Undertreatment of Pain: A National Disgrace
These are the words of Professor Ronald T Libby, in a commentary on pain that appeared in "The Pain Community" a monthly news letter published by The American Pain foundation this month, and he is exactly right.He reaffirmed what I have been saying, that most experts agree that right now there are approximately 76 million people struggling with Chronic Pain. Even though I have focused on the spine mostly, there are a host of other diseases and injuries like cancer, diabetes, rheumatoid arthritis, fibromyalgia, migraines, Hiv/Aids and other trauma from injuries. Even our veterans returning with all types of traumatic injuries are faced with not getting treatment for their injuries and that is a damn shame and a disgrace. If patriotic soldiers who have sacrificed themselves for the defense of their country do not receive adequate pain treatment for combat related injuries, what chance does the rest of the population have of getting pain relieving treatment. The reason for the failure to provide life giving pain relief to patients is the pervasive fear of prescribing opioids, narcotics. The societal enforcer of opioid-phobia is the DEA,(Drug enforcement agency). I really don't blame them entirely and this is why. Much of the problem lies with the powerful committees and sub-committees in Washington, D.C., playing to the cameras for their own selfish gain. Have you ever watched a cabinet member or a department head testifying before them on C-Span. The want more results on the drug trafficking trade so they go after the Doctors who are trying to help people like me and millions of others. Hey you political bastards, we are not Drug addicts. We are people suffering to the point of taking our own lives just to get away from the pain. This medication was approved by the FDA for the purpose of helping people like myself and Richard Paey live.
The biggest problem of all is the disinformation or misinformation by the damn News Media. They will talk about some pro-athelete overdosing on steriods for a month, or some celebrity getting picked up on a drug charge, but they will not devote one minute of time to some of the Chronic Pain Advocacy groups appearing on T.V. to tell the truth about the Chronic Pain undertreatment disgrace going on in this country at this very moment and it affects millions.
10 comments:
Thank you so much, Jerry, for taking the time and energy to sit at your computer and try to educate the population to our plight. I think you are very brave and I know how much it can hurt to sit at the computer long enough to research, teach and give opinions. I really apreciate that you care that much.
KUDOS TO YOU JERRY! YOU ARE THE BEST! WOULD YOU MIND A COMMENT THAT CONTAINS SOME INFORMATION AND I CAN BE "LOG WINDED" THE LAW DEGREE DID THAT BUT I AM DISABLED NOW BEEN RESEARCHING THESE ISSUES FOR OVER 5 YEARS AND SOME OF YOUR WORDS WERE VIRTUALLY IDENTICAL TO THINGS I HAD PUBLISHED IN MAGAZINES, NEWSLETTERS, AND PAPERS AND HAVE BEEN ASKED TO WRITE IN NATIONAL PAPERS BUT I WOULD LOVE TO SPEAK WITH YOU...SO LET ME KNOW IF I CAN POST SOME LONG STUFF ON YOUR BLOG AS A COMMENT AND MORE ABOUT YOUR STUFF AS WELL AS I WANT TO FINISH ALL OF IT AND I AM MORE THAN HALF WAY DONE!
KEEP UP THE GOOD WORK!
DEB
Hi Deb,
I received your comment about putting information in my blog. It seems that it would be better if you put what you wanted to say in an e-mail or MS-word send it to me, then I will copy and paste it into my blog as a post. I will put your name or blog giving you credit for the post.
Thanks for the comment
Jerry
Bravo and thankyou, the issue of pain management in modern medicine is nothing less than a sacred cause effecting folk from every demographic in our society. Your advocacy and effort helps sensitize and inform, filling a vacuum that physicians by and large would like to avoid. And why not? Those of the profession who have stepped up to the plate have ample cause of fearing sanction from professional societies and government agencies alike. So really, it's up to those of us who are independent and free of such potential duress to carry the banner, to educate, inform and advocate. I myself suffer from a degenerative neural disease, and as a consequence have been for many years forced to languish in the quiet agony and isolation that typifies the plight of the afflicted. Sorry to say.
The anguish caused by social stigmatization coupled with the grave harm resulting from the pain itself constitute a deadly and humiliating one-two punch; truly the matter could not be more urgent.
N
cont'd:
Few folk realize, most especially and ironically those of the medical profession itself, that chronic pain and its accompanying stress, constitute the basis for the animal model of the debilitating condition known as depression. Moreover, it has been amply demonstrated on the basis of research on the animal model that under-treated pain poses problems to the afflicted far more hazardous to health than depicted by this psychiatric aspect of the puzzle. Pain induces a cascade effect, whereby stress hormones flood the tissues of the body, resulting in massive oxidative stress injuries of all the organs of the body, accelerating aging, depressing the immune system, and eliciting as a final endgame a condition known as "central sensitization" and "multi-organ failure". A fact that should be well known to all physicians languishes, much as those of us afflicted, in the obscurity of medical specialties that are themselves placed far away from the hospitals, clinics and private lives of patients. One such area of specialization is called "psychoneuroendocrinology", the other, it's mirror twin, goes by the name of "psychoneuroimmunology". In both instances, these areas whose orthodoxies count most, remain far away, out of reach of those most in need. They are the disciplines
that would let the world know that pain is not just "in the mind", a mere subjective experience, but rather in the real world, central to the considerations of outcomes, a matter of life and death, and a disease all unto its own.
cont'd
"Central sensitization" and its close diagnostic sister, "multi organ failure" are known to be the most common cause of death in the intensive care units of every hospital across the industrialized world, and yet few physicians pay any heed to the matter. And no wonder, the topic of pain is barely touched upon by the curriculum of contemporary medical education. It's a taboo. Not even in the domain of neurology is the matter dealt with at all. This prioritization is programmatic; it is intentional; and above all, it should be regarded as nothing less than criminal.
