Conflicts of Interests in CDC's Core Expert Group Opioid Guidelines

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drusso

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http://www.insidesources.com/dysfun...flict-of-interest-in-the-debate-over-opioids/

"Dr. Roger Chou of Oregon Health and Sciences University served both as one of the contributing authors and as a member of the Core Expert Group. In 2009, he was the lead author for opioid guidelines commissioned by the American Pain Society and the American Academy of Pain Medicine that reached conclusions that were significantly more open to prescribing opioids. Research into opioid use has changed little since the 2009 guidelines were written. Chou’s decision to alter course is unclear. He did not respond to a request for an interview.

There are several more moderate members of the Core Expert Group, but Harvard’s Stossel, a resident scholar at the American Enterprise Institute, recognizes potential problems with the panel based on research in behavioral economics. His research indicates that industry connections do not improperly skew medical research. But in the case of the CDC panel, he says there may be a “conformity cascade.” The CDC placed a number of outspoken anti-opioid activists on a panel with only a few moderate members and no pain experts. While vigorous debate can lead to good policy decisions, the Core Expert Group lacked opposing arguments, and a drive to conformity can lead all members to reach conclusions inconsistent with the evidence."
 
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Chow back at it
 
well of course. anything the guv does is politically motivated one way or the other.
 
I agree the conclusions are unsupported by the literature and that there should never be any secret committees. Need to start over with legitamacy as the byword.
 
"should never be any secret committees."

Agree here.
 
NIH PANEL BLASTS CDC PROPOSAL ON OPIOIDS — Members of the NIH's Interagency Pain Research Coordinating Committee, which includes the FDA, AHRQ and the Department of Veterans Affairs, announced at a meeting Thursday that they plan to file a formal objection to a CDC proposal to curb opioid prescribing, Pro's Brett Norman reports. The guidelines are a "key piece of the administration's effort to combat the prescription overdose epidemic that claims more than 16,000 lives a year," he writes — but the NIH group says there's not nearly enough evidence to support them. AHRQ health scientist Richard Ricciardi called the recommendations "ridiculous" and "an embarrassment to the government." All that is adding to a chorus of complaints from AMA, ACS-CAN, and more about guidelines due out next month.

Read more: http://www.politico.com/tipsheets/politico-pulse/2015/12/pulse-211595#ixzz3tQq26aid
 
secret committee started the fed, and its still around.... I don't see this thing going away either 🙁
 
Regardless of the new guidelines put out by the CDC, can anyone seriously question these general feelings/guidelines regarding opiates and prescribing patterns?
1. Pharmaceutical companies and the "pain experts" at the very least misstated and at worst clearly misled the public about the risks involved in freely prescribing opiates.
2. Opiates should never be a first-line treatment for chronic non-cancer pain.
3. Opiates should not be standard of care for those with serious psychological/psychiatric disease, young patients, those with secondary gain, and those with criminal and/or addiction histories.
4. Many in the medical community have a financial gain from prescribing opiates which sways their prescribing habits; whether it be running Utox results in their lab, convincing patients to buy their meds from "In house" pharmacies or accepting money for speaking fees from drug companies. I can list about five instances just in my local area where people were guilty of these issues and it clearly swayed their practice.
5. Opiates should never be the only means of treating someone's pain and should only be used in a multimodal approach.
6. Opiates should be prescribed in non-cancer pain as a means of improving function. If you cannot document an improvement of function it is a treatment failure. Simply allowing someone to say they are in pain while they sit on their @ss, pop pills or smoke cigarettes all day is not appropriate.
7. High doses (>200MEQ and most >100MEQ) are at a significant risk of adverse events and the prescribing pattern should be justified and carefully monitored.
 
More conflicts of interest on CDC Guidelines come to light:

Senator Alleges Conflict of Interest in Fed Pain Panel
February 09, 2016


By Pat Anson, Editor

An influential U.S. senator is raising questions about possible conflicts of interest on a federal panel that was highly critical of the CDC’s controversial opioid prescribing guidelines.

“I was alarmed to read of efforts by the members of the Interagency Pain Research Coordinating Committee (IPRCC) to weaken efforts underway at the Centers for Disease Control and Prevention (CDC) to develop guidance on opioid prescribing practices,” wrote Oregon Sen. Ron Wyden (D) in a letter sent to Health and Human Services Secretary Sylvia Burwell.

As Pain News Network has reported, several members of the IPRCC said the guidelines were “ridiculous” and “an embarrassment to the government” at a December meeting.

“Several non-Federal IPRCC members, their organizations, or both, appear to be recipients of funding from major pharmaceutical companies that manufacture opioids or related products at levels that raise serious concerns regarding the potential for conflicts of interest,” wrote Wyden. “These financial and professional relationships raise serious concerns about the objectivity of the panel’s members that deserve additional review.”

december, 2015 meeting of iprcc.

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DECEMBER, 2015 MEETING OF IPRCC.

