Dear Friends in CIP,

You've faced that last back surgery, or that your physician has
diagnosed RSD, you've done all one can do and now it's time for
pain management. This entails many interventions, for many
depending on where you live, your physician, and today it depends
on state medical boards and the DEA telling your physician how
to practice his/her profession.

One thinks "would I want the DEA doing open heart surgery on
me" or diagnosing and treating my diabetes? The police state of
medicine does little to encourage you to deal with a viable disorder
"pain" and can attempt through means outside of the scope of
medical practice to label you:

1. Addict
2. Drug seeking

However, a M.D., D.O., or RN using that terminology for a viable
pain client is risking "malpractice" and there are medical guidelines
in place in regards to the "hell" many have been through seeking
proper care for their NIP (nonmalignant intractable pain).

My topic posts deal with the scourge of "legal pain medication"
being advertised, epitomized, and blamed for the OD deaths of
addicts around the United States who find, abuse, and lose life
due to medications designed for those:

1. Who have legitimate pain
2. In the case of LA (long acting) have tolerance to
short acting opioids
3. Who don't like side effects (nausea, euphoria, sedation)
4. Who have been tested, cut by surgeons, caused through
injury or the like MORE PAIN in many cases and must
face a life of disability or ENABILITY, the choice often
due to the LA medications.

So when you read a link below about the (2) college to be Joes
who overdosed from snorting Oxycontin those of you on it know
the education given by your physician, not to "crush, break or chew
the pills" and certainly nowhere in the literature is it written that
one should "shoot it up or snort it nasally" and you will not see
anyone who is VIABLE doing so either.

You won't see anyone VIABLE selling "half" their meds, you will
see someone who is an addict SELLING their meds (if they are
getting them) for other substances such as "crack cocaine," "blow,"
and "china white." These ILLEGAL substances are Class 1 they have
no legal or legitimate purpose in medical practice at the given
time, yes the DEA has a measuring stick, and as most know
Hydrocodone is now considered a "drug of abuse potential" and
rises to the top with an overall estimated date of Class 2 in ALL
states by the end of this year.

If one looks at the currently approved LA medications you
will find:

1. Methodone (cheapest)
2. Oxycontin (LA oxycodone seen in short acting combination
medication such as Percocet, Tylox, and Percodan).
3. MS Contin, Kadian (LA morphine).
4. Duragesic Patch (LA Fentanyl seen in short acting form
in the Actiq lollipop).
5. Pallidone (LA Dilaudid now FDA approved in the U.S. for
years approved in Canada and Europe).

Analogs? Stigmas?

1. Methodone was NOT created for heroin addicts it was
created by Hitler when he ran short of 'poppy' during the
war. LONG ACTING pain relief with little sedation.
2. Oxycodone is an excellent medication; long before a LA
form patients coming off PCA pumps for surgery pain
would state (2) Percocet worked better per os than the
IV versions of Meperidine (now hardly used due to
toxicity), Morphine, and Dilaudid.
3. Morphine used in LA forms of "Contin" and "Kadian"
has historically been the oldest pain killer going back
to OTC purchases of syrups and elixirs touting the name
Laudanum, etc. Ironically many near death who suffer
filling of the lungs and fluid as they end life are relieved
by morphine; it tells the brain it is not a struggle to
breathe, and the one dying "does rest in peace."
4. Fentanyl is estimated at 100x the strength of heroin it
is a heroin analog chemically ONCE metabolized in
your system. The Fentanyl MOLECULE is so small it is
measured in mcg (microgram) not mg (milligram) and
you will not see a Fentanyl pill (for it would be so small
it would blow away if found on the head of a pin), but
the PATCH has it's own purpose and it's own adversity.
They say "addicts" do not abuse the patch; I have heard
it has been removed (gel) and shot up (good way to
blow an air embolus and die), and eaten off the patch
(not recommended of COURSE), but when you read the
true meaning of ADDICT most VIABLE pain clients will
readily find they do not FIT in the category and would
do ANYTHING to kill their physical pain, but not to the
lengths an ADDICT goes to feed his/her MENTAL PAIN
and later PHYSICAL CRAVING.
5. Dilaudid in LA form is welcome to those of us waiting
in the U.S. For now we hear the FDA will control which
physicians are ALLOWED to prescribe it (nasty business
again much like DEA antics), and for many years this
old line drug (synthetic morphine estimated at 10 x
the strength of morphine and generically titled
hydromorphone) has "killed pain" when those terminal,
and in CIP took the medication after lowered success
with aforementioned morphine and the like.

