Chronic Pain In the Elderly Impaired and the Opioid Epidemic
Claudewell S. Thomas, MD, MPH, DLFAPA, is an established psychiatrist who is currently retired ,, He received his medical degree in 1956 at SUNY Downstate College of Medicine and specializes in social psychiatry, public health psychiatry, and forensic psychiatry. Dr. Thomas was board certified by the American Board of Psychiatry... more
The opioid epidemic rages on. Federal court judgments have been handed down against Big Pharma companies, sending one into bankruptcy, pending appeal. Physicians have been fined and imprisoned, and at least one major Educational Medical Facility is under investigation.
We all bemoan cupidity and stupidity, and most would agree that the CDC opioid guideline for chronic pain is useful and praise the work of News writer Pam Harrisaon and Gary Franklin MD, MPH and the CDC and COCA sponsored webinar in 2015 (Medscape). There is, however, such a thing as legitimate chronic pain, which particularly affects the elderly and causes misery among patients and their caregivers. This condition is also associated with suicide.
I happen to know several elderly people who serve as caretakers to other elderly people who suffer from intractable diseases, many associated with pain, who are denied the use of opioids by the FDA's incorporation of CDC guidelines. Many benefit from non-THC cannabinol (hemp oil), but would benefit from THC (marijuana). Towards the end of their life, the danger of addiction should not be as much of a risk as for younger patients over the time. Similar to my previous writings, I assert that the medical use of marijuana has a place in the control of addiction and should not be confined to the status of an entry point for more serious addictions.
In a June 2019 Medscape commentary, Prof. Charles Argoff, Professor of Neurology at the Albany Medical College and director of its Comprehensive Pain Center and a contributor to the CDC Guideline, called for flexibility and understanding of the burden that strict conformance to the Guidelines imposed on the patients with chronic pain, who are legitimately seeking pain relief and not euphoria. It is a narrow beam that must be traversed. Once again, you, the consumer of medical aid, can do your part by questioning the use of opioids on your behalf and defending their use in the chronically ill elderly.
