Showing posts with label opioids. Show all posts
Showing posts with label opioids. Show all posts

Wednesday, January 30, 2019

Deadline To Comment On New Federal Recommendations On Pain April 1st – Read Mine




If you have had your pain care jeopardized because of the opioid crisis, please refer to the US Pain Foundation toolkit. You can access the full report and find the toolkit HERE. Or you can comment at Regulations.gov. Write as little or as much as you would like. The important thing is that we use our voice.


Comments on the task force proposal due by April 1, 2019.


RE: The Inter-Agency Task Force Draft Report on Pain Management Best Practices.
Docket Number: HHS-OS-2018-0027

To those concerned,

The IOM report and the National Pain Strategy have addressed the stigma of chronic pain, yet here we are nearly a decade later in worse shape than ever. I appreciate your efforts to take integrative therapies mainstream, educate others on the benefits of responsible opioid treatment, and stop the lunacy that is driving pain patients to suicide as the “opioid epidemic” (which should read ILLEGAL, BLACK MARKET FENTANYL, thank you.) continues to rise. We need factually driven reports, not those that sensationalize inaccurate data to make money at our expense. I wish there was a plan to engage with the media that includes the unintended consequences of addressing the drug problem we have in the United States. 

I could use better pain control, but I would have no life if I had to plan it around monthly all-day visits to a pain doctor to get 60 pills. Thank you for thinking of people like me. It would be great if you could get Medicare to pay for monthly therapeutic trigger point massage and my TENS unit supplies. It would be nice if I had help with the cost of a new PEMF device, pay for my EEG biofeedback device, or pay for unlimited visits to my physical therapist to get active release therapy. Thank goodness I have access to interventional care such as ultrasound guided trigger point injections, cervical nerve ablations, and occipital nerve blocks, but they only provide temporary/partial relief and Medicare won’t pay for me to have them when they wear off. Instead, I have to wait the six months as my pain escalates out of control and tethers me to my recliner, draped in warm compresses and ice packs, praying my TENS adhesive doesn't cause blistering too quickly. I pay an extraordinary Medicare premium (NO! Medicare is NOT free, and tie-in plans rate chronic pain patients up for their “pre-existing” chronic pain condition). My pain specialist does not take Medicare Advantage plans, but even if he did, their would be co-pays. I am grateful that the task force is addressing this. This is a good start, but I have reservations.

Over the long-term, I hope things will be easier for the patient and reduce the justified fear of physicians to prescribe. Patients have become unpaid guinea pigs for Big Pharma as pharmaceutical companies push physicians to prescribe other “newer” central acting agents that come with their own basket of interactions and abuse risk. I have permanent damage to my esophagus and stomach and have suffered the consequences for twenty years. Obviously, there was a time Feldene was my drug of choice.

In closing, I appreciate all those on the task force for providing a report that considers many of my personal concerns; it is comprehensive. We need reliable research that is not paid for by parties who will benefit from the outcome. Let us all hope there is forward motion for making pain care individualized, compassionate, accessible and effective.

Sincerely, Celeste Cooper, Retired RN



In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!



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Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Wednesday, July 11, 2018

FDA responds on behalf of chronic pain patients who require opioids to treat their pain


https://www.usatoday.com/videos/news/politics/2018/07/02/fda-chief-says-long-term-opioid-prescriptions-needed-some-chronic-pain-patients/752552002/


As I said in my June blog, if we want change, we are obliged to share our 
unique individual circumstances and our life encounters. If you have been affected by having your opioids restricted, if you want pain management that fits within your personal framework, it’s time to use your voice.

Hope has turned in to reality; the FDA is listening! 
Our voice is being heard, so let’s keep using it.



ID: FDA-2018-N-1621-0001
The Food and Drug Administration (FDA)

“Patient-Focused Drug Development for Chronic Pain.” The public meeting will provide patients (including adult and pediatric patients) with an opportunity to present to FDA their perspectives on the impacts of chronic pain, views on treatment approaches for chronic pain, and challenges or barriers to accessing treatments. FDA is particularly interested in hearing from patients who experience chronic pain that is managed with analgesic medications such as opioids, acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants; other medications; and non-pharmacologic interventions or therapies.

Comment Now!
Due Sep 10 2018, at 11:59 PM ET


Adversity is only an obstacle if we fail to see opportunity."


