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Aug-26-2012 21:43
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Lynn Webster, MD Attempts to Discredit Physicians for Responsible Opioid Prescribing
Marianne Skolek Salem-News.com“The proper function of a government is to make it easy for the people to do good, and difficult for them to do evil.” - Daniel Webster, author and orator
 Lynn Webster, MD |
(MYRTLE BEACH, SC) - American Academy of Pain Medicine (AAPM) Responds to Physicians for Responsible Opioid Prescribing (PROP) Citizen Petition to the FDA limiting prescribing addictive opioids for long-term non-cancer pain. Is this effort by PROP to save lives in the prescription drug epidemic causing AAPM to attempt to discredit PROP? (Click on link to read PROP's Citizen Petition filed with the FDA) http://www.citizen.org/documents/2048.pdf
On the website of PROP, it states -- "The mission of PROP is to reduce morbidity and mortality resulting from prescribing of opioids and to promote cautious, safe and responsible opioid prescribing practices."
"We have serious concerns about the petition and believe the rationale for the requested changes is seriously flawed, potentially harmful to patients with debilitating pain conditions for whom opioid therapy is indicated, and without substantive scientific foundation,” the AAPM wrote in a letter to the FDA about PROP's Citizen Petition
Members of AAPM's Board of Directors signed the letter and indicated there was no scientific evidence showing that the use of opioids to treat moderate pain was any more or less harmful than prescribing the painkillers for severe pain. It also questioned PROP's request to limit prescriptions to 90 days for the treatment of non-cancer pain. The AAPM is funded by the pharmaceutical industry and they oppose any limitations put on opioid prescribing. “We believe that the adoption of the recommendations in the PROP petition to lower doses or duration would provide a false sense of security for patients and practitioners,” Dr. Lynn Webster, President-Elect of AAPM stated.. “In our view, a more effective means to address this problem would be enhanced prescriber education and adherence to principles of practice, including ongoing monitoring for aberrant behaviors and early signs of addiction.” Reading a daily newspaper in any major city in the U.S. will educate the medical profession on the prescription drug epidemic in addiction and death. And early signs of addiction? Writing opioid prescriptions for long-term non-cancer pain will give any physician the early signs of addiction up front and personal.
Here's where I ask the AAPM and their physicians -- you know the ones under Senate investigation for possibly profiting from pharmaceutical companies such as Purdue Pharma, maker of OxyContin -- by pushing opioids for all levels of pain. Where are the scientific studies conducted by pharma such as Purdue Pharma showing the long-term benefits or risks for the treatment of non-cancer pain with opioids? I'll make it easy for Dr. Webster and his illustrious team of physicians serving on the Board of AAPM -- there are no scientific studies.
“If AAPM wants to defend the right of drug companies to advertise high dose and extended use of opioids for moderate chronic pain as safe and effective, the burden of proof is on them,” said Andrew Kolodny, MD, President of PROP. “We don’t have to prove this. The law requires drug companies to prove that products are safe and effective for use as advertised. It doesn’t require the public to prove that they’re not safe and effective.” “At the end of the day, if FDA implements the label changes we’re requesting, doctors will still be able to prescribe long-term opioids to chronic pain patients who need them and AAPM knows this,” stated Dr. Kolodny.
Dr. Webster was quoted in Newsday in January 2012 as saying about the prescription drug epidemic in the U.S. and Canada -- "I am not sure I would use the word epidemic. There is a public health crisis, but not an epidemic." Webster said critics too often overstate the degree to which people are addicted. Since the Senate Finance Committee is investigating Webster and the American Academy of Pain for their financial ties to the pharmaceutical industry, the Senate may find the statement that we are in a "public health crisis" and "not an epidemic" as relates to the soaring addictions and deaths to opioids around the country interesting. In its response to the FDA pertaining to PROP's Citizen Petition, AAPM had 12 members of their Board of Directors sign the letter. The response expressed the concern that adoption of the three focal points of the PROP petition to limit the dose, the duration and modify the labeling for opioids that are prescribed for non cancerous pain would have unintended societal consequences. Curious about the meaning of what AAPM refers to as "unintended societal consequences?" Societal means "of or relating to society or social relations." Tell that to a family mourning the death of a loved one because they were over-prescribed a dangerous opioid, became addicted and died. Their death according to AAPM is actually due to "social relations."
