Opioids for Pelvic Pain – What Are the Alternatives?

//Opioids for Pelvic Pain – What Are the Alternatives?

Opioids for Pelvic Pain – What Are the Alternatives?

Opioids, FDA

Opioids, FDA

Mesh Medical Device News Desk, June 23, 2016 ~ Douglas Scott got an ultimatum from his wife – wean yourself off opioid medication, he began to treat pain after two car accidents, or expect changes at home. Today Mr. Scott is narcotics free. Instead he entered a program and spent five weeks, six hours a day training in alternative pain management techniques.  They include relaxation exercises, behavior modification and physical therapy.

This story in the New York Times illustrates how difficult it is to reduce the widespread use of painkillers such as OxyContin and Percocet.

As part of a nationwide trend to reduce the abuse of pain drugs, doctors are being urged to first treat pain without using opioids. That has been the traditional course of treatment for women suffering pelvic pain after a transvaginal mesh implant when the doctor no longer understands how he can address her complications.

Other avenues include chiropractic and osteopathic manipulation, acupuncture, yoga, massage, meditation.  Problem is most insurance has not kept up with the push to limit opioids and may not cover these alternative treatments.  Medicaid may cover physical therapy under the Affordable Care Act but that varies by state. Historically when limits were placed on coverage, these alternatives to opioids were the first to go. Now Medicaid must grapple with adding them back.

There is a National Pain Strategy that was issued in March that outlines ways to improve pain care in America.

The Mayo Clinic in a 2008 study found that alternatives to opioid use led to a significant improvement in function and less pain.

In Mr. Scott’s case, he now admits he was addicted to oxycodone and morphine.  His treatment in alternatives led him to Brooks Rehabilitation in Jacksonville, Florida.  Workers’ compensation and Aetna and United Healthcare cover the program’s costs.  Blue Cross and Blue Shield of Florida does not.  In a statement, Florida Blue said some alternative treatments are experimental and unproved. State Medicaid plans have not traditionally covered a range of alternative programs, but now with the national push to reduce opioid addiction, has prompted some states to consider passing legislation to develop pilot programs to incorporate acupuncture, chiropractic, cognitive behavioral therapy, massage, exercise, yoga and osteopathic manipulation. Oregon leads the nation in providing such treatments.

Mental health counselling is also being recognized as a necessary component to pain drug addiction.   ##

By | 2016-06-23T07:14:36+00:00 June 23rd, 2016|Medical News|47 Comments

About the Author:

I’m National News Editor, Jane Akre and I began Mesh Medical Device News Desk aka Mesh News Desk (MND) in the summer of 2011 just after the Food and Drug Administration issued an explicit warning to the public that complications associated with surgical mesh used for prolapse repair (POP) and incontinence (SUI) are NOT rare! That was the starting point for the litigation you see today and thousands of lawsuits have been filed by women whose lives have been altered, some permanently, by the use of this petroleum-based product.


  1. Nameless June 23, 2016 at 7:46 am - Reply

    How does this work if you are in chronic pain that keeps you close to home. Walking a couple of blocks brings out the best of pain. Nice article with a lot of false notions. So now we don’t have to worry. We can meditate the pain from nerve damage away. The example they give didn’t identify if he got hooked going to the dentist or if he was in a car wreck. He must have felt well enough to get his body to intensive rehab. How do people that can’t get out of bed take care of this. We must be the dx.d. malingers. Otherwise, yoga and massage therapy would fix us. Of course, if you are broke just stop buying food and find a guru.

    • Jane Akre June 23, 2016 at 7:50 am - Reply

      The article in the NYT and this one say he was in a car wreck. two in fact.

