The hidden war on chronic pain patients and legitimate pain-management doctors

I am afflicted with chronic pain caused by degenerative osteoarthritis in both knees. The only thing that leaves me 100% pain-free is playing live onstage. The rest of the time, the sole way to manage my pain is via high doses of opioids. Adequate dosages of the correct medications allow me to work a day job when necessary and take 9 hours at the University of Texas at Austin if I so desire.

Opiates are to me what insulin is to a diabetic: I don’t get “high,” they just keep me functional. The body makes its own endogenous  opioids, otherwise known as endorphins. External opioids are either synthesized in a lab or in the case of opium and its alkaloids morphine, codeine and thebaine, found in a poppy. Both endogenous and external opioids bind to the same  set of receptors in the body because external opioids mimic the effects of the opioids our bodies manufacture.. Therefore, most opiates such as oxycodone, fentanyl and even heroin (if it is pharmaceutically pure) are non-toxic to the body. When either acute or chronic pain occurs, these medications are prescribed to help the body handle the pain by boosting the level of opioids in the body. The medications go to the pain, not to the head (hence pain patients not getting high.)

But I digress. Despite the fact of a legitimate medical need for opioids to treat pain, they have been unfairly demonized and pain patients and pain management doctors are made to suffer. Things are getting worse. Here is a letter to the editor of the New York Times that I wrote in response to this Op-Ed. It wasn’t published in the paper, so I’m publishing it everywhere!

“My name is Mike Dubose. I’m a 36-year-old singer-songwriter-guitarist from Austin, Texas. My life changed irrevocably in 2000, when I was diagnosed with intractable pain caused by acute degenerative osteoarthritis and patella tendonitis in both of my knees. After trying many other options – pharmacological, surgical, physical therapy, acupuncture – it was determined by my pain management physician and me that the medications that allowed me to be the most functional human being and member of society were schedule II opioid painkillers. I was prescribed two: a long-acting medication and a short-acting, “rescue” medication for flare-ups or so-called “breakthrough” pain.

The long-acting opiate painkillers with which I have had the most success are OxyContin and Duragesic (a transdermal patch containing the opioid fentanyl.)

These medications keep me able to literally get out of bed in the morning. Dr. Andrew Kolodny and Physicians for Responsible Opiate Prescribing (PROP) may have good intentions, but their petition that led to the labeling change that the FDA enacted is extremely dangerous for me and thousands of other pain patients that depend on medications such as the above-mentioned and others now subject to the FDA’s revised labeling to get out of bed, raise their families, go to work, be good husbands, wives, friends, co-workers, mothers and fathers.

I fear that the FDA’s dropping “moderate” from the labeling and only requiring that medications like OxyContin be used when a patient’s pain is “severe enough” to require round-the-clock treatment in patients who have no other option will further confuse and frighten already-scared pain-management physicians and have a hugely detrimental effect on pain patients like myself and others around the country. One person’s “moderate” pain could be “severe” for another patient. Who determines which patient’s pain is “moderate” and which one’s is “severe”? The physician? The FDA? The state medical board in which the physician is practicing? The Drug Enforcement Agency?

While the FDA’s new labeling rules are extremely disconcerting, PROP’s push for a maximum daily dose and a 90-day limit of usage, along with their request to “rein in prescribing of all opioid analgesics” downright terrifies me. I have been on a combination of either OxyContin or Duragesic and a short-acting opiate for 13 years now, as have most people with severe, intractable pain. Everyone metabolizes medications differently, and opiates are no different. Dosage limits, prescription-duration cutoffs and “reining in [the] prescribing of all opioid analgesics” could have severe to fatal implications for me and the thousands of other patients who, unlike prescription-drug abusers, did not choose to be afflicted with the debilitating condition of intractable pain.

Curbing prescription-drug abuse should be a priority. However, people like myself and many others should not be made to suffer in pursuit of this goal. The medication, dosage and duration of an opioid prescription should be as it is in any other discipline of medicine save pain-management: between a patient and her physician. No government agency should be permitted to intervene.”

Please help me, my fellow pain patients and pain management physicians fight fear-mongering misinformation, willful ignorance and needless suffering.

