Asa
Senior Member
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Medscape: "Three Major Controversies in Neurology: A Debate"
1. Gene-Sequencing in Neurology? Yea/Nay
2. Stem Cell Clinical Trials? Yea/Nay
3. Opioids for Chronic Pain? Yea/Nay
Just thinking of how societal trends affect individuals with ME:
For example--the classic, women-are-hysterical mindset (and of course the only thing worse than an hysterical woman is a man who "acts" like an hysterical woman).
Plus, an epidemic of western obesity means only bad, lazy, or mentally-ill people complain about an exercise regime.
And finally, an epidemic of opioid abuse means only bad, lazy, or mentally-ill people resist instruction by specially-trained, state-certified experts, who possess secret and superior knowledge that can only be ascertained through them.
Edit: See also--P2P The Role of Opioids in the Treatment of Chronic Pain (2014 - alongside ME/CFS P2P)
1. Gene-Sequencing in Neurology? Yea/Nay
2. Stem Cell Clinical Trials? Yea/Nay
3. Opioids for Chronic Pain? Yea/Nay
"The session's feistiest debate explored the question of whether or not neurologists should prescribe opioids for chronic pain...
Dr Argoff started off with some epidemiology, stating that there are over 100 million Americans suffering from chronic pain, and most neurologists treat patients with the condition...
All of this is to say that Dr Argoff feels that pain is so commonly comorbid with neurologic disease that it's crucial that neurologists consider the best possible treatment regimens for their patients..."
http://www.medscape.com/viewarticle/844694_6"...Arguing the con position, Dr Franklin started by explaining that teachings in the early 1990s are what led to the "worst man-made epidemic in modern medical history." There have been over 140,000 deaths from the unintentional overdose of opioids, many more hundreds of thousands of overdose hospital admissions, and millions of people addicted or dependent on the compounds.
"What I'd like to hear from Dr Argoff is not that a few patients with multimodal therapy get along OK," commented Dr Franklin, "[but] how we're going to reverse this public health epidemic."
...Six states in all have in recent years implemented a dosing threshold for opioid analgesics, the first of which was Dr Franklin's home state of Washington. Since the change, opioid-related deaths in Washington have dropped 27%, and a large reduction in chronic opioid use has been seen in the workers compensation system.
"I believe we have to find ways to offer doctors and patients alternatives...like cognitive behavioral therapy and graded exercise," said Dr Franklin..."
Just thinking of how societal trends affect individuals with ME:
For example--the classic, women-are-hysterical mindset (and of course the only thing worse than an hysterical woman is a man who "acts" like an hysterical woman).
Plus, an epidemic of western obesity means only bad, lazy, or mentally-ill people complain about an exercise regime.
And finally, an epidemic of opioid abuse means only bad, lazy, or mentally-ill people resist instruction by specially-trained, state-certified experts, who possess secret and superior knowledge that can only be ascertained through them.
Edit: See also--P2P The Role of Opioids in the Treatment of Chronic Pain (2014 - alongside ME/CFS P2P)
https://prevention.nih.gov/docs/programs/p2p/ODPPainPanelStatementFinal_10-02-14.pdf"Several workshop speakers stressed the need to use treatment options that include a range of progressive approaches that might initially include nonpharmacological options, such as physical therapy, behavioral therapy, and/or proven complementary and alternative medicine approaches..."
"Even if primary care providers had the requisite knowledge, skill, and intent, they often do not have access to the resources needed to manage pain according to current guidelines. This is often true because alternative first-line treatment strategies are not available. For example, most practices do not have access to experts in pain management, including specialty pain clinics, or access to the alternative approaches to pain management (e.g., physical therapy, cognitive and behavioral approaches, acupuncture, yoga, meditation, other complementary and alternative medicine)."
"Other payment structures, such as tiered coverage systems, keep non-opioid alternatives as second- or third-line options rather than placing them more appropriately as first-line therapy."
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