  2. Nameless June 23, 2016 at 7:53 am - Reply

    How does this work if you are in chronic pain that keeps you close to home. Walking a couple of blocks brings out the best of pain. Nice article with a lot of false notions. So now we don’t have to worry. We can meditate the pain from nerve damage away. The example they give didn’t identify if he got hooked going to the dentist or if he was in a car wreck. He must have felt well enough to get his body to intensive rehab. How do people that can’t get out of bed take care of this. We must be the dx.d. malingers. Otherwise, yoga and massage therapy would fix us. Of course, if you are broke just stop buying food and find a guru. I thought we were pain pill dependent not addicted. Dependent and addicted or slippery slope discriminations if you are an outsider and judgmental. That person doesn’t know what it feels like to have to get something done but can’t move because pain is too great. Taken for this reason under supervision isn’t the same to get waisted and nod out with no productive plan

    • Still Standing June 23, 2016 at 5:22 pm - Reply

      The government has labeled anyone who uses opioids as someone having an opioid use disorder. This is loosely defined as as person whose brain chemistry has been changed due to opioids. Technically, this happens after one dose of opiates.
      People think that addiction is the worset evil in the addiction and dependent semantics, actually, our body becomes addicted to the drug THEN a dependent state ensues. An opioid dependent person changes their behavior to get the drug, searches for or seeks out more of the drug, becomes unregulated emotionally without the drug. Thoughts of getting the drug occupy your mind. However, my take for those in pain is that PAIN precipitates the dependency. If there is something that relieves the overwhelming pain, of course people want to continue taking the drug. That is what is missing in the Comprehensive Addiction and Recovery Act, the acknowledgement that pain generates a highly emotional response.

  3. Nameless June 23, 2016 at 7:57 am - Reply

    Sorry for the duplication. A car wreck. Then I guess there is hope for all of us.

  4. mary b June 23, 2016 at 8:32 am - Reply

    i wish it were that simple money dont grow on trees i live by my self with very limited income most of those things cost .hopeful the insurance co. will give us some help on the cost would love to feel normal again , mary

    • Still Standing June 23, 2016 at 7:54 pm - Reply

      Absolutely, there is a big gap in what the treatments cost and what insurance will pay. Even for outpatient pain managment treatment using non-narcotic approach, the cost can be well over $25,000. Not chump change for sure.

      My biggest fear is if complementary and alternative medicine become an insurance benefit, all kind of regulatory crap will be instituted that wont allow for a truly personalized and individualized pain program. I was in hospice care for many years. In the 80s, most hospice programs were volunteer led but then when hospice became a medicare benefit, there were so many rules and regulations attached to it that the true spirit of hospice was lost. Anything that becomes part of the government machine eventually looses its soul.

  5. dan June 24, 2016 at 11:19 am - Reply

    Be careful when using any meds for pain or for any reason. Be sure to research
    the effects and warnings in which some
    may not have all the warnings as we know have happened in the past! I have Been prescribed meds after mesh implants for a double hernia and believe the drugs have caused more health issues has time went on. Our best chance is to get our immune system working as well as we can though exercise and eating well. When all else has failed we need to put it back in the hands of the ones who betrayed us.
    God Bless

    • Still Standing June 24, 2016 at 5:52 pm - Reply

      Dan, not to marginalize your observations, but it is not that easy for mesh women to just eat well and exercise and get better. It is important in maintaining some degree of sanity, but those two behaviors wont work magic on this pain. Just the way the mesh is placed, transvaginally for POP and mesh for SUI creates such an onslaught of pain abdominally, vaginally and rectally it is impossible to describe or have others understand. It is as if a tight elastic band is wrapped around our bodies which have been laid open, doused with kerosene and set on fire. And that is on a good day. Diet and exercise definitely reduce inflammation, and I do eat well and move intentionally throughout the day, but it cant flush away the mesh or the tangle of scar tissue that we are left with. Mesh has rendered most of us unable to have sex, which is a terrible reality others cant begin to fathom. Mesh has made what was created as a source of pleasure a very painful emotional scar. Dealing with the all the aspects of this pain has become the complete focus of life for mesh injured women. Its very complicated.

    • Kitty June 27, 2016 at 7:39 pm - Reply

      Are u kidding Dan? What Dr wants to hear that he screwed up?