Thanks for reading! If you can, please come see us play tonight in Austin at Metal and Lace (AKA Head Hunters) at 720 Red River. We play from 10-11:30, it’s gonna be BADASS (and I’ll be pain-free  through the duration of our set and 2-6 hours later!

Love-

Mike

Headhunters AKA Metal & Lace TONIGHT

Austinites & outta-town ACL attendees: if you’re going to ACL, this is the best after show on Friday….period. If you aren’t going to ACL, you’ll still get to see a transcendent performance. So don’t argue, don’t ask questions, just GO! Ya know ya wanna!!

Metal and Lace/Headhunters:
720 Red River
Austin, TX 78702

All my love-
Mike

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Random Rant: I was a political activist/operative for 18 years. Never again.

A brief foray into a former passion:
I was a political activist-turned-operative for 18 years. I started at 13 manning phone banks as a volunteer for Ann Richard’s campaign against Clayton Williams. I worked on every gubernatorial campaign and presidential campaign since then. By the time I got my first paid gig coordinating fundraising for Kerry in 04, I had grown weary of working for the lesser of two evils. When Obama came along I, along with the rest of the sane folks in this “democracy”, saw the chance for a tectonic shift in paradigm. It felt like I was working for a viable third-party candidate. However, Obama’s subsequent cowardice left me disenchanted. His ramping up of the Bush/Cheney obliteration of our civil liberties left me heartbroken, enraged and sick to my stomach. I realized then that my hero Bill Hicks’ philosophy vis a vis American politics was right on the money:

“I’ll show you politics in America right here: ‘I think the puppet on the right shares my beliefs.’ ‘Well, I think the puppet on the left is more to my liking.’ Hey wait a minute, the same guy is holding up both puppets! Shut up and go back to bed America, your government is in control.”

For 18 years I fought to make a difference. After being jilted at the altar by Obama, I’m done. I’ll still write about this oligarchy that masquerades as a democracy in blog posts, freelance articles and songs, but that’s it. I will not enable this cesspool any longer.
Obama makes Poppy Bush seem relatively benign. Bush 41 did a lot of horrid shit but he did not torture, assassinate American citizens, have a “kill list” etc. Even Nixon didn’t wiretap reporters or engage in the data-mining horrorshow that is currently in use. “Warrantless wiretapping” did not exist. Bushbama took the abortion of our civil liberties into the 4th trimester. After promising to eliminate the rape of the Constitution perpetrated by Dubya, Mr. Constitutional Law professor not only continued the seizure and assault on the Constitution and the Bill of Rights, he ramped it up to rape and murder of the Founding Fathers’ creation. I use the word “rape” because its original definition is to take something by force and against someone’s will. That is exactly what the Obama administration has been doing and continues to do insofar as Constitutional, civil and basic human rights. Candidate Obama pledged to protect whistleblowers. President Obama has destroyed the lives of Bradley/Chelsea Manning, Edward Snowden and countless others. Extrajudicial assassination of US citizens destroys due process. Mind you, I don’t have much sympathy for Anwar Al-Maliki. I could give a shit about a dead Islamofascist. It is the PRINCIPLE that matters! Maliki had ALLEGED ties to terrorists. I am ardently against capital punishment, but it exists. If they wanted to try to kill him, here’s the legal way to go about it: Send the FBI, NSA, CIA to Yemen and apprehend Maliki. Extradite him to the US and try him in a federal court. If and only if his trial proves that he is guilty of having carried out terrorist attacks against the US, convict him of said capital offense, sentence him to death and execute him. The death penalty is dead wrong but United States citizens are not executed for alleged offenses, at least they weren’t until Obama set a dangerous precedent. What’s next? The term “narco-terrorist” is in the judicial lexicon, are alleged drug dealers or users going to be blown up by Hellfire missiles fired from a drone 30,000 feet above Pittsburg? Speaking of the war on drugs, Obama, who thanked his weed dealer in his high school yearbook, has imprisoned more people convicted of cannabis-related “crimes” than any of his predecessors. Obama is Bush, more educated and on steroids. There are 2 major differences between Dubya and Obama: He has a Nobel Peace Prize, but so do sociopaths like Mother Teresa and Arafat. I think that if we launch missiles or bomb Syria, he should have to strap his Nobel Peace Prize on to the first cruise missile or bomb fired/dropped into Syria. Speaking of that enlightened state, half of the “rebels” we are funding in Syria are affiliated with Al-Qaeda…deja-muh all over again! The second and only redeeming major difference between George W. and Obama is Obama’s repealing of DADT.
My father is a talented, left-wing investigative political journalist. HE called Obama out for escalating the Bush/Cheney civil-rights massacre. However, almost NO ONE in the center or left mainstream media has done so. If Bush assassinated an American citizen, MSNBC, CNN, NPR (everyone except Faux News) would have and SHOULD have been screaming for his head. When Obama did it, the silence was deafening. Rachel Maddow and Jon Stewart have taken him to task, but not as severely as they would have done with 43. The lone voice of rage is that of Bill Maher, who gets booed every time he says ANYTHING critical of Obama The Infallible.
Fuck it. I’m out. I’ll still write songs like these though!

