Meet the Doctor Who Refuses to Stop Prescribing Opioids to Pain Patients

"I take the Hippocratic oath seriously that my job is to relieve pain and suffering," says Dr. Forest Tennant, a California pain specialist who patients from across the nation are flocking to see.


Pain patients from across the country are flocking to a boundary-pushing pain specialist in West Covina, California because they can't get the treatment they need in their home states.

A growing "opioid epidemic" in the U.S. has led law enforcement agencies to crack down on so-called pill mills, leading to the arrest of several physicians. Last year, the Drug Enforcement Agency (DEA) clamped down on painkillers, reducing the allowed production of opioid medications by about 25 percent. Some states have filed lawsuits against pharmaceutical manufacturers, and, earlier this year, the Center for Disease Control (CDC) issued guidelines advising physicians against prescribing high doses of these drugs, which can be particularly lethal when combined with alcohol or anti-anxiety medications. Many doctors will only prescribe opioids as a last resort.

Dr. Forest Tennant, 76, says this regulatory backlash is preventing chronic pain sufferers from getting the drugs they need to alleviate their conditions, and he refuses to go along. Critics have denounced his unapologetic style and unorthodox methods, but his patients depict him as one of the only physicians in America to put the needs of his patients first.

"[Tennant was] the first doctor to say, 'our goal is to relieve your pain,'" says Kristen Ogden, whose husband Louis Ogden has suffered from chronic pain for decades. They travel to Dr. Tennant's office from Virginia for treatment every three months. "Every other doctor had said, 'our goal is to get you off any opioid medications.'"

Many physicians have even begun to adjust the way that they think about pain.

In a New England Journal of Medicine article, one of the pain specialists advising the CDC recommended that pain patients "use coping and acceptance strategies that primarily reduce the suffering associated with pain and only secondarily reduce pain intensity." That opioids are never an effective chronic pain treatment is quickly becoming conventional wisdom, and the American Medical Association (AMA) has even begun to advise physicians to abandon the pain rating scale when assessing patients.

"I take the Hippocratic oath seriously, that my job is to relieve pain and suffering," says Dr. Tennant. "So when I see the AMA decide that they're not going to assess pain, I'm not with them."

Tennant has run a pain clinic since the 1970s when he mostly treated patients with pain resulting from cancer and polio. He's never shied away from the public spotlight.

In addition to serving as mayor of his city, he ran some of Los Angeles County's earliest methadone clinics to treat heroin addicts and in the late '80s served as a drug adviser for the NFL, NASCAR, and the Los Angeles Dodgers.

Controversy swirled around him in many of these roles.

He angered the NFL when he publicly disclosed plans to monitor several New England Patriots players for drug use. One NASCAR racer even accused him of colluding to falsify drug tests to target him.

Tennant simply told the New York Times that "[n]o mistakes were ever made."

Tennant says it's true that opioids were overprescribed in the past and should generally be a last resort for pain treatment. But he believes the media and government have now gone too far in demonizing them, and it's legitimate pain patients who are paying the price.

Produced by Zach Weissmueller. Music by Kai Engel and Blue Dot Sessions.

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  1. Does anyone have his number? I'm thinking about shooting up before I read the Trump apologia in the comments section.

    Trump isn't that bad!. liberals are just going nuts over his claims that Obama wiretappped him

    [Wraps rubber tubing around arm... injects]

    Ahh... that's better.

    1. Poor, poor commie kid loser.
      You LOST, loser!

      1. Nono... you've got me wrong. I'm enjoying the shitshow. I just wake up everyday and think of the great American opioid addicts that elected Dear Leader. Irony first, communism second.

          1. God would you trolls just address the actual issue ? Why the hell are you even here?

            1. I'm making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life.

              This is what I do...

            2. Ladyhawk|7.7.17 @ 7:43PM|#
              "God would you trolls just address the actual issue ? Why the hell are you even here?"

              Dunno, troll, why are you here?

              1. I'm making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life.

                This is what I do...

            3. Thank you for your comment Ladyhawk. I am the 'Louis' in this video being interviewed along with my wife. I fail to see why this should be a political issue. Republicans and Democrats both can suffer from chronic pain. If only they would take a stroll in my shoes and feel what it is like. The 'War on Drugs' would end if that were the case.

              1. Personally, I wish that every legislator that has ever voted to restrict opioids would be stricken down with crippling pain that can only be relieved by opioids. If that happened they'd be giving away opioids for free on the street.

                1. I also live with a rheumatic disease which has caused fibromyalgia and while I've taken Opiate pain killers for the last 20 years I've NEVER become "addicted" I doubt your wife was either because addicted people seek drugs to get high, addicted people don't sit with a month or two's worth of opiate in reach and only use the number prescribed per day. Whe first diagnosed I had small children and was aware of the potential for addiction and overdose so I used other methods to accept my pain, and live with it but I ended up missing their childhood to deal with the unremitting pain. It can be done but then life isn't worth living! It's a good thing that more state's are allowing assisted suicide because more chronic pain patients won't have any other options!

    2. Trump isn't that bad!

      When you have people claiming that he's literally Hitler and other ridiculous things, yeah, sometimes he's not that bad.

