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Jeff Sessions’ Cruel Prescription for Pain

The attorney general does not seem to understand how the drive to minimize opioid use hurts innocent people.

When Attorney General Jeff Sessions advised people in pain to "take some aspirin" and "tough it out" during a speech in Tampa last week, the federal prosecutors in his audience laughed. Mitzie Katzen, who has suffered from complex regional pain syndrome since she was a teenager, had a different reaction.

"I was just floored," Katzen says. "I could not believe what I was reading, and I thought that has to be somebody who has never experienced really severe pain for any length of time." Katzen's perspective on Sessions' remarks illuminates the depravity of a policy that sacrifices the interests of patients like her in the name of fighting the "opioid epidemic."

Saying "this country prescribes too many opioids," Sessions cited the stoic example set by White House Chief of Staff John Kelly, a former Marine general who refused to take pain medication while recovering from hand surgery. Although "it did hurt," Sessions said, "you can get through these things."

It's not clear why people would choose to suffer postsurgical pain that could be easily relieved by an opioid analgesic, especially since the risks associated with medical use of such drugs are minimal. A large study reported last month in The BMJ found that just 1 percent of people who took prescription analgesics after surgery showed signs of "opioid misuse." The risk of a fatal overdose among people who take opioids for pain is even lower—something like 0.02 percent annually, judging from 2015 study reported in the journal Pain Medicine.

The attorney general's medical advice is not just senseless but cruel, especially if it is applied to chronic pain patients like Katzen. A 55-year-old mother of three who lives in Fort Worth, Texas, Katzen began experiencing nerve pain after a bout of Rocky Mountain spotted fever when she was 15. The pain became disabling after she caught mononucleosis while working as a child life specialist at a hospital in New Mexico, spreading from her torso to her legs, knees, feet, and face.

Katzen has tried a bewildering array of treatments, including acupuncture, acupressure, biofeedback, physical therapy, nerve blocks, trigger point injections, cognitive behavioral therapy, physical therapy, ultrasound, transcutaneous electrical nerve stimulation, and "a whole list of medications." The one thing that kept the agony at bay was opioids.

Katzen currently takes methadone and oxycodone, occasionally supplemented by injections of Demerol (meperidine) when the pain gets really bad. "Without medication, I really can't function," she says. "It's hard to move my arms. It's hard to walk."

Katzen knows that because a doctor who disapproved of the drugs she was taking once cut her dosage in half, leaving her essentially bedridden. That is the sort of indignity that an indiscriminate drive to reduce opioid use inflicts on people with severe chronic pain, who are often treated like drug-seeking criminals instead of patients.

Thanks to an arbitrary cap that took effect at the beginning of this year, Katzen's insurer is now covering just a fraction of the pain medication she takes. She worries that regulatory pressure will discourage doctors like hers from prescribing opioids, that "they'll decide it's just too great a risk."

That fear is well-founded. "There are many pain clinics flooded with patients who have been treated previously by their primary care physician," says Jianguo Cheng, president-elect of the American Academy of Pain Medicine. He says these refugees include patients who "have been functional" and "responding well" to opioids for "many years." Some have been driven to suicide.

If Sessions talked to people like her, Katzen says, maybe he could "see what it looks like to live with pain all the time." Then he might understand how the conviction that "this country prescribes too many opioids" can lead to policies that hurt innocent people.

"I'm very afraid of what's happening in our country," Katzen says. "I'm concerned that I will not have a functional life any longer if I'm not allowed to have what treats my pain."

© Copyright 2018 by Creators Syndicate Inc.

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  • Inigo Montoya||

    Is it just me or did the opioid epidemic only become news once more and more states started legalizing pot?

    As dumb as Sessions is, I think he senses the War on Weed is lost, and he is desperate not to let that defeat take down the rest of his beloved War on Drugs.

    He really doesn't care how many people are hurt and how many have their lives destroyed so long as authoritah goes unquestioned.

