In the published abstract from the authors of the guideline they readily admit they used low quality evidence as a basis for their recommendations and I quote…
EVIDENCESYNTHESIS Evidence consisted of observational studies or randomized clinical trials with notable limitations, characterized as low quality using GRADE methodology. Meta-analysis was not attempted due to the limited number of studies, variability in study designs and clinical heterogeneity, and methodological shortcomings of studies. No study evaluated long-term (1 year) benefit of opioids for chronic pain. Opioids were associated with increased risks, including opioid use disorder, overdose, and death, with dose-dependent effects.
IMPORTANCE Primary care clinicians find managing chronic pain challenging. Evidence of long-term efficacy of opioids for chronic pain is limited. Opioid use is associated with serious risks, including opioid use disorder

Underlined in the above information (top) provided directly by the authors of the guideline shows that they used poor quality studies to reach their conclusions. In the next underlined part (bottom) it is clearly stated that this information is directed SOLELY to Primary Care Physicians who may find treating chronic pain challenging. It is not intended to apply to ANY specialists, particularly those who specialize in diagnosis and treatment of chronic pain disorders. The bold and italic portion indicates the opinions of the writers with very limited scientific evidence. While some studies suggest an increased effect of mortality with higher doses, they are of the same limited numbers and poor quality. The bold portion indicates that there is limited evidence of long-term efficacy of treating chronic pain with opioids. This is due to the fact that an ethical clinician cannot take patients that have been treated long-term with high dose opioids and replace them with placebo. The patients receiving placebo would suffer from excruciating pain and withdrawals within 1-2 days maximum. Therefor any patient that received the placebo would immediately know they were receiving it and drop out of the study rendering it useless. This may suit the authors of this guideline as the studies that they site as evidence are similarly useless. All of this information is in the guideline itself if someone took the time to read the complete report, a responsibility that would fall directly on the shoulders of each Director.

The following is a link to the suicides resulting from tapering or abruptly stopping opioids based on the CDC Guideline compiled by a compassionate and caring physician named Dr. Kline. These do not represent all of the suicides do to the CDC and regulatory bodies such as yours but is a list the great doctor has composed in his spare time when not treating or advocating for the rights of chronic pain patients, followed by some excerpts.
https://medium.com/@ThomasKlineMD/opioidcrisis-pain-related-suicides-associated-with-forced-tapers-c68c79ecf84d

Dr. Kolodny (the founder of PROPaganda) commented on the pain related suicides cases: “ There is good evidence the majority were suffering from opioid addiction”. He was not familiar with the cases.

Dr. Kolodny is not a specialist in pain medicine. He is a trained psychiatrists who benefits financially from every “addict” he assumes care for. He has also made over $500,000 as a self proclaimed expert for the prosecution in cases where well intentioned, caring and compassionate doctors were put on trial for their prescribing habits without regard to the conditions of their patients. He alone has been responsible for imprisoning doctors who faithfully executed their Hippocratic Oath. Dr. Kolodny also stands to make untold millions and possibly billions as an “expert” witness for the prosecution in the lawsuits against opioid manufacturers and suppliers.

Doctors across the country actually believe the CDC/PROP manifesto of pain medicines not working and too dangerous to use, a false assumption. Their belief that “addictions and overdoses” are being prevented by eliminating opiate pain medicine is a failure of science, reason, and common sense. These people are no longer with us due to the policy of “you are better off without pain medicines”

No case has been reported of true addiction suddenly occurring while taking pain medicine in the 10 million with long term pain disease, belying the governments’s belief that addictions will be prevented if the population as a whole does not take them.

Suicide prevention in the ten million noted by NIH requiring daily pain medicine is pain care. Not providing suicide prevention is negligence. Not treating a person in pain is negligence. Abandoning people with painful disease to the streets with no doctor, is negligence. Believing you can addict the general population is ignorance. Believing serious pain can relieved with Tylenol, meditation, expensive injection therapy, anticonvulsants, and physical therapy — is ignorant. The longer you wait to treat pain the more serious it becomes. Opiates remain the treatment of choice for serious pain, no matter what a few extremists purport.

This nihlist medical view is not accepted by most U.S. practicing physicians, nor in other countries, nor by the World Health Organization. The CDC and its PROP consultants have an extreme view, a pain nihilism manifesto, with unfounded near shrieking polemics, a bizarre “lunatic fringe” (FDA senior official) plan for the earth riding through every doctor office in the land with warnings not to addict or kill using “heroin pills” in the words of Thomas Frieden CDC director allowing the Guideline to be published by an Agency not tasked with opiate recommendations.