  6. Nameless 2 June 30, 2016 at 6:05 pm - Reply

    I am amused at what Nameless said because it is true. Dependant and addicted are two different things. However I moved from the Mid-West to the East where my Family resides and was taken off my pain meds (none Oxy or Perco ) cold turkey and told deal with it we have a drug problem here and opiates are no longer available. In the ER the Dr. Said this to me and I said they (Police, DEA ) have a drug problem out there I am in your Emergency room and you are a Dr. So I think you have a patient to treat right here let them deal with their issues on the street You deal with my problem of not being able to get out of pain and also keep me from a seizure at Discontinuing Xanax that is the other Medication they were or had phased out due to their “Drug Problem” ! Three times I went no one would see me for thirty days waiting on records for which I had a copy of everything right on my phone with my last Dr. At that Facility and they still refused me care. I finally said I need to speak to a patient advocate of this Hospital or a Hospitalist NOW !! Refused me again so two days later I could no longer keep it together and so I opted to ” commit Suicide “. They took me to the Behaviorial Unit and my new Dx was ” Borderline Personality Disorder ” and HyPertention was my Chief Complaint. No lie in twenty-four hours I was no longer in pain they said and since I was going to “Commit Suicide” I would never be allowed to take Xanax ever again … !
    Really I said and what Genious thought that up ? I already heard that like Sixty days ago you idiot that is why I am here not to have a seizure on my Husband who has no previous experience in Medicine and he would have lost it if that had happened. I am so fed up with all this hoopla and all of us know we can’t afford a personal Guru who comes in the middle of the night to soothe our pain so we can sleep for a full night. Drug problems are everywhere in fact I am watching people drink like no other place on earth and drive yes, drive to kill pelvic pain … Driving is not an option. Getting out of bed is a problem some days and I never ever got “High” on my pain medication I just had pain relief now is that addiction to pain relief then ok I guess I will be signing up so for the Pelvic Pain Group next to stop from having that too ! How ridiculous is this in the Medical Community ? Their hands are tied ? They weren’t tied up when they took out my female organs and gave me a piece of plastic that I still pee out blue strings that of course is when I am not catheterizing myself 3-4 times a day. Do something Attorneys and Judges I know just how sick you are of this ! Who did not think after a time of ten plus years these Companies would come up insolvent ? What about the Dr. Did they receive kick backs of course they did and they do !! They did get rich so Drug Companies go sue the Dr.’s for not knowing how to do this surgery with your products !! Now that might turn a few Dr.’s heads around. I worked with many a Physician and I respected them then and they also did me but now I believe it’s got to stop with them. Choose you patients, the ones you would like to practice on after all you are “Practicing Medicine” right ? So we are all stupid now !

    • Still Standing July 1, 2016 at 1:22 pm - Reply

      Nameless 2, your story was told with a sense of humor,but in reality it is so tragic. People with pain are being marganilized completely in all the new policies about drug addiction. It is a scary time to be a person in pain.

      The fact that you were diagnosed with Borderline Personality Disorder is troubling. BPD is a very serious psychiatric disorder, which usually presents during adolescence or early adulthood. People with BPD are highly emotionally unstable. They are generally considered to be manipulative and have wide mood swings. I find it hard to believe that they were able to come to this diagnosis as a result of a 24 hour stay in the behavioral health facility. There are many other disorders , such as anxiety, fibromyalgia, depression, etc that should be ruled out first before you are stuck with that diagnosis. I say “stuck” because it will be difficult to get adequate care for your very real pain with this label. Doctors will believe that you are trying to manipulte them and they will dismiss your concerns.

      I strongly encourage you to request a second opinion as soon as possible. You need to challenge this diagnosis with every thing you have. It has lasting consequences for your medical care for the rest of your life.
      Doctors just throw out diagnoses without fully understanding the implications it has on the individual. This one is serious. While you search for a second, and maybe third opinion, I encourage you to contact the hospital and find out their policy for challenging the findings in your medical records. You have a right to do this and, in this instance, you must do this.

