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beachbum
Stranger


Reged: 01/26/03
Posts: 7
Loc: Key West
BED OF PAIN OR QUALITY OF LIFE - HELP NEEDED
      #53567 - 01/30/03 05:07 AM

Just wanted to share a message I received today. We should all help a bit before it is too late

Quote:

BED OF PAIN OR QUALITY OF LIFE

"THE COURTS MUST DECIDE"


DEAR INTRACTABLE PAIN PATIENTS, FAMILIES, AND SUPPORTERS,

After long, serious contemplation, a few days ago, I asked the Los Angeles Superior Court to take over intractable pain treatment to protect physicians and patients from what I perceive to be an elitist attempt by California State agencies to put a stop to the intractable pain treatment movement. As you are well aware, physicians refuse to treat intractable pain patients due to fear of reprisals from State agencies. Those intractable pain patients who have been fortunate enough to find adequate treatment live in constant fear that their doctor will be put out of business by State agencies.

California has 2 laws which are supposed to guarantee intractable pain treatment:
1. Intractable Pain Act (1990)
2. Pain Patient's Bill of Rights (1997).

Unfortunately, the year 2000 was the year that California State Agencies seemed to attack intractable pain treatment by intimidating IP doctors in an effort to drive them out of business.

I first became alarmed when the Department of Consumer Affairs last year hired a physician "pain" consultant who worked in the prison system and did not even have a pain practice. He declared, in writing, "no multiple sclerosis or fibromyalgia patient should ever receive an opioid for pain." This same agency has walked into pharmacies unannounced without subpoenas, obtained pharmacy records apparently determining "over prescribing" on numbers alone without notification to the patient or prescribing physician that this is being done. I know of one pain physician in private practice who was severely disciplined by the Medical Board for treating a patient with opioids. This same patient was, however, freely obtaining higher opioid doses at a University Hospital clinic.

I am very disappointed that the State Medical Board appears to have reneged on their published documents stating that no physician will be charged with poor medical practice if a pain patient is treated with these guidelines:

(1) History & Physical Examination; (2) Informed Consent; (3) Treatment Plan with Objectives; (4) Consultation when Necessary; (5) Periodic Reviews; (6) Written Records; (7) Compliance with Controlled Substance Laws.

Our program and its treatment protocol not only meet, but exceed these guidelines. Despite this effort some regional Medical Board offices have been unable or unwilling to tell me whether 3 of my intractable pain patients meet these guidelines and are being treated in compliance with our laws after 6 months of repeated inquiry! This is in stark contrast to previous case reviews of some of my other intractable pain patients, who were treated by the identical clinical protocol, and found, by other regional Medical Board offices, to be in compliance.

This inconsistent application of the law between State agency offices is making it impossible to treat intractable pain patients. No California physician or IP patient can possibly have any faith in the Medical Board, until intractable pain treatment is consistently applied and all parties are in agreement as to the implementation of our pain Laws.

In my efforts over the past year to resolve these issues with California State agencies, I have heard some most amazing and depressing comments from enforcement officials who as a matter of course habitually violate the "Pain Patient's Bill of Rights". One comment made was that I and other pain doctors should have all intractable pain patients consult a psychiatrist and stop medications. Intractable pain patients can reject suggested treatments under the "Pain Patient's Bill of Rights". Some officials have claimed we are only aiding and abetting addicts. I was even accused of supplying opioids only for intentional diversion by patients or somehow rerouting drugs back to me since I must be an addict if I treated pain patients.

The worst statements, however, relate to the belief that intractable pain case reviews by State agencies are to be compared to a community standard. Peer review by State contract or consultant physicians is permissible only to the limited extent that the reviewing MD is to determine if the patient has bonafide, incurable, intractable pain and if medical necessity of high dose opioid therapy is necessary because standard, non-opioid and usual dosages have failed. If the reviewer states the patient is not intractable, they must articulate what the cure and treatment should be. This chart review for a bonafide pain specialist takes only about 10 minutes not 6 months. I also believe that the State agencies do not all know that true addiction is when opioids are taken for other than pain purposes. The use of opioids for bonafide pain is really "therapeutic dependence or addiction".