      1. I'm sure some are making that argument. Not me. Dear Leader seems way too overwhelmed by his job and disinterested in specifics to be much of a fascist. He's just remarkably unqualified and laughably inept. I'm just here to watch the car crash as I don't give a fuck what happens to this tinpot banana republic.

        1. "I'm just here to watch the car crash as I don't give a fuck what happens to this tinpot banana republic."

          Notice how this loser is maintaining a calm and clear perspective.
          The fact that we got the better of the two alternatives in no way makes the US anything like a "tinpot banana republic".
          That's what slimy lefties like you dream of.

        2. Stalin, Trump has actually been remarkably adept at keeping several items on his agenda going, in spite of attempts by you and other left-wing fanatics to throw up roadblocks. Now let's turn our attention to qualifications - his opponent, Hillary, has a long history of f*cking up everything she touches, a fact noted by Podesta in some of his released emails. She is most qualified for jail time, given her and Bill's long history of abuse of public office for personal gain, much less the mysterious "suicides" and "unexplained" murders of so many of their former associates. Finally, what makes the US most seem like a banana republic these days is a blatantly left-biased and colluding press.

      2. The thing is, Trump may be bad, but with the Progressive Left in full blown hysteria it's hard to tell. Hitler benefitted from WWI propaganda the same way, in a sense. The Allied Powers in the first World War told the world that the Hun were raping nuns (none were ever located) bayonetting babies (no examples were ever traced) and so on. They did so much plain and fancy lying about the enemy (mostly to cover up their corruption and ineptitude) that when the smoke cleared a lot of it came out. And so, when people started circulating PERFECTLY TRUE accounts of Nazi bestialism and atrocity, very few people believed them because they had heard it before, and the last time it was bunk.

        Trump isn't that despicable Austrian paperhanger. Neither was Bush. But the day may come when come caddied is, or worse, and by that time it's going to be damned hard to convince anybody.

        1. Look, the Boy Who Cried Wolf was written by a bunch of white male slaveowners, so, yeah, cishetetcetcetc

        2. What was the autocorrectism "come caddied" for?

  2. Doctor Who is prescribing pain medicine? And Christ, this new regeneration of his looks just awful.

    1. gonna miss Capaldi

      1. Indeed. The season finale highlighted that. Looking forward to him teamed with David Bradley (as the First Doctor) at Christmas though.

    2. That headline's bad enough without the guy being named Tennant!

      1. Imagine if his successor was named Smith.

  3. I assume "It's my body!" doesn't apply here, because there's not necessarily a uterus involved.

  4. "In a New England Journal of Medicine article, one of the pain specialists advising the CDC recommended that pain patients "use coping and acceptance strategies that primarily reduce the suffering associated with pain and only secondarily reduce pain intensity.""

    So, we should check for air-shirts on Aisle #6 and learn to like 'em?

    1. hair-shirts, that is.

      1. Made sense the 1st time. Like imaginary shirts.

    2. I'm just glad intellectuals are making these decisions for people, rather than the actual people who have to suffer.

    3. One size fits all seldom does, but it's so much easier.

      1. One of the most intelligent comments, so far!

        one who did not do as well as Dr Tennant..

        1. I had to deal with "fucks" like that, who saw to it that I was driven out of medical practice. The petty politicians threw me out of their hospital because the "did not understand what I was doing." They also complained that I acted like I thought I was smarter than they were. With about five years more education than the most educated of the bunch, there might have been a reason! I had a graduate school education, not obtaining a degree because of choice not to complete the paper needed for my degree, plus a two year course in obtaining a Certificate on Pain Management, and completing a SESAP module just six years after completing a surgical residency. Having passed my surgical boards the first time through, I thought I was doing well! During the time, establishing a general surgery practice,practicing as a GP, and getting enough ER moonlighting hours to grandfather into an Emergency Medicine board certification. I also kept up with my ACLS and ATLS certifications, over and over again! It was no wonder at all that I had more education to draw from and appear to be "smarter" than the FP-s who grandfathered into their board certifications,. ( I had the head of the ER in Doctors' Hospital in Tulsa, who requested that I join his staff as an ER doctor and leave the practice of general surgery.)

          1. One of the competitors for general practice patients, only a one year internship prior to starting a rural practice in "Bumbf#&k Egypt" (Egypt was a small town not twenty mile from where I practiced!) I was told by others, in a small hospital ten miles away, that I should have been "practicing in a university setting." The medical board stated that they were worried about someone who was practicing cutting edge medicine in their small rural hospitals.,(;-P...Oh, well! My early "retirement" left me with much less stress, and relief from many of the fibromyalgia pains that I suffered from. Add to that an accident that left me with a hemiparesis and permanent physical disability, I ended up with a retirement income that left me in a position to live a fairly comfortable life, that left me with even less stress! So long fibromyalgia and IBSC!

    4. This is complete lunacy. And doctors with principles can't do s--t about it because guess who holds all the cards.

      "That's a nice practice you've got there, shame if anything happened to it."

