Updated "About Me"

If anyone is interested, I've updated the "About Me" section


-----Updated Text-----
I apologize for not updating this part of my site for a while, but I've been fighting with the incompetent, ignorant, rude imbeciles who run CYS (Children & Youth Services) for over six months concerning my wife's and my need for prescription opioids. I've been told that they've never gone after people as hard as they've been going after us, that includes heroin addicts and crack whores. They routinely lie on court paperwork, leak confidential records, commit perjury, and they're constantly change their story & accusations. We've had to prove that we are ill enough to require opioids, but not too ill that we can't care for our daughter. Thankfully, our family doctor has not abandoned us. He knows how much these medications help us and he knows that our daughter is well taken care of. Thankfully, my state has never had a law allowing children to be taken from disabled parents and there are federal laws (i.e. Americans with Disabilities Act) that protect us, slightly. Unfortunately, we still have to prove that our medical conditions don't prevent us from caring for our daughter. Aside from our doctor, we have our almost useless lawyer who can't schedule a meeting, and a great subcontracted (not a CYS employee) parent educator who isn't afraid to tell the truth, even if it isn't popular and even if it contradicts her conclusions. We've also been complying with their ridiculous WEEKLY urine drug testing (costs taxpayers $100/test per person). I really wish that they'd switch to saliva testing, or better yet hair testing, which covers the last 3 months (more, if you're willing to pay for it) instead of the 2-3 days that UDT (urine drug testing) covers. I did the math once and found out that you could buy a VERY nice car with the money that they've spent harrassing us and violating our rights. Privacy is a thing of the past.

OT - FDA Approves New Opioid Addiction Treatment

FDA Approves New Opioid Addiction Treatment - National Pain Report
http://bit.ly/1oQMbPd

This isn't a new drug, just a new formulation of buprenorphine, but it's worth noting anyway.

Some of you may be wondering why I'm paying about an addiction treatment and it's a valid question. As pain patients, we are constantly grouped with addicts and we need to stay informed. Also, some PMs have prescribed Suboxone for pain, which is stupid because buprenorphine only treats pain with doses below 0.3mg/300mcg per day (Butrans is the only buprenorphine product capable of treating pain). The reason why doses above 2mg don't work for pain is that buprenorphine is a partial mu-opioid agonist (it acts like naloxone/Narcan and naltrexone at high doses and blocks opioids).

If we don't know the names of these addiction treatments, PMs can lie to to us.

SUBOXONE, BUNAVAIL, BUPRENEX, SUBUTEX, ZUBSOLV, AND ALL GENERIC BUPRENORPHINE PRODUCTS ARE FOR ADDICTION TREATMENT ONLY, DO NOT TAKE THEM FOR PAIN. Buprenorphine pills aren't for pain, only buprenorphine patches treat pain.

Steve

My Story: The Dark Side of the Anti-Opioid Campaign - National Pain Report

My Story: The Dark Side of the Anti-Opioid Campaign - National Pain Report
http://bit.ly/1unVrhi

This article, and the comments, really say it all. The anti-opioid propagandists are doing nothing to fight drug addiction, but their restrictions are destroying HUNDREDS OF MILLIONS of lives. Even the lucky few who have prescriptions are afraid to sneeze wrong or risk being cold turkeyed.

Acetaminophen, Opioids, and Safety

Acetaminophen, Opioids, and Safety- Medscape
http://bit.ly/SpUhUq

It sickens me that hydrocodone/APAP 5/500 is still available. No one should have to cost between talking enough hydrocodone & not damaging their liver with acetaminophen/paracetamol/Tylenol (APAP). 500mg APAP gas not been shown to be superior to the safer 325mg APAP. Of course, they never added the acetaminophen for pain relief, it us there to prevent people from taking more hydrocodone that prescribed (doesn't work), which is why hydrocodone is CII, but hydrocodone/APAP is CIII (less restrictive).

Opinion: Bill Would (Have) Force(d) Drug Makers to Make Painkillers Tamper Resistant

Bill Would Force Drug Makers to Make Painkillers Tamper Resistant- National Pain Report
http://bit.ly/1kYSnVB

I know that this story is about two years old, but there is talk of reviving this bill in light of the Zohydro (non-tamper-resistant hydrocodone ER).