Curious about the meaning of what AAPM refers to as "unintended societal consequences?" Societal means "of or relating to society or social relations." Tell that to a family mourning the death of a loved one because they were over-prescribed a dangerous opioid, became addicted and died. Their death according to AAPM is actually due to "social relations."
The Executive Board of PROP is as follows:
| President Andrew Kolodny, MD Brooklyn, NY (Not under U.S. Senate investigation) Vice President Michael Von Korff, ScD Seattle, WA (Not under U.S. Senate investigation) Treasurer Rosemary Orr, MD Seattle, WA (Not under U.S. Senate investigation) Secretary Stephen Gelfand, MD Myrtle Beach, SC (Not under U.S. Senate investigation) Jane Ballantyne, MD Seattle, WA (Not under U.S. Senate investigation) Irfan Dhalla, MD, MSc Toronto, ON (Not under U.S. Senate investigation) Gary Franklin, MD, MPH Seattle, WA (Not under U.S. Senate investigation) | Pete Jackson Arlington Heights, IL (Not under U.S. Senate investigation) David Juurlink, MD, PhD Toronto, ON (Not under U.S. Senate investigation) Petros Levounis, MD, MA New York, NY (Not under U.S. Senate investigation) Edwin Salsitz, MD New York, NY (Not under U.S. Senate Investigation) Jon Streltzer, MD Honolulu, HI (Not under U.S. Senate Investigation) Betts Tully Chicago, IL (Not under U.S. Senate investigation) Art Van Zee, MD St. Charles, VA (Not under U.S. Senate investigation) |
AAPM Board of Directors
2012 - 2013 Board of Directors
 | President Martin Grabois, MD Baylor College of Medicine Dept of Physical Medicine & Rehab Houston, TX Under Senate Investigation |  | President-Elect Lynn R. Webster, MD Life Tree Pain Clinic Salt Lake City, UT Under Senate investigation |
 | Treasurer Bill McCarberg, MD Kaiser Permanente Chronic Pain Management Program Escondido, CA Under Senate investigation |  | Secretary Zahid H. Bajwa, MD Associate Professor of Anesthesia (Neurology) Harvard Medical School Director, Clinical Pain Research Beth Israel Deaconess Medical Center Boston, MA |
 | Vice President for Scientific Affairs Sean Mackey, MD, PhD Stanford University Medical Center Associate Professor Director, Pain Management Division Palo Alto, CA |  | Immediate Past President Perry G. Fine, MD University of Utah - Pain Research Center Department of Anesthesiology, School of Medicine Salt Lake City, UT Under Senate investigation |
Directors at Large | |||
 | Director at Large Donna Marie Bloodworth, MD Quentin Mease Community Hospital Dept of Physical Medicine & Rehab Houston, TX |  | Director at Large Allen Burton, MD University of Texas MD Anderson Cancer Center Department of Pain Medicine Houston, TX |
 | Director at Large Timothy R. Deer, MD President & CEO Center For Pain Relief Inc Charleston, WV |  | Director at Large Gilbert Fanciullo, MD, MS Dartmouth-Hitchcock Medical Center Pain Management Center Lebanon, NH |
 | Director at Large Leonardo Kapural, MD, PhD Carolinas Pain Institute Winston Salem, NC |  | Director at Large Tim J. Lamer, MD Mayo Clinic Rochester, MN |
 | Director at Large Steven P. Stanos Jr., DO Rehabilitation Institute of Chicago Chicago, IL | ||
 | ABPM Liaison Director Robin J. Hamill-Ruth, MD Pain Management Center University of Virginia Health System Charlottesville, VA |  | Representative of Past Presidents Richard L. Stieg, MD LoDo Pain & Headache Clinic Aurora, CO |
 | Editor, Pain Medicine Journal Under Senate Investigation Rollin M. Gallagher, MD MPH Pain Management Service Philadelphia Veterans Affairs Medical Center Philadelphia, PA | ||
Lynn Webster, M.D., President-Elect of AAPM offers a "fun" and "exciting" program about safe opioid prescribing as shown on the AAPM website and listed as "2012 Safe Opioid Prescribing Course Video Message" -- as every state in the country and Canada reels in addiction and deaths in the tens of thousands. Tell me Dr. Webster, where does the "fun" come into play? Here is Webster's reference to "fun" opioid prescribing - (Click on top video with photo of Webster) http://www.painmed.org/
For some reason after viewing Dr. Webster's video and the AAPM rebuttal to the PROP Citizen Petition, I thought of Hannibal Lecter. May I suggest that when Dr. Webster presents his 2012 Safe Prescribing Course -- you know the "fun and exciting" program, that he serve fava beans and a nice Chianti for lunch.
