Pain Management

The silent crisis hurting pain patients and their doctors

Physician

April 17, 2025

The actions taken by the Medical Board against a compassionate physician dedicated to alleviating chronic pain are nothing short of egregious, deeply flawed, and emblematic of a system that seems intent on punishing rather than protecting. This esteemed doctor, who has spent years serving patients in dire need with integrity and professionalism, now finds himself ensnared by a process that appears more vindictive than just, more biased than fair.

How the CDC’s opioid rules created a crisis for chronic pain patients

Charles LeBaron, MD

Conditions

April 15, 2025

Adapted from Greed to Do Good: The Untold Story of CDC’s Disastrous War on Opioids.

The 2016 CDC opioid guideline seemed to make obvious sense: Americans were consuming far too many prescribed opioids. Many users of illicit opioids reported that prescribed opioids had been their gateway to illicit usage, even addiction. And users of illegal opioids, whether addicts or not, were dying of overdoses—more and more each year. The prescription …

Cutting opioid use in half: a hospital’s pain management breakthrough

Myles Gart, MD

Physician

March 23, 2025

I’ve witnessed what’s possible when we rethink pain management. By implementing a multimodal assessment approach at my hospital, I achieved a 50 percent reduction in inpatient opioid use, measured in morphine milligram equivalents (MMEs). The Numeric Pain Scale (NPS)—that 0-10 score we’ve leaned on too much—drives overuse when it’s the only guide, and with the U.S. consuming 80 percent of the world’s opioids as just 4.4 percent of its population, …

When state legislators are given the opportunity, they vote overwhelmingly for doctor autonomy in pain treatment

Richard A. Lawhern, PhD

Policy

March 20, 2025

As I have written elsewhere, the United States is now embroiled in a highly contentious debate concerning the causes of the so-called “opioid crisis.” Prescribing guidelines updated in 2022 by the Centers for Disease Control and Prevention (CDC) and Veterans Administration (VA) have become the basis for continuing scientifically unsupported restrictions on patient access to long-term prescription opioid therapy. Doctors …

The criminal enforcement of HIPAA

Muhamad Aly Rifai, MD

Physician

January 29, 2025

Congress passed the Health Information Portability and Accountability Act (HIPAA) in 1996. This federal regulation was aimed at maintaining the privacy of medical records while ensuring the smooth flow of medical information pertinent to patient care. Penalties assessed for violations of the HIPAA Act mostly involve financial penalties (between $25,000 per violation up to $100,000 per violation). Congress also included criminal penalties for violations of HIPAA rules enacted under 42 …

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The criminal enforcement of HIPAA

How a systems approach can revolutionize pain and depression treatment

Richard A. Lawhern, PhD

Conditions

January 19, 2025

As a health care writer and patient advocate for over 27 years, I have interacted with thousands of patients who experience chronic severe pain, caregivers who support struggling family members, and clinicians who treat painful conditions. Depression and anxiety are very common in these patients and may significantly complicate treatment. Untreated depression – or under-treated pain – can cause increases in healing times, suicidal ideation, and Read more…

How a systems approach can revolutionize pain and depression treatment

Why the opioid crisis and youth mental health demand urgent parity reforms in 2025

Mitchell Berger, MPH

Policy

January 16, 2025

At the beginning of 2024, the nation continued to experience the impact of three declared public health emergencies with significant behavioral health implications: COVID-19, Mpox, and the opioid crisis. At the same time, three major national associations continued to highlight what they first described in 2021 as a “youth mental health crisis.” As we enter 2025, emergency declarations for two of these — Mpox and COVID-19 — have …

This perspective will change how physicians address pain and recovery

Amelia L. Bueche, DO

Conditions

January 11, 2025

I implore all physicians to watch the film Tipping the Pain Scale. Invited by a friend to view from the perspective of recovery, I accepted in support and out of curiosity for the proposed approach to the treatment of pain. As an osteopathic neuromusculoskeletal medicine physician, this is the chief complaint of many patients seeking care, often addressed with hands-on treatment considering structure and function and the unity of body, …

From liquid handcuffs to miracle molecule: MOTAA would expand methadone access and help fight the overdose epidemic

Michelle Breda, MD and Marco Barber Grossi, MD

Conditions

January 6, 2025

Kayla was referred to our addiction clinic after a visit to the emergency department for a skin infection, common in people who use drugs intravenously. Recognizing her fentanyl use was escalating out of her control, she made an appointment to discuss starting buprenorphine, a mainstay of treatment for opioid use disorder (OUD). While our initial office visit with Kayla was straightforward and optimistic, during subsequent visits she continued to experience …

Acupuncture helped when nothing else did

Christine Hucko

Conditions

December 20, 2024

The waiting area in Kayla’s (name changed) practice was so peaceful that I felt better just sitting there. I had come to receive acupuncture treatments and didn’t quite know what to expect. While I sat and waited for Kayla to lead me back to a treatment room, I looked around. There were flowers on an end table next to a blue wooden bench. On the wall, there was a huge …

How objective pain management can save lives and prevent addiction

Myles Gart, MD

Conditions

December 17, 2024

The management of pain in clinical practice often involves navigating the critical tension between compassionate care and ensuring patient safety. While subjective self-reports of pain are essential for understanding a patient’s experience, relying solely on these assessments may risk overtreatment, leading to adverse outcomes. Incorporating objective measures can enhance safety and maintain clinical integrity without compromising compassion.