      This is a word of warning for people in pain…..this is happening all over the country and it is tragic. Do not allow yourself to be part of their collateral damage. You have a pain condition, and you should receive appropriate treatment for it as any other person with a medical condition. Sadly, though, this is not happening. I wish I could end with an affirmative bright side, but I cant find one right now. This fight is going to be fought in the muddy trenches of collective thought fostered by our government. Do you realize how many news programs, newspaper articles, political statements , even Hollywood, have coalesced around this addiction story? Have you seen any that balance out the story of those with debilitating chronic pain? I have not. This is the rest of the story………it is ours to tell.

      • Nameless2 July 1, 2016 at 4:13 pm - Reply

        Thank you so much for your feedback and much needed next steps. I have known for some time this would be a battle to remove but as you know “real pain” slows you down and makes easy things hard again. It is up to us to tell this side of the story and as I move forward into this next phase of my life I intend to take this “Bull” by the horns and let others know how badly you can be damaged by a Doc’s Dx ! It was rediculous and unfair just to say the least.

        There was another encounter with a Dr in town that made me wait three hours to have four people , his New Resident, NP, Medical Assistant and my Husband into one small exam room as he saved me until he had seen everyone else. I was appalled by all the people in the room and then he started his ” You need to check into rehab speech ” I did walk out on him as I was a side show for his followers. I suppose he needed to show them how to kick a “Drug Addict” to the curb without hearing their Chief Complaints.

        Yes, I am working on my record as I speak with all of you. It has taken me down to the depths of my belief system to continue to know … I have been hurt physically through no fault of my own and the very ones that hurt me want to make sure that I stay exactly that way. I do hope all of you know we do have a voice wether or not it gets to your “Offender” or not at least no one needs to go there themselves or ever have any kind of procedure without seeking more than one maybe two opinions.

        Wishing you all well … Try to find the Joy in this Holiday !

        • Still Standing July 4, 2016 at 12:55 am - Reply

          I watched a special about George Washington tonight and I thought about the mesh women. He was out numbered and outgunned in this country’s fight for independence. He didnt even have confidence about himself as a leader. He had been turned down for a position in the Queen’s army. My how history would have been changed if he had not been willing not just to fight, but to risk everything to win it. So, ladies, my hope and prayer is for us as individuals and as a group to have the strength to win this war for legitimacy and in the process make care for women better for future generations. I celebrate all of you who march on and those of you who physically and emotinally can’t. Those who can will carry your flag into battle. May today be a time of inspiration. You can, I can, we can change the world and how it sees women. It’s about time

    • Kitty July 7, 2016 at 3:38 pm - Reply

      Very interesting !! Why would Medicare and Medicaid give kick backs to Drs’ an facilities if they cut back on opoids? Perhaps the Mafia is FUNDING THE GOVERNMENT.ie Medicare and medicaid

      • Still standing July 7, 2016 at 9:13 pm - Reply

        Kitty, they dont give kickbacks per se, but they absolutely do provide different reimbursement depending on outcomes for hospitals right now, but better reimbursement rates for physicians are part of the Comprehensive Addiction and Recovery Act (CARA) if they reduce their rx of opioids. They will be tracked. It is interesting that some national pain experts point to the attention and importance that was put assessing pain as the 5th vital sign as a reason doctors prescribed more opioids so they would get better scores on patient surveys that include their satisfaction with how their pains was assessed and treated. Think of the 1-10 pain scale. Most people with pain hate that and many medical professionals admit it is pretty subjective, but that became the standard that they are held to. The end game is better reimbursement from Medicare, Medicaid, and private insurers. All physicians do not get the the same reimbursement nor do hospitals. It is based on outcomes that are defined by those who pay for the care. You can look up HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) or Press-Ganey to become familiar with the assessments that result in different purchasing of reimbursements. Yes,those hospital and doctor surveys you are asked to fill out really do make a big difference, monetarily anyway.

        • Kitty July 9, 2016 at 9:37 pm - Reply

          SS look under Jane’s blog…Dr Sunshine. Then think about it. Maybe this is bigger ad more organized than u think…scarey

          • Still Standing July 10, 2016 at 9:26 pm

            Could be, but I dont know those facts. My comment was about the opioid rx and why the government would be incentivizing doctors to reduce opioid prescriptions.

