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How best to fight the opioid crisis? (1 Viewer)

Stealthycat said:
https://www.cnn.com/2018/03/11/health/prescription-opioid-payments-eprise/index.html
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Less than one fourth of all docs in the study wrote opioid prescriptions. Of those who did, less than 2% of them received a payment of some kind totaling more than $15k, (about 16% receiving $1k or more.) Those who write more scripts for opioids are more likely to have received more money, which makes sense given that those who see a lot of pain patients will probably be the ones most likely to be giving talks on the topic. Correlation doesn't mean causation.

Some really big leaps being made in that 'study'. I'm sure there are some bad eggs out there, don't get me wrong, but this is a poorly organized and written study. Individuals who wrote unnecessary and ill-advised prescriptions for opioids for monetary gain should lose their licenses and be prosecuted to the fullest extent of the law. I still don't see a systematic abuse of the system by docs to get paid for unethical use of opioids.

 
I'd add that the average "PAYMENTS TO Physical medicine DOCTORS SPECIALIZING IN PAIN MEDICINE" in their article is only $3,711. And those are physicians who specialize in treating pain.

 
Ketamine Dreams said:
Some really big leaps being made in that 'study'. I'm sure there are some bad eggs out there, don't get me wrong, but this is a poorly organized and written study. Individuals who wrote unnecessary and ill-advised prescriptions for opioids for monetary gain should lose their licenses and be prosecuted to the fullest extent of the law. I still don't see a systematic abuse of the system by docs to get paid for unethical use of opioids.
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just an article I saw in CNN that shows another problem maybe with this opioid crisis

 
Just Win Baby said:
Just Win Baby said:
D_House said:
More evidence-based prescribing: 

For all their risks, opioids had no pain-relieving advantage in a yearlong clinical trial - Los Angeles Times https://apple.news/A9rvM9RC7QTCN-Og4JAWqVA

This is just the latest publicized study showing the relative lack of benefit of opioids in chronic pain vs other less risky analgesics. The guidelines have already caught up, but we still see patients with relatively new opioid prescriptions for their low back pain.
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I will be interested to see the reaction in the medical community to this study. It does not track with my own experience with my wife, who has suffered from severe chronic pain for 20 years. And given her situation, I read a lot on this subject, and I have encountered many pain practitioners and pain patients over two decades, and these results do not seem to fit my experience with that population either.

Also, you say "just the latest publicized study showing the relative lack of benefit of opioids in chronic pain vs other less risky analgesics" as if you are aware of multiple other studies that show the same results. I am not aware of any such studies. If you have links, please post.
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And some reaction is now available, and it supports my skepticism about the study. From Is New Opioid Study Based on Junk Science?

“You've been had by anti-opioid advocates disguising their advocacy as science.  Krebs is well known in professional circles for this kind of distorted advocacy junk science,” wrote patient advocate Red Lawhern, PhD, in a comment submitted to the Philadelphia Inquirer after it published a misleading headline of its own, “Prescription opioids fail rigorous new test for chronic pain.”

“I suggest that you retract your article.  In its present form, it is propaganda not fact,” said Lawhern, a co-founder of the Alliance for the Treatment of Intractable Pain (ATIP). “Opioids have never been the first-line medical treatment of choice in lower back pain or arthritis. That role is served by anti-inflammatory meds, some of them in the prescription cortico-steroid family.  NSAIDs have a role to play, recognizing that they are actively dangerous in many patients if taken at high doses for long periods.
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The same article makes it clear that the study's author has a strong anti-opioid bias, which has been demonstrated in the past.
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More reaction to this so-called study.

From Real World Study or Reality Show:

We can drone on to enumerate a list as long as your arm of the methodologic flaws of the study. They may be forgivable. The misrepresentation of what they say are unforgivable. JAMA publishing this garbage is unforgivable.
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From the comments on that post:

...the great majority of the patients in the opioid group were given only 50 ME/day or less. Remember that a typical starting dose for any type of pain is Percocet 5 mg, 1-2 qid prn, which is 40 mg oxycodone/day, which is 60 mg ME/day. A rather low dose, yet more than most of the opioid group were given. Which would of course diminish the number of patients who might benefit “from opioids” when the dose is that low.

