Pain management

Rethinking U.S. opioid policy

Rethinking U.S. opioid policy

Richard A. Lawhern, PhD

October 24, 2023Oct 24, 2023

I write widely as a subject matter expert on U.S. policy for the regulation of prescription opioid pain relievers and of clinicians who employ them in managing their patients' chronic pain. Because I am a patient advocate and the spouse…

I write widely as a subject matter expert on U.S. policy for the regulation of prescription opioid pain relievers and of clinicians who employ them in managing their patients’ chronic pain. Because I am a patient advocate and the spouse of a chronic pain patient, I hear from a lot of suffering people. In one form or another, many of their pleas amount to, “My doctor has deserted me, …

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Physicians behind bars: the consequences of medical misjustice

October 19, 2023Oct 19, 20232

In 1985, Mr. Charles McCrory was on trial. Charles had found his wife dead, and her family was convinced that he was responsible, despite the fact that Charles denied any involvement and just wanted to grieve in peace. There was no real evidence against him, but the state had an ace up its sleeve in the form of Dr. Richard Souviron.

Dr. Souviron was a forensic odontologist, which is a dentist …

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A breakthrough in chronic pain detection?

October 16, 2023Oct 16, 2023

Recently, a group of researchers at the University of California, San Francisco, reported that they may have found the holy grail of pain management. They accomplished this by performing "the first-in-human, long-term direct brain measurement of chronic pain-related neural activity."…

Recently, a group of researchers at the University of California, San Francisco, reported that they may have found the holy grail of pain management. They accomplished this by performing “the first-in-human, long-term direct brain measurement of chronic pain-related neural activity.”

Physicians have long sought a reliable way to detect and track the presence of chronic pain and its response to treatment but have failed completely so far. Old tropes like …

Balancing medical ethics in opioid treatment

October 9, 2023Oct 9, 20232

What is a legitimate medical reason to prescribe an opioid medication today? For pain or addiction? Who decides which patients are worthy of treatment? This question is not just of academic interest. Any prescribing medical provider today must constantly live in fear that a law enforcement agent somewhere will disagree with the prescriber’s answer to these questions. On its face, it seems simple. If a patient has severe pain, a …

Addressing dual diagnosis needs in addiction treatment

Susan Hertz Berrick, EdD

October 3, 2023Oct 3, 20232

An excerpt from Slow Dancing with the Devil: A Son's Substance Use Disorder, A Mother's Anguish. The only time my anxiety was gone, or at least on pause, was when Luke was in a treatment center or sobriety house. I…

An excerpt from Slow Dancing with the Devil: A Son’s Substance Use Disorder, A Mother’s Anguish.

The only time my anxiety was gone, or at least on pause, was when Luke was in a treatment center or sobriety house. I knew he was safe and surrounded by those who understood the game. Neurobiology is a part of addiction, and so is coming to grips with the fact that SUD is …

Vague criteria can lead to misdiagnosis and prison

September 24, 2023Sep 24, 20232

The definition of addiction, now called substance use disorder, has varied greatly over time. The first edition of the Diagnostic and Statistical Manual, from 1952, didn't include specific diagnostic criteria for this condition. Over the next sixty years, the DSM…

The definition of addiction, now called substance use disorder, has varied greatly over time. The first edition of the Diagnostic and Statistical Manual, from 1952, didn’t include specific diagnostic criteria for this condition. Over the next sixty years, the DSM went through six revisions, with a slow evolution of the terms “substance abuse” and “dependence.” The first was limited to substance use causing social and occupational problems, while the last …

Balancing pain management and legal realities [PODCAST]

September 13, 2023Sep 13, 2023

Join L. Joseph Parker, a research physician, as we dive into the intricate world of medical practice and legal challenges faced by health care professionals treating patients with pain and addiction. Joseph sheds light on the complexities of opioid prescriptions,…

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Balancing opioid medication in chronic pain

September 13, 2023Sep 13, 202313

She walked in with a cane, bent over like a question mark. She was in her seventies and as sweet as people in that age group tend to be. I think most of the cranky ones don't make it that…

She walked in with a cane, bent over like a question mark. She was in her seventies and as sweet as people in that age group tend to be. I think most of the cranky ones don’t make it that far. She was something of an emergency because her doctor had just passed away, and it was time to refill her medications. It would not be safe for her to …

Doctor convictions: Unmasking the 3 threats you need to know

September 10, 2023Sep 10, 2023

Why would anyone lie about you? And what makes you prone to conviction? There are three types of people that will absolutely bring your world crashing down on you, and you need to know who they are. But first, we…

Prosecutors go after doctors because they are easy targets. The formula developed by prosecutors has three steps: First, make …

Misunderstandings about opioid use disorder

Amy Baxter, MD

September 3, 2023Sep 3, 20232

At a recent scientific conference on narcotics, a researcher mused, "Honestly, opioids make me feel gross. I don't see how anyone could get addicted." This is a little like a doctor in the delivery end of a needle saying, "Honestly,…

At a recent scientific conference on narcotics, a researcher mused, “Honestly, opioids make me feel gross. I don’t see how anyone could get addicted.” This is a little like a doctor in the delivery end of a needle saying, “Honestly, you’re a wimp. This doesn’t hurt.” Both examples reveal a lack of empathy and a fundamental misunderstanding of current neuroscience.