LP - “Love is like the wind, you can't see it -- but you can feel it.” Nicholas Sparks
Marianne Skolek
Investigative Reporter for Salem-News.com
Activist for Victims of OxyContin and Purdue Pharma - a criminally convicted pharmaceutical company
www.salem-news.com/by_author.php?reporter=Marianne%20Skolek
www.vawd.uscourts.gov/PurdueFrederickCo/default.asp
www.oxydeaths.com
908-285-1232
Salem-News.com Investigative Reporter Marianne Skolek, is an Activist for Victims of OxyContin and Purdue Pharma throughout the United States and Canada. In July 2007, she testified against Purdue Pharma in Federal Court in Virginia at the sentencing of their three CEO's - Michael Friedman, Howard Udell and Paul Goldenheim - who pleaded guilty to charges of marketing OxyContin as less likely to be addictive or abused to physicians and patients. She also testified against Purdue Pharma at a Judiciary Hearing of the U.S. Senate in July 2007. Marianne works with government agencies and private attorneys in having a voice for her daughter Jill, who died in 2002 after being prescribed OxyContin, as well as the voice for scores of victims of OxyContin. She has been involved in her work for the past 8-1/2 years and is currently working on a book that exposes Purdue Pharma for their continued criminal marketing of OxyContin.
Marianne is a nurse having graduated in 1991 as president of her graduating class. She also has a Paralegal certification. Marianne served on a Community Service Board for the Courier News, a Gannet newspaper in NJ writing articles predominantly regarding AIDS patients and their emotional issues. She was awarded a Community Service Award in 1993 by the Hunterdon County, NJ HIV/AIDS Task Force in recognition of and appreciation for the donated time, energy and love in facilitating a Support Group for persons with HIV/AIDS.
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Pain Management pharmacist December 7, 2013 3:04 pm (Pacific time)
Skolek has no credibility period, has she ever stepped foot in a pain clinic, the physicians listed are physicians of high integrity trying to do what's best for their patients.
All the credibility of an anonymous poster, it is so low class to refer to Ms. Skolek that way. She is a champion in this world and she is right. The doctors are pain profiteers with all the integrity of carpetbaggers/
Patients often come to a pain clinic escalated on high dose opioid by their well intentioned primary care physician, A physician has no control once a prescription is written as to how the patient takes the drug. Ms Skolek is careless in her reporting period.
Of course pain clinics see the worst, they helped create the problems in the first place, I fail to see how you miss that. Ms. Skolek is careful and thoughtful, all she is trying to do is help the human beings who are forced into addiction by doctors.
These physicians have facilitated the understanding of how to get to the root of the problem, yes the pharmaceutical companies step up to try to find safer ways to deliver pain treatment and limit abuse/misuse.
Right, while many drugs already exist. The new ones are more addictive than ever which further nullifies your point. It is a money game, nothing more and nothing less. Some people are not dealt a fair or kind hand, but pain is part of life is it not? Continually masking it causes so many other physical problems. And for the record, those physicians ARE the root of the problem.
Research cost millions of dollars, goes for any drug investigated, cancer drugs, cardiovascular drugs. Physicians get paid to conduct study's just as you get payed to write this pathetic article that only attacks and doesn't offer solutions. Ignorance is bliss and is obviously paying your check Ms Skolek.
Ms. Skolek is not making money from these articles, she doesn't write for that reason. She lost her daughter to OxyContin. Her daughter was not an addict, she was prescribed the medication and then died from a respiratory failure. You must have no idea how your words come across here. We live in a nation that profits from everything, too many rules are broken along the way. Lest we forget that Purdue's top officials were convicted of felonies for initially marketing OxyContin as non lethal and non addictive. Friend, your advocacy for these vultures is misplaced.