Additional Reading:

Opportunity Knocks Again: Public Comments on Patient-Focused Drug Development for Chronic Pain (includes my comment)


In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!



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Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Saturday, June 2, 2018

Comment Now to NIH Pain Management Best Practices or Forever Hold Our Peace


The comment period has been extended to June 15th.

PLEASE NOTE: Following is my voice. Your story is different from mine. To date there are only 1454 comments out of over 100 million Americans who live with chronic pain. I know there are  more who want to comment, because I hear from you, and now, they want to hear from all of us. 

Our stories put a face to the meaning of our plight to be treated with dignity and respect. We are more than statistics and it's time to show it. 


“Our lives begin to end 
the day we become silent 
about the things that matter.”

~Martin Luther King



When you are finished, you will receive a "Comment Tracking Number".

RE: Meeting of the Pain Management Best Practices Inter-Agency Task Force
Docket ID: HHS-OS-2018-0009 Agency: Department of Health and Human Services (HHS)

Those of us living with chronic pain deserve to have our pain treated, yet the illegal drug abuse epidemic is making it impossible to receive the care we need to survive. As an RN and lead author of five books on pain and integrative therapies, I am sickened when I read about another suicide by a fellow pain patient, one that resulted from the government "crackdown" on opioid prescribing. I am tired of hearing how physicians will no longer prescribe a drug they have been using for years because they are fearful of the DEA. I am a person aging with severe inoperable musculoskeletal disease and a lesion in my sacrum that causes such pain I cannot bear weight or sleep. When it flares, I get epidurals, but they are limited. Why does the government think they can judge me for needing an opioid? I have severe damage to my esophagus and stomach from NSAID overuse. My mother died from a heart attack caused by NSAIDS, yet we never hear about how unsafe they are with prolonged use. I tried the antidepressants, they did not help, and the side effects were intolerable. Lyrica® and Neurontin® disconnected me from reality. I am not alone in this, so why don’t we hear about that? I am elderly and I am angry that my primary doctor will no longer prescribe the small amount of opioids that work for me, that I can afford, and that allow me to participate in other practices I find helpful. Government overreach has led to this lunacy. Pain physicians require monthly visits, whether you need a new prescription or not. These practices are driving the cost of pain care to the moon. Making patients succumb to a pee test is demoralizing, and they aren't all accurate, resulting in the destruction of innocent lives, yet they are allowed, even encouraged, to add to the burden of escalating costs. What happened to watching for untoward behaviors and making appropriate referrals? Few patients expect total relief with opioids, but it should be their right to have their pain managed well enough to participate in integrative therapies like mindfulness, tai chi, physical therapy, etc. Education is needed, not prohibition. Addicts deserve to have the "right treatment", not therapy based on ability to pay. Money is being wasted on the war on drugs that could be used to develop outcome-based programs to help these people. Many of us live with debilitating conditions for which there is no cure and opioids are the treatment of last resort. Many of us do not have transportation to pain clinics or the ability to make co-payments. Please hear my voice. The crime here is allowing people in pain to be exploited by those who profit from our demise, and a false narrative driven by media hype.


In healing,

Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!



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Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Tuesday, February 6, 2018

A PATIENT's VOICE – Life in Chronic Pain with Frank Elliot


Since the CDC Guidelines on Opioid Prescribing were published, I have been bombarded with requests for help. The number of contacts became too much for this one-person to handle individually. So, I have posted a FB Note, The Pain Advocate’s Corner: How to Raise Your Voice. You will find many links for contacting or interacting with federal and state legislators, medical associations, advocacy organizations, insurance commissioners, and more. Sharing your story is not only a cathartic experience, it is helpful to others, including patients and those who write policies that affect us as a patient community. Becoming involved in movements like No Longer Silent is empowering and a good anecdote for feelings of isolation.

Sit Awhile – Tell Me Your Story© Celeste’s Photography

Many thanks to Frank for sharing his story as a Google+ comment and allowing me to share it with you.