Having been involved in lobbying for the Intractable Pain Act in 1990 and the principal author of the Pain Patient's Bill of Rights1997, I know first hand of the great support these laws generated in the Legislature. The Governor at the time of the passage of these laws signed them into laws. (Deukemejian - Intractable Pain Act and Wilson - Pain Patient's Bill of Rights). Inexplicably, the current Executive branch is interpreting or misinterpreting these laws which I firmly believe violates the legislative intent of the bill.

Due to my fear that some State agencies are on a crusade to wipe out intractable pain treatment, I have filed a "Declaratory Relief" action in Los Angeles Superior Court. Although this is technically a lawsuit against California State Agencies, the practical effect is to demand that the Court interpret laws and "declare" whether our treatment complies with them. If our treatment does not measure up, the Judge is asked to tell us what we are doing wrong and provide appropriate protocols for future treatment. This is a critical and essential step to preserve treatment for intractable and hospice pain patients, because physicians and pain patients everywhere must know the parameters of legal intractable pain treatment. The ruling handed down by the Judge will apply to doctors everywhere.

I ask that all concerned parties review California's pain laws and the "Declaratory Relief" action which I have filed. Please write Honorable Judge Ronald Sohigian and lend him your insight, concern, and knowledge regarding this matter. Without question, the Judge's decision will establish the parameters for all physicians to comply with California pain laws. I have filed this Declaratory Relief action with great sorrow and regret. I have met a stonewall in attempting to get the elitist State agencies to tell me if we are in compliance with the laws or what we need to do to be in compliance. I am truly afraid that a failure to have the Courts intervene and take-over will result in thousands of intractable pain patients dying an early, miserable death and suffering in bed waiting to do so. If the Court desires I will step out of the picture so long as intractable pain patients can receive medications of the type and dose that relieves their pain. More and more persons are agi!
ng
and developing severe pain. I'm seeking Court intervention, because I will not stand back and let a few elitist State agencies deprive needy intractable pain patients of treatment which is what I truly believe will happen if the Court does not intervene and declare the parameters of our laws so physicians can practice and patients can be treated. We have the tools to give the pain patient dignity and to greatly improve their quality of life if the laws are properly used.

I'm sure you join me in wanting intractable pain patients everywhere to avoid the bed of pain and have a quality of life. Please help by writing Judge Sohigian and tell him of your concern that State agencies will deprive thousands of patients from getting adequate intractable pain care.

With gratitude,
Forest Tennant M.D., Dr. P.H.

Write to the Judge and refer to case no. BC 288765, Tennant Vs State Agencies. A handwritten letter is fine.

Honorable Ronald M. Sohigian
Judge of Superior Court
111 N. Hill - Dept. 41 - Rm. 417
Los Angeles, CA 90012
BC 288765
_________________________________





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quincy
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Reged: 11/07/02
Posts: 333
Loc: pacific northwest
Re: BED OF PAIN OR QUALITY OF LIFE - HELP NEEDED [Re: beachbum]
      #54005 - 01/31/03 04:31 PM

Scary article. I hope the states won't get any more involved in the pain issue. The people who make the laws and decisions regarding pain management and treatment are usually not physicians. They have no idea what the standard of care is for pain patients, nor do they know what it is like to suffer from a pain that does not go away. The state medical boards and the politicians are way to worried that a few real drug addicts will get away with obtaining narcotics from these pain docs. I have been to a few pain docs, and I think it would be next to impossible to fake one of them out. And really, who cares if an addict or two gets a few vicodens?? How many legitimate pain patients have to go without effective meds because a few rotten apples spoiled everything? This is rediculous and the whole topic makes me mad!! The government needs to stay away from my doctors office and stick to their own business.

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chaos626
Member


Reged: 08/06/02
Posts: 151
Loc: Northeast
Re: BED OF PAIN OR QUALITY OF LIFE - HELP NEEDED [Re: beachbum]
      #54317 - 02/01/03 08:54 AM

you know, this is disgusting. I cant even begin to express how pissed i get when I read sumthing like this. Who does the gov think they are protecting? Junkies? An addict will do one of two things over time, die or recover, For every person who abuses these meds there are 100s or 1000s of people who truly need them to live their lives. Living in pain is no way to live (believe me I know). We should all write our reps and tell them this crap has to stop. If we all do, maybe we can make a change. I personally am writing everyone I can think of.