There are several problems with tamper-resistant opioids:
1) tamper-resistant opioids don't always work as well (or at all)- they're tested on healthy people who have an easier time absorbing them (the healthy people have to absorb them within a 30% tolerance)
2) they don't stop people from abusing them, but it does weaken the "high", which causes them to go to diacetylmorphine/diamorphine/heroin
3) they increase pharmacy prices, which makes it harder for pain patients to afford their medications
3b) increased pharmacy prices lead to increased street prices, which causes addicts (& sometimes even pain patients) to switch to heroin
3c) street heroin has unknown potency, unknown impurities, & poor oral absorption causing people to resort to intravenous injections

The ONLY way to reduce the harm caused by drug addiction is to switch from the law enforcement model to a treatment based model and to LEGALIZE ALL DRUGS (private prisons and the DEA would lose money, so they spend a small fortune fighting this). Legalization (& the drop in prices that this would cause) would eliminate the violence, crime, and disease (people inject heroin because it HA poor oral absorption & injecting is cheaper- same high from less drug; legal drugs also lack the dangerous impurities found in street heroin).

Rat Park

Rat Park Comic

Please check out the comic version of the Rat Park experiment, which shows that opioids are not the addictive demons that we've been told that they are.

http://bit.ly/ratpark

Be sure to check out the "Links/Articles" page on there right for more great resources, such as the Intractable Pain Patients' Handbook for Survival.

Steve
IntractablePainKills@gmail.com

Xartemis XR

I recently saw an advertisement for Xartemis XR. The new opioid is overpriced, completely unnecessary, and dangerous. Xartemis XR is essentially OxyContin with acetaminophen (INN: paracetamol), aka Tylenol, added. Tylenol alone kills or hospitalizes more people than all legal opioids combined. The US government has a campaign against the unnecessary use of acetaminophen because of the hepatotoxicity of acetaminophen, even when used within guidelines.

Daily intake of acetaminophen (APAP) should not exceed 2600-3000mg (THREE GRAMS) per day and it should NEVER be taken on a regular basis because even normal doses of acetaminophen can be toxic after two weeks.

Tylenol is added to Percocet & Vicodin for ONE REASON, as an abuse deterrent. Unfortunately, that doesn't work, people just get acetaminophen poisoning.


Extended release opioids are primarily intended for long term use by chronic pain patients, so who is this stupid product intended for?


Xartemis XR (oxycodone/APAP extended release) is a SCAM to extort more money from insurance companies and cash in on the current climate of opiophobic hysteria. If your doctor tries to prescribe this for you, ask them why they are giving you an expensive name brand drug that is inferior to the generic alternatives and push for something better.

Why are patients shut out of the debate over prescription pain medicine? - The Washington Post

Why are patients shut out of the debate over prescription pain medicine?- The Washington Post
http://wapo.st/1j9NRo1

This article really says it all, well maybe not everything, but they hit the major points. Please read it in its entirety

Poppy seed ingestion as a contributing factor to opiate-positive urinalysis results

Poppy seed ingestion as a contributing factor to opiate-positive urinalysis results- PubMed
http://1.usa.gov/1ohUKpd

The DoD utilized higher cutoffs than NIH and most employers, which minimizes false positives, but some foods actually trigger the DoD cutoff for GC/MS urinalysis and many trigger the common cutoff of 300ng/ml of morphine or codeine. We, as a country, place far too much faith in these tests and RUIN people's lives over tests that aren't nearly as accurate as most people believe.

DoD cutoff- morphine 4000ng/ml
DoD cutoff- codeine 2000ng/ml
Standard cutoff- morphine & codeine 300ng/ml

Remember, most testing behind with an immunoassay and then confirmatory GC/MS testing is done, which most people treat as infallible, which it clearly isn't.

Opiophobia & Insurance

It has come to my attention that more and more insurance companies are refusing to cover pain management, opioids, longterm opioids, and/or procedures. Or, no PMs in network and within a reasonable distance.

I've heard of this occurring with Medicaid (parts of Florida), HeritageCare (parts of Florida), and private insurance (some BlueCross BlueShield plans) and I find this very worrisome.

I would appreciate it if anyone who knows about specific cases of this would common below and/or email me (please specify whether or not I may publish the information you email me). Please include:
* the type of discrimination (higher copay, unrealistic quantity limits, prior authorization on generics, duration limits, PMs not covered or not in network, PMs who practice opioids not in network, etcetera)
* the company name
* the type of plan (Medicare Part D, Medicare Advantage, Medicaid, Medicaid HMO, private insurance HMO, private insurance PPO, private POS, private FFS, ACA exchange, Tricare, VA, etcetera)
* state
* description.

If anyone knows about any petitions focused on this issue, please add them as comments and/or email them to me.

We cannot allow this practice to continue or, even worse, spread.