      1. These fucks are evil in the extreme. A long term friend had chronic back pain bad enough to interfere with work until he found a doctor that would competently prescribe opiods. He stayed with dr ten years, and actually kept to a reasonable level of pain meds. Since the doctor didn't do random drug tests, they shut down his practice, and knocked 250 patients off their meds. Several committed suicide, about 5 or 10 had strokes, its likely that some had died from ODs by now.

        All to break up a successful practice by a doctor that was helping people.

        1. Thanks for your comment. I'm the 'Louis' that is interviewed in this video. Whoever said 'pain doesn't kill" is bat-shit crazy. Extreme pain can raise blood pressure, cause heart failure, strokes, along with other things that CAN KILL. I know people who've had their medications taken away that have committed suicide. Thanks for your support!

    5. What other medical issues do doctor's prescribe "acceptance strategies"?

      1. the terminal illness that makes the opiods necessary in the first place.

  5. AMA to America:
    "You hurt? Suck it up buttercup. Better to live a lifetime in pain, than take a chance you might decide you like the feeling opioids give you."

    Do people get addicted to opioids? Sure. And obviously fentanyl patch shouldn't be the first line of defense for a slight twinge.

    But hey, how about this:
    "You are in pain, and I can give you Vicodin/Percocet etc. it can be addicting, and cause wicked constipation. So ask yourself if pain relief is worth that. If it is, her is your script."

    1. Slightly OT:
      I am doing Cognitive Behavioral Therapy for anger issues (my screen name is bear, have a bit of berserker in me, and my patron god is Odin. Go figure!)

      Dr Thomas Szasz came up today. My therapist and I had an interesting discussion about the WOD.
      Shorter: our approach sucks, Portugals is much better.

      1. So you or your insurer were paying good $ for an interesting discussion?

        1. What business is it of yours?! At least she was trying to do something that might help her cut down on the need for as many opiates in her treatment! Interdisciplinary treatment includes the use of such alternative therapies. It has been well know, for years, that it is the best approach to treating chronic pain, when it is available and paid for by insurance. People cannot get such good care because of backwards thinking of so many in charge of our medical care, and busybodies like you!

    2. "You lost your job. Suck it up buttercup. Open borders create the social atomization and confusion that allows spergy nerds to not feel as self conscious about their inability to connect with others."

      The problem with libertarianism is that it can always be restated in ways that make libertarian misrepresentations of things like for example the AMA policy look positively enticing.

      1. Sam Haysom|7.7.17 @ 1:34PM|#
        "You lost your job. Suck it up buttercup. Open borders create the social atomization and confusion that allows spergy nerds to not feel as self conscious about their inability to connect with others."

        Sam, even for a dimbulb like you, that is an award-winning piece of baffle-gab!

        1. It's the argumentum ad aspergers that really gives it that little something extra.

      2. libertarian misrepresentations of things like for example the AMA policy

        In what way are we misrepresenting this? Read the linked article - they clearly are more concerned with "drug abuse" than "pain reduction".

        "Addressing the opioid epidemic capped a wide range of public health-related issues addressed by the delegates this year."

        Drug abuse is not a public-health issue.

        The new policy calls for the AMA to describe gun violence as a "public health crisis,"

        Neither is gun policy.

        These people are delusional and deserve every bit of scorn we can heap on them.

        1. I recall reading President Dwight D. Eisenhower's caution, in his Farewell Address, against the dangers of a Military-Industrial Complex.
          What I don't remember reading, but was in the same address, was his warning that "in holding scientific research and discovery in respect, as we should, we must also be alert to the equal and opposite danger that public policy could itself become the captive of a scientific technological elite".
          Both of these bad things are happening today.

        2. They deserve to be in the crippling pain that they're condemning others to "for their own good".

      3. This is why I insist that Tulpa is sadder than amsoc.

    3. Personally, my reaction to ""You hurt? Suck it up buttercup. Better to live a lifetime in pain, than take a chance you might decide you like the feeling opioids give you."" would involve a ball peen hammer and a number of the idiot's joints.

      If one person in chronic pain is prevented from getting relief because of the State's obsession with Prohibition on Drugs, that is grounds for rounding up every single one of the WOD myrmidons and dousing them with flaming gasoline.

      1. They are. Gasoline's easily available. Start to it.

      2. You're kinder to them than I would be. Dousing them with flaming gasoline would kill them before they get to suffer the kind of pain they've been inflicting on others.

    4. You are misinformed. I am the pain patient 'Louis' that was interviewed in this video. When one takes the meds for legitimate pain, there is no euphoria. Study the issue, please, before making such comments.

      1. This was a reply to CSP Schofield!

      2. It's true. I have a friend who has bullet and skull fragments lodged in his head resulting from a home invasion years ago. He takes a massive amount of opiates, and has never appeared to be high to me.

  6. The problem is that this isn't about just pain. Or even mere addiction to opioids. It is about the cost forced onto others. Opioid-related (ie principal diagnosis is opioid misuse not something else) ER visits and hospital inpatient stays have more than doubled since 2005. NO ONE pays the actual cost of hospital stays. That is always a cost transfer to someone else (via higher insurance costs or govt spending). This was not an issue when 'pain relief' was bigger doses of aspirin/NSAIDs.