  • Number 2||

    It is not your imagination, and it is not just Jeff Sessions. Just like the original war on drugs, the war on opioid addiction is bipartisan. And it very much appears as though the stepped up war on opioids is the trade-off for the government backing down on marijuana.

    What puzzles me is how it became suddenly a Republican talking point that the "opioid crisis" was caused by the over-prescription of pain medication and the "overselling" and a "over marketing" of opioid medication by pharmaceutical companies.

  • LEAPGuyAZ||

    I fear you are correct.... With less marijuana enforcement what are you going to do with a huge agency like DEA?

    Thirty states and the District of Columbia currently have laws legalizing marijuana in one form or another. Marijuana prices paid to growers in Mexico have fallen from about $74 a kilo in 2010 to a little over $26. Cocaine, Meth, and Heroin imports are going up....

  • MarioLanza||

    You can look at the graph of the opioid deaths. It is not a fake issue. Approximately 80 percent of the global opioid supply is consumed in the United States. We do have a problem.

    And Jeff Sessions is correct to enforce federal law. If you don't like it, change the law. If we have Obama style executive usurpation of the legislature powers, we are that much closer to tyranny. I care a lot more about descent into tyranny than you stoners wanting to get high.

  • Sedona Vortex Hunter||

    its not your imagination and it is exactly what I thought would happen. It is also the reason that I hated how much of the talk about drug legalization seemed to be totally and only about Marijuana. I felt like it was a bad strategic move to focus so much on Marijuana instead of the fundamental issues regarding ownership of ones own body and an individuals right to pursue his own type of happiness.

    But what often happened instead were long debates about how dangerous one drug was compared to some other drug etc...arguing in this manner is playing the states game and essentially conceding that the government should have the power to dictate what a individual may or may not do with their own person. Such a stance essentially implies that we just need to argue which particular drugs are on the banned list.

    I think part of the reason the arguments were often framed this way is because the left actually does believe the state should ban drugs, but they want to be able to smoke Marijuana. But I had a strong feeling this escalation with regards to opiates would likely play out this way when Marijuana began to be re-legalized......continued below

  • Sedona Vortex Hunter||

    I often hear that the current Marijuana reform is a win for liberty minded people and that it is smart strategically to make incremental change. I actually disagree- I believe the state backing down on Marijuana will result in a tighter grip by the state going forward with regards to other still illegal drugs.

    I don't feel like the anti-prohibition argument has really made any headway at all. If you read mainstream news articles about opiates and meth, (even and often especially in left wing slanted publications) you can see in the comments that people seem totally in favor of more and increased government intervention and are very opposed to arguments for total legalization.

  • DajjaI||

    My doctor gave me opiates for a sports injury and never told me they could be addictive. So I got addicted to them and this lead to heroin and a life of crime and debauchery and I nearly died many times in my attempts to get high. Only through the fellowship of other addicts and a strict program of abstinence have I found serenity and restored my life and can now provide for my family. I think it's great if he cuts off opiates because first of all no one needs pain meds for more than a few days and secondly, it helps people like me who would otherwise still be living a life of crime and meaningless sex.

  • Wanderer||

    Full agreement

    The opioid epidemic is NOT a fiction.

    There are libertarian solutions about it : make sure cheap opioids are both available (so that you don't need crime to afford them) and frowned upon. Frowned upon like nazi flags.

    Prohibition may be a bad policy, yet it's a bad (and failed) attempt at tackling a real problem.

  • Tionico||

    the OTHER thing Sessions needs to get done is to remove cannabis from Schedule One status. It is NOT addictive, and DOES indisputably provide a wide range of significant medical benefits for many individuals, many of those brought with NO psychoactive component. Analgesic, antiinflamatory. calming are just a few medical uses. Relief of epileptic seizures in many cases is another, as is reduction of some tumours, and I forget some of the others. Quite a list. Seems he just wants to fill up our for-profit prison system.

