Wednesday, July 10, 2013

Bias and the Band. Concerns and comments, “Are Doctors Paying Attention to Women in Pain?” from the National Pain Report


Are Doctors Paying Attention to Women in Pain?
July 8th, 2013 by Ed Coghlan
At the National Pain Report, here.

CDC Vital Signs. “Prescription Painkiller Overdoses: A growing epidemic, especially among women,” saying opioid deaths are as “under-recognized problem, here.

My comments:

This is what I have to say about the CDC report. [Vital Signs]. The IOM report "Relieving Pain in America..." states there are three groups of people who are discriminated against when it comes to adequate pain management, WOMEN, the poor, and African-Americans. [Complete report, pg 69-70, here. IOM Brief, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research, here.

It perplexes me that opioids are the big concern when the first drug used to treat women is antidepressants and psychoactive drugs, because after all, we are a stressed out lot in an emotional state, right? 

Antidepressants are handed out like candy. I would argue that opioids are not, at least in my experience. The culture on managing pain has changed drastically over the past 5 years. Antidepressants interact with more medications, and when prescribed inappropriately, can increase the likelihood of suicidal ideation even when the patient wasn't clinically depressed. 

[See Dr Oz, Antidepressant Serotonin Imbalance, Suicide Warning, Depression, here]

One must bid the question, "Why are the effects of this classification of drugs not sensationalized, or considered?"  “How many women were also on these meds?” “Where is the data collection tool for this classification of medications? They are not only expensive; they come with far greater consequences.  They are not as effective as the pharmaceutical sales agent attempts to convince physicians, i.e. relieving pain and IMPROVING symptoms. There is an “under-recognized problem” on the effect of antidepressants, which completely restructure the brain. 

[See. CDC Vital Signs. “Prescription Painkiller Overdoses: A growing epidemic, especially among women,” saying opioid deaths are as “under-recognized problem, here.]

In their own report, they say men are more likely to die from overdose, so we focus on educating women? Hey! Aren't men important too?  This reeks of bias, just as stated in the IOM report. [And, the band rolls on, but the sound is deafening]

Statistics are just that, statistics. They can be skewed in data collection and study constructs.  Pain is pain. The CDC only focused on "illicit" pain killers. I would argue that NSAIDS are abused because they are about all we have left to take, and they are equally life threatening. [See, Study Finds NSAIDs Overused for Chronic Pain, here.]  Where are the stats on those? We were given opioid receptors for a reason, and I would like to see the research move in that direction. We should be focusing on the patient.

Summing up post comment:

I am not a proponent of any one thing except the right to choose and have our pain treated adequately. Instilling fear in our physicians and pharmacists creates malfeasance.  The biased culture on pain is not improving things. Look at the correlation with the CDC report.

I have the same concerns as Dr. Mehmet Oz regarding overprescribing of antidepressants. Read “Antidepressants: Are They Right For You?” here. or Dr Amen, expert psychiatrist, on “Do Antidepressants Do More Harm Than Good?” here.

In my search I found studies suggesting that antidepressants aren't treating clinical depression effectively, if at all. Other information suggests that antidepressants are treating the depression angle of chronic pain, but even in these studies, they were considering people with MAJOR depression, a clinical psychiatric condition.  We need research on psychoactive drugs that are NOT conducted by pharmaceutical companies.

Opioid medications have been around for centuries, physicians have a firm understanding of what they are, but there is a educational deficit between defining addiction vs. dependence, and patient teaching needs, but I would argue that patients do not receive enough information on psychoactive drugs of ANY sort. Also to be considered are any medications that increase tolerance, antidepressants happen to be among that group. Any medication that requires you to reduce the dose slowly has the propensity to be life threatening.

Wouldn't it be better to educate physicians and patients on how to watch for untoward symptoms and restore the doctor and patient relationship?    Relieving pain responsibly is only manifested by an improvement in function. We don’t need new tools, we have them. They are called patient assessment. Have we become so technological that we have forgotten how to interact with a human being?

You might be interested in reading the PAINS/Project Environmental Scan, Chronic Pain Management and the Practical Implications of Addressing Recommendations Put Forth in the Institute of Medicine (IOM) Report, Relieving Pain in America, here.

Treatment without bias is our right, and we as patients  must speak up. You can find ways of doing that on my website, here. I encourage you to leave comments when you read an article.  Feedback from the people like us is not only needed, it is desired. We must begin the dialogue.

We are law abiding citizens. Most of us do play by the rules, so why do we allow ourselves to be treated as criminals, or to be discriminated against because of our gender, our socio-economic status, our age, or the color of our skin? How can criminalizing a human condition be legal? What is happening to our society?

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  For more information about the author see

Celeste Cooper is a retired RN, educator, fibromyalgia patient, and lead author of the Broken Body Wounded Spirit: Balancing the See Saw of Chronic Pain devotional series (coauthor, Jeff Miller PhD), and Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome and Myofascial Pain: The Mind-Body Connection (coauthor, Jeff Miller PhD)

She is a fibromyalgia expert for Dr. Oz, et al., at, and she advocates for all chronic pain patients as a participant in the Pain Action Alliance to Implement a National Strategy (

Celeste's Website

Celeste's Website
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