Thanks for reading my sleep-deprived cathartic rant! Come see the band play Austin’s Metal and Lace (Headhunters) on Fri October 4 from 9:30-11. No cover and a Friday! There’s no excuse!! See you there!!

HOUSTONIANS: We are playing Walter’s Downtown on Friday, December 6. Cover charge and set time TBA. Come get rocked like you’ve never been before!!!

All my love-
Mike

We’re BAAACK!!!

Hey there!!

So both I and the band have been on a much-needed vacation! My fiancee Alma and I went to rural upstate New York for a week to visit her parents and the band just chilled out for a bit…no rehearsals or gigs. But now we are refreshed and ready to rock!

We are auditioning drummers because our beloved drummer Kenny is deservedly getting more and more session-player gigs and his daughter and granddaughter are going to be living with them for awhile.

Kenny, like Gary and Diana, will always be a Dissident, whether or not he is playing with the band. Kenny will play gigs and do studio sessions with us as his schedule permits, but we are booking shows and need a steady drummer (or 2 or 3!) We have several promising candidates, hopefully all of them will be onstage with us at the passel of shows we are working on nailing down in Austin, Houston, San Antonio, Corpus Christi, Dallas, Baton Rouge and New Orleans.

Presently the only confirmed dates are:

Austin on Friday October 4, at Metal and Lace (formerly Head Hunters.) There’s no cover and we play from 9:30-11. So, dearest hometown fans, since it’s on a Friday night, it’s free and we promise you a KILLER show, grab some friends and come out and see us!!

Houston on Friday December 6 at Walter’s Downtown. Set time and cover TBA

We are also slated to play a Saustex showcase in Austin or San Antonio in the next couple of months.

As I said before, we are in the process of booking more regional gigs in Houston, Dallas, San Antone, Corpus Christi, Baton Rouge and New Orleans! We will keep you all posted and let you know as soon as a new show is booked.

There are several ways to keep abreast of shows by the band and whenever I play the occasional solo acoustic gig:

  • Go to our Reverbnation page and sign up for our email list (there’s also videos, downloadable MP3s, an online store and cool pix!)
  • Friend me on Facebook https://www.facebook.com/mike.dubose
  • “Like” the Mike Dubose and The Dissidents page on Facebook at https://www.facebook.com/mikeduboseandthedissidents
  • Follow me on Twitter (I follow back!) @MikeDubose226

That’s about it from here for now, thanks again for supporting me, Diana, Gary and Kenny for all these years. Without you folks none of us would be here! You have our undying love, respect and gratitude!

RNFNR-

Mike Dubose

Blog entry number one

So, I’ve finally started a blog for myself and The Dissidents. This is my first entry. We are on a brief hiatus until after August 13. My fiancee Alma and I are going to be visiting her folks in upstate New York and our drummer Kenny Felton is recovering from back problems.

However, we will soon resume playing local gigs, are working on booking some tours and will continue recording our debut CD at Wire Recording with Grammy-winning engineer Stuart Sullivan behind the boards and Bill Teags and Leonard Cohen’s producer, bassist and musical director Roscoe Beck co-producing the album, which is slated for release in 2014. Thanks for the love, keep reading for more updates and anecdotes!

Cheers-
Mike Dubose