Frank Elliott’s Story

When I hear or read the reporting about the bad side of opioids, I cringe, Celeste. There is seldom any reporting on people like you and me. Many of us need something in addition to meditation, relaxation, pacing, non-opioid pain medicines, and medicines like Lyrica®, which provides pain relief for a small proportion of people and can have horrible side effects. Lyrica® gave me a terribly debilitating and chronic case of inflammatory lymphedema, which has led to me being bed bound and homebound for months at a time. Nothing even approaches the relief I get from 15 mg a day of methadone. My pain drops from an 8 or 9 level to a 2 or 3 level. I've reduced the methadone from 30 mg a day to 15 mg a day as my peripheral nerve damage gradually heals. In nine years, I haven’t had any problems with methadone. I remain very stable on a gently declining dose. Severe constipation is an issue, but I address that issue with daily use of Mirilax®.

I'm a diabetic, have severe, persistent asthma, have chronic pain from nerve damage, a hypothyroid condition, and I am depressed from time to time because it can be difficult to live with a long list of chronic illnesses. If my burning, frying, electric shock kind of pain is under good control, my life can be very active. I don't know how I would be able to handle things or cope if my pain was out of control again. When it was, about ten years ago, I thought passing away might be a viable option. That tells you something about how overwhelming the pain was.

Thankfully, I am much better now and my chronic illnesses are not endangering my life. I am fortunate to have access to a wonderful university teaching hospital pain practice. Still, I am very concerned, like you, that the stories of people like us aren’t being heard. I don't like having to take methadone. I have to be very careful, chart every dose, and make sure I don’t make a mistake. Still, after 9 years with the hospital pain center, the doctors and nurse practitioners trust me. I'm very reliable and steady. My practitioner says, "Frank, if I could only bottle you!" She knows we've tried everything else gradually and only methadone controls my neuropathic pain from peripheral neuropathy.

I think a good place for me to start is with my two senators from my state. I bet they haven't heard the stories of the millions of people who use opioids because they work effectively to control our pain. We are not addicts or drug abusers. We use opioid pain relieving medicines only to control our unrelenting and unmanageable pain. Thank you for listening, Celeste.

Frank’s Afterthought

I enjoy your pieces on lymphatic drainage system massage. My inflammatory lymphedema is in a flare, so it’s time for monthly drainage massages, what my medicine doctor calls Frank's tune-ups. Eight to ten sessions and doing the things they teach me will allow me to regain control. Working together, we've found patterns of my disease and identified warning signs so we can intervene in a timely fashion. I have made a great deal of progress because of the people at the pain clinic. It’s encouraging to me. The teamwork and communication between patients and my wise providers is a wonderful thing.

Celeste’s Note

I am not a journalist; I am a registered nurse and I am a fellow person living with chronic pain. As lead author of five books on “integrative” care, I believe we should have all tools available to us, and for some that includes opioids or state legalized medical cannabis. Access to any treatment that improves our function in any direction, physical, mental, emotional, or spiritual is the right one. 

Have you shared your story?

Additional Reading:

No Longer Silent – I hope you will join us.

 In healing,,Celeste
Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!



“Listen closely; I hear the sweet sound of existence.”

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Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.

All blogs and comments are based on the author's opinions and are not meant to replace medical advice.  

Saturday, December 23, 2017

Celeste’s Saturday Salutes to Chronic Pain: Issue 6




Celeste’s periodic blog “Saturday Salutes to Chronic Pain” honors the collaborative spirit of fellow bloggers, advocates, and the many friends who share this journey. You inspire me.

SATURDAY SALUTES

Comment: Morphine equivalents are not created equal. @JeffreyFudin ..." the CDC’s promotion of a flawed App for opioid conversion, which may have the potential to cause more overdoses than careful manual conversion when transitioning therapy between opioids!"

Practical Pain Management: A Model to Incorporate Functional Medicine into Chronic Pain Care
Comment: Do you know there are "Seven Nodes of the Functional Medicine Matrix?" I didn’t.

Comment: The truth revealed.

PAINS Project Brief 11: Understanding Chronic Pain and Suicide
Comment: Is someone you love at risk?


CELESTE’S TOP TRENDING PUBLICATIONS



OTHER PUBLICATIONS

*The Advocates Corner – Blogs of Interest at CelesteCooper.com PAINS Project page


ON THE WEB       

Follow along on my Facebook Page
Find previous SATURDAY SALUTES in the archives calendar on My Blog


Thank you guests and fellow pain survivors
October 2017 blog visits - 13,269   website visits – 14,820


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"Adversity is only an obstacle if we fail to see opportunity."


Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.


All blogs and comments are based on the author's opinions and are not meant to replace medical advice.  

Monday, October 23, 2017

Chronic Pain Disease and the Opioid Crisis: Myra Christopher Changing the Narrative


If you are like me, you are upset by the reporting of the opioid crisis by mainstream media. I have found myself screaming at the television because of the skewed reporting. Make no mistake, there is an opioid crisis and it breaks my heart, but how in the world will we ever get those addicted the right treatment if we don’t look at the problem with eyes wide open? How can we blame and abandon people living with incurable diseases that keep the body at constant war with homeostasis because of the disease process that potentiates the disease of chronic pain?

“We must have balanced policy—policy that addresses two public health issues—untreated and inappropriately treated chronic pain and the opioid crisis—without unintentionally harming one patient population or the other. To get there, we MUST also have balanced media coverage.”

~Myra Christopher, Director of the Pain Action Alliance to Implement a National Strategy (PAINS, an initiative of the Center of Practical Bioethics)

Maybe you have read some of my blogs or visited my website where I share information on my personal opportunities as participant in PAINS and PAINS-KC. One of the pleasures of my own advocacy is getting to know and meet with Myra Christopher and the many other advocates and chronic pain citizens who share my journey. Following is Myra’s voice published in the PAINS Member Update, October 17, 2017.

By Myra Christopher


Sunday night, I watched 60 Minutes on CBS as they interviewed Joe Rannazzisi, former Deputy Director over Diversion at the Drug Enforcement Administration (DEA). Rannazzisi was portrayed as a “whistleblower,” and he blamed drug distributers, unscrupulous physicians, and members of Congress for fueling the opioid crisis. The week before, NBC did a week-long series on the opioid crisis, and the week before PBS did one also.  I could go on—week by week by week—there is not a major news outlet (print, blog, television, radio, or web) that I could not list as well.

Before proceeding, I need to make two disclosures:

·        I have met and worked with Joe Rannazzisi.
·        We have worked with the DEA closely in the past—with Rannazzisi’s predecessor and colleagues at the DEA for whom I have great respect.

In 2008, we worked with the DEA, the National Association of Attorneys General, and the Federation of State Medical Boards to measure the impact of physicians diverting prescription pain medication. That study was published in the journal Pain Medicine (Vol. 9, No.6). I tell readers this to assure you that PAINS is very concerned about the opioid crisis and respects the role of law enforcement in protecting the US population from illicit drugs AND assuring that an adequate supply of medications is available to maintain the health and well-being of all Americans. My concern is about the irrefutable lack of media coverage of a related but separate public health issue, i.e., inappropriate and untreated chronic pain management.

On Friday, October 13, PAINS hosted a roundtable in Washington, DC, that included top officials in the federal government, leading pain care providers, people living with chronic pain and their advocates, academics and a handful of media representatives to discuss the need for more and better reporting on the “chronic pain epidemic” and the unintended consequences that pain sufferers are experiencing related to federal policy attempting to contain the opioid epidemic and the media frenzy around it. This is critically important because it is our view that media shape public perception and public perception leads to votes, which leads to public health policy – interestingly the foundation of the argument made by Joe Rannazzisi in his 60 Minutes interview.

·        For years, PAINS and others advocating for better chronic pain care have called for “balanced policy.” More than a year ago, PAINS decided to move upstream with our No Longer Silent initiative that led to last week’s meeting in DC. We must have balanced policy—policy that addresses two public health issues—untreated and inappropriately treated chronic pain and the opioid crisis—without unintentionally harming one patient population or the other. To get there, we MUST also have balanced media coverage.

“If it bleeds, it leads!” is an adage often repeated about media coverage. Granted, the chronic pain crisis is not as “sexy” as the opioid epidemic. However, both of these issues are critically important to our society’s health and well-being.

I will be honest that there are many days I feel pretty discouraged about ever accomplishing our goals, then I see a report like this one that appeared on the front page of the Worcester, Massachusetts paper which highlights the plight of Lauren Deluca and quotes PAINS Advisory Committee Member, Cindy Steinberg, who also lives with chronic pain. I encourage you to read this article and ask you to share it with your friends and colleagues via social media, email, carrier pigeon!