The contributions or fear, reward, fight, and flight are a complicated …

Post-surgery opioid risks [PODCAST]

Post-surgery opioid risks [PODCAST]

August 27, 2023Aug 27, 2023

Join Amy Baxter, a clinical associate professor of emergency medicine, as we explore the intricate balance between physicians' roles in perpetuating the crisis, addressing systemic factors, and the influence of pharmaceutical industry-sponsored education. Discover the brain's response to pain and…

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Join Amy Baxter, a clinical associate professor of emergency medicine, as we explore the intricate balance between physicians’ roles in perpetuating the crisis, addressing systemic factors, and the influence of pharmaceutical industry-sponsored education. Discover the brain’s response to pain and opioids, contextual risk factors for opioid use disorder post-surgery, and the …

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Drugs and prescribing

The preference for insurance coverage of opioids over non-pharmaceutical options explained

Amy Baxter, MD

August 16, 2023Aug 16, 20232

Pain is the primary reason people seek medical care. Pain is also the problem that ignited the opioid crisis and continues to supply fuel. Eighty percent of opioid misuse begins with a pill prescribed for pain. Purdue invested heavily in marketing Oxycontin to physicians, training them that home opioids are the standard of care for recovery from surgery. While addiction debunked the myth of universal safety, two fallacies embedded in …

Reshaping opioid policies: a patient advocate’s call [PODCAST]

August 9, 2023Aug 9, 20237

Join patient advocate Richard A. Lawhern as he challenges prevailing myths surrounding the opioid crisis. With insights from medical literature, he questions the link between opioid prescribing and toxicity, highlighting the need for evidence-based public health policies. Learn about the…

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The persecution of pain management doctors

July 25, 2023Jul 25, 202332

The call came in during a busy workday. My comprehensive primary care clinic had been built over a decade of hard work and had a general practice clinic staffed by a very capable former surgeon and several nurse practitioners, as well as a pain management program and an addiction treatment clinic. We also had several counselors on staff. I immediately recognized the voice on the other end of the line …

How legal liabilities and skewed decision-making plague clinical encounters

Jay K. Joshi, MD

July 15, 2023Jul 15, 20232

The opioid crisis continues to ravage communities, and everyone, including politicians and federal agents, has a plan. However, no one has an actual solution. It's time to examine the crisis from a more detailed perspective: the clinical perceptions that form…

The opioid crisis continues to ravage communities, and everyone, including politicians and federal agents, has a plan. However, no one has an actual solution.

It’s time to examine the crisis from a more detailed perspective: the clinical perceptions that form during a clinical encounter between a physician and a patient. It is here that we see the true effects of opioid policy and understand why they are so ineffective.

At the end …

Ending the opioid crisis starts with physicians

Amy Baxter, MD

July 11, 2023Jul 11, 20235

A recently published opinion article by opioid advocates attempts to assuage physicians' prescribing guilt, arguing "doctors prescribing to their patients did not create the U.S. opioid crisis." As lawsuit after lawsuit concludes, Purdue Pharma, Johnson and Johnson, and blindered distributors…

A recently published opinion article by opioid advocates attempts to assuage physicians’ prescribing guilt, arguing “doctors prescribing to their patients did not create the U.S. opioid crisis.” As lawsuit after lawsuit concludes, Purdue Pharma, Johnson and Johnson, and blindered distributors and pharmacies share the blame for propping up pills for profit. Physicians may inflate home narcotic quantities for convenience, but with rare prosecutable exceptions, not monetary gain. But the …

Everything the government thinks it knows about the opioid crisis is wrong

Richard A. Lawhern, PhD

July 1, 2023Jul 1, 202316

"In July 2015, journalist Johann Hari gave a TED Talk that over 20 million people have since viewed. Hari offered convincing evidence that vulnerability to opioid addiction is a consequence of the conditions under which people live — the social…

“In July 2015, journalist Johann Hari gave a TED Talk that over 20 million people have since viewed. Hari offered convincing evidence that vulnerability to opioid addiction is a consequence of the conditions under which people live — the social determinants of health — rather than simple exposure to opioid pain relievers. This theme is brilliantly elaborated by economist Anne Case and Nobel Prize winner Angus Deaton …

A physician’s journey through propaganda and misinformation [PODCAST]

June 20, 2023Jun 20, 2023

Join us for a fascinating podcast episode as we explore the dangerous consequences of propaganda and misinformation within the context of the opioid epidemic. Our guest, Jay K. Joshi, a family physician and author of Burden of Pain: A Physician's…

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