“Chronic pain is an unrecognized and under-resourced public health crisis with devastating personal and economic impact”
The 2011 IOM report “Relieving Pain In America” called undertreated chronic pain a human and economic crisis in America. The statistics suggest it is.
Pain is the biggest ticket item in the American medical system yet the NIH only started tracking pain expenditures in 2014
Treating chronic pain is the single biggest ticket in the medical system- costing upwards of 600 billion dollars a year. The NIH didn’t even start tracking expenditures on pain research until 2014. There is no “Pain Institute” and has been no strategic approach to understanding and treating pain. Instead pain is addressed in an ad hoc manner with predictable results: an overemphasis on opioid drugs and fragmented research efforts that all too often yield too little in the new treatments. Most doctors receive little to no training on how to treat pain.
Enter the National Pain Strategy (NPS) the first strategic plan for advancing pain research, education, treatment and prevention. Developed by 80 nominated volunteers with expertise in many fields it contains short and long-term goals in six areas: research; pain prevention and care; care delivery; education; pain disparities and public education. It was opened for public comment on April 2, 2015! You can read the NPS Draft Report here.
Seventeen organizations in the Consumer Pain Advocacy Group have banded together to prod the NIH to pay attention to this issue. All it takes is five minutes of your time. (ME/CFS patients might notice it is addressed to Wanda Jones – the former CFSAC liason that many remember fondly.)
Your comments must be made by May 20th – just two days from now.
We are at a crucial time in history for people with pain. The very first national strategic plan to advance pain research, education and treatment—The National Pain Strategy (NPS)—has been released for public comment for a short period of time. More than ever, your voice is needed NOW to make sure that the NPS is changed from words on a page to a reality for the millions of Americans who urgently need improved pain care and treatment!
There are 17 consumer organizations working together as part of the Consumer Pain Advocacy Task Force to make sure the National Pain Strategy will benefit all people affected by pain.
The next step in this process is to urge the Department of Health and Human Services (HHS) to develop a federal oversight body now, so that HHS can quickly begin working on the plan as soon as it is finalized and released!
Please take 5 minutes to help – here’s what we need you to do!
Please personalize and send a letter to HHS by email (to ASH@hhs.gov) or U.S. mail (to the address listed below). Below is a sample letter that you can personalize and send automatically through this online system after you enter your contact information below, and then hit “SUBMIT”. Don’t forget to add a sentence or two about yourself so that your letter is not the same as everyone elses.
Dr. Wanda Jones, Dr.P.H., Principal Deputy Assistant Secretary for Health
Dr. Anand Parekh, MD, MPH, Deputy Assistant Secretary for Health
Office of the Assistant Secretary for Health
Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201
Dear Drs. Jones and Parekh,
I am a person affected by chronic pain. [Please insert 1-2 sentences here summarizing how your health and quality of life has been impacted by chronic pain and the challenges experienced in obtaining quality medical care and effective treatment. Family members, friends & caregivers of those with pain, please insert 1-2 sentences here describing how your life has been impacted in caring for or supporting your loved one with pain.]
I appreciate the leadership of the Office of the Assistant Secretary for Health in developing the National Pain Strategy and for providing the public with the opportunity to review the Plan and submit feedback on it.
During this time, I urge the Office to dedicate needed resources and begin the important process of creating an oversight body, so that once the Plan is finalized and released, a coordinated launch can begin right away. I am also very concerned about where dollars to pay for the Plan will come from, and urge the Office to do its part in making future budget plans for HHS agencies. Millions of Americans like me are counting on an improved state of pain care, education and research that is urgently needed and will result from this first-ever comprehensive plan and the hope that it provides for our futures.
Sincerely,
[Insert First and Last Name]*For additional information on the National Pain Strategy and the Consumer Advocacy Task Force, please view our press release and visit our web site,www.ConsumerPainAdvocacy.org.