  • MarioLanza||

    To the libertarian stoners: Jeff Sessions is the attorney general, not the king of the country. He does not decide which drugs are schedule 1, 2,... Read the Wikipedia article on the controlled substances act.

    "The Drug Enforcement Administration was established in 1973, combining the Bureau of Narcotics and Dangerous Drugs (BNDD) and Customs' drug agents.[19] Proceedings to add, delete, or change the schedule of a drug or other substance may be initiated by the DEA, the Department of Health and Human Services (HHS), or by petition from any interested party, including the manufacturer of a drug, a medical society or association, a pharmacy association, a public interest group concerned with drug abuse, a state or local government agency, or an individual citizen. When a petition is received by the DEA, the agency begins its own investigation of the drug."

    "The DEA also may begin an investigation of a drug at any time based upon information received from laboratories, state and local law enforcement and regulatory agencies, or other sources of information. Once the DEA has collected the necessary data, the Deputy Administrator of DEA,[20]:42220 requests from HHS a scientific and medical evaluation and recommendation as to whether the drug or other substance should be controlled or removed from control. This request is sent to the Assistant Secretary of Health of HHS. ...."

  • Finrod||

    Just because you're an addict doesn't mean everyone else is, slaver. Hope you get stricken with chronic pain and are denied anything to treat it.

  • DajjaI||

    Addiction is a disease but I am fortunate to have it. It made me a better person. I feel sorry for all the normies who don't experience our level of spiritual enlightenment.

  • Robert Beckman||

    Hello Mr Attorney General, I didn't know you followed Reason.

  • MarioLanza||

    Note that the chronic painer example given above is completely irrelevant. Jeff Sessions was talking about post-surgical pain. I can hear you say, "But, but, but,..only a small percentage of post-surgical patients get addicted to opioids!!!" Do you have any idea of how many surgeries are done in the country?

    And doctors are being pressured to over-prescribe. Google "minor knee surgery 90 percocets".

  • Myk||

    THEY are not addictive, YOU are addictive. They create dependency. The only thing the Dr possibly did wrong was not taper you off the dependency and sent you to the streets. Take some responsibility for your own actions. You took a pill without knowing about it. You took the pill too often (take one tablet every 4hrs and forgot about the "as needed" part). It is your genetics that put you in the 1% with an opioid receptor disorder (or you simply lack self control and have an "additive personality").

    Give me a hammer and an hour with you and I'll have you discovering why some people with spine injuries need long term pain medications. Not all diseases or conditions are curable. Many people treated with long term opioids were perfectly fine until the government started pressuring Drs to cut them off.

    Keeping me in pain for life or pushing me to suicide because there is no other end to my pain in sight does not help your addictive personality or receptor disorder one bit.

  • Tionico||

    when ya picked up the little pills from the DRUGstore, didjya bother to read the four page poop sheet on the little pills, the one that WARNS you opioids can be very addictive? The pharmacists these days all but stand there and MAKE you read it right in front of them, and ask you questions about what it says.

    So YOU got addicted.... lucky you. And since YOU did, you hold that no one should have them. That is a logic fail, a "part to the whole" class fail.
    Do you personally know everyone who lives with chronic pain, year round, decades at a time? I have done that... but mine is, so far, marginal enough I've learned some tactics to deal with it, like eating right, stayung as active as I can... but there is serious nerve damage lurking and waiting to come out and make my life a living hell. When that time comes, I hope SOMETHING effective will be available. Sessions' meme about eliminating the stuff is insane. SOME people need it. Yes, as a class of drugs they are WAY over prescribed. But some people buy cars that will do 160 mph. Does that mean everyone needs it? Does that mean NO ONE CAN HAVE THEM? No to both.You seek equality of outcome, a fallacy.

  • Sedona Vortex Hunter||

    I think Dajjal is actually trolling. Many people love the idea that their addiction is the fault of somebody else or the result of some uncontrollable and unlucky mishap ( like catching the 'disease' of addiction). I think Dajjal may be doing an impersonation of this type of person. I could be wrong, I am not certain of it, but think its likely...