In other words, from what I can tell, this study is based on a patient population that at the start of the study did not have a lot of pain, and in which the opioid treatment group received only a rather low dose of opioids. I do not think that one can generalize from this study to the benefit, or lack thereof, of opioid treatment for OA-related back, knee or hip pain. Opioids may still be very helpful for many people with OA. To say that opioid treatment is not useful for OA, which is what the newspaper article (and others. . .) said, cannot be legitimately concluded from this study.
Jennifer Schneider, M.D., Ph.D. Internal Medicine, Pain Management & Addiction specialist
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From Does That JAMA Study Really Show That Advil Is Just As Effective As Opioids?:

People in pain vary widely in how they respond to medication, so the fact that opioids did not have an advantage, on average, for this particular sample with these particular types of pain does not mean they are not a better choice for some patients. The study sample was 87 percent male, and it was drawn from V.A. clinics, which may not be representative of the general patient population. The conditions were limited to chronic back pain and chronic hip or knee pain caused by osteoarthritis, so the study does not speak to opioid treatment for other kinds of pain. The initial pain intensities were middling, so the study may not reflect the experiences of patients with more severe pain.

Notably, the researchers excluded patients who were on long-term opioid therapy, which means they ignored people who had already found they did not get adequate relief from other treatments. It seems reasonable to assume that people who are currently using opioids to treat chronic pain are doing so because they think these drugs work better for them than Advil or Tylenol, and they may even be right to think that. If you exclude those patients from a study of pain treatment, you are excluding precisely the people who are most likely to get more relief from opioids.
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In addition:

  • The study addressed a form of chronic pain for which opioids are not routinely used as a first choice therapy.
  • The study employed dose levels at and below the very bottom of the therapeutic range for opioids when they are used.
  • The authors failed to acknowledge effects of anti-depressant medications added to the non-opioid side of the trial; such medications are frequently used off-label in pain management, particularly for neuropathic pain.
Basically, the conclusions drawn from the study about opioid effectiveness are bogus. Despite all the fake news about that.

@D_House, you did not respond to my post asking you to link the other studies you implied you have seen that drew similar conclusions to the one you linked. Is that because you don't know of any other such studies?

 
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Opioid crisis SOLVED!

David Martosko @dmartosko

Kellyanne Conway's advice for millennials about Fentanyl: "Eat the ice cream. Have the French fry. Don't buy the street drug. Believe me, it all works out."

1:50 PM · Mar 22, 2018

 
caustic said:
Opioid crisis SOLVED!

David Martosko @dmartosko

Kellyanne Conway's advice for millennials about Fentanyl: "Eat the ice cream. Have the French fry. Don't buy the street drug. Believe me, it all works out."

1:50 PM · Mar 22, 2018
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Now THAT'S a plan!  Have french fries and ice cream and don't buy heroin...I just wish someone would've thought about this sooner, it would've saved 10's of thousands of lives.  Ok, what's the next problem that needs to be solved? 

 
Just Win Baby said:
Basically, the conclusions drawn from the study about opioid effectiveness are bogus. Despite all the fake news about that.
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More on this study from What the JAMA Opioid Study Didn’t Find:

But the most fascinating result of the study – the one not being reported -- is what wasn’t found. The 108 people in the study who took opioids for a year did not develop signs of opioid misuse, abuse or addiction, and did not develop opioid-induced hyperalgesia – a heightened sensitivity to pain.

And no one died of an overdose.

This is significant because it runs counter to commonly held beliefs in the medical profession about the risks of prescription opioids.

...

Krebs and colleagues closely monitored the 108 people in the opioid arm of the study, using “multiple approaches to evaluate for potential misuse, including medical record surveillance for evidence of ‘doctor-shopping’ (seeking medication from multiple physicians), diversion, substance use disorder, or death.” They also had participants complete the “Addiction Behavior Checklist” and assessed their alcohol and drug use with surveys and screening tools.

What did Krebs find in the opioid group after 12 months of treatment?

“No deaths, ‘doctor-shopping,’ diversion, or opioid use disorder diagnoses were detected,” she reported. “There were no significant differences in adverse outcomes or potential misuse measures.”

...

Krebs told the Minneapolis Star Tribune that this “could reflect the fact that the study did not enroll patients with addiction histories, and because the VA provided close supervision to all participants during the yearlong study.”

In other words, Krebs and colleagues used an opioid prescribing protocol that achieved an admirable level of patient safety. Their approach is similar to what many pain management practices currently pursue and what the CDC and various state guidelines recommend: Risk assessment before initial prescribing and careful monitoring over time.

The Krebs study provides rare and detailed observations of what happens when people are put on long-term opioid therapy. A lot of what is claimed about dose escalation, opioid-induced hyperalgesia, and misuse or abuse didn't happen at all.