Carol Levy April 3, 2013 3:48 pm (Pacific time)
I have yet to see a responsible article about the "epidemic" of opiods including oxy that breaks it down into those who are given the drug by a doctor vs. those who are using them illicitly, by stealing them from pharmacies, buying them on the street, etc. Missing also, in this article, as well as most on the "epidemic" is the fact that while pain patients may become physically dependent on these meds, they rarely become addicted, and usually it is in people who are prone to addiction. It is bad enough that many in pain are presumed felons, having to sign an opiod contract that includes "permission" for random urine testing. We are in pain, we rarely 'enjoy' the opiates we are taking. For many of us all other forms of treatment, procedures, surgeries, and medications have failed leaving no option but narcotic medication. It is time to stop demonizing those in chronic pain. This article was commentary. I did not see it titled as such. (As my bona fides: I have been in chronic intractable pain from trigeminal neuralgia, atypical facial pain and anaesthesia dolorosa for over 30 years)
Jimmy September 15, 2012 9:26 pm (Pacific time)
You do realize that there are many other competent physicians who voiced a negative opinion of PROP's petition, who are not under Senate investigation, don't you? Many physician organizations have written negative responses to the petition as well, including, but not limited to, the American Society of Anesthesiologists and the American Society of Regional Anesthesia and Pain Medicine. I don't believe either of these groups that represent thousands of highly trained physicians are under Senate investigation. And I agree with them one hundred percent. PROP's position is based on weak scientific data, and is an over-broad proposal that, if passed, will cause undue agony to millions of non malignant pain sufferers.
M. Dennis Paul, Ph.D. August 30, 2012 2:48 am (Pacific time)
Steve Gelfand, MD, above, attempts to make further connection for opioid induced deaths by promoting the "pain is all in their head" malarkey and associating this with higher incidence of morbidity and mortality... but offers not one shred of evidence in support of this phony assertion. He continues to promote the canard of "chronic non-cancer pain" as though this was an established, proven criteria for assessment of pain. It is not and never has been a rational criteria and there exists no scientific evidence in support of such a foolish notion. It is bias such as the contentions of this doctor that have held back important research and inquiry. Claiming that those who are not suffering chronic cancer pain, neuropathy or "end stage" RA are more susceptible to the addictive and/or lethal effects of narcotics is ridiculous unless you are completely sold on the idea that because science has yet to discover the causes of pain that do not fit into your picture of the world those presentations are definitively psychosomatic. The doctor, because of his own bias, completely misses the point of my earlier message.
For the Doctor and for Richard Marshall and his trite comment, my specialty for many years has been Thought Addiction (which, unfortunately, many in both science and medicine suffer from). A portion of my post grad work was in Psychopharmacology and also Theories of Addiction. Rather than reading into my messages those things which you believe I am promoting, try just reading my messages absent your own filters and conditioned bias. You may come to a deeper understanding of this issue and begin to see ways in which all can make genuine changes where needed. Changes based in rational, reasonable and honest research and inquiry. I do not side with any of the groups mentioned in these articles nor am I associated with them or any pharmaceutical companies and I make absolutely no money discussing these issues. I will shortly submit an article regarding the dangerous emotionality behind these groups and the writings of authors on both sides. I respect Marianne and understand where she is coming from with her efforts. I disagree with them in numerous ways and believe the problems would be better addressed absent the emotionality and black and white prejudiced and largely incorrect thinking.
Steve Gelfand, MD August 29, 2012 6:33 pm (Pacific time)
The post by M. Dennis Paul raises the issue of the rising volume of morbidity and mortality in chronic noncancer pain patients on chronic opioids who may also have "anxiety, depression, PTSD, psychosis and multiple medication and/or alcohol abuse." But he fails to recognize that it is precisely this large segment of the chronic pain population in whom pain is directly related to the effects of chronic psychological distress acting on the central nervous system [and not to peripheral tissue-based pathology like of cancer, neuropathic pain or end-stage arthritis], which has a much higher risk for the addictive and lethal effects of opioid analgesics. These are the types of patients for whom primary care providers have for so many years overprescribed opioids for the misguided hope that opioids can "relieve pain and suffering," as encouraged by organizations like the AAPM and many others in the pro-opioid movement in the complete absence of scientific evidence.
