Anonymous ID: d2f958 March 30, 2019, 4:20 p.m. No.5983751   🗄️.is 🔗kun   >>3787 >>3864 >>4250 >>4270 >>4283

CDC Guidelines & Psychiatrist A. J. Kolodny ARE AS FAKE AS FAKE NEWS! BUT TRUMP DOES NOTHING TO CORRECT IT

 

Ignorant Government bureaucrats continue to refuse to correct their own errors, biases, complete fabrications and lies. The 2016 CDC guidelines on opioid prescription in chronic pain — and misdirected doctor persecutions carried out by the Drug Enforcement Agency — are responsible for driving a significant number of Physicians out of Family Medicine and Pain Management practice and denying pain relief to people in agony ( The CDC does not collect suicide data specific to the denial of pain treatment or intentional suicides) Several case reports show that deserted patients have committed suicide because of provider abandonment, unrelenting pain, rapid opioid tapers, or a combination of all three.

 

Government bureaucrats have been informed repeatedly of their errors in public media. But they are passively refusing to do anything to correct them.

 

Multiple published studies and over 1.6 million patients maintained on doses over 200 MMED, reported by the Department of Health and Human Services in their 2017 Drug Outcomes Surveillance Report disprove the CDC & CDC's Guidelines's claim that RX opioid pain relievers don’t work for long term management of severe pain. The CDC & CDC Guidelines also claim that safe and effective non-pharmaceutical alternatives for pain management exist and are preferable to opioids.

 

Details of a major outcomes study of the US Agency for Healthcare Research and Quality conclusiely disproves this obsurd claim, even while asserting that unproven non-opioid therapies should be tried as substitutes for proven opioid analgesics!

 

Was the Opioid Crisis Created by Over Prescription?

 

Published data of the CDC itself disprove this assertion.  When State by State rates of doctor prescriptions for opioid pain relievers are compared to rates of opioid overdose related mortality, we find no relationship at all.  Any contribution by medically managed opioids is so small that it gets lost in the noise of illegal street drugs that include opioids from licit and illicit sources, with or without other sedative hypnotics including alcohol.

 

If prescription opioids were substantially contributing to opioid-related deaths, then we should see higher mortality rates in groups which use more prescriptions.  But this doesn’t happen, as seen in Analysis of US Opoid Mortality and ER Visit Data [CDC Wonder and AHRQ HCUP-US Databases.  Opioid-related deaths among youth and young adults have skyrocketed since 2001, largely because of illicit fentanyl. But opioid deaths from all sources among people over 50 have been stable. 

 

Seniors are prescribed opioids about 250% more often than teens. Thus, the group that benefited most from liberalized prescribing policies of the early 2000’s has shown no increased mortality due to opioid drugs from all sources as seen in the link immediately above.

 

Also compelling is a direct quote from Dr Nora Volkow, Director of the National Institutes on Drug Abuse:

 

“Unlike tolerance and physical dependence, addiction is not a predictable result of opioid prescribing. Addiction occurs in only a small percentage of persons who are exposed to opioids — even among those with pre-existing vulnerabilities… Older medical texts and several versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) either overemphasized the role of tolerance and physical dependence in the definition of addiction or equated these processes (DSM-III and DSM-IV). However, more recent studies have shown that the molecular mechanisms underlying addiction are distinct from those responsible for tolerance and physical dependence, in that they evolve much more slowly, last much longer, and disrupt multiple brain processes.”

 

Do Opioids Work Long Term for Chronic Pain?

 

Writers of the 2016 CDC guidelines “stacked the deck” against opioid therapy by unfairly rejecting any opioid trials conducted for less than a year, but including much shorter trials for non-opioid medications and behavioral therapy.  They got caught at this fraud by their medical peers.

Part 1 of 2

Anonymous ID: d2f958 March 30, 2019, 4:23 p.m. No.5983787   🗄️.is 🔗kun   >>4250 >>4270 >>4283

>>5983751

CDC Guidelines & Quack Psychiatrist A. J. Kolodny are as FAKE as FAKE NEWS, yet TRUMP refuses to do anything to CORRECT it!

 

Was the Opioid Crisis Created by Over Prescription?

 

Published data of the CDC itself disprove this assertion.  When State by State rates of doctor prescriptions for opioid pain relievers are compared to rates of opioid overdose related mortality, we find no relationship at all.  Any contribution by medically managed opioids is so small that it gets lost in the noise of illegal street drugs that include opioids from licit and illicit sources, with or without other sedative hypnotics including alcohol.

 

If prescription opioids were substantially contributing to opioid-related deaths, then we should see higher mortality rates in groups which use more prescriptions.  But this doesn’t happen, as seen in Analysis of US Opoid Mortality and ER Visit Data [CDC Wonder and AHRQ HCUP-US Databases.  Opioid-related deaths among youth and young adults have skyrocketed since 2001, largely because of illicit fentanyl. But opioid deaths from all sources among people over 50 have been stable.  Seniors are prescribed opioids about 250% more often than teens. Thus, the group that benefitted most from liberalized prescribing policies of the early 2000’s has shown no increased mortality due to opioid drugs from all sources as seen in the link immediately above.

Also compelling is a direct quote from Dr Nora Volkow, Director of the National Institutes on Drug Abuse:

 

“Unlike tolerance and physical dependence, addiction is not a predictable result of opioid prescribing. Addiction occurs in only a small percentage of persons who are exposed to opioids — even among those with pre-existing vulnerabilities… Older medical texts and several versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) either overemphasized the role of tolerance and physical dependence in the definition of addiction or equated these processes (DSM-III and DSM-IV). However, more recent studies have shown that the molecular mechanisms underlying addiction are distinct from those responsible for tolerance and physical dependence, in that they evolve much more slowly, last much longer, and disrupt multiple brain processes.”

 

Do Opioids Work Long Term for Chronic Pain?

 

Writers of the 2016 CDC guidelines “stacked the deck” against opioid therapy by unfairly rejecting any opioid trials conducted for less than a year, but including much shorter trials for non-opioid medications and behavioral therapy.  They got caught at this fraud by their medical peers.

 

Are Safe and Reliable Substitutes for Opioids Available?

 

While it is appropriate for doctors to try non-opioid medications first before proceeding to opioid therapy, anti-inflammatory drugs have their own problems and side effects mostly related to gastrointestinal bleed, kidney dysfunction, and cardiac risk. Additionally, there are inherent toxicities and contraindication to all medications, including but not limited to various anticonvulsants, noradrenergic reuptake inhibitors such as certain antidepressants, anticonvulsants, skeletal muscle relaxants, and others.

 

In June 2018, the US Agency for Healthcare Research and Quality published a systematic outcomes review for non-invasive, non-pharmacological therapies in chronic pain.  Among 4996 published trial reports for six categories of chronic pain, only 218 survived rigorous quality review.  Quality of medical evidence was “weak” in more than 150. .  However, AHRQ flinched from admitting the basic problem of the “alternatives” literature:  none of the alternatives has undergone large scale Phase II or Phase III trials.  Though most appear safe, we don’t know yet if they work any better than placebo.

Part 2 of 2