The stigma of OD and death is wrongly issued to the LA medication
class. Let's take a look at most examples shall we?

1. For instance in this link:
a. The boys snorted Oxycontin (crushed, broke, abused)
b. Had alcohol and other drugs in system
c. Had no tolerance
2. The story line:
a. Presumes the LA was the cause of death
b. VIABLE clients do not smoke dope, or drink
while properly taking per os medication
3. The DEA, police state, local authorities:
a. Presume the problem with ADDICTS exists
due to pain management for those in CIP
b. The problem with ADDICTS is relapse and
they will go to any lengths to FIX when they
are dope sick.
4. For YEARS prior to the LA:
a. Addicts would steal scrips for Meperidine,
Morphine, and Dilaudid.
b. Go to ERs with fake pain, toothaches, and
the like to obtain injections of the same,
and perhaps a scrip for Oxycodone, or
Hydrocodone.
c. These addicts MAY NOT HAVE died of OD's
in the ERs (where VS and the like are
observed), or from shooting up combination
medications such as Vics and Percs because
ADDICTS have a track record of knowing
what works.

The terminology and media blast forces VIABLE pain clients to work
harder to:

1. Obtain proper pain management.
2. Obtain proper treatment and medications.
3. Travel further, and suffer social stigmas assoicated with
bad publicity.
4. Face relieved pain (our medical expertise about 5 years
ago allowed far better treatment than it does due to the
DEA) relief and outcomes, RTW, family relations, and
LESS INSURANCE costs, but now you will see MORE
clients suicidal, without relief, DISABLED and costing
economically more.

I have made an impetus always for what a client can do to aid
their specialist (treatment records, ancillary treatments) and ample
documentation and testing, so that your medical records far outweigh
some DEA attack on your physician.

Furthermore I have heavily encouraged those in VIABLE pain as a
group to be vocal; write and call your representatives, governors,
anyone involved in the state medical board. Form groups of those
in CIP willing to "tell their story" with good outcomes (RTW, no
divorce, happy and quality of life).

But today as I watch just another OD story of ADDICTS go by I see
another side that we must all encourage:

1. Federal funding to
a. Cut down on ILLEGAL drug abuse
b. PROTECT those in VIABLE pain from ADDICTS
c. Teach police departments, state officials, and the
like about "pain management" CIP, and what
the difference is between ADDICT and those who
are in medical need.

2. An agency ABOVE THE DEA
a. Consisting of medical licensed professionals to
oversee potential "busts" of M.Ds, D.Os, and R.Ns,
by DEA "set ups" and the like.
b. Consisting of addiction specialists.
c. Consisting of scientists who know the chemical
outcomes of prescribed medications.

3. HARDER laws on the federal and felony level for ADDICTS
a. If you're sent to jail or treatment then a
sheltered setting with work for a YEAR
b. Mandatory drug testing for life
c. Specificity of testing; test for heroin, not all opioids

If they won't look to medical science, if they won't respect the
professionals who "save lives and encourage quality of life" we LOSE
as a NATION. What we are given under our Constitution is lost for
we are not free, and this is not a democracy by any means.

As I see it there is no ABUSE of precriptive medication, when ONE
blames or uses "cause and effect" against the suffering CIP client,
or as a group those in NIP. There is ABUSE and has been for YEARS
before the life saving LA's of heroin, alcohol (legal drug), cocaine,
and other synthetic chemicals (meth labs and the like), and when the
ADDICTS who are "legal criminals" are patted on the back while we
who are NOT SUFFER there has to be a turnaround of justice.

Give THEM (addicts) full benefit. Make sure they DO NOT ABUSE or
use any drugs. Put funding into housing them indefinitely so that
those who are free, who are in CIP, are not in "prison" due to the tactics
that prevail in America today.

Food for thought.

Drug overdoses bring awareness
http://www.wisinfo.com/northwestern/news/local/stories/local_20040618


Peace,
Karen


Karen Hallenbeck~Sikorsky~George BS,RN,UM,QC
Owner-Moderator
"AnGeLsInPain"
Interqual Certified
Published Psychiatric Researcher
Advocate for those in CIP, HIV, Psychologic Pain
"A Higher Power is necessary to find the ability to withstand self
destruction.."


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