Allison Kimberly, age 30, of Colorado was denied treatment for her intractable pain from interstitial cystitis and several other painful conditions. Interstitial cystitis can end in suicide from the failure to treat it properly as it is an extreme form of agonizing discomfort. It is said that the University of Colorado emergency room in Aurora refused her treatment for her pain.
deceased

Allison posted on Instagram describing how she was treated as an addict and sent away without pain medicine. “I was rushed to the ER because my pain was so out of control I couldn’t take it anymore, I got ZERO help. After 7 hours I was discharged. The nurse has the nerve to say that my kind of pain shouldn’t be that bad and basically I was faking for medication. I am so beside myself I am shaking as I type this. Screaming and begging in pain, needing any kind of help they’d give me and I was just sent home. As soon as I am able I’m reporting my whole experience.” Allison did not have time to file a complaint against the hospital as she violently ended her life while her mother walked her dog, the animal companion that had made her anguish less lonely. No doctors appear to have been charged. The Colorado Hospital Association was in the process of piloting a no-opioid policy for the state. She died in June, 2017.

How any human being can read these stories and fail to take appropriate measures to keep it from happening again is gruesome, scandalous, repugnant, outrageous, obscene and nefarious. No longer can you claim ignorance of the harm and dangers this is causing. Lack of action at this point would be gross negligence and dereliction of duty. The purpose of having an agency to regulate medical treatment is there to safeguard patients not to commit negligent manslaughter. Instead the focus has been driven not only to the treatment of addicts but to treat anyone suffering from chronic pain AS addicts.

The ADA prohibits government agencies that receive any federal funding from discriminating against Americans with Disabilities. Chronic pain is a leading cause of disability in the United States. Denying proper and adequate medical treatment that effectively reduces pain to those of us that are disabled by chronic pain is a clear violation of law. Hiding behind a guideline produced by an agency with NO authority to regulate prescription drugs in the United States is not a valid excuse. A strong case could be made for malicious intent.

With the swipe of a pen almost all of the harm that was caused can be reversed. This will not bring back Allison and the others that have died due to the overzealous application of an invalid guideline, but their deaths do not have to be in vein. If it were to effect change the circumstances for the rest of us I believe their families would be happy knowing their loss has helped millions of others. I don’t wish to make any threats as I believe that the appropriate agencies will do what’s right for those of us suffering in MO, however if a remedy can not be reached by communication I will be forced to gather all my struggling brothers and sisters together to file an ADA claim against Steve Corsi, Psy.D as the director of the Department of Social Services, Randall Williams, MD as the director of the Department of Health, and Mark Stringer, as the director of the Department of Mental Health.

In addition you will find attachments of the press releases by the CDC and FDA that discourage forced tapering and stress that the guidelines have been wildly misinterpreted. You will also find the FDA’s refusal to accept the recommendations of PROP that later formed this grotesque unlawful guideline.

From: “Boeger, Michael” <Michael.Boeger@health.mo.gov>
> Date: November 12, 2019 at 8:33:12 AM CST
> To: “‘ff5863@yahoo.com'” <ff5863@yahoo.com>
> Subject: Your email about opioid milligrams and enforcement
>
> November 12, 2019
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> Dear Dr. Pezzani:
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> As a result of the opioid abuse epidemic, the CDC issued and published an educational guideline relating to the prescribing of controlled drugs.
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> Our department made it a specific point to let practitioners know that this was an educational guideline and that it was not a law that could be enforced. If doctors choose to prescribe more, this is not a direct violation of law or regulation. The guideline wanted to stress that doctors review their patient charts and look to see how much they are prescribing, then make their own decisions.
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> During the past several years, our bureau has not revoked or suspended any doctors merely for prescribing too many opiates.
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> Upon reviewing our records, the Board of Healing Arts and the Dental Board have not revoked or suspended anyone from over-prescribing.
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> Doctors are allowed to review their own practices and make their own decisions. The CDC guidelines are not being enforced upon them
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> as a law.
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> Our current studies we have seen online show that about 30% of the overdoses are from prescription drugs and 70% are from “street drugs.”
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> However, of the 70% addicted and abusing street drugs, the study showed that 80% of them started off with a prescription drug problem.
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> At this point, that only action taken is that the CDC has asked the doctors to review and make their own decisions.
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> Michael R. Boeger, Administrator
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> Missouri Bureau of Narcotics and Dangerous Drugs
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> P.O. Box 570
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> Jefferson City, MO 65102-0570
>
> Phone: (573) 751-6321 Fax: (573) 526-2569
>
> Website: www.health.mo.gov/BNDD

