Chronic Pain in the Aftermath of Opioid Backlash??

[drusso]

Does anyone think that these statements are justified?

Chronic pain remains cruel challenge to treat

Chronic Pain in the Aftermath of the Opioid Backlash

"Imperfect treatments do not justify therapeutic nihilism. A broad menu of partially effective treatment options maximizes the chances of achieving at least partial amelioration of chronic pain."

"Drs. Kroenke and Cheville recommended more research into pain-relief methods, including non-drug solutions, and fewer references to an “opioid epidemic,” saying the term disproportionately focuses on reducing opioid use. They wrote, “only a small fraction of patients prescribed opioids progress to long-term use.” Those who find their pain under control and are using the drugs appropriately “should not be unilaterally compelled to wean off opioids,” they said."

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[lobelsteve]

Yes.

 

[Ducttape]

Does anyone think that these statements are justified?

Chronic pain remains cruel challenge to treat

Chronic Pain in the Aftermath of the Opioid Backlash

"Imperfect treatments do not justify therapeutic nihilism. A broad menu of partially effective treatment options maximizes the chances of achieving at least partial amelioration of chronic pain."

"Drs. Kroenke and Cheville recommended more research into pain-relief methods, including non-drug solutions, and fewer references to an “opioid epidemic,” saying the term disproportionately focuses on reducing opioid use. They wrote, “only a small fraction of patients prescribed opioids progress to long-term use.” Those who find their pain under control and are using the drugs appropriately “should not be unilaterally compelled to wean off opioids,” they said."

Depends on the risk benefit assessments of those treatments. IMO risk of high dose opioids over 90 MED are extremely hard - almost impossible - to justify for chronic non cancer pain.



and I disagree with the assessment that only a small fraction progress to long term opioid use.


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[DrCommonSense]

Does anyone think that these statements are justified?

Chronic pain remains cruel challenge to treat

Chronic Pain in the Aftermath of the Opioid Backlash

"Imperfect treatments do not justify therapeutic nihilism. A broad menu of partially effective treatment options maximizes the chances of achieving at least partial amelioration of chronic pain."

"Drs. Kroenke and Cheville recommended more research into pain-relief methods, including non-drug solutions, and fewer references to an “opioid epidemic,” saying the term disproportionately focuses on reducing opioid use. They wrote, “only a small fraction of patients prescribed opioids progress to long-term use.” Those who find their pain under control and are using the drugs appropriately “should not be unilaterally compelled to wean off opioids,” they said."

I think this guy is mostly a joke after looking at his "research" on pubmed.

Just CBT pablum that WAY overestimates its effectiveness in the real world.

 

[lobelsteve]

I think this guy is mostly a joke after looking at his "research" on pubmed.

Just CBT pablum that WAY overestimates its effectiveness in the real world.

Internal medicine. 3465 on propublica dollars for docs in 2013. Not on the take.

Dollars for Docs

 

[DrCommonSense]

Internal medicine. 3465 on propublica dollars for docs in 2013. Not on the take.

Dollars for Docs

Never said he was on the take, I said his "research" is mostly some kind of cognitive behavior hocum or stuff about "pain measures" using various metrics.

He probably makes his money through those metrics, which wouldn't show up on propublica either.

 

[Ducttape]

Internal medicine. 3465 on propublica dollars for docs in 2013. Not on the take.

Dollars for Docs

if they really are true believers in opioid therapy, why almost 0 prescriptions on the CMS site?

Unless, again, they are hidden under the guise of the VA....


Fyi I find it an interesting disconnect that he trumpets the huge financial and quality of life costs due to chronic pain - most of the data occurring during the well-known era of opioid overprescribing.

If opioids were even marginally effective, why did the chronic pain epidemic get even worse over the past 15 years?


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