Chronic pain has destroyed my “quality” of life since I became pregnant in the spring of 2006. Previously, I was active such that I was in the gym 5 days a week and played various sports on the weekends. Now the pain, accompanied by extreme fatigue, has left me lying in bed when I’m not struggling to get ready for work and then to get through the day! Recently separated with two children 8 and 9 years old! I have no energy and hurt throughout my entire body. I fear that my children will eventually want to live with their dad because I never feel like being active, going anywhere or doing anything! Their dad tells them that we separated bc I slept so much and never felt good with pain and fatigue. He was never supportive of my health issues and felt that nothing was wrong with me! He was tired of looking at me and hearing that I was going to see another doctor and having more tests. There were, of course, underlying problems in the marriage; however, I believe that if I hadn’t been in so much pain and so fatigued, we may have been able to make our marriage work. We met in March 2000, married in July 2002 and when my health began to decline in March 2006, the marriage declined with each day! Now as a single mother living with pain and fatigue, I am struggling just to get out of bed in the morning, get my kids to school and try to give them a fun filled and active life which I am not currently delivering! The pain and fatigue is now negatively impacting my life to the degree that I’m struggling to work. If there is not a change soon, I could see myself losing my job and my children! Please continue your efforts to find an answer to this epidemic! Thank you in advance for your time and efforts! Bonnie Lynch and children!
Dr. Wanda Jones, Dr. P.H.,
Principal Deputy Assistant of Health
Dr. Anand, MD, MPH,
Deputy Assistant Secretary for Health
Dear Dr. Jones & Dr. Parekh
I am a person who has been effected by chronic pain for 28 yrs. Since I was 28 yrs. old. I was diagnosed with Fibromyalgia. I was fortunate to find a diagnoses after only seeing five physicians. I went from managing a convenience store to going back to school, being a medical assistant in the back office to medical assisting to the front office so I could sit more to a medical secretary for a group of Psychiatrists and Phycologists, then back to school to be a Phycologists/Therapist where I could not continue because of fibro-fog and pain. Then I managed the front of a Pharmacy and sometimes filled prescriptions, where I could not keep working because of constant pain and fatigue! Now I am home. I took up photography and have sold a few pictures in a small gift store up until the two years ago. The pain is now so extreme along with the fatigue that I do little to nothing. I can only shower once or twice a week and am lucky to fix dinner and pick up some. I stretch and occasionally walk on a treadmill or occasionally go to a pool. I miss my life!!! If I didn’t have my husband, son, two dogs and a rabbit, I would have killed myself by now. My brothers and sisters do not understand but my best friend from childhood does though. I live on antidepressants, pain killers and muscle relaxers and Disability. I want to at least get to the point where i can leave my house and do something and a big goal would be to go back to work, even though it has been fifteen years. My physician in Harry Klien, M.D. He is a great doctor, but there is only so much he can do.
At this time, I urge the Office to dedicate needed resources and begin the important process of creating an oversight body, so that once the plan is finalized and released, a coordinated launch can begin right away. I am also very concerned about where the dollars to pay for the Plan will come from, and urge the Office to do its part in making future budget plans for HHS Agencies. Millions of Americans like me are counting on an approved state of pain care, education and research that is urgently needed and will result from its first-ever comprehensive plan and the hope that it provides for our futures.
I’m hoping it will help me and all the other people who are in chronic pain. Thank you for your time.
Sincerely,
Mary Hamilton
Dear Mary,
I feel for you and hear you and get it. marcie
If this is an indication of how fast the IOM’s urgent recommendations are acted upon, a report first submitted to HHS four years ago in 2011, we are in for some kind of long wait before CFS/ME/SEID gets its turn. Yes, I’m in pain and was apparently misdiagnosed for more than 10 years with FM likely because my initial diagnosis 6 years earlier had been CFS. Oh, why not? Ten methadoned years later, I left that physician, detoxed myself, and went out in search of a real diagnosis which was discovered by incidental accident. Turns out I had spinal stenosis of my cervical vertebrae and 2 herniated discs. So 2 major neurosurgeries in 2012, a long convalescence, and a neck full of hardware later, I am now in far less pain but not pain free. And I still have CFS/ME/SEID. And I am still waiting…….
THe wait will continue to be loooong as their is no sense of urgency by HHS or the federal governemtn to improve pain care. Actually the conquering pain act was introduced in Congress in 1999 after 2004 the NPCPA replaced it- in 2010 the NPCPA became integrated into the ACA Since the NPS has no implementation science behind it and organizations like the AAFP dont favor parts of it- well…..
Dear Dave,
You apparently are far far better versed on this subject that I will ever be. So I will defer to your knowledge base and hope that you are able to make some more headway. I don’t see where anyone is trying to “point a finger” at you. Thanks for your advocacy and tenacity. Marcie
Marcie- no problem. Everyone involved can get involved-and i think that is the best way for pain care to improve. The government and health care industry have been empowered by default-that is Americans have largely left pain care in their hands. So the best way to change things, in my opinion is for people in pain to ask for themselves to hav much more say over their own care.