    Pricing system can fix this better than govt mandates. But it does need to be fixed because opioids clearly have a very large negative externality.

    1. Drop the Prohibition on Opioids and allow for legal recourse regarding purity issues, and a lot of those hospital visits will go away. Not all of them, obviously. But an awful lot of the problems the WOD cites as justification are caused by the WOD.

      1. ^ This.

        Opioid addicts are actually astoundingly good a self-regulating their dosage when that dosage is predictable (i.e. not cut in random percentages with random substances).

      2. and allow for legal recourse regarding purity issues

        That's already a thing, isn't it?

        1. Not when it comes to vegan ersatz mayonnaise.

        2. only enforceable when registered pharmaceutical manufacturers are the source. The street stuff, how ya gonna "git" the creep who cuts his poppy pulp with strychnine? He's already a dirtbag lawbreaker, no morals, so why should he sweat it when it comes to an honest product?

          Legalise it (more accurately, de-illegalise it) and bring it above the table and out of the shadows and cartels. Then responsibility for a pure and accurate strength level product can return.

          FedGOv have NO business medding with anything we might/mightn't put into our bodies. NOWHERE amongst the authority assigned FedGov comes anything like that. DEA and the CSA are all illegal, Dump them. ALL the substances named in the CSA need to be deregulated.

          1. A hundred thumbs up! I am a doctor who had extra training in pain management, driving out of practice, now a sufferer of chronic pain, from a post traumatic neuropathy, as the result of a broken back, and cauda equina injury! I have been fighting on three sides of the problem, a provider, patient advocate, and chronic pain patient! I was attacked in all three situations by TPTB!

          2. I agree completely. The whole damn FDA is unconstitutional as far as I'm concerned.

    2. Two questions if you know the answer.

      You said the number of visits doubled, but do you have the absolute number of visits?

      What does an Opoid-related ER visit usually entail? Overdose? What does that mean?

      1. The numbers I've seen are 400,000 visits/year for prescribed opioids misuse - 5 million/year for 'overdose' (prob incl alcohol and illegals). Both different sources with different base years. But somewhere a bit under 1 million is probably right. Opioid overdose deaths (some heroin, some prescribed) are 33,000/year.

        The average cost for those ER visits is $3600 if not admitted to inpatient - $29,000 if admitted to inpatient

        1. what's an ER visit for "prescribed opioids misuse" that's not an overdose?

          1. don't know. I'm not a doctor and don't even play one on the interwebs. That's what they call it. For example -

            1. Suggestion:
              Read your own link.
              I'm pretty sure it does NOT say what you think it does by the time you get done with the footnotes regarding the data reliability.

              1. Suggestion:
                Maybe YOU should actually read those footnotes - for comprehension instead of the mere appearance of a word.

            2. You are right, JFree! You are not a doctor and should not fool yourself to think you have enough knowledge to be making calls on the fake opiod crisis. Most overdoses have been the result of Fentanyl laced diacetyl-morphine (heroin), all clandestinely produced, not regulated for potency of contents.

        2. Try living with constant chronic pain for 20 years. It gets old.
          Chronic Pain sufferers generally don't have ODs until cut off, when about 5% turn to black market sources.
          When the concentration of pain killer can vary by factor of 10, ODs are almost inevitable over period of years.

          1. We just need to get government out of the equation. Why is it my fault as a legit patient that other some other people abuse their meds? If they are that self destructive and unwilling to seek help, then tough shit. The rest of us should not have to suffer because they can't deal.

    3. Says the guy who is not currently recovering from hip replacement surgery without opioids. Fuck you!

      1. Do you think that gives you the right to pass on those costs to me if you're one of the ones who can't kick the medication? Fuck you!

        1. the decline into socialized medicine is a separate issue.

          1. Not really. The costs of the hip replacement were passed to others via 'insurance'. There is no such thing anywhere of ANYONE actually paying for their own healthcare.

            Health insurance is the great fiction, through which everybody endeavors to live at the expense of everybody else.

            1. quote: There is no such thing anywhere of ANYONE actually paying for their own healthcare.

              yes there is. I've been doing it for four decades and more. ALL my medical needs have been paid out of MY pocket. The total cost to me during that time is about one fourth of what OhBummerTax would cost me for one year, and THEN I'd still have to pay the "deductible" and "co-pays" before OhBumerTax pays a nickel,

              WHY can't gummit get their gummy mitts OUT of medicine, health care, insurance, and "controlled substances" manglement, all areas in which they have NO AUTHORITY.?

            2. I realize that I'm replying to a dead thread, but couldn't let this comment stand on its own.

              Health insurance is the great fiction, through which everybody endeavors to live at the expense of everybody else.

              There is absolutely nothing wrong with a market-based risk pool (ie health or any other insurance). If you don't like it, don't buy it. Good luck when some catastrophe happens in your life.

              The problem is that the government gets more and more involved in what should be a market solution, with voluntary participation in any plan that one wants to buy.