  7. Nameless July 2, 2016 at 9:58 pm - Reply

    Thank you for sharing this information. We need to know to protect ourselves. It’s impossible to imagine the degree to which they will go unless an example like yours comes to light. Just when you think you have experienced the dregs of this life a new instance appears. Dx’ing you like that seems illegal and unethical. As still standing wrote a 24 hr stay in any facility would never be enough time to label without any accepted evaluation with such a catastrophic diagnosis. Not only would it effect any future treatment or failure to treat – you would be an insurance liability. Any application that required mental health status would be effected. If you left it off you would be liable for omission. In some cases work life could be effected. This is really quite an attack. This is their push back. All these whining, moaning women complaining about their doctors and what’s been done to them. Let’s not be too niave in the future and expect empathy. We are a threat with our hundred thousand strong litigants. They know too well that the tide could turn against them at any time (refocus away from the manufacturer). They most be communicating among themselves. I see a two fold issue. The so called war on drugs. Then there is this very large group of people who are in pain and ready to sue, point a finger of blame, malign reputation, create a money fiasco. You can bet your boots they are taking down their insurance paperwork and making sure everything’s in order. What they did to you is absolutely archaic. It’s a good thing you weren’t there alone. A women in this situation fifty years ago would have had her butt hauled off to a state hospital without representation. It would have been a preferably male relative that intervened. The mental health industry has a history of abusing women. Depriving us of liberty. And in some instances treatments that were akin to torture. Just be careful as you go forward. Document everything done and said. Do not expect kindness and do not try this alone. I don’t know if you have the money for a lawyer who specializes in this type of issue. I would recommend if you do. I wish you luck. I certainly know this is just one thing more you didn’t need to handle as you struggle with your chief complaint of pain. Damn they can be so g-d awful cruel.

    • Nameless2 July 3, 2016 at 1:13 pm - Reply

      The first Doc I saw in my home town told me to go to rehab up the street and I had said very politely we can slowly get me off it here I do not need rehab to wean off a Medication I have taken responsively for almost 13 years.
      What I should not have said was , you want my Insurance Company to pay a 40,000.00 rehab facility for something we can handle is not only rediculous but it is Borderline Criminal. Feeding people to their choices and I am sure kick backs ! It’s just sad …

      • Still Standing July 4, 2016 at 2:01 pm - Reply

        Have you had mesh for 13 years or was there another pain condition you were treated for? That does not change how you need to treat your pain,,but just as a reminder that these new opioid pain policies are aimed at EVERYONE who has chronic pain. So, we are a much bigger group than the mesh 100,000. I know people in my pain advocacy group who have been cut off despite being well managed for years on narcotics. The main reason for this is that doctors are being incentivized to stop prescribing pain meds. They will eventually be “rewarded” for this by being able to negotiate a higher medicare/medicaid/private insurance reimbursement for their facility or practice. They will also have to get additional training in order to treat pain patients with narcotics. So will their nurse practitioners. The family doctor is probably not going to invest that much time and money, so pain clinics are full. I live in a rural area. There is one pain clinic in a multi-county area. Hospital patients are being sent home with 3 days of pain meds and a referral tomthe pain clinic,despite being on them for significantly longer periods of time. The pain clinic can’t handle all these new people. It is full, with a very long wait..weeks or more, but the doctor feels they have done their duty to the patient by giving the referral. Absolutely crazy. It is the same thing that is currently being done at hospitals with their patient surveys. The higher the scores, the better rate they get paid, even though it has been shown to not be an effective way to measure quality of care. It is all about collecting the dollars, not have a patent centered practice. By the way, have you noticed that since “patient centered care” has become the new buzzword that care is exactly the opposite of patient centered?

        • Kitty July 18, 2016 at 8:04 pm - Reply

          Yes..they work with the “organized families” to gives kickbacks to Drs and facilities for not prescribing opoids. Perhaps they are working with the cartels to bring cheaper drugs in.