  • Alan Vanneman||

    If Sessions talked to people like her, Katzen says, maybe he could "see what it looks like to live with pain all the time."

    Sorry. Jeff Sessions don't talk to no sissies. Period.

  • croaker||

    Jeff Sessions should eat a bag of Tide Pods.

  • MarioLanza||

    Jeff Sessions was talking about post-surgical pain. I am sick of the fake outrage that rules the country now.

  • Jerryskids||

    Pain is the cleanser. We are all sinful in the eyes of God and suffering is the path to righteousness and forgiveness. Yea, I shall be waterboarded in the Blood of the Lamb, the Staff of the Shepherd shall whang me upside the head and the Flame of the Holy Spirit shall consume my nethermost portions, yet I shall be lifted unto Paradise by my testicles and I will rejoice.

  • Anomalous||

    Oh, the schadenfreude when Sessions has to take his own advice.

  • I am the 0.000000013%||

    Politicians are politicians because they simply can't believe the rules they are pushing apply to them.

    To a lesser extent, that's true of every control freak.

  • croaker||

    Little shit better not end up in the back of MY ambulance. He won't even get aspirin unless medically necessary, and according to him nothing is medically necessary. That's what happens when you practice medicine without a license.

  • MarioLanza||

    Again, the U.S. consumes 80% of the narcotics in the world. Opioid deaths are skyrocketing.

  • LEAPGuyAZ||

    I'm about as familiar with the opioid crisis as anyone. I spent a career in public safety as an EMT, a law enforcement officer in three states - as a deputy sheriff, an undercover narcotics officer, a deputy coroner, and a small town police chief. After a back injury and subsequent surgery in 1984 I was left with severe chronic pain. I've been an advocate for sensible pain management ever since.

    The vast majority of pain patients use opioid medications responsibly. Some pain patients do become addicted during pain management and fall into heroin addiction. One main reason is because the heroin is cheaper and often easier to get than prescription opioids. As pain management physicians cut their patients medications without medical justification I fear some will end their life to end the pain.

    If a physician had medical justification to prescribe opioid pain medications, then they need medical justification to stop or reduce the dose or explain to why medical regulators.

    It's sad when someone who abuses opioids dies from an overdose. It's a tragedy when a pain patient ends their life for lack of pain control.

  • DajjaI||

    I'm sorry for your pain however opiates are pouring over our border and poisoning the blood of our youth. Chronic pain is a tragedy, but addiction turns good kids into criminals and prostitutes and is an existential threat to the country and our future.

  • Berserkerscientist||

    Studies have shown that legal prescriptions for pain medication almost never turn people into adicts (

  • LEAPGuyAZ||

    Than you...
    This study "Postsurgical prescriptions for opioid naive patients and association with overdose and misuse" also agrees saying only around 1% have a problem with opioids.....

    http://www.bmj.com/content/360/bmj.j5790

  • MarioLanza||

    Note that this is from the BRITISH journal of medicine. It is for post-surgical pain. It doesn't apply to the millions who get prescriptions for their low back pain, fibromyalgia, TMJ,...

  • MarioLanza||

    "Studies have shown that legal prescriptions for pain medication almost never turn people into adicts [sic]"

    Yet 75% of heroin addicts started out with legal narcotic prescriptions (and the other 25% stole them from their elderly parents).

  • Tionico||

    "good kids" don't do illegal drugs off the black market. Stop kidding yourself. Just cause YOU ended up owned by these pills, due to your OWN wilful ignorace and carelessness, does not mean others can't, or that they will or won't. YOU made some personal choices INCLUDING not reading thr poop sheet that ALWAYS somes with any drug. That little document contains all the warnings you needed... which you heeded...... not.
    And on what basis do you rest your claim that addiction turns kids (I dealt with the innacurate modifier "good" above, read that bit again) into prostitutes............ so here you have "good kids" doing TWO things "good kids' never do.... illegal drugs for fun, and prostitution. Kids who do these things are not "good", and "good" kids don't do these things. By definition. You are floating scare tactics to bolster your already failed argument. Double fail.