Richard Marshall August 29, 2012 1:16 pm (Pacific time)
To D.P. Phd Spoken like a true "mind" specialist, thank you Pudue Pharma. Another example of American GREED.
Dr. Robert Ben Mitchell, D.O. August 29, 2012 1:56 am (Pacific time)
As the prior administrator of a legitimate chronic pain management program (2001-2007) and currently the administrator of one of the largest Opioid Based Office Treatment programs in Southeast Florida, I have always found the AAPM to be on the WRONG side of these issues. At the very start of this pill-mill crisis, they were advocating false credentialing by instructing their members to say they were "Diplomates" of the AAPM, when diplomate is a legal term denoting being a member of an ABSM (American Board of Specialty Medicine) or similarly approved medical board (the AAPM never has been ABSM or similarly approved, and it still isn't). Then, when doctors were killing people by the thousands here in Florida each year by improperly prescribing pain medications, the AAPM consistently defended the drug-dealing doctors' rights instead of the patients these doctors were victimizing. Now the AAPM wants to interfere with further steps to rectify this tragedy which has killed tens of thousands needlessly. Rather than continue to be part of the problem, why doesn't the AAPM start being part of the solution, or at least get out of the way of those who are? Dr. Robert Ben Mitchell, D.O. 16375 NE 18 Ave, Suite 310 North Miami Beach, FL 33162 786-262-5750
August 28, 2012 8:15 pm (Pacific time)
In the 15 years since the introduction of OxyContin, the volume of opioid-related addiction, overdose and death continues to grow to levels unparalled in the history of medicine. At the same time that the problem has been covered-up, or one ineffective solution after another has been proposed [including those of the FDA], warnings from experienced clinicans have been ignored while medical research has shown that there is a lack of evidence that opioids are safe and effective over the long-term for patients with chronic noncancer pain, in whom other much safer and more effective non-opioid multidisciplinary therapies are often neglected. Considering the gravity of the situation as stated in many of these postings to Marianne's effective article about the AAPM, aggressive strategies to limit physician overprescribing and overdosing, such as the present FDA petition, are essential and mandatory in order to save future lives and prevent another generation from becoming victims to the mounting toll of opioid-related addiction, overdose and death.
Janet Colbert stoppnow (stop the org August 28, 2012 4:05 pm (Pacific time)
These drug dealer doctors care more about $ than the value of a human life. The reason why cancer is mentioned in conjuction with this oxycodone is for the pallative care patient. It is not feasible to take these drugs and function in society. Too many parents have buried their children there are other means of controlling pain than heroin
M. Dennis Paul, Ph.D. August 28, 2012 3:46 pm (Pacific time)
It is a disservice to all when articles such as this are used to support what amounts to a political attack on a medical question. It is a childish and disingenuous approach for any researcher to claim they have no requirement to accurately and honestly prove their case and that such onus falls upon those whom they attack. It is a mockery of science. It is, further, highly dishonest to present citations within a petition that fail miserably to actually address the facts, which can be readily discerned in an honest fashion, regarding a question of science and of treatment. A question, I might add, that is never answered by petition unless such petition is a request for instituting genuine science and inquiry. The petition offered by PROP is anything but.
Selective accumulation of data which supports a predetermined outcome, in the manner presented by PROP, is no different than how most pharmaceutical companies advance their product conclusions. PROP is resting upon no higher moral ground than the industry it seeks to control. The greatest misconception, among many, promoted in the above article and in the cited petition is the criteria of pain measured against cancer.. as if the gold standard of pain is cancer pain. It is not. There are other conditions which are demonstrated through subjective criteria (the only known method of determining individual pain) to be more painful than cancer. Any researcher suggesting otherwise is being purposefully dishonest or woefully ignorant.
Having read the cited petition, it is further notable that PROP proponents suggest the 90 day rule for prescribing is anything other than what it clearly states. It is notable that not one piece of scientific evidence is cited in support of this arbitrary control. It is notable, also, that PROP and the article's author consistently fail to reference the full and conclusive data regarding overdose and cause. It is purposeful to mislead the public into belief that opiates are "the" cause knowing that most individuals will not research and discover the true facts of multiple medication and alcohol abuse as well as anxiety, depression, PTSD amd psychosis as factors influencing morbidity and mortality. Such articles as this are plainly designed to stimulate emotionality as opposed to encouraging genuine research, reason and rational thought in the exercise of seeking help for those of us who suffer greatly with pain syndromes.
