FDA to consider disapproving opioids for chronic pain

This article is part of an ongoing investigative journalism piece drawing from a number of different sources, including studies, recent meetings of organizations involved with pain management and policy, etc. There is no one source for this article. Also, there is no "stupid journalist" who wrote it. There are two journalists in the byline. Regarding the comments asking what we're going to prescribe for cancer patients, the article states:

"In an email, Nelson said he also supported the idea of a label change that would block the prescribing of opioids for chronic, non-cancer pain."

No offense to anyone in particular, but I don't think many people actually read the article before getting angry, scared that their opiates are going to be taken away, over generalizing the content of the article, and finally logging in to vent about what are arguably tangential topics. This is my first time ever reading internet comments ... is this usually how things go?
 
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psood0nym said:
This article is part of an ongoing investigative journalism piece drawing from a number of different sources, including studies, recent meetings of organizations involved with pain management and policy, etc. There is no one source for this article. Also, there is no "stupid journalist" who wrote it. There are two journalists in the byline. Regarding the comments asking what we're going to prescribe for cancer patients, the article states:

"In an email, Nelson said he also supported the idea of a label change that would block the prescribing of opioids for chronic, non-cancer pain."

No offense to anyone in particular, but I don't think many people actually read the article before getting angry, over generalizing the content, and going off on it.
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Oh no... I read it and it is fucking offensive! I have someone I care about a lot who was almost killed by a drunk driver when she was 18. She has told me sometimes that she wished no one had saved her... Why you ask? Because her stupid doctors and the people who whip them into submission refuse to prescribe ANY opiate/opioid painkiller for her to take at her own will. I can't even list all the problems she dealt with in the accident but some of them are several broken vertebrae, broken legs and arms in several places, severe internal lacerations and minor (loosely) head trauma. After she was done being bed ridden and injected with ketamine and fentanyl (Another doctor once freaked out that they were using fentanyl for pain maintenance between surgeries... no kidding) every few hours for months they sent her off to be semi bed ridden at home with a bottle of hydromorph and lots of fent patches. Once she was cut off she was in constant pain just sitting or laying down for more than a few hours... she could not walk a block.
Months later people started selling hydromorph 30's (beads) which she would crush and snort. I understood this but immediately showed her how to do CWE on codeine pills etc.
Thankfully she got in with what I thought was a good doctor that was willing to give her 30 5mg percocets per months (4 days worth of pain relief) Of course she took the prescription and it would help, but, she started finding sources for oxycontin and more hydromorph and when sickness coupled with her existing problems and cash shortage made it too much I personally had to start buying her pills on ration (I spent more than $3000) and trying to convince her family to find a pain specialist (they are dumb hicks who dont understand medicine at all)
Her 'good' doctor decided during a checkup and upon seeing her tracks that he was no longer prescribing her oxycodone... made the call that day and she was never given another percocet.
She got a large settlement which she partially spent on opiates (yeah, that story!) while doctors were not willing to prescribe for her. Since we are in Canada, this is extra sad because this girl has had to blow part of her life savings on pills and is now having to pay for cab rides to and from the local methadone clinic where she pays $6 per day for pain relief while standing in line with a bunch of diseased fucking pussies who shoot up everyday because their parents worked too much and they are ssaaadddd :(
It is like telling someone who is quitting smoking to try cigars for the cravings.... FUCKING MADNESS! Methadone for pain management is one of the biggest crocks of shit I have ever heard and it is degrading. WHY do pain patients have to take piss tests while being watched? Why is methadone so fucking expensive?
 
The Network said:
I don't even know what to say to things like this. People are going to start going to things that aren't controlled like kratom which I'm sure anyone on here would agree is far more dangerous for idiots than a prescription that clearly says "Take 1 tablet by mouth every 6 hours, do not exceed 4 in any 24-hour period."

There are always going to be people who abuse prescription drugs. No matter what. And it's always going to be going up with immigration and overpopulation. Nothing they do is going to change anything.
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Are you seriously saying kratom is more dangerous than opiates? 8) Its not dangerous at all, unlike real opiates its pretty much impossible to fatally od on. Maybe you should go read up about kratom some instead of automatically assuming its dangerous.
 
slayerhatesusall said:
Are you seriously saying kratom is more dangerous than opiates? 8) Its not dangerous at all, unlike real opiates its pretty much impossible to fatally od on. Maybe you should go read up about kratom some instead of automatically assuming its dangerous.
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Why don't you follow your own advice?

Seizure and coma following Kratom (Mitragynina speciosa Korth) exposure.
Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa)
FATAL 4x100; HOME-MADE KRATOM JUICE COCKTAIL

madhatter4 said:
Sure make these drugs illegal for pain... maybe people will turn to medical marijuana and or help the marijuana legalization movement
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un-huh. Cannabis is going to replace opioids for treatment of severe pain. What else is cannabis going to replace? Fuck, from reading the ramblings of potheads, I gather it will replace chemotherapeutic drugs, anti-virals, neuroleptics, basically anything that is at all a drug, can be substituted for with cannabis! The cure to everything is really just one single plant!
 
rangrz said:
Why don't you follow your own advice?