              1. You are exactly right.

            3. JFree, I have not had insurance for 10 years and have paid for ALL of my doctor's appointments, dentist appointments & chiropractors out of my pocket. And I am 63 years old. I've been blessed with good genes, but do try to minimize my health risks, no smoking, moderate drinker, no drugs. Your statement is categorically false.

          2. I'd be happy with a couple of weeks of opioids that I pay for myself. Xanax just doesn't cut it.

        2. Kicking the medication requires doctors who actually give a shit that someone is properly titrated down at a rate that minimizes withdrawal. You pull the rug out from under them like when the DEA or the FDA says cut them back by 25% immediately, all you do is drive them to the streets where heroin is cheaper and more available, and THAT is when people get their shit cut with carfentanyl which they use to trank elephants fer Chrissakes. OD is guaranteed.

          1. And the reality is that this prescription opioid problem ONLY exists in the US. Everywhere else, opioids are prescribed only to terminal patients - or for one week or so max at a time in a post-surgery or trauma type situation. They transition patients to NSAIDS - before addiction kicks in and often while they are still inpatient. If that means the patient has to endure a bit of pain or visit the doctor very frequently early on - well maybe that's a personal cost of having everyone else pay for the operation/care via insurance/govt.

            Everything you are describing is nothing but treating an addict (at someone else's expense) that has already been created (at someone else's expense) because we are a nation of entitled snowflakes. What a fucking waste. And if libertarians are so wedded to the drugs-good-rules-bad mindset that they can't see what's happening here - maybe they should stop being entitled snowflakes too.

            1. How about I come over and arrange to shatter a few of you lower vertebrae so they aggressively pinch your sciatica. Then you can tell me how people who need opiates are 'snowflakes'.

          1. So sorry, I must needs elaborate on my reply to this gentleman in order to make it crystal clear what he deserves for that remark:
            To JFree: Do you think that gives you the right to pass on those costs to me if you're one of the ones who can't kick the medication? Fuck you!

            Most appropriate answer: Yes asshole.

        3. Bull shit. You feel pain meds should be withheld because he *may* in 20% that gets addicted.
          Bet if you got bit by a couple Bullet Ants(, you would be looking for anything to kill the pain before you start cutting off limbs.

        4. JFree they have as much right to pass on the cost as an alcohol user, which causes far more hospital visits, tobacco users, with their massively costly cancers, non-compliant diabetics, car accident victims who were at fault for their accidents, every other medication in existence besides opiates that also have side effects (NSAIDs and liver damange? hello?), etc. And since you specifically complained about prescribed opiate misuse, you can't even fall back on a legal status (but not moral) distinction.

        5. We should all help one another, JFree. I believe very strongly in socialized medicine. Addicts also deserve medical care - addiction is a disease!

        6. Reading comprehension? WITHOUT opioids. I guess that I should pay for insurance for a few decades and never use it.

        7. You think you have the right to condemn people to chronic pain when there is relief for them available?

          Go fuck yourself with a running chainsaw, slaver.

      2. I was just thinking to myself, "I hope the people making these rules fall and break their hips."

    4. JFree|7.7.17 @ 1:43PM|#
      "The problem is that this isn't about just pain."

      You're right.
      The problem is with statist retards like you,

  7. I could have sworn I read much this same article a few years back about a doctor in Florida warring with the DEA about his pain medication dispensing business. Some of the suspicions the DEA had about him revolved around the fact that so many of his patients came from far away to see him and so many got pain meds. He had to explain to them that since they had shut down a couple other doctors and scared off the rest of them from prescribing pills he was now the only doctor for a hundred miles around that would still prescribe pain meds so, yeah, no shit he was seeing a lot of people from far away wanting pain pills. I mean, if you've got two grocery stores in town and one of them burns down, are you going to think it mysterious that for some strange reason the other grocery store's business suddenly doubled?

    1. I'd probably at least take a look at the involvement of the remaining grocery in the burning of the other grocery store.

      Which, with this metaphor means that the Doctor in the video framed all the other Doctors who were arrested.

    2. I remember that article, too.

  8. You get government involved in medicine, and you get chaos.
    In the interests of fairness, why is it only women who get to 'choose'? Why can't all patients choose? I mean with opioids, only the patient can die.
    How about anyone who whines about 'excessive' use of opioids get their leg broken and not treated. Then see if they would like a pain pill or not. If they say no, break the other leg.

    1. Leg? That's getting off easy. Feet. because, good luck fixing that with surgery.

  9. This is a pendulum that swings both ways due to misguided government interference.

    My grandfather died of various cancers just about exactly 20 years ago. He was a doctor who had been self-prescribing codeine for years and was addicted. He purposely concealed what he knew were fatal symptoms in the hopes that he could die at home. His wife (not my grandmother) eventually called the police and had him forcibly admitted to the ICU.

    In the ICU they refused to give him opioids even though he was clearly terminal and suffering from withdrawals. They didn't want to risk addiction (even though he clearly was already addicted). My dad asked at what point they would decide the pain was worse than any chance of addiction in his remaining weeks, and they said "when we see whites on his knuckles from clutching the bedrails."

    After that time, "pain management" started becoming a factor in licensing, because stories like that were becoming kind of common. When my daughter was born about 10 years ago, I was surprised by how cavalier hospitals and doctors had become about pumping opioids into people at the slightest hint of discomfort.