Steve
IntractablePainKills@gmail.com

Rat Park

Rat Park Comic

Please check out the comic version of the Rat Park experiment, which shows that opioids are not the addictive demons that we've been told that they are.

http://bit.ly/ratpark

Steve
IntractablePainKills@gmail.com

High-dose opioids could crack chronic pain

High-dose opiates could crack chronic pain: Nature News & Comment
http://bit.ly/1iWsaaL

Note: The author of this article titled it incorrectly, opiates only refers to natural opioids, like morphine and codeine. Opioid refers to:*natural opiates: morphine & codeine
*semi-synthetic opioids: hydrocodone, oxycodone, oxymorphone, hydromorphone, and diacetylmorphine/diamorphine/Heroin (although it is not legal in the USA, it is a commonly used opiate in the UK & other countries)
*synthetic opioids: fentanyl, sufentanil, meperidine/pethidine/Demerol

Living with Pain: The DEA’s War on Pain Patients Reaches California | American News Report

Living with Pain: The DEA’s War on Pain Patients Reaches California | American News Report

http://bit.ly/1f3IJuy

"The DEA is using a meat cleaver when a scalpel would do. To simply cut off pharmacies without first determining the nature of the customers being served suggests something more sinister."

Marijuana Works Better Than Opiates To Control Pain: Here’s How

Marijuana Works Better Than Opiates To Control Pain: Here’s How- Cannabis Now Magazine
http://bit.ly/1iZJQkP

Instead of rewriting my opinion, again, I've included my comments... They may not be pretty or perfectly formatted, but they get my points across.

~~~~~ Comment #1 ~~~~~

Why is it always cannabis OR opioids?

They work wonders together and cannabis doesn't help everyone.

We don't need more bashing of opioids in the name of advancing cannabis. All opioid side effects wear off over time (except constipation, which is readily managed with Miralax OTC),it's a function of tolerance.

Also, (a side note) while THC is helpful, it is important to remember that THC alone is almost worthless for pain relief (otherwise, my Marinol/dronabinol (CIII) would help). High THC is fine, as long as CBD isn't sacrificed. Also, oral consumption causes rapid, extensive first pass metabolism, which modifies the THC (one of the issues with Marinol/dronabinol when taken as directed).

I think that the most important thing to remember is that CP/IP (chronic/intractable pain) patients are NOT one size fits all.
~~~~~

~~~~~ Comment #2 ~~~~~

Sativex (natural cannabis with plenty of THC & CBD as a transmucosal oral spray-similar to a cannabis tincture) will be a great leap forward for pain patients and other medical cannabis users alike. Aside from being legal and covered by insurance, it will be easily measured.
~~~~~

~~~~~ Comment #3 ~~~~~

That 6% statistic is a gross overestimate, which also includes those who purposefully acquired opioids to abuse them (pill mill patients) and pain patients who were cut off from their legitimate prescriptions by pharmacies like Walgreens & states like Florida.

If you look only at the CP/IP patients who take their medications as prescribed, addiction only occurs in 0.05-0.3% of patients.
~~~~~

~~~~~ Facebook Comment ~~~~~

Why is it always cannabis OR opioids?

They work wonders together and cannabis doesn't help everyone.

We don't need more bashing of opioids in the name of advancing cannabis. All opioid side effects wear off over time (except constipation, which is readily managed with Miralax OTC),it's a function of tolerance.

Also, (a side note) while THC is helpful, it is important to remember that THC alone is almost worthless for pain relief (otherwise, my Marinol/dronabinol (CIII) would help). High THC is fine, as long as CBD isn't sacrificed. Also, oral consumption causes rapid, extensive first pass metabolism, which modifies the THC (one of the issues with Marinol/dronabinol when taken as directed).

I think that the most important thing to remember is that CP/IP (chronic/intractable pain) patients are NOT one size fits all.
~~~~~

Fear Of Addiction Means Chronic Pain Goes Untreated | Health News Florida [Transcript]

Fear Of Addiction Means Chronic Pain Goes Untreated | Health News Florida [Transcript]
http://bit.ly/1iJH9Vs

Judge Overturns Massachusetts Ban on Zohydro - National Pain Report

Judge Overturns Massachusetts Ban on Zohydro - National Pain Report

Apparently, I missed this while sick with an eight day stomach bug, but in case you've missed it Zohydro AND compounded hydrocodone are both available in Massachusetts. The judge set a powerful precedent, and I'd personally thank her for using her brain and not giving in to opiophobic propaganda and paranoia.