15 Responses

  1. U KNOW,,I AM REALIZING,,,THE TRUTH,THAT THEY ARE LITERALLY TORTURING US TO DEATH,,VIA FORCED PHYSICAL PAIN,,IS OBVIOUSLY A TRUTH NO-ONE WANTS TO HEAR/ACKNOWLEDGE,,THUS THIS WILL NEVER GET FIXED,,IF THE TRUTH IS NOT ACKNOWLDGE,,IN ORDER TO FIX THIS MESS,,,AS IN ALL WARS,,,AND WHEN SOOO MANY GOOD PEOPLE ARE DEAD,FROM THEE ACTS OF A POLICED POLICIES BY HUMANS,,IT IS A FORM OF WAR UPON THE GROUP OF PEOPLE EFFECTED BY THOSE POLICED POLICIES,,IE,,THE WAR ON DRUGS,”; IS COMBINED W/THE WAR ON OUR MEDICINE,OBVIOUSLY,,BUT TO MY POINT,,,,TRUTH IS ALWAYS UGLY WHEN IT COMES TO THEE ACTS THAT KILL FELLOW GOOD HUMAN BEING,,WHO’S ONLY CRIME ACCORDING TO SOME//IE KOLODNY/PROP/DEA/ETC KOOLIAD/PROP-AGANDA,,,,,,WE ARE PRE-EXISTING MEDICALLY ILL IN PHYSICAL PAIN,,,AND THE UGLY TRUTH IS,,,,THEY ARE TORTURING US TO DEATH,,LITERALLY,,,AND YES,AGREED’D,,THAT IS UGLY,,WHEN ITS THE MINDS OF SOME HUMANS THAT HAVE BEEN ALLOWED TO COMMIT THIS ACT,,IE KOLODNY CRONIES,,,JMO,,MARYW

  2. I REMEMBER SEEING THIS CRAP IN SC,,,THIS IS THE HUGE REASON ,”WHY”’ MENTAL IE ADDICTION SHOULD NEVER EVER
    BE FORCIBLE COMBINED W/A MEDICALLY ILL PERSON,,,EVER,,,,,,FOR THE TRULY MEDICALLY ILL WILL DIE,,,ALWAYS……..NEVER EVER ALLOW MENTAL TO BE FORCIBLE COMBINE W/MEDICAL,,,PSYCHAITRY WITH MEDICAL CONDITIONS,,,THEY HAVE NO CLUE HOW TO TREAT A MEDICALLY ILL PERSON,,,,BUT FALSELY LABELLING ,,IE A PERSONAL JUDGEMENT,,WITH A MENTAL ISSUE WILL KILL A MEDICALLY ,IE A PHYSICAL RERESENTATION OF DISEASE/CONDITION,,THUS NOT JUST A ,”JUDGEMENT,”WILL KILL A TRULY MEDICALLY ILL PERSON EVERYTIME,,,THUS NEVER COMBINE MENTAL W/MEDICAL,,,EVER,,,MARWY

  3. Can any state file with ada?? Patients?? In ohio after abandonment, forced tapers, forced suboxone that end in 911 call from clinic emergency room gave my husband pain meds back ..they forced husband same week into pain doctor with guidelines below cdc added trama parts of this week my husband dont even remember I told them that they were only dose targeted still but as family we stayed bold demanding our lives back!! 2 yrs after they used excuse of insurance company to change treatment plan without discussing anything with our family or patient!! I call director and she said they were wrong but many phone calls before they changed it back leaving family in trama fight or flight they kept trying to negotiate before they put it back!! Praise God holy spirit kept me firm saying no negotiations u violated his rights and to negotiate would put us back under oppression!! No!! Finally they put it back but still trying to force him back to pain management!! Ohio law protects legacy patients they tried to lie!! To my face I said that would be gaslighting and denying our trama!! This has gotten so bad they are literally trying to kill out of fear!! The fear won’t let them see I said first do no harm!! U are admitted this is causing trama yet still push forward what!!!!!! My God works righteousness and justice for ALL OPPRESSED!!! By faith his righteousness is established forever!! More law more sin!! GRACE GRACE GRACE IN JESUS NAME!!