Dear Mary and Marcie! I feel for both of you. I failed to mention in my initial blog that I am 47 years old became pregnant at 38. None of my symptoms were present prior to becoming pregnant with the exception of depression. The pain began approximately 5-6 weeks into the pregnancy. I was so tired and felt like I had the flu 24/7 so I found my self doing nothing but lying on the couch. I thought that the pain in the lower extremities were secondary to lying down in a fetal position all the time. My son was born, in 2006, three weeks early which I was praying that he would come early (as long as his lungs were fully developed). I believed that my body would return to normal after he was born. However, I was wrong. I had been experiencing pain in my neck for years but not enough to have it checked out. The pain that began during the first 5-6 weeks of pregnancy was new. I continued to believe that eventually it would go away. In 2013, I was hurriedly scooting across the bed to get to the alarm clock and in a strange way that I won’t even try to explain, I flew past the end of the bed with my legs crossed and fell on my lower back. I could barely walk for 4-5 days at which time I decided to see a neuro surgeon. I had an MRI of the lumbar area and found that I had two protruding disks with stenosis. The neuro surgeon gave me injections and the lower back was almost pain free for just over three years. However, the injections don’t last forever and now the lower back pain has returned but not so severe as at the time of the fall. During all of this, the pain throughout my body that began when I became pregnant never went away and has only gotten worse. I went back to the neuro surgeon and explained that the lower back pain was back but not debilitating as when the fall occurred. I told him about the pain throughout my body. He decided that we needed a new MRI of the lumbar region and to include the cervical area secondary to the reported pain in my neck, shoulders, shoulder bblades, biceps, triceps, fore arms, wrist, hands and fingers. The results from the MRI wwere that the injury at the lumbar region was consistent with the MRI after my fall off the bed. He then told me that the MRI of the cervical region showed 5 protruding disks with stenosis. He could not do injections in both areas because it would require too much medication to relieve the pain in both areas. If he decreased the dosage and did injections in both regions, the dosage would have to be decreased which would result in little to no pain relief. He decided that the cervical region should have injections first secondary to the injury to the cervical region being more extensive. The only thing I could think of that could have caused that kind of injury is the physical abuse, to include sexual abuse, verbal abuse, emotional abuse, etc, that my first husband dealt out on a daily basis when I was 20-22 years old. I’m not sure why all of a sudden after all those years, that the neck pain suddenly became severe enough to see the neuro surgeon. The injections to the cervical region were 6 months ago. The physician believed that all the pain in my upper and lower body was due to the injuries to the cervical and lumbar inuries. Well….this time, the injections did not relieve any pain unlike the previous injections to the lumbar region. The physician felt that another round of injections would not have any impact on the pain in the upper body. He also stated that at this time, he does not recommend surgery and that we will use pain management to control the pain. Well….what happens with that is that the body builds up a tolerance to the prescribed pain medications and pain relief is minimal. Having shared that “LONG” story, sorry it was so long but I’m becoming desperate as my quality of life is limited. During all these years with all the back injuries and injections, the pain throughout my body and the debilitating fatigue continues to become more severe. I have had many, many blood tests. I’ve seen a Rheumatologist because I’ve had an elevated RH factor since I became pregnant and all the other symptoms started. 6 blood test over the last 8 years have shown elevated RH factor; however, the Rheumatologist reported that she did not feel that I had Rheumatoid Arthritis. An Endocrinologist found vitamin D deficiency and prescribed vitamin D. The PA at my OBGYN did blood work and diagnosed me with Reactivation of Chronic Ebstein Barr Virus. At that time, I was running a random fever every day at different times that would come and go and sometimes as high as 102. Also had a sore throat for about 6 months. That PA said that she believed the reactivation of Chronic EBV was causing the body pain. She recommended two weeks of bed rest which I could not do bc I had to work. Finally, I only have the sore throat and fever occasionally. In addition, approximately 7 years ago, I began to have chronic allergy/sinus issues with a continuous stuffy nose/runny nose. Treated the symptoms and moved on. In the last year, I have had five or six sinus infections with 102-103 temperature and felt like I had the flue. With each one, I was in bed sick for 4-5 