  • The Federal Farmer||

    Dependency and addiction are quite different.
    Junkies who just want to get high are a self-limiting phenomenon; Pain patients who are dependent upon opioids so they can function in their jobs and in their lives shouldn't be punished by government.
    Sessions is getting along in years, and will likely suffer some of the painful conditions that older people experience, at least we can hope he does.

    Like LEAPguyAZ, very few government drug enforcers realize the harm they visit on their fellow citizens until they, or a member of their immediate family starts to suffer.

  • croaker||

    And frankly they should reap what they sow. If they cut off pain relief for others, they should expect no pain relief for them or theirs. Fuck them. Sideways. With a chain saw. Dipped in satan peppers.

  • LEAPGuyAZ||

    Federal Farmer... For almost 15 years now I've been trying to make up for the damage I did to people their families and their children while enforcing our failed drug policies as a speaker for LEAP, The Law Enforcement Action Partnership.

    LEAP is a large group of current and former city, state, and federal police, prosecutors, and judges who feel our current drug laws are a total abject failure.

    If you feel our drug policies have failed please check out LEAP https://lawenforcementactionpartnership.org
    Go to the speakers page and find a speaker in your area and have them speak to your service club or group.

  • LEAPGuyAZ||

    I understand opioid pain medications are a serious problem for a few people, so please don't call it an epidemic. The vast majority of pain patients don't abuse their medications, they use them to get up, get out and be active.
    When you only look at the numbers and count pills it really sounds bad. There are 325 million people in the US and around one third – 92 million – Americans were prescribed an opioid pain medication in 2015. ..92 million....

    I live in Mohave County, it has one of the highest overdose rates in Arizona. If you look at the numbers Mohave County has a population of 200,000 people, not counting the thousands of snowbirds who come every winter.. Of those 200,000 people at one third or 76,000 residents were prescribed an opioid pain medication.
    Four Mohave County doctors wrote prescriptions for 6 million pills in a 12-month period. Sounds pretty bad… BUT when you do the math 6 million divided by 76,000 patients is only 76 pills per patient….

    Add the fact that most opioid pain medications are four-hour medications, and it takes 180 pills a month for one pill every 4 hours, or 2,160 pills a year. When you divide the 6 million pills by 2,160 pills per patient per year it's only enough pain medications for 2,700 patients for one year.

    It's sad when someone abuses opioid pain medications and overdoses.
    It's a tragedy when a pain patient ends their life for lack of pain control.

  • m.EK||

    The opioid problem is an alapathic medicine problem. The use of the "health care" system by the Big Pharma industry is to have continuous and ongoing patients.
    The pains are real, the scams developed are real. This is going to pass soon. People are slowly waking up.
    The abuse of drugs in our area is disheartening. Education is the key and normalizing marijuana would go a long way to helping. However, as long as people buy into the M.D., AMA model of "health care", this problem will continue.

  • UnrepentantCurmudgeon||

    All true. It's also a tragedy when the meds we take to reduce the pain to liveable levels impact our ability to work at our best. I now have memory deficits along with a decrease in cognition. I'm hoping that all goes away after the hip replacement and I can return to something like normal functioning, but I can't know.

    In the meantime, I suspect I'm not alone in saying that my issue is not addiction, it's habituation. I take one opioid for 6 to 8 months and have to change because it is no longer sufficiently effective. I've been on this merry-go-round for so long that my docs just tell me to tell them when I have to switch again. But if/when the day comes that I no longer have to live with the incessant pain I will gladly, and without reluctance, dump every pain-killer (including the medical marijuana) as fast and as safely as possible.

  • MarioLanza||

    Statistics from above then this:

    "It's sad when someone abuses opioid pain medications and overdoses.
    It's a tragedy when a pain patient ends their life for lack of pain control."