A great mystery lurks behind the cursory observation of such matters; and while the vast majority of those of us in need, together with our oft over burdened caregivers struggle relentlessly in the quagmire of advocacy in search of immediate relief, the deeper and more abstract dimensions of the issue tend to get neglected. We forget that the medical profession itself did not emerge free of bias and nefarious influence. As the very name of the discipline suggests--"medicine"--it is an enterprise whose birth can be traced to entities, lineages and institutions whose cultural stamp has been indelibly etched. The heinous patterns of official misconduct so readily observed represent the cultural and philosophical dispositions of those who gave birth to this thing called "the clinic". Recall the name of the family, the "Medicis", the kingpins of the Medieval banking cartels, pillars of organized crime to this day, quite literally the bastions and purveyors of the cultural milieu that Stanley Kubrick depicted in his final work. I'm talking here about the matter of "Eyes Wide Shut". Behind the masks, outside the bounds of rituals rooted in antiquity, the modern day manifestation of the Medici prevails among those of the academy and ivory towers of today. Let there be no doubt, there is the underlying issue of transgenerational satanism that must be noted. And as the ill timed and suspicious death of Kubrick himself serves to illustrate, the influence of this presumed long-dead cult of horror prevails to this very day. Hidden though it may be, behind the twin veils of proceduralism and puritanical demogoguery, it never the less reigns supreme. A cult whose influence underpins the orthodoxies of neglect that those of us afflict must work hard to fight, must be reckoned with; must be understood.
cont'd
It is the experience of chronic pain and the apparent negligence of the contemporary clinician who under-treats it that should serve to unmask the reality that would otherwise be denied or ignored.
As we come to terms with this issue of denial, of "Eyes Wide Shut" if you will, we awaken to this reality. That the modern day medical world is but a cut-out that facilitates a continuity of governance rooted in a deeper antiquity. As the analytical gaze passes from veneer to reality, we pass through the imagery of the bloodthirsty corruption of the Medici, the family from whom modern medicine derives its name,
and then stumble upon the hideous edifice of an entity more ancient and even more deadly--the Club of Rome, and the Jesuit Order of the Magesterium. It is the Club of Rome whose infamous reportage dictated the outcomes of accelerated death that we confront today. In the name of health care, we are made to suffer an endgame designed to facilitate a deeper strategic vision, that of depopulation--mass murder and genocide by any other name.
there is therefore, a great and insidious enemy afoot. Make no mistake. Be it by way of endowments funded under the names of Rockefeller, or Carnegie, the Pew Memorial Trust, the Rand Corporation, and the American Enterprise Institute, the structure of awareness and intent is the same. So please take heed, and be well. The fight and struggle that calls us to engage this terrible battle in the service of this great cause is by no measure or means a superficial one. The matter of pain strikes to the heart of the existential difficulties that drive the very engine of history itself. Make no mistake.
So again, many thanks for carrying the banner and calling attention to the plight of those in need.
The effort is much appreciated.
sincerely,
Noel
Thank you so much for increasing the awareness of the national (and worldwide, according to the World Health Organization)disgrace of chronic pain's undertreatment. So many still don't understand that "PAIN medicine was made for PAIN PATIENTS" and we deserve to have the access to them! Thank you so much for standing in the gap for so many (including me). God bless you!
I am a disabled veteran that has back pain due to bad parachute landings in the Army. I beleive the VA has stigmitized me as an addict just because I keep complaining about my pain. I found items im my med records that were false and twisted because they are biased towards addiction. I do not smoke or drink and do not take elegal drugs. I have never been convicted of drug or alchohol laws. They have given me many drug test all with negative results. They are treating me with percocet which only gives me 3 to 4 hours of relief then I have to wait untill 6 hrs is up to take the next dose. I have not slept a full 8 hour night for as long as I can remember. I get what work I can get done while the pain med give some relief. I am unemployed and have to get things done myself. My pain is getting worse but I believe they attribute this to wanting more due to addiction. I am also getting depressed but don't dare tell them that so they can say he depressed , therefore prone to addiction. This is a living nightmare.
This is just not right!
I am angry at the VA Health system.
The only thing that keeps me going is that I believe the world is due for a major shake-up. It is happening now. We cannot continue with greed and lack of compassion much longer.
Sorry to be negative. I was never negative untill now.
God bless everyone in the same situation as I am. Hang in there something is going to change soon.
I have a rare congenital muscoskeletal disorder (about 1 in 100,000) and have had intermittent severe pain since my mid-30s. About 1-1/2 years ago, at 56, my pain became chronic and I began a demoralizing search for adequate pain management. Luckily, I had had two complete workups for my congenital condition since 1997 (MRI, EMG, Doppler blood flow). I finally stopped begging generalists to help me, instead going back to the Bone and Joint Clinic of the major teaching hospital which has provided most of my care for the past 17 years. A P.A. there examined me, prescribed some hydrocodone acetominaphin, ordered a CT myelogram, and referred me to the medical center's Center for Pain Control. The clinicians there are trying a variety of approaches, including Botox injections in spastic muscles, antispasmodic medication, and opioid treatment. I realize opioid medication can be abused -- I know a young alcoholic/addict who's been buying opioids from offshore pharmacies for years and has pretty much destroyed himself -- but Iit is cruel and senseless to withhold pain relief from people with severe chronic pain. I was amazed that even my long-term family physician was far more concerned with limiting my medication than with relieving my pain. Thank God for the Pain Clinic, which does not shy away from treating people in pain.
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