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  Equal Rights for people with mental and physical pain ?

  Because ,there are some150 million second class Americans victimized by chronic mental and physical pain.

  Because , false alarms make it very painful for people with chronic mental and physical pain  to get relief for their suffering.

    We can change this . Please support my petition for equal rights.                                                                      http://tinyurl.com/senpetition

 Millions Victimized By

 CDC’ False Alarm

Alen J Salerian MD

November 1, 2014

            Millions of victims of chronic mental or physical pain suffer needlessly because of misinformation about opiates that  govern medical practice.

    According to the Institute of medicine some 120 million Americans suffer from chronic pain. This number does not include an additional 30 million people with complex psychiatric disorders who may benefit from opiates.

     For many years CDC has been broadcasting an epidemic of prescription pain medication overdose deaths. CDC statistics suggest annually some 14,000 people or 3.5 people in a population of 100.000 die of overdoses from pain medications.

   Our annual loss  of 37,000 lives  to suicide or 12 people per hundred thousand population represent  a robust indicator of the human cost of untreated psychiatric conditions. Some of them may benefit from opiates .Many of 120  million Americans of chronic pain may also benefit from opiates.  Access to opiates for therapeutic benefits faces formidable challenges . But no challenge is  greater than  CDC false alarm of an epidemic of pain medication deaths.

   

     Opiates and evidence-based medicine:

     Do opiates help chronic pain?  

        Opiates are helpful for chronic pain (Goodman and Gilman textbook of

pharmacology)

     Do opiates have antidepressant and mood stabilizing properties?

   There is a plethora of evidence to support the antidepressant and mood stabilizing properties of opiates.

A.     Endorphins are of central importance in pain, impulse control, addiction and mood regulation (Nolte2012).

B.     There is high comorbidity among patients with depression, addiction and chronic pain (Grant2004, Blair 2003).

C.     Postmortem data reveal people with severe depressions have endorphin – morphine starved brains (Iseroff 1990).

D.    Clinical data support the mood stabilizing properties of methadone (Pickar1979) oxycodone (Nyhuis2008) and buprenorphine (Bodkin1994).

E.     Discontinuation of opiates many increase mortality and suicide (Grant 2004, Kakko 2012).

F.     Opiates have been used as mood stabilizers since ancient times (Weber –Emrich 1998).

          Are there opiates with low-risk of abuse?

    In general long acting formulations of morphine like substances ( slow absorption and long half life) have low abuse potential(Salerian2010,Linores 2011). This is because they don't elicit euphoria and their influence to promote drug seeking behavior  is feeble. Methadone ,long-acting oxymorphone  and buprenorphine are common examples of opiates with low abuse potential.

  Do we have an epidemic of painkiller overdose deaths?

 CDC statistics show annual deaths from prescription pain medication overdoses are 3.5 people per 100.000 population. In comparison 12 people die of suicide, 4 people die of motorcycle accidents, 4 people die of drowning , 10 die of alcohol ,

   The above findings suggest regular CDC warnings of an epidemic of  prescription painkiller deaths is a  false alarm.

 No crises seems to  justify our super vigilance to victimize millions of Americans with chronic mental and physical pain.

References:

1.     Grant BF Stinson FS et al. The prevalence of substance use disorders and independent mood and anxiety disorders. Archives of Gen. psychiatry. August 2004 volume 1, PP 807 – 816.

2.     Kakko J ,Svanborg D K ,Kreek M J Hellig M .One year retention and social function after buprenorphine assisted relapse prevention treatment for heroin independence in Sweden: in randomized, placebo-controlled trial. The Lancet 2003 volume 361, issue 9358, pages 662 – 668.

3.Apkarian AV Sosa Y Sonty S Levy RM  Harden RN Parrish TB Gilelman DR . Chronic pain is associated with decreased prefrontal and thalamic gray matter density. The Journal of neuroscience,  2004 – 24 (46) 10401 – 10415.

4.Webster RL Dasgupta N. Obtaining adequate data to determine causes of opioid related overdose deaths. Pain Medicine 2011;12:S86-S92.

5.Libby R. Criminalization of medicine. 2008 Praeger publications.