One of the primary basics of the practice of medicine – starting, changing or stopping a pt’s therapy.

The DEA started creating production quotas of control meds  abt 2015 and ended up overall reducing the availability of control meds by > 50% over the following years.

How many pts have a valid medical necessity for many of those controlled meds that were no longer in the distribution system? Isn’t that changing or stopping some pt’s therapy?

In 2016 the CDC – outside of its normal focus on contagious diseases and vaccines – decided to establish their Opioid dosing guidelines. Their committee published guidelines that ignored the pharmacogenomic (PGx) testing that can justify higher doses and more frequent doses based on their liver enzymes. The adopted the (MME) Morphine Milligram Equivalent system that has no double blind clinical studies without a control group and just picked a arbitrary number of a max of 90 MME/day for any all diseases, post surgery, pain resulting from any accident.

The CDC has no ability to create any law or regulation, nor any authority to enforce anything that they create, because all they produced was GUIDELINES.

Shortly after those guidelines were releases, the DEA and Veteran Admin adopted those as the new standard of care and best practices and some 35+/- states used the guidelines to create statutory limits of opioid doses for all painful health issues.

Imagine what kind of a uproar we would have if the same bureaucrats that have created the opioid guidelines, did the same thing for diabetic type -1 , insulin dependent- if they came up with that all type 1-diabetic could only have 10 units on a particular insulin/day. Never mind some would die, at least they wouldn’t get addicted to “shooting up every day”.

Then we moved on to the fact that the DOJ/DEA could no longer find any “dead bodies” to attached to some practitioners to take them to court and accuse of being the reason that a person over dosed no matter the time frame between the first opioid Rx provided nor the time since the last Rx opioid provided by the practitioner nor the number of opioid Rxs were provided – even just one. 

The DEA/DOJ moved on to any practitioner prescribing Rxs of opioids >90 MME to any pt and/or prescribing concurrently to the same pt a Rx for a benzodiazepine and a muscle relaxant.   It was determined that violated the Control Substance Act which the DEA determined that those 3 meds concurrently prescribed to a pt was technically illegal.

Then as the 1999 Tobacco settlement was coming to the end, 45 state AGs decided to sue the three major 3 drug wholesalers – that control abt 85% of the drug wholesale market place. It did not even go to trial, the 3 drug wholesalers mediated an agreement where the three wholesalers, while admitting no wrong doing in concerns of contributing to the opioid crisis, but agreed to collectively paid 21 billion dollars over 18 yrs.  Also, they agreed to sell fewer control meds to community pharmacies. Disregarding if any patients that have a valid medical necessity and prescription for the controlled medicine.   The wholesalers even created rations for each pharmacy and the pharmacy could not find out what their ration for each Rx controlled med/strength.

No consideration if a lack of inventory would throw a chronic pain into cold turkey  withdrawal and uncontrolled pain  for days, weeks or a couple of months or a person that is trying to get sober or stay in sobriety and it would all fall apart. 

Then there is this law from 1935, 35 years before the CSA was signed into law

42 USC 1395: Prohibition against any Federal interference

https://uscode.house.gov/view.xhtml?req=(title:42%20section:1395%20edition:prelim)

Per perplexity.ai:  Does this suggested that this is a planned covert genocide? A sort of thinning of the herd?

There is well-documented evidence of a significant increase in suicides, premature deaths, and reduced life expectancy among chronic pain patients and people dealing with addictions.

Suicides in Chronic Pain and Addiction

• Chronic pain patients have about twice the risk of suicide compared to those without chronic pain.

• Meta-analyses report lifetime suicidal ideation rates near 29% and suicide attempt rates near 11% among chronic pain sufferers.

• More than 8% of U.S. suicide decedents had a history of chronic pain—a major risk factor for suicide, independently from mental health disorders.

• Catastrophizing about pain, mental defeat, and lack of coping skills all contribute to heightened suicide risk.

• Patients abandoned to untreated pain or rapid opioid withdrawal have a nearly 300% increased risk of overdose death and markedly higher suicide risk.

Premature Deaths in Chronic Pain and Addiction

• People with opioid addiction (many with chronic pain) are over ten times more likely to die within a four-year period compared to those without substance abuse problems.

• Among opioid-related deaths, over 60% had a chronic pain diagnosis in the year before death.

• Opioid-related deaths represent up to 12% of deaths among 25-34 year-olds in the U.S..

• Chronic pain directly contributes to both fatal and nonfatal overdoses and sudden unexpected deaths, including cardiac arrest in severe cases.

Reduction in Life Expectancy

• Both opioid addiction and long-term painkiller use are linked to reduced overall life expectancy and welfare.

• Opioid overdose deaths, often seen in addiction and chronic pain populations, surged 292% between 2001 and 2016 in the United States, reflecting dramatic impacts on life expectancy at the population level.

• Chronic pain is strongly associated with decreased healthspan and lifespan due to behavioral health comorbidities (e.g., anxiety, depression, opioid misuse) and unmet mental health needs.

Conclusion

Chronic pain and addiction are closely linked to increased suicide risk, frequent premature deaths, and measurable reduction in life expectancy, backed by large-scale studies and systematic reviews. These findings underscore the urgent need for integrated pain management and addiction treatment programs to address both physical and psychological risks for this vulnerable population.

Filed under: General Problems