[Insert from Telegram.com, Worchester, Massacusetts]
“Ms. Steinberg noted that legitimately prescribed painkillers weren’t the main source of the opioid crisis. The majority of fatal overdoses were associated with illegally obtained substances.”

SHARE
Many with chronic illness denied prescriptions in fight against opioids 
by Susan Spencer 

We will ask you to do the same with the report from last week’s No Longer Silent meeting when it is published in mid to late November. Until then, let me share just a few “take-aways” from that meeting:

Improving chronic pain care in America will require culture change. More specifically:

·        Changing the public narrative about chronic pain as a disease
·        Removing the stigmatization of those who live with chronic pain and those who care for them
·        Better education of physicians, nurses AND patients
·        Reimbursement models that support comprehensive chronic pain care, not just prescription opioids, interventional procedures and surgeries
·        Better data and more research

It’s a tall order but what one of my colleagues calls “worthy work.”

Comprehensive chronic pain care will improve the lives of millions of Americans, save billions of dollars and reduce opioid prescribing.

My conclusion

Will people be left to chew off their limbs like wild animals to escape pain? Will we continue to read about suicides because of untreated or undertreated pain? Will the public continue to blindly trust those in authority who have a political agenda? Can we make informed decisions based on unfair, unbalanced reporting? Are we ready for the consequences of staying silent? Your voice is only a click away.  Please join the PAINS Project initiative...



Additional Reading:


In healing,,Celeste 
"Adversity is only an obstacle if we fail to see opportunity."

~ • ~ • ~ • ~ • ~ • ~

Celeste Cooper, RN
Author—Patient—Freelance Writer at Health Central & ProHealth Advocate

Celeste’s Website: http://CelesteCooper.com

Learn more about Celeste’s books at her website or find links here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.

All blogs and comments are based on the author's opinions and are not meant to replace medical advice.  


Wednesday, July 5, 2017

Collateral Damage in the Opioid Epidemic


I wish I were writing this blog to report good news. Unfortunately, things are no different today than they were in 2011 when the Institute of Medicine (IOM) report “Relieving Pain in America” was written. Instead, and even though the IOM report spirited the drafting and publishing of the National Pain Strategy, things have gotten much worse. Hardly a week goes by that I don’t read about a fellow patient taking their life because the source of the physical pain was inadequately treated and their emotional pain unbearable because of feeling judged, many times by those they seek for help and support.

The opioid epidemic is very real and I do not mean to minimize that fact in any way. However, it is now painfully obvious that the CDC guidelines for opioid prescribing have not helped those who live with addiction. In fact, the guidelines have led to more deaths, not fewer. The forgotten, stigmatized, and judged, people living with persistent pain are now joining the death toll. That’s why I am sharing this article.If you have been injured, I encourage you to use the links you find in the following letter. Or if you know someone like a recent victim, please encourage his or her family to take action. 


___________________________________________________________________________


Find helpful links for finding your senator, representative, and governor; medical organizations, and government health related websites, your states attorney general, your state’s pain care laws and more in "The Advocate's Corner" header of this blog.
___________________________________________________________________________


Dear concerned fellow person living with chronic pain,

It is rewarding to write books, articles and blogs to help others manage chronic pain and illness. But coping strategies alone are often not enough. Opioids allow many patients the ability to participate in things they otherwise couldn’t. I advocate for moving complimentary therapies into mainstream but these days, the bulk of my time is donated to the crisis created by limited patient access, if any, to their opioids.

Because of the volume of requests for help and the need to meet the demands for my own care, I investigated information to help you with your personal situation.

It’s important to understand what is happening. Physicians are caught in the middle. The DEA crackdown on prescribing opioids has made them fearful of because of perceived threats to their livelihood. On the other hand, if patient harm results from negligence or abandonment, the provider can be  liable for that too. When a patient is fired, the physician has an ethical obligation to ensure a patient’s care is uninterrupted. However, the DEA, the CDC, the Center for Medicare and Medicaid, and or other government agencies have no liability for the results of their actions. 
We have the ability to hold the right people accountable by providing factual evidence. Evidence includes things, such as:
  • A written letter from your physician stating his/her reasons for stopping your pain care. (If you don’t have one, demand it.)
  • Chronological documentation your physician failed to provide ample notice for finding another provider. 
  • Following are other things to consider:

  1.  Is your physician negligent if no one is willing to continue your care?
  2.  Is your provider fearful to bridge the gap because of the CDC Opioid Prescribing Guidelines or other governing bodies?
  3. Is your provider using the changes as an excuse to abandon care?" Pain that does not abate is a reason to seek medical care, but physicians often feel helpless because treating chronic pain is complex. 
  4.  When the standard of patient care is breached (i.e. abandonment, negligence, or malpractice) and that breach causes harm, there is legal recourse. Currently, three things affect the changing standards, as I see it, (1) the influence of government agencies (2) lobbying by PROP--follow the Phoenix House money trail, and (3) the American Medical Association's decision to cut pain as the 5th vital sign from routine assessment, affecting the standard of pain care negatively.  
  5. Why isn't acupuncture, counseling by a provider trained in pain care, therapeutic manual therapies, or other proven modalities also considered when making changes in the standard of care? Answer: insurance lobbying, another player identified in the pain care market. 
  6. Patient outcome is seldom discussed even though it should be the driving factor of all patient care standards. 

*If you are forced to sign a contract, read it. A contract is between TWO people and may be litigated if either party fails to uphold their part of the contract. The physician’s responsibilities toward your care should also be provided. 

 The laws to protect both the physician and patient are very gray in today’s stormy climate.

  • The physician must  provide evidence as to why they withdraw  care. Yet, some may feel protected by the CDC guidelines. They are not. The guidelines are not LAW!
  • Failure to provide information such as copies of relevant medical records, treatment notes, tests, etc. to those who are continuing your care is a breech. This does not meet patient care standards.
  • Voice recordings or notes in your medical record that the DEA or other government agency created a burden on the physician’s ability to treat pain are helpful for both the physician and patient, but  difficult to obtain unless a case is being litigated.
  • Documentation of refused emergency care, such as treatment, hospital admission for withdrawal symptoms, suicidal ideation, or any other untoward effect is mandatory. (This is not the same as expecting an ER to continue your outpatient pain care.) 
  • Your loved one has committed suicide and there is documentation abandonment or untreated/undertreated pain was the cause. (many statistics are likely skewed because of the inability to collect life insurance and the stigma associated with suicide and chronic pain). 

*As a patient, you also have a duty. If you are unreasonably demanding, non-compliant (i.e. abusing, diverting, or misusing opioids), or threatening to the physician or staff, you are not protected.

If you have been abandoned and have evidence of harm resulting from changes in your pain care, you have recourse thanks to required reporting in Senate Bill S.483, Ensuring Patient Access and Effective Drug Enforcement Act of 2016, signed into law April 2016. [addendum, but is now in jeopardy, 2/6/2018]


Harm constitutes:

  • pain and suffering
  • cost of additional treatment
  • loss of earning capacity, and
  • loss of the ability to enjoy life

If you have sufficient evidence, please submit it to the attorney general for your state, which you can find at  NAAG | Who's My AG?   If anyone is providing evidence on someone else’s behalf make that disclosure and provide contact information.

Remember, if it wasn't documented, in didn't happen. Gather your arsenal and become empowered. Record what you can, when you can. The attorney general needs concrete evidence to move forward. Make sure they know you know they are required to report your case as part of S.483.  [addendum, which could now be in jeopardy].  I suggest sending a copy of your letter to your attorney to those you feel are appropriate. Be sure to mention the pain care laws for your state (link is courtesy of the Academy of Integrative Pain Management, SPPAN) or by typing “your state’s name state law on pain care” in your browser search engine and select from the results.

Because every case is different, each of us must demand our rights to be treated with dignity and respect. There is opportunity in adversity. Rome wasn’t built in a day, nor will our cries for help be solved quickly, but we must have hope. Despite what many think, those in chronic pain are tough. We overcome hurdles on a regular basis.

I recommend joining an advocacy group to help you stay abreast of recent newsworthy information and/or fight for our rights in Washington.

See The PAINS Project for links to their steering committee members for additional information. 


In healing,,Celeste


(Signature line appended, April 2018)


Celeste Cooper, RN / Author, Freelancer, Advocate

Think adversity?-See opportunity!



~ • ~ • ~ • ~ • ~ • ~

Learn more about Celeste’s books here. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others. 

Celeste's Website

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