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Jul-26-2014 21:15printcommentsVideo

Scott M. Fishman, MD Profiteer 'Responsible for Opioid Addictions and Deaths'??

His "guide" became the holy grail to the medical profession in minimizing the dangers of addiction and death from prescribed opioids.

Scott M. Fishman MD
Scott M. Fishman, MD. Salem-News.com File Photo

(MYRTLE BEACH, SC) - I have been writing articles over the years on the prescription opioid/heroin epidemic crippling the U.S. and Canada and the contributing factors involved.

These factors are the physicians paid by the pharmaceutical industry to write books and speak directly to the medical profession downplaying the long term use of opioids for chronic pain.

One of the physicians paid by Purdue Pharma, maker of OxyContin is Scott M. Fishman, MD. Fishman wrote a book entitled "Responsible Opioid Prescribing - A Physician's Guide" endorsed by the State Medical Boards in all 50 states and Canada.

This "guide" became the holy grail to the medical profession in minimizing the dangers of addiction and death from prescribed opioids. The Fishman book was written in 2007 and is currently under U.S. Senate investigation because of the controversial medical statements made by Dr. Fishman.

The book was also sponsored by pharmaceutical companies and their financed pain foundations -- many also under U.S. Senate investigation including Purdue Pharma.

What the U.S. Senate may not be aware of is that Dr. Fishman put the "finishing touch" on the medical profession in 2012 by writing yet another holy grail entitled "Listening To Pain - A Clinician's Guide to Improving Pain Management Through Better Communication."

Curious as to Dr. Fishman's further attempts to influence the medical profession and downplay the word "addiction" from 2007 until 2012? Here are some highlights of his 2012 Clinician Guide -- and you decide if the medical profession was further duped by the good doctor:

"There is no debate among public health experts about the fact that pain is under-treated. Under-treatment of pain has been recognized as a public health crisis for decades. The consequences are often catastrophic for patients, in terms of suffering and disability, as well as for the healthcare costs we all share, since untreated and under-treated pain often lead to expensive utilization of resources."

"....we tend to think of pain as a sensation. But if you look at it in its full human and psychosocial dimensions, pain is actually as much an emotional as a physical experience."

"Similarly a host of life-situations can affect pain either directly (such as the use or abuse of licit or illicit drugs) or indirectly (such as high stress levels at work or home or physical deconditioning caused by lack of exercise).

"I believe clinicians must be very careful with the label "addict." I draw a distinction between a "chemical coper" and an addict. Many people are "chemical copers" either with legal or illegal drugs. They use drugs to cope with life and remain relatively healthy and functional despite, perhaps, being chemically dependent on a drug. Addicts, on the other hand, have a disease that impairs their ability to control or modulate their use of a drug that is causing them dysfunction. They also continue to crave and use the drug despite the dysfunction. For an addict, enough is never enough. (More on the coining of the word "chemical coping" next article).

"Distinguishing between someone with addiction and pseudo-addiction can be challenging, and at times impossible on a single visit. This determination usually can only be made once the clinician prescribes an opioid that either improves or worsens function. Whereas pseudo-addiction resolves when the patient obtains adequate analgesics, true addictive behavior does not. (Pseudo-addiction was coined after one patient study and has been considered unreliable by the medical profession in recent years).

"Behaviors LESS indicative of addiction":

"Taken (sic) someone else's pain medication. Aggressively complained to doctor for more drugs. Used more opioids than recommended. Taken (with permission) someone else's prescription opioids. Raised dose of opioids on own. Expressed concern to clinician or family members that pain might lead to use of street drugs. Ever used opioids to treat other symptoms."

"Clearly, since pain itself is untestable and the sources of pain can be legitimately obscure, we must be very cautious before concluding that a patient is somatisizing. Because somatization is ultimately a diagnosis of exclusion, I recommend that you take a patient's claims at face value during the initial phases of treatment, even if you harbor suspicions about their ultimate physical validity."

Dr. Fishman now serves on the Advisory Board of a publication named "Pain Pathways Magazine." And this off their website:

CHRONIC PAIN When acute pain doesn’t go away after the injury or cause of pain has healed, it is considered chronic pain. Typically, chronic pain lasts more than six months. Chronic pain is now considered a disease that may best be managed with a complementary, team-based approach. Relaxation technique and water therapy, for example, may be used along with medication, nerve blocks or surgery to control pain.