days. My family doctor can’t figure out why I’m having sinus infections so often and why the symptoms indicate the flu but I do not have the flu. Typically, with a sinus infection, a few dayss pass while you treat symptoms, then you go to the doctor, get antibiotics, never miss work, etc. But for me, I’m “down” for days with flu-like symptoms. I was diagnosed with sleep apnea about 5 years ago and then with Narcolepsy a year ago. The medication for Narcolepsy seems as if it is not working as well as it used to. The symptoms are becoming more severe to include cataplexy in which I can’t move my body to get up, can’t hold my eyes open all while experiencing the hallucinations that sometimes occur with Narcolepsy which feels like I’m dreaming. I try to talk and the muscles of my mouth won’t work correctly so my speech is slurred as if I’ve been drugged or or as if I’ve had a stroke. The cataplexy and hallucinations last for varying amounts of time with sometimes only 30 minutes to other times being hours. The Rheumatologist told me at my last visit, last fall, that she believes that I have fibromyalgia but there is nothing she can do for me. So…no official diagnosis of fibromyalgia. Right now as I’m typing, my fingers are beginning to cramp and feel like they need to be stretched which also causes the pain. So here I am, just over 8 years since the first symptoms and progressively getting worse such that it seems as though my life is just passing me by and still I have no idea what is causing all the pain and fatigue. Any suggestions from anyone out there?
Dear Bonnie, My heart goes out to your complicated but well told history. My own story would parallel yours in some ways…… until about 6 months ago, I had a lowgrade fever every day since 1994 and you know how miserable it makes you feel never mind what the actual cause is.
Oddly, it disappeared after 20 years as mysteriously as it came with my onset of CFS. I was only able to continue my nursing career for 5 more years before I ran out of steam and coping skills and was forced to medically retire at the tender age of 43.
The pain in both of my arms (hands not included) and upper back began suddenly at 3am in 2000 and felt like a truck had run over them but at the time no real pathology was discovered so I ended up with a diagnosis of fibromyalgia.
Hence the 10 years of methadone for pain with no further work up to ascertain the cause. And for those of you with real pain, you’ll understand that achieving pain relief by any means necessary sadly becomes our only goal… not the drugs.
Sadly, I honestly don’t have any suggestions for you except to seek second, third, and fourth opinions and remember that there are some fairly unusual diseases out there that the vast majority of any kind of specialty wouldn’t be familiar with. I assume you’ve had an MRI of your brain to rule out Multiple Sclerosis though even this test isn’t 100% reliable. Your fever…. elevated white blood cell count? I bet not. Which in my layperson’s opinion would point to either a viral cause which I assume they’ve more than checked for or immune issues causing an inflammatory response which can contribute to the stenosis.
Have you had your INTERcellular magnesium levels checked? (not simply your “serum” level) It’s the Mg within the cell itself that is the reliable measurement and Mg is in charge of many cellular events, especially that of allowing the muscles to relax after contraction by closing the doors on the calcium which creates the muscle contractions.
I’ve had B12 levels so low that the lab made notation of the possiblity of psychosis and all the B vitamins are responsible for many neurological events going on in our bodies. And, last but certainly not least is the research regarding Substance P in our brain as well as that we can form pain pathways that just continue onward in spite of the cause being relieved.
It’s a drag, huh? That you’re able to continue employment as well although a life housebound 24/7 is its own torture. No medication, not Lyrica or Gabapentin or Cymbalta or muscle relaxers even touched my pain which felt like it was emanating from my brain and not something that I could touch or make worse with movement prior to my 2 cervical neurosurgeries in 2012 for two herniated discs which didn’t help my pain and the one for the severe spinal stenosis where my vertebrae had calcified around my spinal cord causing spinal cord compression which did stop about 70% of the extreme pain in my arms and upper back.
Only narcotic pain relievers which I use very judiciously along with large and regular quantities of plain old Ibuprofen for the inflammation make my life bearable.
Since I still have CFS, my life is barely what I’d term being lived to anywhere near the extent prior to my sudden onset of this disease. Don’t give up!!!
Take a break when you need to and then resume your search for an answer.
Love yourself. Throw the guilt aside and tell everyone else to…. Ha! I must add that I agree with a commentator that the concept of pain is even more multi-faceted than CFS/FM and we are just now pioneering the brain and its secrets. Likely not in my lifetime.