This outcome demonstrates that long-term opioid therapy can be safe and effective, and may be useful in treating other chronic conditions, from intractable neuropathies to painful genetic disorders. That’s worth reporting too, isn’t it?
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Just Win Baby said:
And some reaction is now available, and it supports my skepticism about the study. From Is New Opioid Study Based on Junk Science?

The same article makes it clear that the study's author has a strong anti-opioid bias, which has been demonstrated in the past.
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I can say from my experience that opiods werent the first line of treatment for me just as your link says. They first prescribed meloxicam. Then they stepped it up from there. 

 
Banger said:
Now THAT'S a plan!  Have french fries and ice cream and don't buy heroin...I just wish someone would've thought about this sooner, it would've saved 10's of thousands of lives.  Ok, what's the next problem that needs to be solved? 
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Obesity?

 
From TRUMP’S FALSE WAR ON OPIOIDS WILL ONLY PUNISH PATIENTS IN PAIN:

...Our government is now, in effect, dictating what constitutes acceptable prescribing of controlled substances, mostly opioid painkillers. That is both unprecedented and disturbing, and patients who need potent pain medications are suffering.

...Thus, it can reasonably be assumed that the number of deaths from opioid pills alone is probably about 5,000, roughly as many people who die each year from bicycle and bicycle-related accidents. Yet, we don’t hear scaremongering alerts about a bicycle accident epidemic.

...Once the false narrative is peeled away, the policy flaws and the suffering they cause become evident. Deaths from appropriate and responsible use of opioid pain medications are, in fact, relatively uncommon, but the politicians and bureaucrats soldier on. Their one-size-fits-all legislative and regulatory remedies are doomed to fail and can inflict tremendous inconvenience and pain on patients along the way.
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Posted this in the other thread:

I think there are two problems:

  1. Growing use of illicit opioids, like illegal Fentanyl and Heroin
  2. Diversion of prescription opioids to those who misuse/abuse them
IMO problem #1 is 1-2 orders of magnitude greater than problem #2. Trying to combat problem #1 falls into the classic "war on (illegal) drugs." I don't think long running efforts to fight the "war on (illegal) drugs" have been very successful, and better methods are needed to yield a higher success rate in that effort.

IMO the solution for problem #2 is for opioid prescribing to be carefully monitored and screened to ensure prescribing is appropriate. In my experience (with my wife, a chronic pain patient), this has largely been achieved over the past several years due to the Government's "war" on our opioid "epidemic." Scrutiny on opioid prescriptions, prescribers, and patients as well as pharmacies filling the prescriptions has drastically increased, and overall opioid prescribing is at a 10 year low. Unfortunately, opioid deaths are at a 10 year high, which underlines the point that problem #2 is not really the main problem.

Unfortunately, our Government is trying to address opioid deaths by attacking problem #2, even though the vast majority of those deaths come from problem #1. The fact that the two problems are mostly unrelated explains why the Government's efforts are not having a positive effect on opioid deaths. Yet their efforts are harming millions of pain patients. It is obvious that this is the wrong approach. Well, obvious to anyone with a clue about the situation, which, unfortunately, does not describe our politicians.

I think additional positive steps could be taken. For example, pass a law that makes patients subject to prosecution if their medications are found to be in possession of others who are not caregivers of the patient. Make a law that opioid medications are required to be locked up in the patient's home, which would prevent family or friends from diverting them. These laws would be difficult to monitor/enforce, but they would likely represent incremental gains without doing harm to pain patients with legitimate need. And that - incremental gains without doing harm to pain patients with legitimate need - should be the focus of the Government's effort to solve problem #2.

I'm sure there are other positive steps that can be taken. Those are just a couple of ideas.

I also think it is very hypocritical of our Government to attack opioid prescribing in the manner it has. Consider that approximately 9 times as many people have already died in 2018 from alcohol than from prescription drugs, including more than 2 times as many people from drunk driving, implying many of those deaths were innocent victims. Drinking alcohol has no benefit equivalent to the benefit of opioids for pain patients. Why are we as a society so de-sensitized to alcohol deaths while being so hyper-sensitive to a relatively small number of prescription drug overdose deaths?

 
Sheriff Bart said:
Just Win Baby said:
I will be interested to see the reaction in the medical community to this study. It does not track with my own experience with my wife, who has suffered from severe chronic pain for 20 years. And given her situation, I read a lot on this subject, and I have encountered many pain practitioners and pain patients over two decades, and these results do not seem to fit my experience with that population either.