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gwb
Member


Reged: 08/19/02
Posts: 132
Loc: Fl
Re: BED OF PAIN OR QUALITY OF LIFE - HELP NEEDED [Re: beachbum]
      #54860 - 02/03/03 01:17 PM

Folks,
I read this a few times and I see this as Gray Davis Governor of Caifornia and/or whatever baords are under the executive branch aegis impugning upon two laws on California state laws on the books at this time.The good doctor has seen fit to file for injunctive relief and determine what is going on.I am so broke we could not afford to exchange glances at Christmas, but some good may come of the Dr.'s money-I hope for the people in California anyway.This is JMHO, very humble.
gwb

--------------------
Illegitimi Non Carborundum


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quincy
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Reged: 11/07/02
Posts: 333
Loc: pacific northwest
Re: BED OF PAIN OR QUALITY OF LIFE - HELP NEEDED [Re: beachbum]
      #54922 - 02/03/03 05:09 PM

I find this issue facinating. It makes me wonder about the sanity of this country, picking on people with legitimate medical conditions. But why now is the war on drugs focusing on prescripton drugs? Is it because a famous governors daughter got caught forging a script? Or that famous movie stars are taking opiates for recreation? Someone should tell the government officials that are against these drugs, that the drugs themselves aren't the cause of the problems these people are having. The drugs didn't make Jeb Bushs daughter commit forgery. Most likely that is a genetic weakness (dosent' addiction run in their family). Why are opiates being blamed for the fatal weaknesses of some unfortunate people? To me that is as stupid as the lawsuit against McDonalds that some obese people filed, saying that McDonalds made them fat. No-your lack of willpower made you fat, not the product. Its just like the Oxycontin issue the media is blowing-up. A few people who have no business having them in the first place OD, and all of a sudden, legitimate pain patients are placed under scruitiny for taking it.

The thing that kills me, is the way the media is relaxing its standards about other, illicit, drug use. Nowadays on TV, movies and videos, marijuana use is common, even glorified. I mean, my six year-old son thinks that weed is not any worse than cigarettes. He got this idea from his friends at school and the TV. Not that I think that marijuana is really harmful-it dosen't really hurt anyone and isn't addicting-but its still illegal. As far as I know, Vicoden, Valium and Oxycontin are not. In one day of watching TV, I saw three news channel "specials" about prescription drug use and "oxycontin." They talk about a patient taking an oxy pill like he was downing speedballs. While at the same time, "Friday"(a movie about smoking weed) is on a regular channel which any kid can see. I just don't understand the hypocracy thats going on. I really think that since the government has never made any real ground on winning the drug war, they decided to go after an easier target: legal prescription drugs. Do you know what I think the real crime is? The real drug problem is the millions of people who can't afford to pay for their prescrption medication.


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lakjaw
Veteran


Reged: 11/22/02
Posts: 545
Loc: Planet Zartran
Re: BED OF PAIN OR QUALITY OF LIFE - HELP NEEDED [Re: quincy]
      #55077 - 02/04/03 08:20 AM

Quincy, your guess is probably as good as mine re: why the domestic 'war on drugs'. Personally, I think it has to do with phony prissy attitudes toward "proper behavior", an unrealistic vision with regard to history (drug use has been with us for centuries), the failure of the *real* war on drugs, and the tendency to blame anything and everything for the ills of our society rather than taking a hard look at reality. During the 50's and 60's, many of us were drug users of one sort or another, but very few of us were violent or even socially unacceptable. Things have changed with the swinging of the pendulum, and pouncing on prescription drugs was an easy "Aha!" Unfortunately, the idiots who did that createed a whole new category of "soft domestic criminal", and one can only hope that someone, sometime, will do a little head-smacking and come to their senses.

In the 20th century we went from having cocaine in Coca-Cola, lithium in 7-Up, and doctor's advertising the merits of smoking one brand of cigarettes over another, to a goof-ball actor president telling physicians how to treat their patients, and television convincing us that we all needed SSRI anti-depressants, and proton pump inhibitors to counteract the GERD engendered by our Run-For-The-Border fast-food lifestyle! Let's hope the pendulum swings the other way sometime *very* soon!

--------------------
When trouble arises and things look bad, there is always one individual who perceives a solution and is willing to take command. Usually,that individual is crazy.


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