Wyden mentioned several of the panel members by name, including Myra Christopher and Dr. Richard Payne of the Center for Practical Bioethics, Penney Cowan of the American Chronic Pain Association and Cindy Steinberg of the U.S. Pain Foundation. All three non-profit organizations get a substantial portion of their funding from pharmaceutical companies, including Purdue Pharma, the manufacturer of OxyContin. Purdue gave over $100,000 to U.S. Pain Foundation in 2014, according to Wyden.

“I do not and have never been paid by a pharmaceutical company,” said Steinberg, who became a patient advocate after she suffered a serious back injury in an accident. Steinberg, who is National Policy Director for U.S. Pain Foundation, currently receives a small stipend of about $8,000 a year.

“I am fortunate in that my husband works to supports us. I do this work despite my daily, debilitating chronic pain, often needing to lie flat in meetings to control the pain and lay across two plane seats to travel because I am passionate about improving pain care in this country,” Steinberg said in an email to Pain News Network.

“If anyone watches the video of the IPRCC meeting they will see that they had to bring in a special small sofa for me to lie on every hour so that I could participate. I am proud to do this work and am honored to represent the voice of millions of disempowered Americans who suffer from the pernicious disease of chronic pain and desperately need more and better treatment options."

Penney Cowan, another member of the federal panel mentioned by Wyden, also serves on the CDC “workgroup” that recently endorsed the agency’s recommended guidelines, which discourage primary care physicians from prescribing opioids for chronic pain.

“When treating a person with pain, a health care provider needs to determine what is best for that individual based on physical examination, test results and what is important to the individual. The recommendations seem very clear on that point,” Cowan wrote in an email to PNN. “The American Chronic Pain Association advocates for a balanced approach to pain management - that means that all therapies such as PT (physical therapy), counseling, biofeedback and stress management, OT (occupational therapy), nutritional guidance and more should be available and used based on their appropriateness for each individual.”

Wyden’s letter does not mention that some IPRCC members who were most critical of the CDC guidelines are federal employees of the Food and Drug Administration and the Agency for Healthcare Research and Quality (AHRQ), who as government workers are not allowed to accept financial contributions.

The senator’s letter and an Associated Press story about it also fail to mention that the CDC itself has a foundation that accepts funding from healthcare companies such as Abbott Laboratories, Amgen, Medtronic, Johnson & Johnson, Merck, Quest Diagnostics and Pfizer, companies which stand to benefit from the CDC guidelines because they offer non-opioid treatments or tests. The CDC Foundation accepted over $157 million from donors last year.

Up to 11 million Americans use opioids daily to treat their chronic. A survey of over 2,000 pain patients by Pain News Network and the Power of Pain Foundation found that many fear losing access to opioid pain medication if the guidelines are adopted.
 
prediction - one of these companies will soon come up with a "new" class of "opioid-like" medications that will relieve pain without fear of addiction. how do i know this? because whenever Big Pharma decides an older, turned generic medication is "bad" for you, they always have a patented new medication waiting in the wings. that way the docs are forced to prescribe the new way more $$ drug. i have seen this happen so many times it does not even provoke a response out of me anymore. the "new" medication will eventually be proved to be bad, but not until a nice profit has been generated. there is nothing you can do about it. except complain? LOL.
 
More likely, it will be a drug that greatly reduces the risk of addiction on the drug comapny sponsored study.

This will encourage narcosupporters to advocate for "Oxys for all! Just add OIC agent + Addiblock (short for addiction blocker) + rescue naloxone for 100% guaranteed safety!!"
 
NIH PANEL BLASTS CDC PROPOSAL ON OPIOIDS — Members of the NIH's Interagency Pain Research Coordinating Committee, which includes the FDA, AHRQ and the Department of Veterans Affairs, announced at a meeting Thursday that they plan to file a formal objection to a CDC proposal to curb opioid prescribing, Pro's Brett Norman reports. The guidelines are a "key piece of the administration's effort to combat the prescription overdose epidemic that claims more than 16,000 lives a year," he writes — but the NIH group says there's not nearly enough evidence to support them. AHRQ health scientist Richard Ricciardi called the recommendations "ridiculous" and "an embarrassment to the government." All that is adding to a chorus of complaints from AMA, ACS-CAN, and more about guidelines due out next month.

Read more: http://www.politico.com/tipsheets/politico-pulse/2015/12/pulse-211595#ixzz3tQq26aid

Does Chou work for the AHRQ?

Is one scientist on AHRQ crapping on Chou?

Chou's guidelines magically changed from 2009 to 2016 (APS/AAPM to PROP essentially) without ANY CHANGES IN RESEARCH in the interim.

This guy is the biggest lying scumbag I think I've seen yet in medicine (which is pretty bad).

Also, the guy basically doesn't practice medicine by is an IM physician that did a "research fellowship". He basically has a for profit racket where he ****** himself out to the highest bidder, hence the change in his viewpoints from 2009 to 2016 despite no change in research.
 
Roger is the man. We aren't so much.
 
Roger is the man. We aren't so much.

Explain how "the man" changed his opinions so dramatically from 2009 to 2016 when no new research was published?

Roger seemed to be a paid ***** of big pharma in 2009 then did a 180 and became a paid ***** for PROP.

What other reason can be given for such a dramatic change without new research?

Also, does Roger even practice medicine?
 
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