Over-the-Counter Pain Relievers Linked to Heart Problems - National Pain Report

Over-the-Counter Pain Relievers Linked to Heart Problems - National Pain Report
http://bit.ly/1ezpZcn

Drug Maker Seeks to Block Ban on Zohydro - National Pain Report

Drug Maker Seeks to Block Ban on Zohydro - National Pain Report
http://bit.ly/1ivz8zc

I know that Zogenix will get a lot of crap from the anti-opioid lobby (aka rehab business) for this, but I'm glad that they're protecting Massachusetts CP/IP patients and challenging this drastic overreach.

Steve

Naloxone Part 2

To clarify... The government is advocating it's use in pain patients who are BELIEVED to be in overdose. The problem is that most people can't tell an overdose from fatigue or the flu. Intractable pain patients on opioids are usually opioid tolerant and naloxone/Narcan/Evzio causes abrupt withdrawal. In a patient who actually needs opioids (intractable pain patient, not drug addict), this abrupt withdrawal can trigger a heart attack.

This is unnecessary because...
If pain patient (or addict) overdoses, the symptom is respiratory depression, which can be overcome with oxygen, BiPAP, and/or CPR. This product is intended to reverse believed overdose while waiting for an ambulance, but CPR has been fine for years.

Naloxone/Narcan/Evzio reverses the opioids, which is fine for an opioid-naive patient, but this device is only for opioid tolerance patients.

With so many family members not understanding us and many being called druggies, would you really want them wielding an opioid blocker? I can easily see easy access to naloxone leading to pain patients (& addicts) being forcefully injected with naloxone against their will to "prove" to them that they're an addict (those people never understand the different being addiction and tolerance & physical dependence).

This product should only be prescribed directly to the addict or pain patient, not "concerned family members" WITH THEIR PERMISSION. It should be treated like Antabuse (giving to someone without permission is forbidden and legally considered poisoning, and carries a black box warning).

Steve

FDA: Naloxone Injector Not Just for Drug Abusers - National Pain Report

FDA: Naloxone Injector Not Just for Drug Abusers - National Pain Report

http://bit.ly/1kEtGLQ

This is SCARY! This device would be scary enough, but to advocate its use on pain patients is somewhere between malpractice & medical terrorism. Instead of reposting my thoughts here, I've included the comments that say it all.

Even if unconscious, it is illegal to administer naloxone unless you are a doctor or an EMT being actively advised by a physician. I doubt that these laypeople will bother along for consent. Without significantly training (like the REMS programs for Accutane & Xyrem), this is scary.

Why was this rushed through approval?

~~~~~
Kurt says:
April 4, 2014 at 7:14 pm
I guess I need a new Medic Alert tab for my necklace in case I faint the next time I am in Safeways shopping for dinner, and succumb to shock over the high prices they’re charging these days for a pound of hamburger.

I am a chronic pain patient maintained on opiates.

DO NOT INJECT WITH NALOXONE. I am opiate tolerant and not likely to overdose on opiates. Naloxone could put me into immediate opiate withdrawal causing a health crisis.

Lord keep us safe from do-gooders.

~~~~~~~~~~~~~~~
Steve says:
April 7, 2014 at 6:36 pm

Exactly, Kurt! Thank you!...

[trimmed]

...I’m considering a permanent tattoo claiming allergy to naloxone. I already have a DNR refusing naloxone, but where I live DNRs are ignored in the prehospital setting (ambulance, etcetera), which is why I’m thinking about the allergy tattoo, I’d love your thoughts.

~~~~~~~~~~~~~~~
Steve says:

April 7, 2014 at 6:29 pm
Naloxone only reverses opioids, but the vast majority of overdose deaths are not opioid only, they usually involve alcohol and/or benzodiazepines (Valium/diazepam, Xanax/alprazolam, Ativan/lorazepam, etcetera)

This is deeply rooted in opiophobia.

Also, of they really wanted to help people, it would be OTC or OTC worth log book (like pseudoephedrine/Sudafed), but then they wouldn’t benefit from Rx insurance reimbursement. This should be “Pharmacy Only Medicine”, like Imitrex in the UK, where you don’t need a doctor’s prescription, just counseling with the pharmacist (slightly more restricted than Sudafed because training should be required).

This product is used to COMPLETELY reverse opioids, which is fine for an opioid-naive overdose, but would kill an opioid tolerant IP patients like myself. Without dose control, it could kill. Without dose control, I’d imagine most Heroin addicts will refuse a dose because every documentary that I’ve seen involves a human going around with naloxone and they always have trouble convincing these people to take the naloxone. They frequently convince them to take half of a dose.

Pain patients rarely overdose. Family members who can’t mind their own business and don’t know ANYTHING about opioids will abuse this and/or abuse their pain patient family members.

This is all about money, generic naloxone is ~$0.50/dose

Steve