Janet Colbert stoppnow August 28, 2012 3:04 pm (Pacific time)
Thank you Marianne for all that you do. This massacre continues to destroy families and devastate communities. Janet Colbert stoppnow (stop the organized pill pushers) NOW
Avi Israel August 27, 2012 4:25 pm (Pacific time)
Lynn Webster is under investegation by the u.s senate he is not to be belived about anything until his name is cleared.why would the F.D.A. listen to anything this man has to say?why would anybody go see a doctor under investegation?
August 27, 2012 1:22 pm (Pacific time)
Did I just read a "fun" and "exciting" program that he's offering??? REALLY and SAFE. This just makes me sick to my stomach. What if your child was addicted to these poisonous pills??? Maybe then we would get your attention. All of you It seems to me that ever since these Oxy's came about, things are SOOOOOOOOOOO much worse and yes it is an EPIDEMIC, WAKE UP!!!
Ann August 27, 2012 2:52 pm (Pacific time)
Dr. Webster is right there is a Public Health Crisis due to the OPIATE EPIDEMIC, which was caused when Perdue Pharma decided to DECEIVE physicians into believing their gold mine drug OXYCONTIN was safe for every ache including a tooth ache. If I had one wish, it would be to be granted TWO. ONE for my child to over come his addiction DUE to OXYCONTIN and TWO for when the makers of OXYCONTIN meet THEIR Maker on judgement day they are made to experience all the pain and suffering their deadly drug cause to families all over the US and Canada.
Ann August 27, 2012 2:35 pm (Pacific time)
Yes Dr Webster, you are right there is a Public Health Crisis due to the opiate epidemic, which by the way started when Purdue Pharma decided they had a gold mine with their deadly drug OXYCONTIN. And before the makers of these deadly drugs come before their maker on their judgement day, they are made to feel the pain of all the families lives they have destroyed.
CORBOVAL August 27, 2012 9:14 am (Pacific time)
Seriously? Educated people making this comment can not possibly be serious about opiates. Something has to be wrong. Where do you live? This is the most horrible epidemic for kids in Massachusetts. It is mind boggling to think that you could possibly be honest with this type of opinion. My prayers are that you will see the light and the problems that opiate addiction causes for families and children. I am in disbelief and horror for the opinions expressed in this article.
Mike Sprague August 27, 2012 12:49 pm (Pacific time)
Dr. Webster has only one reason to try to downplay the opposition to his willingness to not acknowlege the epidemic of addiction to pain pills and more. That reason is payola and he knows it. What happened to honor and trust in our medical field?
Joanne Peterson August 27, 2012 11:05 am (Pacific time)
Perhaps any one of the board members of AAPM would like to come to one of our support group meetings which we have 6, soon to have 8 here in Massachusetts. At our meetings they will see rooms FULL of parents in anguish who's sons and daughters are in the midst of the EPIDEMIC we have in this country. Or talk one of the over 3000 registered members to our National website. All parents of former athlete's, honor students and yes legitimate patients who were prescribed OxyContin for broken ankles, wisdom teeth, Cancer you name it. Yes there IS an epidemic. We are all living breathing proof. Sadly many of our parents kids are now dead. It ALL began with these pain medications flooding the market and being over prescribed. It began with Purdue Pharma being dishonest and telling doctors it was safe for moderate pain. Now there is more and more on the market. We are not fools, we see that it's a way to fill pockets in the industry and out in the world poisoning people, patients and young kids experimenting alike. Shame on all of you.
Anonymous August 27, 2012 8:49 am (Pacific time)
I will always feel that these Dr's who prescribe any narcotics, and I KNOW they KNOW these kids are just looking for a "HIGH" should be held accountable....and the pharmacies KNOW these DRUGS are addictable....whether you are YOUNG or OLD...this affects EVERYONE...ACCOUNTABILITY is the WORD!!!Please STOP THIS..so many young kids have DIED..DIED, to never come back..YOUNG>>when will it STOP..LET'S stop this..
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