  8. Still Standing July 18, 2016 at 8:36 pm - Reply

    I promised updates on CARA (Comprehensive Addiction and Recovery Act), which will severly limit a physician’s ability to prescribe opioids for chronic pain, has passed the Senate and the House on July 16th. It is headed to Obama for his signature. So now, it is very evident that thousands of people with chronic pain will be restricted in their preferred choice for pain management. It will be a rough ride. Please, have a conversation with your doctor. Take a print out of a summary of the bill( if you need a link, say something and I will post). Imdont know if any of you remember when HIPPA was enacted, but it was a train wreck for medical providers to figure it all out. It took time and I imagine physicians will over react to this law to be on the safe side. Dont wait for your doctor to bring it up, it is important to be proactive and advocate for yourself on this one.

    • Jane Akre July 19, 2016 at 9:50 am - Reply

      The solution seems to be knee jerk. There w as just a story Florida leads the nation in babies born to addicted mothers…. so they blame the mothers of course. Who are these doctors dolling out prescriptions?!??? That would seem to be the root cause of the skyrocketing addiction levels, at least in Florida. Maybe that is too simple a solution.

      • Still Standing July 19, 2016 at 6:10 pm - Reply

        Yes, unused prescriptions that are given out for knee surgery, back surgery, hip surgery, etc are prescribed in big numbers and make their way to people who are misusing them. So, part of the solution is to reduce the amount of drugs prescribed. Opioids for chronic pain are not recommended as the 1st line of treatment, ,and, once again, the doctors are not getting kick backs, but they will eventually have their medicare, medicaid and provate insurance reimbursements cut depending on their use of opioids for their patients. Scientific research does show, that opioids are not the most effective way to manage chronic pain. That is not what the pain community is saying, but it is what science is discovering.

  9. Nameless July 19, 2016 at 8:34 pm - Reply

    Maybe the pain community should speak for itself with some respect that those in pain no more about what they need than – what ? science ? what’s that? AUGS the organization of scientists. The scientists that have their hand in the money pot and have crippled us. What science is behind this withholding medication movement. The scientists that wasn’t that want to clean up addiction? Good grief! Does anyone want to look at why people medicate? Maybe there is something wrong with the culture. Like doctors that open you up and implant contaminated plastic then run like hell and hide behind regulations that make no sense. I think you over think what you think you know.

    • K. Doro July 29, 2016 at 7:29 pm - Reply

      so well stated Nameless

      • Nameless2 July 29, 2016 at 9:14 pm - Reply

        I also agree !

  10. Still Standing July 19, 2016 at 11:55 pm - Reply

    Nameless, I know the facts of the CARA bill because I have read the bill and stayed up to date with how it went through chambers. There were several open comment periods where citizens could comment on the bill. I tried to post those opportunities.

    THE and urged people to post. I also I stay current on new scientific literature on pain research because that is my job. There is a vast amount of research that suggests that opioids for chronic pain should not be the first line of treatment. Some issues that have been studied the best brain impairment of those using pain medication, which can cause decreased cognitive function R, tolerance, which could require higher doses, and respiratory. Issues. We must remember that this new laws don’t just impact women with mesh concerns, they impact all pain patients who use opi.oids.

  11. Still Standing July 23, 2016 at 6:03 pm - Reply

    President Obama signed the Comprehensive Addiction and Recovery Act this week. While the government and press touts that it is an opioid addiction bill, it also has great impact on those who use opioids to treat their chronic pain. It outlines permissible uses for opioids and length of time a patient should be using them…it is recommended that patients with acute pain from surgery and other trauma get 3 days of opioid or opioid like drugs. There will be quite a bit of confusion, and I imagine physicians will want to pass off pain patients to pain clinics even more so now than before. Talk with your physician about this bill and how it will impact your care.

    • Jane Akre July 25, 2016 at 4:52 am - Reply

      In our zeal to crack down on drug use, we forget there are LEGITIMATE uses for pain medication…!!!