    • you can contact the federal agency that over ADA enforcement, but they are under the same Presidential Cabinet seat as the DEA.. and I can’t count the number of pts that have told me that they tried an got “we don’t have the resources to pursue that”… and all pts have told me of getting the same “reason” from the ACLU… but that was some time ago… things may have changed

  4. Of course they missed the part where nearly all of those who became addicted from prescription opioids were not holding valid prescriptions for them but had stolen, had been given or bought the medications from another source who was not a prescribing doctor. That’s absolutely vital information, since it undermines their narrative that doctors are “drug dealers in white coats”. Not to mention the fact that it thoroughly invalidates the entirety of their alleged justifications for putting chronic or acute pain sufferers through all of this to begin with. I wish the sender had thought to include that data in their communications. Other than that, the writer is well spoken, concise and correct. Good for them!! May they see the intended response by resulting in triggering appropriate corrective actions and further protections for those in pain in MO. If they can gain ground there, it’s a good step in the right direction for other states. And if nothing else, it would no doubt turn MO into a pain patient safe haven. Whatever comes from it, any progress is progress indeed.

  5. About 3 years ago I felt I couldn’t breathe. I called my husband and he came home from work and took me to the local ER. They took a look at my chart and noticed the meds that I was on for my chronic pain among other issues. The two they narrowed in on for the gabapentin and the 5/325 mg hydrocodone. Within about 2 minutes they accuse me of faking that I couldn’t breathe to get narcotics. Who fakes having problems breathing and expects narcotics?? They sent me home. I struggle to breathe the rest of that night and into the early morning hours until 4:00 a.m. I just couldn’t handle it anymore and I wasn’t getting any better. My husband again took me into the ER and since the first time I went in and this next time there had been a shift change. My husband explained what went on before and how I’ve been struggling ever since. I think I was so relieved that somebody recognized that I truly was in distress, and I passed out. I woke up in a completely different hospital in a completely different City. Guess what? It was a freaking heart attack and a pulmonary embolism! The embolism caused the problematic breathing, the heart attack? I am attributing the heart attack to the stress of this ER.

    • Yes, it’s a potentially deadly game they’re playing by wrongly conflating emergency situations with drug seeking behavior. I nearly died once myself due to that type of situation. I was accused of ‘frequent flying’ even when I hadn’t stepped foot in that ER (or any other since there are only 2 bandaid stations for 70 miles) for years. The nurses treated me extremely poorly based on the assumption that I was there for drugs. I can only surmise that they came to this conclusion based on how I looked because as I said, I hadn’t been to any ER for several years, I was not on pain medication at that time and I certainly did not ask for pain medication, so I have no idea how else they would have come to that consensus, but they did. When the doctor finally came in, he ordered a blood draw. They brought in a 3rd nurse, who I’m assuming had already been filled in on the assumption. She looked to be about 7 months pregnant and I honestly believe they put her up to this because they didn’t think I’d hurt a pregnant woman for doing it. They were correct but the fact that they even thought to put her up to it to begin with was what stuck me. When she went to stick me, my vein collapsed. I can only imagine what they must have assumed that meant, when it reality it made sense when we got the final verdict. So she then proceeds to give me the most excruciatingly painful blood draw that I’ve ever had in my life. What should have taken under 5 minutes took 20 of her sawing the needle back and forth in my skin, without removing it to get a better position. If I honestly believe that she scraped bone with the needle. The whole time, she’s got this vague smirk and kept saying things like “Oh, it’s not that bad” and “I’m almost done, you’re fine”, which only affirmed what I believed, that they were doing this intentionally to deter me from coming back. The other nurses had already said in front of me that they bet they would see me again soon, amongst other unnecessarily vicious remarks. I nearly broke my husband’s fingers because they blood draw was so painful. The inexcusable behavior of the first 2 nurses started before I even told them that something was wrong, I was experiencing too much bleeding from a menstrual period. I guess that just cemented it in their minds, that I was looking for drugs. I tried to tell them that I was cold like I was going into shock (I’ve been in shock before), that I was having trouble breathing, my heart was beating irregularly and that I was having trouble staying awake. They didn’t want to hear any of it. However, I must say that I felt rather vindicated when the results came back from the blood test. You never saw 3 nurses scurry off faster than when the doctor came in and told me I was being admitted because my blood count was so low that if I had waited a couple more hours to come in, I would have died. I was admitted for blood transfusion. If the nurses had their way or had been able to convince the doctor that I was just looking for pain medication, no doubt I’d have died. This behavior should be viewed as intolerable and it really needs to stop before more people die over false assumptions. I don’t know how they confused the symptoms of someone bleeding to death with drug seeking, but somehow, they did.