    Now we have an opioid crisis, and the pendulum is swinging back again. Rinse, repeat.

    1. Torture is illegal. Those doctors should arrested.

      I've known one person hopelessly addicted to opioids. I've known a few heroin junkies. But I've known more who've had their life turned upside down because some idiot doctor decides that now, after literally decades of stable use, NOW is the time that opioid addiction is a life-risking concern.

    2. This entire scenario began when Nixon declared a "war on drugs" in the '70s that resulted in the medical profession finally seeing in the '80s that it created a welfare issue for chronic pain patients. Yes Square-Circle, it IS happening all over again, because in the '90s Bush chastised the DEA for failing the "War on Drugs" (an impossible task by current methods of banning street drugs and trying to stop imports) and they responded by pivoting to prescription drug abuse. THIS is the result.

  10. Dudes just asking for some pig to shoot him.

  11. Critics have denounced his unapologetic style and unorthodox methods

    This motherfucker, unapologetically rejecting their orthodoxy, THE NERVE. Does he even consensus, broh? I just can't even.

  12. All I read was Doctor Who and Tennant.

    1. Ditto. This must be a future Doctor, with a sonic prescription pad.

  13. I started out in favor of the War on Drugs, based on some bad experiences with drug abusers when I was young.

    Dealing with the circus around pain management was the last straw that made me realize what a farce the War on Drugs is. I redacted some stuff here because it's too personal and nobody likes being used as someone else's talking point. Let's just say jumping through hoops, getting treated like a criminal, and often being refused medical help after following all the rules, while taking care of a disabled family member in chronic pain, is as much fun as it sounds like.

    The way the government deals with drug problems leads to untold horror and misery, it's eating away at our civil liberties, and they have nothing to show for it. Put an end to this bullshit now, and let the chips fall where they may.

    1. and they have nothing to show for it

      If anything, they have only made the problem worse. The same way Prohibition got people drinking bathtub gin instead of beer and wine, the war on drugs took an "opium problem" and gave us the hard-drug problem that has been part and parcel of modern society.

      Morphine was in fact first promulgated as, among other things, a cure for opium addiction.

  14. Opioids are very useful for relieving temporary pain. I've had several surgeries, and prescriptions for opioids afterward. I usually end up with a bunch left over, because I stop taking them as soon as the pain goes away, or even becomes sort of a background thing.

    But I'm lucky in some ways. I'm unlikely to get addicted because I _hate_ feeling sleepy (except at bedtime). Opioids make me feel sleepy, so I'll stop taking them as soon as I can. Other people may enjoy that feeling and get addicted.

    That said, I oppose the nanny state. Let people deal with their own problems in their own way, and handle the consequences, just like any other decision. (Offering treatment to those who have gotten addicted and want to not be addicted is, however, useful.)

    Just one thing about opioids: as far as I know, you develop a tolerance for them. So if you have long-term pain, you may simply reach the point where no dose that your body can tolerate will do much for the pain. What then?

  15. I don't think many of the previous 65 or so comments that I've read so far have come from anyone who has lived with chronic or intractable pain or had someone close to them that did. I'm happy for them, it's an experience I wish on no one. Most have probably heard very little about?the dire straights patients using opioids, especially in higher doses, are facing. It's likely they do hear a good deal about lives lost all too soon to addiction. ANYTHING that prevents this seems logical and necessary. The problem is that efforts to prevent addiction have resulted in a shift from routine instances of overprescribing , though even then a substantial number of patients were still under-treated to an environment of tapering en masse with no regard to how individual patients are faring, doctors leaving the practice of pain management altogether, and patients abandoned, without a source of treatment. Patients with severe pain from serious, verifiable diagnoses like adhesive arachnoiditis - and even some cancer patients have been left without pain medication, to fend their way through withdrawal. Discussion of suicide has become commonplace among patients and deaths of patients from suicide appears to be rising as well -: though reasrach is still in process.

    Just because you haven't experienced ongoing pain doesn't mean your life won't change forever, tomorrow, next year, or ten years down the road. 100 million Americans have chronic pain and 3-5 million need opioids .

    1. Continued:

      Would you want the ability to make a decision with your doctor about what's best for you? Would you want your doctor to stay within prescribing thresholds, whether or not he/she believes it's in your best interest?

      The human race is highly diverse and genetic variabilities, acquired conditions, and injuries produce a broad range of dosing requirements, though MOST patients do well under 200 MME. Most does not equate to all though. Having metabolic defect(s) should not compound suffering because the patient is unable to receive a dose of medication adequate for their individual needs.

      I'm one of these people whose quality of life and even overall physical health has been impacted by prescribing reforms. In 2015, my entire life was ripped away within a few weeks as I had to taper my medication because the responsible doctor who'd treated me for the past nine years was simply too scared to continue treating patients.

      1. Continued Part 3 of 3:

        Despite lots of referrals and phone calls, no one was willing to treat me - ANYWHERE, except Dr. Tennant. Dr. Tennant helped me get my life back. No, HE SAVED MY LIFE. To say I'm grateful is woefully inadequate. He genuinely cares about helping his patients have the best quality of life possible.