      • Still Standing July 25, 2016 at 6:39 am - Reply

        Well, as far as the government ,there are very few legitimate uses for long -term opioid pain meds. I believe most now will try to eliminate treating those patients who have that legitimate need. See the link I posted below for the physician guidelines. Chilling.

        • Still Standing July 25, 2016 at 9:42 am - Reply

          Just an interesting note, an FQHC ( Federally Qualified Health Center) in Kansas City posted a memo in their waiting room that they DO NOT treat chronic pain. These clinics are all over the country and provide primary care for medically underserved populations. So, where will these already medically vulnerable patients go?? Further brings home the federal position that long term opioid use is opioid abuse.

          • Jane Akre July 25, 2016 at 10:50 am

            That is frightening. Thank you for sharing … must the pendulum swing so far the other way before we get wise?

      • Kitty July 27, 2016 at 8:36 pm - Reply

        There is a lot of fear mongering g going on. If one has primary Dr…and u are doing well with pain regime it will not be affected. Stay put and stay grounded with your dr.

        • Still Standing July 28, 2016 at 8:09 pm - Reply

          Kitty, I dont know where you are getting your facts. There has not been one thing said about this bill from any pain advocacy organization that even comes close to “if you are doing ok with your pain regimine, you get to keep your pain regimine.” Where have we heard that before.? If your pain regimine does not include narcotics, that is correct. If it does include opioids, then things will probably change. I posted the guidelines, which are now basically law instead of guidelines. I agree that you need to stay grounded with your physician. However, most physician practices are now owned by hospital groups, large corporations such as HCA. There will be issues of policy that their physicians have to adopt. Im sure that cooperation in handling opioid using chronic pain patients has already been discussed. When more opioid rx equals less reimbursement, what do you think will happen? Cigna has already adopted a flag with patients on opioids for chronic pain and one option is to deny payment for the rx if you take more than they think you should, not if your doctors thinks you should or you think you should, but what they (Cigna)determine. All I can do once again is to encourage everyone to have the discussion with your doctor about pain management options. To understand this more thoroughly, please look up the Comprehensive Addiction and Recovery Act and dont just read the summary, in which the government totally ignored the parts of the bill that impact chronic pain patients, but read the full text, which is available online. Take it with you to your treating doctor and start the conversation. I imagine many doctors are not fully informed yet about its implications to their practice. Kitty, i hope you are right and all the doctors in the US. just decide to not follow the regulations. I just want to encourage women to be prepared if hers does.

          • Kitty July 29, 2016 at 6:59 pm

            What u posted is for new patients…

  12. Still Standing July 23, 2016 at 10:28 pm - Reply

    Here is an inkling a out what is coming:


    • Still Standing July 25, 2016 at 8:17 pm - Reply

      Jane, haha. wise? Our government doesnt value wisdom or thoughtful processes. It will move the other way once this social disaster plays out and political pressure is put on our elected congressmen and women to correct the travesty of denying adequate pain management to those who need it. It will happen, but unfortunately, not in the near future. I do not believe it was wise to put opioid abusers and opioid users in the same basket. They dont get it. They just dont get it. Some will encounter chronic pain on a personal level at some time in their lives..then, unfortunately, they will “get it”, too. I dont wish that burden on anyone.

      • Jane Akre July 26, 2016 at 7:43 am - Reply

        Well put… thank you.

  13. Nameless July 29, 2016 at 10:53 am - Reply

    So, the suicide statistics will go up. Those that were able to contain pain and continue to function with purpose in life may just give up. Chronic pain over time changes brain structure (according to the literature). Feelings of depression and hopelessness may supplant those experiences of meaningful and purpose filled life. Legitimate use of pain medication legitimately treats pain as a symptom just as any other medication may not be a cure but contain and present with a treatable outcome. Alcoholism and abuse of other substances are available through most neighborhood self employed sales persons. Their business practice will increase and remain a viable option. This is the reality of the real world. All ethnic groups, as well as, all economic groups have the same opportunity. No need to Doctor shop any longer. It’s right there in the neighborhood. Uncontrolled and without mental health support. If anyone thinks people are going to flock to pain management rehabilitation they are living outside of reality. Those that cannot afford the uninsured street value of medication or cannot find a local entrepreneur may not handle abstinence well and so, therefore, choose to end their pain along with their life. Has that topic and possible outcome been covered in the new legislation? Or is the topic of pain management an intellectual endeavor that has no roots in reality? Is there a plan heretofore not mentioned?

