To Paul Fanlund, Editor and Executive Publisher, Capital Times of Madison.
I’m writing you to follow up on a letter you published from Joseph Othler Jr, on “Prescription Opioid Epidemic is Fake”. This is to offer you an opportunity to further publish an editorial or investigative reporting series that is badly needed by chronic pain patients and potentially ground-breaking for The Cap Times. You can become a force for constructive change and relief to millions of people. I implore you to engage on this issue. There’s a Pulitzer lurking in these murky waters, Paul.
I write as a non-physician subject matter expert on prescription opioid practice and the CDC’s March 2016 prescription guidelines. I have 20 years experience in peer to peer social media, patient support venues and technical analysis of medical research, with publications in multiple online venues. I daily reach an audience of over 20,000 chronic pain patients, family members, and medical professionals on Facebook. I can refer you to multiple medical professionals and informed pain patients who will independently verify or add to anything I offer you in interview or from my published work.
As a beginning on a process, I offer three references among several archived at “The Lawhern Files.” These were also documented during my short presentation before the May 9-10 2017 FDA Workshop on Educating Physicians in the Safe Prescription of Opioid Analgesics. Both the references and the comment threads by medical professionals are worthy of your consideration. I wrote the first two for the Journal of Medicine of the National College of Physicians, and gave a presentation at the Washington Rally Against Pain in October 2016 which drew heavily on the third.
The CDC’s Fictitious Opioid Epidemic, Part 1 (January 15, 2017)
The CDC’s Fictitious Opioid Epidemic, Part 2 (April 15, 2017)
This article is re-published from its original appearance on the National Pain Report under the title “How Would Prescription Opioid Guidelines Read if Patients Wrote Them?” It has also been introduced in the April 11th online issue of PAINWeek, with the title “What if Prescribing Guidelines Were Patient Centered?”
This is the introduction offered by PAINWeek:
What if Prescribing Guidelines Were Patient Centered?
Rethinking Public Policy for Better Patient Outcomes and Expanding CDC Guidelines
An article posted earlier this week in the National Pain Report offers a comprehensive but succinct perspective on what public policy on opioid prescribing might look like if written from the point of view of pain patients themselves. Richard Lawhern, PhD, a nonphysician researcher and advocate for patients with chronic pain has compiled a “summary of principles” for the practice of pain management encompassing not only the role of opioids, but many other aspects of patient centered care as well. Members of the PAINWeek community will recognize many of Dr. Lawhern’s observations from the diverse topics explored each year in the PAINWeek Conference curriculum. As Lawhern asserts, “There should be no distinction in principle between the objectives of treating pain which is acute, chronic, or associated with advanced medical conditions assessed to be terminal. The objectives in all three cases are to alleviate suffering, promote patient functioning, and improve quality of life.”
“It is now clear that CDC Guidelines must soon be withdrawn for a major rewrite,” Lawhern contends. “Especially important in any rewriting process must be the inclusion of stakeholder voices that were largely unheard in the first writing of the Guidelines.” With respect to public policy on opioid prescribing, the context of the public health crisis of addiction and overdose death is ever present. But, Lawhern notes, the most reliable risk factors associated with addiction include adolescent status, history of family trauma, and long term unemployment, and “None of these factors is addressed by restriction of opioids prescribed to patients in pain.” Going beyond opioid therapy, Lawhern also suggests a context for nonopioid and nonpharmacologic modalities, and points to the need for rescheduling of marijuana to address the dearth of medical research on efficacy for pain.
Also useful and deeply referenced is “Neat, Plausible, and Generally Wrong: A Response to the CDC Recommendations for Chronic Opioid Use” by Stephen A. Martin, MD, EdM; Ruth A. Potee, MD, DABAM; and Andrew Lazris, MD
I am available to talk by phone at your convenience. Feel free to do a google profile on me before we talk. I’m easily found on the Net.
Richard A. “Red” Lawhern, Ph.D.