    More people are now dying from narcotic overdose than MVA's. Do you know anyone who "ends their life for lack of pain control"? Does it happen, somewhere, sometime in this country. Probably. But can you find one real example? Sorry, but this is an appeal to emotions fallacy.

    And your math is dumb "BUT when you do the math 6 million divided by 76,000 patients is only 76 pills per patient…."

    The issue is that you aren't distributing the pills evenly. Some are getting 12 Norco's and some are getting 90 percocets a month.

  • m.EK||

    I must admit I haven't really listened to Jeff Sessions speak much. I can't watch politics or the "news" as being lied to that much about everything is more than I'm willing to endure.
    That said, it does not sound as if this person has a world view other than political. He apparently does not know many people outside of politics. NO understanding of LAW, only rules called "laws". He certainly has not read the Constitution, nor the Declaration of Independence. Has no respect for the first 10 Amendments and apparently thinks his Oath of Office is some sort of ceremony and not the LEGAL AND BINDING CONTRACT WITH THE CITIZENRY that it is. A CIVIL contract that he is bound to find out about with his stupidity.
    I would love to have a 15 minute debate with him on LAW and Constitutional Law. He could have the first 10 minutes to sell his bullshit and pablum. I would need 3 to explain how fucked in the head he is and wouldn't even need to use an expletive.
    How does a person that ignorant even hold office? Of course, there are so many of them that this could be said about. Speaks loudly of the "educational system" and the blatant corruption in the voting/political system.

  • MichaelL||

    Been there in more ways than one! When we have politicians, guided by physicians with an agenda, the ignorance in the matter shows through. Having been forcibly removed from practicing medicine over the same stuff, it is terrifying. Even more so to me, now, that I have a post traumatic cauda equina syndrome and its accompanying neuropathy. I would like to put a TENS unit on Mr Sessions, crank it up all of the way, then tell him to deal with it! He is listening to people like Dr Kolodney, who would benefit greatly in his addiction rehab business. The benefit would mean millions for his business! Addictionologists write articles that say 60% of our population is addicted! These men are not reliable witnesses. He is hardly an uninvolved bystander. As noted, very few of us that use "opiods" become addicted (.02%). The biggest epidemic is among people who abuse heroin and illegal fentanyl to get stoned! They are dying from their behavior and their addiction. I hope that my final endpoint is not suicide! It might make me very angry! It disturbs me that guys like this are in charge and the rest of us, especially us in pain, can go to hell!

  • MarioLanza||

    He was talking about post-op pain. (And your 0.02% stat is meaningless.)

  • UnrepentantCurmudgeon||

    I'm certainly not in Katzen's league, but I have dealt with 24/7 pain for the last ten years. I wake up with it, get through the day with it, try to sleep with it. It never stops. Try it sometime. I've used opioids, medical marijuana and now CBD because it does a decent job of masking pain without the disorienting effects of marijuana (and yes, time was I thought that was a lot of fun). Finally an entry-level physical therapist told me at out first appointment that she saw no muscular or neurological deficits and opined that I had an arthritic hip. She sent an x-ray request to my primary who sent it to my ortho who is now going to do a hip replacement. And the therapist knows less than any or all of them.

    So I may prove to be lucky. But it won't make up for commuting hours that brought me to tears, having to take pain killers during the work day just to get through while making me far less than the best I could be. But I, like most pain sufferers I know, will be overjoyed to get off the junk. When you live a life like ours opioids or any sort are not fun they are necessary and we all pray for the day they will not be necessary for us. Until then, Mr Sessions, keep your hands off what I need to do to get through the day. Thank you very much.

  • MarioLanza||

    For the umpteenth time, he was talking about post-op pain.

  • willard3rd||

    We desperately need a nation wide petition to removed Sessions immediately! I think the people need to speak out and take control over those who are suppose to be working for them/us.!

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