Luck and love to ya. marcie
What a wonderful comment Marcie – thanks!
Here’s what I added to the letter, if it helps anyone come up with ideas.
Thank you for the opportunity to provide a comment on the National Pain Strategy.
I was first diagnosed with fibromyalgia around 1985 (30 years ago). After a severe car accident in 1996 in which I was hit from behind, I underwent a full year of physical therapy, surgery, followed by more physical therapy. I was left with additional severe chronic pain. For a year or two, I wished that auto accident had killed me, instead of leaving me in such unbearable pain.
Years later, I still struggle with the disabling pain, along with profound and unrelenting fatigue, sleep issues and side-effects from the pain meds. Thankfully, pain meds somewhat improve my quality of life by reducing the pain. However, I am unable to work and provide a living for my son and myself because of these health issues.
Too often, I have read about the physicians who prescribe pain medications to chronic pain patients, and how they are often cracked down on and/or prosecuted for helping their patients. Then, the patients can’t get legal pain meds, so they turn to illegal sources. I know of several people who were unable to find relief from their pain because their physicians didn’t believe they had a pain issue or were too conservative in prescribing pain meds, who out of desperation turned to either heroin or methadone from a methadone clinic for pain relief.
I hope that more money will be set aside for research & development of additional treatment options and medications for pain relief, along with additional education for medical providers. And I hope for studies on patients who metabolize pain medications quickly, and require higher doses than the average person does.
I appreciate the leadership of the Office of the Assistant Secretary for Health in developing the National Pain Strategy and for providing the public with the opportunity to review the Plan and submit feedback on it.
I urge the Office to dedicate needed resources and begin the important process of creating an oversight body, so that once the Plan is finalized and released, a coordinated launch can begin right away. I am also very concerned about where dollars to pay for the Plan will come from, and urge the Office to do its part in making future budget plans for HHS agencies.
Millions of Americans like me are counting on an improved state of pain care, education and research that is urgently needed and will result from this first-ever comprehensive plan and the hope that it provides for our futures.
Sincerely,
http://www.painnewsnetwork.org/stories/2015/4/29/national-pain-strategy-a-rough-beast?rq=rough%20beast
The NPS was written by and for special interest groups who stand to profit from such and fails to consider the voices of those in pain.
I would note that most of the groups are patient advocacy groups – whose specific goal is to advocate for people in pain.
Cort- less then 1% of all people in pain are part of advocacy groups- to assume they advocate for people in pain doesnt mean they can serve as a substitute for hearing from the other 99% that decided not to join them. Frankly i have authorized none of them to speak for me-and furthermore none of them have the breadth of knowledge to speak meeaningfully for all individuals in pain-but if you would like lets debate the issue openly in public- i think my dorsolateral prefrontal cortex is methylated enough for that..
David- Sorry but suggest that advocacy groups formed by people in pain to advocate for people in pain don’t have the breadth of knowledge necessary to advocate effectively for pain – doesn’t make sense in my book.
I’m not going to debate you either. Whatever objections you have – and there are always objections to any document – I’m going to assume that the wide array of chronic pain groups who have gathered substantial numbers of experts together to produce a consensus document know better.
https://edsinfo.wordpress.com/2015/05/22/national-pain-strategy-a-different-view/#comment-3520
Cort- Its unfortunate youre not the most democratic or discerning person around. Confidance is everywhere the parent of despotism as Thomas Jefferson wrote. Clearly the NPS is an amatuerish document that leaves out the 30 million Americans with multimorbidity, it fails to recognize the problem of treatment burden, it doesnt empower people in pain to have a greater say over their treatment. You were too lazy to see if their interdisciplinary biopsychosocial model was proven or well reseearched- and since i took the time to find out- the answer is their model lacks enough evidence.
What good is served by your promoting your assumptions about the NPS and groups when it is clear you arent concerned enough to have taken the time to look into those special interest groups.
I hope when you go for medical help you are much more discerning then you appear to be here. I had cfs and fibro for 4 years- no thanks to medicine I am now free of both for 15 years- if i wasnt discerning i would have not overcome my conditions. But i thank the good lord I care enough about peoples suffering to take the time to look into things.
You can keep skating on the surface- thats the easy way-and it wont do yourself or people in pain much good. Change your course and become more serious and more dedicated to helping people in pain.
Your arguments would be more convincing Dave if you packed some facts into them.