Also, you say "just the latest publicized study showing the relative lack of benefit of opioids in chronic pain vs other less risky analgesics" as if you are aware of multiple other studies that show the same results. I am not aware of any such studies. If you have links, please post.
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Same here with my wife.  She can't walk in the morning until about 45 minutes after she takes her pain meds.  FWIW, she also does yoga and cardio work outs 3-4 times a week so isn't lazy.
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My wife was told by her pain doctor today he can prescribe percoset to her any more. Nobody in town wants to because they're all scared of the feds.  At least not regular percoset. There's this time release version that loses most potency when crushed.  Oh and it's $250 a month because insurance doesn't cover it.  There's already a $50 co-pay because she has to see him by law every month and get popped for random drug tests. Plus her other nerve pills and crap are easily another $100 a month.  So we're talking $400 a month for pain meds.  Oh but we could avoid that $250 if she would go to Oxycontin.  Wife says #### that. So now we get to fight the insurance company, again, for meds someone in my family needs.  I guess we could go get some of the cheap plentiful heroin if we needed to. 

Stupid government.  Overreact to everything and don't consider the consequences.  Except for assault rifles and mass shootings. Nobody gives two ####s about that. 

 
She can't smoke pot because of work and like I posted a few months ago, pot doesn't do **** for pain for me and I've been smoking 35 years. 

 
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Sheriff Bart said:
My wife was told by her pain doctor today he can prescribe percoset to her any more. Nobody in town wants to because they're all scared of the feds.  At least not regular percoset. There's this time release version that loses most potency when crushed.  Oh and it's $250 a month because insurance doesn't cover it.  There's already a $50 co-pay because she has to see him by law every month and get popped for random drug tests. Plus her other nerve pills and crap are easily another $100 a month.  So we're talking $400 a month for pain meds.  Oh but we could avoid that $250 if she would go to Oxycontin.  Wife says #### that. So now we get to fight the insurance company, again, for meds someone in my family needs.  I guess we could go get some of the cheap plentiful heroin if we needed to. 

Stupid government.  Overreact to everything and don't consider the consequences.  Except for assault rifles and mass shootings. Nobody gives two ####s about that. 
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Neurontin? This literally did nothing for me, might as well have been tic tacs. 

 
BOOM...LONG overdue....I hope they bankrupt them and senior executives go to jail...

NY AG Underwood‏Verified account @NewYorkStateAG

FollowFollow @NewYorkStateAG

More

#BREAKING: We are filing suit against Purdue Pharma for persistent and widespread fraud and deception in marketing #opioids. Purdue lined its own pockets by deliberately exploiting our communities, fueling a crisis that has devastated NY families. We are holding them to account.

8:15 AM - 14 Aug 2018

 
Didn't Jared solve this yet? What's he waiting for? Peace in the Middle East?

 
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Wifey has RA.  MD legalized medical weed a few years back and the clinics opened last December.

She's been doing ok controlling the pain with diet and keeping fit, but there are days...

So anyway, a recent flare up got her off her butt and she saw the doc, got the paperwork started, and a few weeks later got her card.  Went to a local dispensary, got some CBD pills and also a vape pen and a charge of CBD oil.  Its been working for her, which is lovely.  She inhales once off the pen, about 4 times each day, and takes the pills.  I haven't noticed any change in behavior, and she reports no high other than a brief sharpening of vision lasting for a few minutes after the inhale.  Her general inflammation has gone down.  When she shakes her hand her two rings rattle against each other, which hasn't happened in years.  She has far less pain as well.  Oh, and this makes her a lot happier, which makes my life better.  Total win.  Only problem is that I can't touch the stuff given my job, and I'd like to see what it is like.

She's related all this to my aunt, who also suffers from RA, and that will probably happen too.

 
proteus126 said:
Wifey has RA.  MD legalized medical weed a few years back and the clinics opened last December.

She's been doing ok controlling the pain with diet and keeping fit, but there are days...

So anyway, a recent flare up got her off her butt and she saw the doc, got the paperwork started, and a few weeks later got her card.  Went to a local dispensary, got some CBD pills and also a vape pen and a charge of CBD oil.  Its been working for her, which is lovely.  She inhales once off the pen, about 4 times each day, and takes the pills.  I haven't noticed any change in behavior, and she reports no high other than a brief sharpening of vision lasting for a few minutes after the inhale.  Her general inflammation has gone down.  When she shakes her hand her two rings rattle against each other, which hasn't happened in years.  She has far less pain as well.  Oh, and this makes her a lot happier, which makes my life better.  Total win.  Only problem is that I can't touch the stuff given my job, and I'd like to see what it is like.

