Clarity in Oregon Opioid Saga as Website Reveals Advisory Group…

Ballantyne & Kolodny Lead Taper Group While OHA/HERC Continues To Lie to the Public

The Oregon Pain Guidance Clinical Advisory Group-Tapering Workgroup is a Who’s Who of Pain Academia’s Best Charlatans Revealed to Display their Sophistry.

Finally, a reveal of sorts.

It took long enough.

Where’s St. Patrick when we need him?


A dear friend of mine sent me a link to a webpage.

I have been recovering from a nasty bout of viral gastroenteritis, brought home as a belated Christmas present from my children’s school, along with a few forgotten cardboard decorations covered in Satan’s powder (ie glitter).

I opened the link I was sent and to my surprise (why after all these years should I have been surprised?)

I saw OHA — Oregon Health Authority, Oregon HERC Committee, yada, and then I saw something new that hasn’t appeared with what has gone on over all these months and meetings regarding their plots and plans of abruptly force tapering their state Medicaid patients off their opioid medications to zero and having them do other stuff’.

I saw a list of “contributors”.

This was a new list of people, but the names (most of them) were familiar to me.

I sighed.

Written was this,

Below are some guidelines and tools that will help prescribers assess and weigh risks versus benefits, and decide whether tapering is indicated.
For tapering to be successful, clinicians must approach the taper as an alliance with the patient with the goal of improving their safety and quality of life.
Contributors:
These tools, guidance, and resources for tapering were collected and developed by the Oregon Pain Guidance Clinical Advisory Group, Tapering Workgroup. The workgroup participants and contributors include:
Dr. Jane Ballantyne — University of Washington Dept. of Anesthesia & Pain Medicine
Dr. Roger Chou — OHSU Department of Medical Informatics & Clinical Epidemiology and Department of Medicine
Dr. Paul Coelho — MD Salem Health
Dr. Ruben Halperin — Providence, Dept. of Medical Education and OHSU Affiliate Associate Professor, Dept. of Medicine
Dr. Andrew Kolodny — Brandeis
Dr. Anna Lembke — Stanford University School of Medicine, Psychiatry and Behavioral Sciences and Addiction Medicine
Dr. Jim Shames — Jackson County Health and Human Services
Mark Stephens — Change Management Consulting
Dr. David Tauben — University of Washington Dept. of Anesthesia & Pain Medicine

Perusing this list, it’s as the Oregon HERC committee specifically sought the exact medical establishment people they knew would establish the result they wanted, period.

Result being zero opioids at all, natch.

For the unenlightened, here is a brief curriculum vitae of most of these contributors, as seen from a wizened point of view.

  • Dr. Jane Ballentyne is a physician who we last saw cowrite a piece in the New England Journal of Medicine proclaiming that reducing pain should not be the goal of physicians who treat pain. She added that patients should learn pain acceptance and move on with life.
  • Dr. Roger Chou was one of the lead authors of the infamous 2016 CDC guidelines for prescribing opioids for treatment of Chronic pain. Thousands have died and millions are suffering as a result of those guidelines.
  • Dr. Andrew Kolodny has been around since 2005 trying to get opioids severely restricted, if not banned already. I have written about his rise to fame here. He is an infamous “illicit fentanyl denier” (as in, the skyrocking opioid related deaths we see happening today are not due to illicit Chinese fentanyl or its analogs, according to Kolodny) as well as an apparent philathropist on the level of Milton Hershey, working for years to get Suboxone into prisons and hospitals, physicians offices and rehabs across the country, without any compensation for his toils.
  • Dr. Anna Lembke is a Stanford psychiatrist who takes pleasure in making and promoting CME videos tutoring physicians in how to fire patients who are supposed doctor shoppers. In addition she on the spot pronounces them with bizarrely inappropriate, incorrect psychiatric diagnosis. How astute!
  • Dr. Paul Coelho of Salem Health has a 1.2 rating on rateMDs.com. Here are a few quotes from different patients left for public consumption on the aforementioned website, no edit:
“Not good. He called me a drug addict and basically walked out of the room. I was shocked. I was referred to him for back pain and he refused to look at my CD’s or examine me’- 1 ⭐️
‘My experience(s) with him have been nothing short of horrendous. He’s cocky, condescending, judgemental, unprofessional and honestly does 100x more harm than “good.” He clearly assumes everyone who is on pain meds (even those that are under a doctors care and follow the pain contract) is an addict and abusing them.’ — 1 ⭐️
‘I was referred to this doctor for pain management and basically just told me that I’m making up my pain. He wouldn’t make eye contact with me and would just saw the same thing over and over. I think that there is something the matter with him. I won’t go back to him.’ — 1 ⭐️
Surprise, Surprise, just like all the other reviews on this site, I too had an absolutely HORRIFIC experience with this man. The crappy thing is, I did my research beforehand and had a pretty good idea that he was at least a jerk, but he certainly upped his game for me! I would never have seen him except for the fact that he was literally the ONLY freakin choice. He literally talked at (actually more down to) me and clearly had not read my medical history. If he did read it, he obviously only got as far as “pain meds” and closed it up, made his mind up about who I was and what kind of patient I was and went from there. He was demoralizing, demeaning, condescending, rude, judgemental, and just a flat out jerk! I could go on and on about how horrible that appointment was, but I would literally write a novel. So basically — whatever you do (if you have a choice) DO NOT SEE THIS “doctor!!!” Best of luck! — 1⭐️
  • Dr. Jim Shames is the Jackson County, Oregon Medical Director and has been since 2002. He has and will continue to tow the line of “pills & heroin bad, we see nothing else causing issue”. It matters nothing to these folks that advocates, physicians, specialists, scientists, and technicians have shown them and state Governor Brown studies, statistics, and even graphs with pretty lines showing in stark relief that they are wrong. It apparently doesn’t even matter that other drugs deaths are skyrocking in Oregon, even ones that have nothing to do with opioids.
screen cap taken from Oregon Vital Statistics/ color and notation added by author
  • Dr. Ruben Halperin an Emory University grad, same as Director of CDC Injury Deb Houry. He is a buprenorphine advocate. He seems a liked physician and he has written on Medium in favor of medical marijuana, framing it as harm reduction.
  • Dr. David Tauben is a well liked physician who retired from active practice to teach at the University of Washington. He has lectured on the need to transition all long term patients on opioids off their opioids and onto buprenorphine.
  • Mark Stephens is a consultant from Change Management Consulting. He was obviously brought in because Oregon HERC has a plan to implement that is a 180 away from what is in place now, and they need major help in putting it into place. This is where his firm will be needed. His speciality is assisting in implementing significant changes to the operation of any business’s day to day. Change management consultants assist any entity through a major upheaval and ensure that they transition in an effective, efficient, and cost effective manner. His presence, more than any of the others, signals to me, this is happening.