Cort- in the evidence based pyramid- the highest evidence is meta-analysis- reviews are second best- here are links to reviews on biopsychosocial approach to the more common pain conditions- osteoarthritis, neuropathic pain, migraine and back pain- it is plain to see that not much reviews have been done-and of the reviews done – none show strong evidence for outstanding outcomes for biopsychosocial approach to pain:
http://www.ncbi.nlm.nih.gov/pubmed osteoarthritis biopsychosocial
http://www.ncbi.nlm.nih.gov/pubmed/?term=neuropathic+biopsychosocial neuropathic
http://www.ncbi.nlm.nih.gov/pubmed/?term=migraine+biopsychosocial migraine
http://www.ncbi.nlm.nih.gov/pubmed/?term=back+pain+biopsychosocial back pain
For many of the 300 pain conditions the biopsychosocial and interdisciplinary approach of the NPS dont even have a single RCT- let alone review.
Itis well known pain specialists miss the glory days of a 1000 pain clinics- now there are only about 250- maybe you should think about why there are so few pain clinics compared to years ago.
Dear Dave, I am curious…. how were you able through your own discernment to cure your CFS and FM? If you have a 15 year solution, I and many others would certainly care to hear of it. Thanks. marcie
MArcie- My experience has been whenever i tell people how i overcame my pain condition- they are very doubtful and dismissive. In fact, a year ago when Pat Anson of the NAtional Pain Report asked me to include my bio, on an article, he left out details how i became better. I can say this, though, that most of it was the good Lords doing.
Dear David,
As I’ve had CFS since 1994, the same “1%” statement could be said of the mere handful of us who have the education and understanding and tenacity to continue as patient advocates. Having said that, my voice is better than no voice at all. I realize that every case is different regardless of diagnosis, and I do wish that every one of the millions would be standing up and screaming in one united voice right now, but that’s not reality. Many are giving it their best shot to just stay alive from one moment to the next. I do what I can when I can and there are often times that I, too, fall off the platform for various periods of time before getting back up again. I’m for each and every spokesperson we can get even though it is obvious that there is an amount of infighting since nobody was voted president or czar and we each see the world through our own pain-filled and fatigue ridden eyes. So stay with us and not against us. Speak for us and speak for yourself. marcie
MArcie- I am not opposed to anyone advocating and using their free speech rights. What I dislike is organizations or individuals claiming they speak for anyone in pain.
My comments to the NPS indicate their doesn’t seem to be much careful thought behind their plan. Their plan is clearly undemocratic, managerial, and an occupational strategy whereby 80 individuals wish to impose their ways of doing things on 310 milllion American. They failed to give any and every American a chance to have a say in developing the NPS. And since I believe in democracy, and since i beleive in fundamental fariness- I am opposed to the NPS.
It is interesting, when PAt Anson of the PAin News Network asked Dr Porter about people in pain being represented on the working groups of the NPS- she was dishonest in saying that people in pain were on the working groups- its clear to see that they werent. Its also interesting how Dr. Terman – President of the APS- indicated he didnt know how they were going to implement the NPS and that there was no price tag to the NPS. Americans shouldnt have to by a pig in a poke. Youd think between 2011 when the IOM PAin Care in America came out-and 2015 with the NPS they would have gotten a price tag and a strategy for impelementing their plan- but of course they lack the expertise and sense of urgency to move forward on that.
On MAy 10th I submitted my comments to the NPS- I indicated they lacked implementation knowledge, lacked knowledge of multimorbidity or treatment burden. The NPS iss one rough beast destined to failure. Already the AAFP has come out in opposition to the core curriculum of the NPS- they have 120,000 members. The NPS failed to invite or allow many different medical specialties to get involved in developing the NPS- and trust me soon there will be a big backlash from them. Dont you remember when the IOM report came out- didnt medical organizations rat out the creators of the NPS indicating they took large donations from pharmaceutical companies to promote opioids. So Dr Webster, Dr FOley were subjected to federal investigation by Senator Grassleys committee for their role in promoting opioids. And so i bet before the end of the year there will be a backlash against the NPS.
Anyone who wants to point a finger at me- feel free to do so- as I have gotten 3 bills in NYS requiring education in pain care with 26 legislators signed on- I dont mind the criticism. But I hope readers of this blog will take a careful look at the NPS and the politicis, science, and morality behind it- maybe youll agree with me- the NPS fails in so many ways.