She's related all this to my aunt, who also suffers from RA, and that will probably happen too.
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Nice.

This just came out today.  CBD is all the rage.

https://www.leafly.com/news/health/research-cbd-autism-therapy-promising-results

 
People who feel connected to others and aren’t desperate are much less likely to become addicted to anything. 

Social safety nets and active community programs are the best way to battle addiction crises. 

 
The Commish said:
Had a brief conversation with her last night....here's a bit of her history.  It seems that all she's on now is this Kratom.  She had to leave before we finished our conversation so I had a couple other questions for more clarity:
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I wanted to update on my relative.

I ordered it immediately after we chatted.  It took me seven months to get her to try it.  She was hemming and hawing and refusing... there was a warning that went out right around the time we were discussing it about salmonella in some kratom company's supply and she used that as an excuse.  I finally sat her down last week and asked her if she's addicted to the opiates, because otherwise I just can't understand her position.  She finally said she'd try it.  Last night was her first attempt, small dose.

I just got a text from her this morning: "It's only one time, and maybe it was just a good night, but if this is repeatable I could get my life back." 

Thank you for your advice. I don't know if this is a long road or a short one where it works, but one night/day of something that actually helps and doesn't make her feel worse in some other way is more than she's had in a decade.

 
Henry Ford said:
I wanted to update on my relative.

I ordered it immediately after we chatted.  It took me seven months to get her to try it.  She was hemming and hawing and refusing... there was a warning that went out right around the time we were discussing it about salmonella in some kratom company's supply and she used that as an excuse.  I finally sat her down last week and asked her if she's addicted to the opiates, because otherwise I just can't understand her position.  She finally said she'd try it.  Last night was her first attempt, small dose.

I just got a text from her this morning: "It's only one time, and maybe it was just a good night, but if this is repeatable I could get my life back." 

Thank you for your advice. I don't know if this is a long road or a short one where it works, but one night/day of something that actually helps and doesn't make her feel worse in some other way is more than she's had in a decade.
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i wish the new format had a "good luck" button

 
wikkidpissah said:
i wish the new format had a "good luck" button
Click to expand...
Thanks.  I'm trying to not get my hopes up for her.  I honestly don't believe in the  granola/supplement/naturopathic/snake oil B.S.  At all.  Neither does she anymore, though she hoped for a lot of years that it would be her saving grace.  And cannabinoids have been the biggest difference before this, so I guess there's that.

But there was a happy face with her text this morning and the last time I got a smiley face emoji from her when I inquired about how she was doing, the iphone probably hadn't been released yet.  I'm a little shocked.

 
Henry Ford said:
Thanks.  I'm trying to not get my hopes up for her.  I honestly don't believe in the  granola/supplement/naturopathic/snake oil B.S.  At all.  Neither does she anymore, though she hoped for a lot of years that it would be her saving grace.  And cannabinoids have been the biggest difference before this, so I guess there's that.

But there was a happy face with her text this morning and the last time I got a smiley face emoji from her when I inquired about how she was doing, the iphone probably hadn't been released yet.  I'm a little shocked.
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That's great news. So I make sure I get this right, what is it that she's taking? I've unfortunately got family history with opiod addiction and feel strongly about trying to find solutions. I want to make sure I'm getting the info right from you. 

 
Henry Ford said:
I wanted to update on my relative.

I ordered it immediately after we chatted.  It took me seven months to get her to try it.  She was hemming and hawing and refusing... there was a warning that went out right around the time we were discussing it about salmonella in some kratom company's supply and she used that as an excuse.  I finally sat her down last week and asked her if she's addicted to the opiates, because otherwise I just can't understand her position.  She finally said she'd try it.  Last night was her first attempt, small dose.

I just got a text from her this morning: "It's only one time, and maybe it was just a good night, but if this is repeatable I could get my life back." 

Thank you for your advice. I don't know if this is a long road or a short one where it works, but one night/day of something that actually helps and doesn't make her feel worse in some other way is more than she's had in a decade.
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:clap:

:pickle:

All the emojis!!!!!!!  That's freakin' awesome. 