        It would surprise many people, but opioids aren't his first line of attack, but he won't hesitate to use them either. Dr Tennant has done extensive researched on endocrine abnormalities in pain, consequences of inflammatory processes and scar tissue, and the auto-immune consequences they produce. His findings have enabled him to provide patients with better pain control - and.many have? been able to make large reductions in dose as tolerated over time. Improved function and pain relief - not dose reduction are the primary goals.

        1. My chronic pain is from rampant osteoarthritis which, trust me, is NOT relieved by hot baths, meditation and aromatherapy. One wishes for a productive life, not just a temporary reduction in pain that allows a bit of mobility. The doc who put me on opioids says my dosage is nothing compared to some of his patients, including one who was at 600 mg a day. These people suffer total loss of meaningful life without opioids, and the self-righteous pain-free do-gooders who think they can decide what others should get are people who ought to have some permanent pain inflicted on them for a dose of reality that too many people live with daily. I had one specialist tell me that no one needs anything stronger than an extra strength tylenol. Jesus.........

          1. I would like to take that specialist and educate him on what terrible agony is like. Reminds me of my friends who don't suffer from back problems.

            1. I'll help hold him down while you "educate" him.

  16. "it's legitimate pain patients who are paying the price."

    Ignoring for now the question of who decides what is 'legitimate', it is *always* the people who truly need these medicines that suffer when prohibitionists get after it.

    When you limit access you are choosing addicts over actual suffering patients as the target of your ministrations "for their own good".

    In the prohibitionists minds, it is literally better that a person live in debilitating daily agony than for someone who doesn't "need" the medicine to use it inappropriately.

    The people who choose and enforce this are some of the most despicable human beings who have ever lived.

  17. Thanks for confirming my suspicions. I felt this whole "epidemic" was manufactured by the media from the beginning. I also wonder how much the Drug War folks have influenced the hysteria. At least one Dr. is clear headed.

    1. You got that right.
      I recall all the local new reports around 2000 that would show how drug abusers crush and snort oxycontin to get a rush better than heroin.

  18. Most opioid overdose are really polypharmacy overdoses, adding alcohol, benzodiazepines like Valium or recreational drugs. So here's an amazing solution by yours truly: make Narcan (nalaxone) available over the counter, in every state.

    I once landed at 70 mph, pulvarizing my sacrum and the lumbar spine (turns out you do need a working parachute!). One year in a spinal cord clinic, and twenty years later I developed adhesive arachnoiditis, incurable spinal cord inflammation.

    Oh yeah, also a third spinal cord injury, but who's counting right? At the T4 (chest) level I've got an intramedullary hemangioma which causes central pain syndrome. Imagine simultaneously standing in a barrel filled with ice and yet, deep in your spine radiating to your feet, someone pours molten lead.

    I'm one of those examplary patients who only uses opioid pain meds as prescribed, for breakthrough pain (when my daily normal 6 goes to an 8 or 9). I use a very low dose, at most two 5 mg tablets daily. Never more, when I hit a 10 it's a flare-up and I get a short course of steroids.

    My PCP, after 7 years, gave me a number to a pain management clinic for opioid rx. Except that they won't accept me. Dr Kuhn doesn't do medication management, just interventions like epidural steroidal injections, all the stuff that's detrimental to adhesive arachnoiditis patients.

    Google Guardian and opioid hysteria, June 2016.

  19. PS: America, don't make me move back to Europe! I love America despite everything. Because although I'm mostly bedbound, I perform comedy once or twice a month and my Liberterian, wild comedy won't fly in Europe. You know what else doesn't fly? Me without a working parachute!

  20. I no longer watch Doctor Who. It's an opioid for the masses.

  21. Color me unimpressed with both the content and direction of this article. At least coming from an ostensibly libertarian magazine.

    To be sure people should be free to choose their own forms of medical treatment.

    Likewise, if a profession seeks to maintain some standards then by all means we should accept their ability to hold their members to those standards.

    The problem here is that that profession - calling themselves "medicine," and arrogating all authority over medicine to themselves - is acting as gatekeepers preventing people from choosing their own forms of medical treatment. And the good doctor featured in this article is doing exactly the same. He is firmly wedded to his gatekeeper role and does not seek to change that one whit. He just wants more government approved gatekeepers like himself.

    More bothersome is that the author(s) here never seek to question him about that aspect. They present him as some sort of hero, when ultimately he is just another facet of the primary problem - the fundamental lack of medical liberty.

    Disappointing in the extreme. Reason truly is the place where libertarianism has morphed into kinder, gentler statism.

    1. ThomasD|7.8.17 @ 9:07AM|#
      "Color me unimpressed with both the content and direction of this article. At least coming from an ostensibly libertarian magazine.
      [.. piles of horseshit proposing to justify government interference.]"

      Stuff it up your ass, Thomas. No one was fooled by that steaming pile of crap.

      1. Go fuck yourself you worthless troll.

        If the doctor truly thinks himself a life saver, or if he just likes being Dr. Feel good means nothing to me.