Seizure and coma following Kratom (Mitragynina speciosa Korth) exposure.
Intrahepatic cholestasis following abuse of powdered kratom (Mitragyna speciosa)
FATAL 4x100; HOME-MADE KRATOM JUICE COCKTAIL
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One of those was deadly because he had a ton of substances in his system not just the kratom by itself:
"These following substances were found in the blood and urine samples: mitragynine (an alkaloid found in Kratom; Mitragyna speciosa leaves), caffeine, diphenhydramine, alprazolam, nortriptyline, methadone, tramadol, methamphetamine and some of their metabolites."
And the other 2 could have just been random occurrences or due to allergies or spiked kratom or due to a combination of drugs. The guy with jaundice could have been a heavy drinker for instance. So yeah it is still way safer then opiates, you really didn't prove anything with those links. Not that I think opioids should be disapproved for pain or anything, thats just plain evil.
 
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You made the claim "Its not dangerous at all" I provided some, albeit tentative, evidence that it may have some harmful effects.

Now you have revised your theory to "Its still way safer then opioids" which is a more reasonable position.

Of course, it might be that you are comparing apples and oranges. Is kratom a plug in replacement for typical opioids, or is a different sort of analgesic?
 
rangrz said:
You made the claim "Its not dangerous at all" I provided some, albeit tentative, evidence that it may have some harmful effects.

Now you have revised your theory to "Its still way safer then opioids" which is a more reasonable position.

Of course, it might be that you are comparing apples and oranges. Is kratom a plug in replacement for typical opioids, or is a different sort of analgesic?
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I suppose I should have worded it differently. I wouldn't call it a replacement for opioids since it isn't as strong as a painkiller so for someone in severe pain kratom probably wouldn't work as good.
 
rangrz said:
un-huh. Cannabis is going to replace opioids for treatment of severe pain. What else is cannabis going to replace? Fuck, from reading the ramblings of potheads, I gather it will replace chemotherapeutic drugs, anti-virals, neuroleptics, basically anything that is at all a drug, can be substituted for with cannabis! The cure to everything is really just one single plant!
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Ok you beat me to it. I smoke Cannabis to help my pain but alone it does not do the job nearly enough to say the least. It does help me keep my morphine dose abit lower then if i didn't smoke it and it does help along some anti-emetics like metoclopramide but if i had to get by on Cannabis alone i would die. On another note it does help my bipolar disorder as well as insomnia quite abit. Smoking a joint or whatever is also convenient when i can't take a pill due to the fact that I'm puking my guts up :\

I swear maybe weed does affect some people brains in a negative way because i get so sick of the weed cures everything crowd that it's not even funny :!
 
paranoid android said:
Ok you beat me to it. I smoke Cannabis to help my pain but alone it does not do the job nearly enough to say the least. It does help me keep my morphine dose abit lower then if i didn't smoke it and it does help along some anti-emetics like metoclopramide but if i had to get by on Cannabis alone i would die. On another note it does help my bipolar disorder as well as insomnia quite abit. Smoking a joint or whatever is also convenient when i can't take a pill due to the fact that I'm puking my guts up :\

I swear maybe weed does affect some people brains in a negative way because i get so sick of the weed cures everything crowd that it's not even funny :!
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Agreed. I forgot which documentary I was watching that discussed this but basically it included a woman who said she could halve the dosages of her anti anxiety and pain meds. It can certainly supplement other meds I'll go ahead and kick the dead dog by saying that it cannot stand alone when it comes to the severe pain that comes with cancer, not to mention everything else that goes wrong with the body. Cannabis is great, its use should be encouraged but as a supplement, not as the end all, be all.
 
^ i thought cannabis was used by cancer patients to reduce nausea and increase appetite?
i too am dubious of cannabis' effectiveness as a painkiller, but i didn't think that was always the justification for its medical use?
 
I wish they'd look heavily into NMDA antagonists for pain. I know that when I take >150 mg of DXM my back and shoulder pain simply vanishes
 
The safety and effectiveness of such drugs for chronic pain is unproven, the investigation found
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Well... set up some studies and test it, then! There must be groups with a vested interest in the continued dispensation of opiates for chronic pain, who have deep enough pockets to fund and run a study like this. Plenty of willing volunteers too -- as Cane2TheLeft has pointed out true chronic pain patients will try anything.

I don't feel like pulling up PubMed on my day off but I have a very hard time believing that no methodologically sound studies (nay, Cochrane Report type meta-analyses) have ever been done on the effectiveness of opioids on chronic pain. Chronic pain is a pretty forefront issue in medicine today, since its sufferers command an inordinate amount of healthcare practitioners' time, material resources, and emotional energy, and (understandably) tend to be very vocal, even litigious, in their quest to be pain-free.

Something is not adding up here.

For what it's worth, I do not think opiates/opioids will, or should, ultimately comprise the centerpiece of chronic pain management. They're best viewed as a stopgap measure until something better comes along, both at the individual and systemic levels. But to say that these drug have no role in chronic pain management is just foolhardy and inhumane.
 
legalize marijuana. more people can depend on that to get through medical ailments. Leave the opiates for those in severe pain. Howver, if someone is truly suffering i feel it is unfair to deny them any type of medication that could possible relieve their pain. Politics need to put the people first.
 
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