They seem to be making progress with getting an association together trying to fight for the legalization (or should I say to block making it illegal...what the drug companies are pushing for) of it.  Link to the organization.  This makes me really happy.  :thumbup:  

 
Joe Bryant said:
That's great news. So I make sure I get this right, what is it that she's taking? I've unfortunately got family history with opiod addiction and feel strongly about trying to find solutions. I want to make sure I'm getting the info right from you. 
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She's not using it for addiction.  My comment about addiction was just to kind of make her understand that if she won't try an alternative, it leads me to believe she wants the Norco for some other reason.  Many people claim it helps them get off of opiate addiction, but I can't speak to that.

She is taking approximately 3 grams of Green Malay Kratom from GaiaEthnoBotanical.com per dose, spaced 6-8 hours apart, in hot chocolate right now (it's really bitter, so it needs to be mixed with something until the person discovers it works and it's worth tasting, is my understanding.)

I ordered the raw powder.  My understanding is that the pre-filled capsules are often not fresh, not well handled, may have fillers, and are therefore not as good an idea.  In the future, if it continues to work, I will probably fill capsules for her so she doesn't hate the taste (though that will also add probably 30 minutes to how long it takes to start acting.)

 
The Commish said:
:clap:

:pickle:

All the emojis!!!!!!!  That's freakin' awesome. 

They seem to be making progress with getting an association together trying to fight for the legalization (or should I say to block making it illegal...what the drug companies are pushing for) of it.  Link to the organization.  This makes me really happy.  :thumbup:  
Click to expand...
Thank you.  I've sent them my information in case they need a litigator in Louisiana.

 
Henry Ford said:
She's not using it for addiction.  My comment about addiction was just to kind of make her understand that if she won't try an alternative, it leads me to believe she wants the Norco for some other reason.  Many people claim it helps them get off of opiate addiction, but I can't speak to that.

She is taking approximately 3 grams of Green Malay Kratom from GaiaEthnoBotanical.com per dose, spaced 6-8 hours apart, in hot chocolate right now (it's really bitter, so it needs to be mixed with something until the person discovers it works and it's worth tasting, is my understanding.)

I ordered the raw powder.  My understanding is that the pre-filled capsules are often not fresh, not well handled, may have fillers, and are therefore not as good an idea.  In the future, if it continues to work, I will probably fill capsules for her so she doesn't hate the taste (though that will also add probably 30 minutes to how long it takes to start acting.)
Click to expand...
Thanks. For your relative, she's using for pain control? In place of pain medicine?

This whole thing is a complex and vicious cyle and problem. My younger brother died a few years. He was addicted for several years. My best friend is a doctor and has to find the right balance on how to responsibly use the medicine for good. It's rough. 

 
Joe Bryant said:
Thanks. For your relative, she's using for pain control? In place of pain medicine?

This whole thing is a complex and vicious cyle and problem. My younger brother died a few years. He was addicted for several years. My best friend is a doctor and has to find the right balance on how to responsibly use the medicine for good. It's rough. 
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Pain, insomnia, anxiety, and depression all work in a pretty vicious matrix together.  I have always believed (and she does too) that if she started sleeping properly a lot of the rest of the symptoms would go away, but she definitely can't sleep because of the pain and other neurological symptoms (she has brain abnormalities that may be caused by trauma, maybe by genetics, maybe disease, no one's sure.)

She's taken every sleep medication known to man, and it doesn't help.  I paid $2500 a month for her to try one that has to be registered with the federal government and delivered by personal courier from the company.  Nothing.  She was on propofol and it didn't give her more than 3-4 hours of sleep at a time.  Chloral Hydrate (the drug that killed Anna Nicole Smith) doesn't make her sleep.  

Last night she had six hours, on a low dose of Kratom.  And woke up virtually pain free, not feeling anxious.  

 
Joe Bryant said:
Thanks. For your relative, she's using for pain control? In place of pain medicine?

This whole thing is a complex and vicious cyle and problem. My younger brother died a few years. He was addicted for several years. My best friend is a doctor and has to find the right balance on how to responsibly use the medicine for good. It's rough. 
Click to expand...
Hey Joe, if you want to go back through this thread, you'll see the story I posted of my friend that pointed Henry to Kratom in the first place.  She's had unmanageable pain for as long as I've known her from fibromyalgia.  She's a friend from high school and after we parted ways and sort of lost touch it got worse.  She was on opiods for pain management then all the regulations changed, insurance changed etc and yanked her pain management right out from under her.  She was close to death (suicide) until she found this stuff.  She still has really bad days because of the disease, but her bad days are no longer greater than her good days.  I can ask her whatever questions you have.  I don't know much about it outside of what we can read on the internet.  Let me know and I'll see what I can find out.

 
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