        That people have no choice but to submit themselves to the vagaries of others is a serious affront to liberty.

        1. [.. piles of horseshit proposing to justify government interference.]"

          I suppose I should add that reading comprehension is not your strong suit.

  22. We know the drill. Some of the public loves too much of a good thing (in this case, pain management), and full-blown hysteria ensues.

    People fart out all kinds of platitudes about "social change", but then partake in the latest hysteria about whatever scourge is gripping the country today. Until this mentally undeveloped cycle stops, people will undoubtedly continue to quietly suffer.

    "Moderation" has far more merit than taking the crazy path of swinging a sledgehammer around like a lunatic and hoping all the problems go away.

  23. Thanks to being trampled by a horse and a couple of other unfortunate (if less dramatic) incidents I have not had a pain-free day in 9 1/2 years. I have been on prescription pain killers that entire time. To avoid addiction my doctors cycle them between 4 or 5, switching about every 6 months. To me the real problem with opioids (aside from constipation) is habituation; it isn't so much that you get addicted as that your body gets accustomed to a certain dose of a certain product, and you risk addiction (or overdosing) in the quest to get the relief you are used to.

    In the last two years, while continuing to take the opioids, I also take medicinal marijuana. The main benefit of that is that it sufficiently masks the pain as to allow me to sleep, for a few hours at least.

    None of these medications cure the pain; at best they mask it. OK, care not cure. Believe me, when you live with pain 24/7 for 9 1/2 years, you'll take that.

    Yes, there are problems prescribing doctors must be aware of. But so long as there is no real cure for the underlying problem (my pain is now mostly neuromuscular; after 3 surgeries (I told her she needed to start autographing my stitches) my orthopedist has no more surgical options. So pain relievers it is. I understand the need for oversight, but this is indeed an area in which government needs to tread very lightly.

  24. Do you ever wonder how large institutions lose the trust of the public? This is how it starts, with doctors going out of their lane and deciding that they know better than their patients what is best for them.

    Between this and doctors asking patients about gun ownership I predict in 10 years we'll see doctors with an average trust rating in the 20's. Then we'll see articles about how doctors can gain that trust back like the media today.

    Unfortunately for them, that trust is built up over years and once it's gone it may never come back. So fine AMA, become politically polarizing and patronizing to your customers and watch people demand the right to see nurses instead of you

  25. When you have individuals asserting that he's truly Hitler and different strange things, no doubt, now and then he's not that awful.

  26. My wife developed juvenile rheumatoid arthritis before it was known to exist. She had to put up with doctors telling her for *years* that the pain was all in her head. As she got older, it became full blown rheumatoid arthritis. She was also diagnosed with fibromyalgia. The RA then complicated into Pulmonary Hypertension. She died four years later. She was 47.

    Our family doctor, as well as myriad specialists, understood her need for oxycotin. Did she need increasing dosages to make existence bearable? Yes. Was she physically addicted to it? Without a doubt. Did she hate that fact with every fiber of her being? Absolutely. Did she *ever* take so much of her meds that she was pain free? No, since taking more than the prescribed dose will leave her short down the line, and she had experienced withdrawals before when the hospital doctors thought that they knew better than everyone else.

    My wife was in pain every day for at least the last *10 YEARS* of her life. There were days that she couldn't even get out of bed, she hurt so badly. To any of you *assholes* who think that she shouldn't have had access to those needs, I can only say that I pray that you never have to watch your wife slowly, but surely, dying and having been denied the drugs that could make her few remaining years somewhat tolerable.

    1. If you still don't feel that those drugs are necessary, the English language does not have the words to express what a vile, loathsome waste of flesh you actually are. Please stand down-range, and I'll gladly send you to meet my wife.

      1. My preference is to inflict ongoing unbearable pain on that sort. It tends to provide perspective.

    2. I'm so sorry your wife had to go through so much. She was lucky she had you for support. Just a quick FYI, you may want to say physically? dependent instead of physically addicted, just so people understand exactly what you are trying to say. Thanks for taking time share her story.

  27. Anslinger was an asshole who messed things up good where drugs are concerned.

  28. So pain patients should "use coping and acceptance strategies that primarily reduce the suffering associated with pain and only secondarily reduce pain intensity."

    Sarah Palin was derided as going completely overboard when she talked about "Death Panels." But now we're on track for instituting something even more evil: Pain Panels.

  29. Best tips about health download this mobile app.

  30. I would like to say that I wish I had a doctor closer to me like Dr. Tennant that would help me with my chronic pain. I am poor so I can't go see him in person. Has he ever considered sending scripts to people who can prove to him that they are on opiods but it's not enough and now they are going to cut back on me again? I am so very disgusted and so very depressed that I am contemplating suicide because I just can't take the pain much longer. I have sent letters to everyone I can think of about how wrong it is what they are doing to us. I think it is against our Human Rights because of the cruel and unusual punishment they are putting us through. Also we have no quality of life because we can't do anything but watch TV. I am not being treated with dignity because they put me in the same category as a an addict, which I am not. I could go on but I have said plenty for now and I thank you for the oppertunity to comment on this and atleast get it off my chest. Thank you again.

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