    • I CAN TELL EVERYONE HORROR STORIES FROM MAYO CLINIC E.R.,,FOR 20 YEARS,,ONLY TO GET 16 CARDIAC ABLATIONS,JUN-NEEDE BTW, A COMPLETE THORCIC SPINE LAMECTOMY,MULTIPLE COLLASPED LEFT LUNGS,,AND EVERYTIME I WAS IN THE E.R,,,I WAS BASICALLY CALLED A WIMPY WOMEN,,WHEN NOT A SINGLE MALE DOCTOR DID A SIMPLE ULTRASOUND,,WHICH WAS FINALLY DONE 23 YEARS LATER FOR THE 1ST TIME EVER,,EVEN THEN ,THAT ULTRASOUND MISSED A GALLBLADDER COMPLETELY PACKED FULL OF STONES,COMPLETELY CALCIFIED,AND ALLL INTERNAL ORGANS,DAMAGED,,FROM UNDIAGNOSED PANCREATITS,AND A THORACIC SPINE THAT NEVER STOOD A CHANCE IN HELLL TO HEAL,5 YEARS OF DERMAL LEAK HEADACHES,AND MORE,,,,MY POINT IS,,NOW A DAYS,,,I TRUST NO-ONE WHO SEAKS TO DESTROY BOTH OUR BODIES AND OUR SOULS,,BY FORCING US TO ENDURE TREATABLE PHYSICAL PAIN FROM A MEDICAL ERROR/CONDITION,,,,JMO,,MARYW

  6. The solution is available through my ecourses and http://www.sevenpillarstotalhealth.com. People need to learn or soon live without opioids.

    • WOW,,,UNLESS I AM MIS-UNDERSTANDING,,U BOUGHT THE KOOL-AID DR.CHEEK????BUT THE FLIP SIDE,,IS ALLL OF US STILL DIEING OR LITERALLY BEING TORTURED TO DEATH FROM A TREATABLE CONDITION,,,TORTURE OF THE MEDICALLY ILL IS NOW ACCEPTABLE??MARYW

      • Mary, I think you know me and what I represent. Sorry, but I don’t understand what you mean by “U bought the kool-aid”. I know the real cause of addiction, and it isn’t the drugs. And it is only by learning the real cause that we can fight the propaganda. As more people buy into the propaganda, opioids will become history. That’s my prediction. And since people aren’t learning what it will take to offset it, we will soon see if my prediction is correct.

        • I WENT OVER TO YOUR SITE,THE ONE LISTED ON THIS POST,,SAW THE ACUPUINCTURE ETC,,,AS U KNOW,,MOST OF US HAVE ALREADY TRIED EVERY NON-MEDICAL WAYS TO END OUR PHYSICAL PAIN,,AND FOUND ONLY A EFFECTIVE DOSE OF MEDICINE WORKS,,,,THUS WHY I ASKED THE QUESTION,,,”BOUGHT THE KOOLIAID W/ A QUESTION MARK,,,MARYW

          • So you focused on one tree, missed the forest, and basically lose out on what you could learn. Acupuncture is simply listed on the website as a form of energy medicine, which it is. And energy medicine is where healing lies. But the most important energy medicine is homeopathy. And you don’t fix much with just using one technique. You need the 7 steps to healing. So go back to the website and study the 7 steps and you will see where the alternative methods that conventional medicine is now throwing at pain patients will not work for most people because they just use one approach when several approaches are necessary. And they miss the most important aspect because conventional medicine hasn’t recognized it yet, and that is toxicity. But thank you for visiting the website even if you reached the wrong conclusion. Come back more, and hopefully eventually the light bulb will go off.

            • I KNOW ALLLL ABOUT HOMEOPTHY,,MY HUSBAND BORN AND RAISED IN IT,,HAS NOT 1 VACCINE,,EVER,,,,I HAVE CABINET FULL OF ARNICA,,BUT TO ASSUME I DON’T,,REFERRING TO A LIGHT BULB,,YEA WELL,,SUCH IS THE CASE WITH ALLL CPP’S,,WE DON’T KNOW OUR OWN BODIES,,,WHEN THE TRUTH IS ,,,WERE IN THEM,,,WE KNOW THEM BETTER THEN ANYONE,,EVEN A DOCTOR,,,I GUESS ASKING A ??? IS A SIGN OF NOT HAVING KNOWLEDGE THEN???HAVE A NICE LIFE,,,MARYW

              • Thank you. Blessings to you as well, Mary. No need to be ugly. But that has become the American way. I just offer people the knowledge to heal if they so choose. But everyone has a choice. I’ve ended my comments here.

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