    • Still Standing July 29, 2016 at 3:42 pm - Reply

      It is an intellectual endeavor at this point. Brain science suggests that cognitive behavior therapy, mindfulness, meditation, other complementary and alternative medicine help decrease the experience of pain. However, because individual pain is profoundly unique, no one knows what you will respond to. It’s a crap shoot to figure out what works for you. Unfortunately we cant standardize these therapies, they are subjective plus all providers are different. There are not standard manuals for how to be mindful that all mindfulness teachers use across the country . Doctors are different but there is a standard practice for example colonoscopies or EKGs. Plus, rural Americans don’t have access to these alternative treatments. I would think your physician will give you news if he/she is going to change your pain medication. Ask . Beats not knowing

    • Kitty July 29, 2016 at 7:14 pm - Reply

      Namless…I know a woman who moved to Arizona. She had terrible Fibromyalgia. She is 72 and taking Marijuana regularly an essentially pain free. I never took pot…but that might be a viable option. Arizona is legal.

  14. Nameless July 30, 2016 at 11:58 am - Reply

    It’s not an intellectual endeavor. These are my feelings and experience. Street drugs are real. Alcohol is real. I see them sold and I see them bought. In my nice lawn kept neighborhood. People suffer. I suffer. Some make it some don’t. I feel,that you are undermining my effort to express my feelings and concerns. Yes. I too have some experience and higher education. Your responses make me feel belittled and unheard. And that has nothing to do with where you work or what you do for a living. It has to do with feelings. Kitty is right organized crime is making a bundle. And will make even more as time goes by.Communicating on this blog, for me, is personal. I don’t know this from a book. I see it. Write something about your experience that isn’t over intellectualized. How do you feel? Chronic pain without relief is turning me into a raving blogger. There you go!????

    • Still Standing August 1, 2016 at 11:09 pm - Reply

      I think you must have misunderstood my answer. You posed the question in your previous post if pain management was an intellectual endeaver not based in reality. I answered that it was, not because I was belittling you, but because I believe the medical community IS responding to pain management as a scientific, theoretical endeavor that is disconnected from real people with pain. i thought you hit the nail on the head. I do write how I feel. i just dont feel angry any more. I dont find it personally helpful to spend time in negative territory. It took up too much space in my life the first eight years post mesh and pulled down my marriage, my family and friends. So, I decided to move that pain and hurt and fear away from my focused present attention. This will not work for all other women, but that mindset shift changed how I move through my day in a powerful way.

      I educate people about pain and I post here to pass along any knowledge I have gained from my personal pain, my research, and those I work with, not because I want to over intellectualize, but rather with hope that by sharing that knowledge some may find something that works for them, too, then they will pass their personal pain tips to other women as well. Very little of that has come from a book, but I won’t apologize for trying to understand this pain thing on an academic level. That is just who I am at the very core. There you go.

  15. Still Standing July 31, 2016 at 6:01 pm - Reply

    Below is a link to the First Do No Harm petition to the white house from people who have been cut off from their opiates for chronic pain. There are thousands leaving their signature along with heartbreaking stories of how they have suffered because their doctor will no longer prescribe pain medication. States are also jumping in with their own no-opioid policies and surveillance of physicians who write rxs for them. If you are interested in giving your voice to this issue, I urge you to sign the petition. Even if your medication has not been stopped or eliminated, there is a very high probability that it will be soon. This does not just impact new pain patients, it sweeps up all patients who rely on opioids for adequate pain management. Visit this site. It is eye opening to say the least.


    • Jane Akre August 1, 2016 at 9:31 am - Reply

      Still standing… thank you for this. So important. I will post it so everyone sees it! thank you!!!

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