The role of objective measures in pain management

1. Promoting patient safety

Preventing overmedication: Objective …
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How objective pain management can save lives and prevent addiction

The U.S. Food and Drug Administration is talking when they should be listening

Richard A. Lawhern, PhD

Physician

December 6, 2024

On May 9-10, 2017, the U.S. Food and Drug Administration (FDA) held a workshop titled “Training health care providers on pain management and safe use of opioid analgesics — exploring the path forward.” I attended the workshop in person to offer comments on behalf of chronic pain patients. A summary of my observations at the time was published by the now-defunct Pain News Network. The following extended extract is from …

Restoring compassionate pain care: a call to action

Arianne Grand-Gassaway

Conditions

November 14, 2024

As a patient advocate, I have witnessed firsthand the devastating effects of policies leading to untreated and undertreated pain. As a mother who has lost a child to drug poisoning, I have also witnessed how drug policy is driving an increasingly lethal street drug supply. With overdose deaths rising, well-intentioned policies have left many suffering without the medications they need for quality of life. Tragically, some patients, overwhelmed by unrelenting …

The real cause of the opioid crisis isn’t what you think

Richard A. Lawhern, PhD

Conditions

November 13, 2024

For years, the U.S. public has been hearing that prescription opioid pain relievers are always and forever a bad thing—and that doctors and big pharma companies are supposedly responsible for an epidemic of addiction and drug overdose-related deaths. However, these assertions are outright lies. Both the U.S. Centers for Disease Control and Prevention and the Veterans Administration know it.

The recent national opioid settlement is as bogus as a three-dollar bill—and …

How alternative therapies could be the key to ending the pain care crisis [PODCAST]

The Podcast by KevinMD

Podcast

November 11, 2024

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

We dive into the pain care crisis in the United States with Cindy Perlin, a social worker and chronic pain expert. We explore the epidemic of chronic pain, the limitations of conventional treatments, …

The shocking truth behind the DEA’s role in America’s pain crisis and doctor prosecutions

L. Joseph Parker, MD

Physician

November 3, 2024

The United States federal government is a single entity, despite its three equal branches having more heads than a hydra and more arms than Mahakali. One part of that federal government is not supposed to create and propagate standards that another part arrests you for following, as confirmed by the U.S. Supreme Court in Gonzales v. Oregon. When it comes to the criminalization of medicine by the DEA and other …

Why physicians need to become more educated about alternative pain treatments

Cindy Perlin, LCSW

Conditions

November 1, 2024

All indications are that pain care in the United States is in crisis. There is an epidemic of prescription opioid-fueled opioid addiction and overdoses (over a million dead and millions more addicted) as well as an epidemic of chronic pain. Estimates of the prevalence of pain indicate that from 21 percent (2021 National Health Interview Survey) to 56 percent (2021 Harris Poll) of Americans have chronic pain, and about 7 …

How the DEA’s use of predictive algorithms is worsening crises in urban communities and raising suicide rates among African Americans

L. Joseph Parker, MD & Neil Anand, MD

Physician

October 28, 2024

The true definition of criminal behavior has always been problematic. Are we criminals because we break the law or because we have been convicted? Famous and revered people throughout history have clearly broken the law but are almost never defined as criminals. All the founding fathers of the United States self-admittedly committed treason against the crown, a capital offense. In contrast, others, like Stalin and Hitler, had every legal right …

Why good doctors are being jailed—and what it means for you

L. Joseph Parker, MD

Physician

October 27, 2024

Today, in America, if you are suffering from certain medical conditions, physicians are being taught that you cannot be trusted or even treated. This results from a decade of law enforcement targeting physicians, pharmacists, and nurse practitioners for making medical judgment calls the police don’t agree with when it comes to the treatment of certain conditions. I use the term “police” here to include federal agencies, knowing that, while policing …

The choice between integrity and power in a world of chaos

L. Joseph Parker, MD

Physician

September 27, 2024

The world is benefited by a variety of human beings. Almost everyone can contribute greatly to our societies, no matter what their personal drives. Even the selfish and hate-filled can give us people like Henry Ford, the antisemitic supporter of Hitler who had union organizers beaten, but also doubled the standard wage for his workers and gave us the assembly line, standardized production, and vertical integration. His closest parallel today …

Pain Management

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