Chronic pain is now considered a "disease"? Says who? Chronic pain is a symptom -- but as long as the Fishmans in the medical profession peddle their snake oil, this deception will be bought. Possibly Dr. Fishman can answer a question for me -- why is there a blank page under "corporate sponsors" for "Pain Pathways Magazine?" Corporate sponsors were once listed in the magazine.

I wish there were a publication called "License Plate Making." I would be happy to send complimentary subscriptions to those paid shills of pharma -- including the FDA -- responsible for the raging rate of deaths and addictions in the U.S. and Canada because of sheer evil and having no conscience.

LP - Some people take romantic walks in the park -- but you take me to the much needed "president" -- some days more than others.



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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dave August 15, 2014 8:48 am (Pacific time)

Dr Schatman does well to talk as he is friendly with folks at the aapm. But Fishman and his friends were wrong to not be more careful about their beliefs about opioids-whether or not they did it just for the money. Opioids as they should know are inferior to many pain treatments simply because they do not address the underlying pathology of pain. They seem to believe that someone without arthritis can still have arthritis pain. And we all know they have yet to establish good quality evidence of opioids for chronic "noncancer" pain. And dont thye like to go on on how "noncancer" pain is less significant then the pain from trigeminal neuralgia or thunderclap headaches or end stage ankle osteoarthritis.

dave August 15, 2014 8:41 am (Pacific time)

Marianne- Schatman- he is good friends with folks in the aaapm and he -needless to say gets benefits from such. I am on nobodys payroll- i cant be bought or sold when it comes to pain care and it is clear Dr Fishman and co could have and should have been more cautious when it comes to their beliefs about the good of opioids.

Amy Graves July 29, 2014 6:30 pm (Pacific time)

Thank you Marianne for exposing the deceit and propaganda that has fueled the opioid addiction and overdose epidemic in both the US and Canada. Shame on Dr. Fishman!

Pete Jackson July 28, 2014 6:39 pm (Pacific time)

Let's not recreate history. Fishman is a known purveyor of the pro-opioid propaganda that got us into this mess. It is going to take a lot of hard work, and a lot of lost lives, to un-do what he did with his book.

Bob Pack July 28, 2014 12:24 pm (Pacific time)

The tentacles of special interest reach far and wide.Prop46 in CA is taking Rx drug abuse and public safety to the people and out of the hands Pharma, Insurance and medical industry.

Stoppnow July 28, 2014 10:13 am (Pacific time)

Let's give Scott Fishman the benefit of the doubt that when he first promoted Pharma's pain killer with no adverse side effects he was ignorant. The continuance of defending his actions and those of the drug companies after so many deaths can only be that of selling your soul to the devil. Marianne Skolek is a hero and she fights for all the parents that cry themselves to sleep every night in our country. Scott Fishman is the one that places more value on $ than a human life.

Ada Giudice-Tompson July 28, 2014 6:08 am (Pacific time)

Marianne is revealing the truth - the Fishman's of this world have spawned an opioid epidemic. The 'shameless attack' has been on patients and families who have put their trust in the medical system. So many families grieve the loss of a loved one due to the lies opioid manufacturers spread in marketing their drugs to prescribers. Some prescribers were complicit in promoting these lies. The medical profession has failed patients. The standard of care to treat pain with an opioid has caused an epidemic of iatrogenic addiction and overdose death. Even those prescribers who initially were well-intentioned must now acknowledge the harm. Stop abusing patients' trust, eliminate Conflict of interest and influence and abide by the oath 'First Do No Harm'.

Marianne Skolek July 28, 2014 4:13 am (Pacific time)

And I hate to read the "drivel" on pseudo-addiction and the downplaying of the risks of taking dangerous opioids long-term for chronic pain that Fishman has peddled for years -- while the country deals with the count of body bags. Guess we're even Dr. Schatman. Now who's an "amazingly excellent physician?"

Dr. Michael Schatman July 27, 2014 7:53 pm (Pacific time)

Shameless attack on an amazingly excellent physician who has spent his career working for opioid risk mitigation. Oh well - this type of exploitative, neuromystic garbage certainly sells press - which is obviously more important than accurate and unbiased reporting. As a bioethicist who has been on the "anti-opioid" side of the argument for many years, I nevertheless hate to read this type of uniformed drivel.

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