They wouldn’t spend the bucks on this guy if it weren’t.

What really is depressing is who isn’t here.

Also “what” isn’t there… like the letters PROP (Physicians for Responsible Opioid Prescribing) by the names of at least two of the physicians…

I think actually four of them belong to PROP all told, but I am rock solid certain that two of them belong to PROP, and we all know Kolodny is the co founder!


In the FAQ on the website, a question is asked about a stable patient.

Too bad.

An incurable patient who is doing fine on their opioid therapy, not exhibiting any problems, can’t win.

THIS IS THE PROBLEM.

My patient has chronic pain and has not exhibited aberrant behavior. Why should I worry about addiction?

Answer:

Some patients on chronic opioid therapy have an opioid use disorder (OUD) that may become clearer if you try to taper down the dose. Making a diagnosis of an OUD is valuable to the patient since there are effective treatments for an OUD, like buprenorphine, but the diagnosis needs to be made. If you are treating a patient with chronic opioid therapy, be clear on the diagnosis.
Some chronic opioid patients develop hyperalgesia which means the opioid actually contributes to causing the pain. Whereas the patient feels like they need more pain medication, the treatment is tapering the dose down, or off.

I have seen this same logic espoused in other workshops on chronic pain by buprenorphine champions.

How do we treat (O)pioid (U)se (D)disorder? These people say by giving a patient an extremely powerful, long acting opioid, with an morphine milligram equivalency twice that of pharmaceutical fentanyl.

That is, before they ditched Buprenorphine’s MME, stating it was “unimportant” and those who were concerned about it “didn’t understand”.

When asked why they would even taper a stable patient who is doing well and having no issues or exhibiting no bad behaviors, they deflect the question.

When asked if they are purposely attempting to “force” diagnosis of supposed OUD by instituting an aggressive opioid taper on stable patients and then seeing them struggle with the taper, they deny the charge.

I challenge any physician to distinguish between what they say is Opioid Use Disorder (OUD) and simply a patient trying to adjust to a lowered dose of medication after years at a stable dosage, along with their bodily response to the increase in pain that occurs when the painkiller is lowered.

Do people have insulin use disorder? Topamax use disorder? Prozac use disorder?

Those are three other drugs that have difficult tapers and dosing schedules, that also make a patient’s life hell when one is trying to find the exact right dosage for them.

Hyperanalgesia is a diagnosis also that is “in vogue” now when a patient has increased pain after their dosage is cut, or just to rationalize the idea of forcing a taper in the first place.

When a physician tells a patient that they feel hyperanalgesia is an issue for them, the patient should ask what test they did to determine they have hyperanalgesia (there is none), if they actually determined they indeed have it, (they didn’t) what damage is it doing? (Where are the actual scientific studies on this?)

When did this happen during my treatment (when the doctor decided he was not prescribing anymore)?

If my pain isn’t relieved by the taper or by the alternatives, will you resume my opioid therapy at the dosage I was on, as then we can conclude this theory was incorrect (fat chance)?

Sad to say, I predict within 2 years no one will be on traditional opioid therapy in Oregon.

Suboxone for all! Suboxone is the brand name for buprenorphine.

There is no generic for Suboxone, and its maker has fought successfully for years to keep it that way.

All the subsidies pay for brand name Suboxone therapy, upwards of hundreds of dollars per patient per month.

How lovely for Milton Hershey!


Oregon, we all knew this was going to be ramrodded through.

HERC only made it just that much more contemptible by who was invited to “oversee” the process.

And who wasn’t.

No one has any self awareness.

But then, I have observed that trait in so many of the people in this whole rotten circus.

So there we have it, folks.

The above is the final deciding factor on the “tapering”.

God help Oregon.

For some unknown reason, HERC and OHA (and some invested people) continue to tell people they have a chance at repealing this at meetings.

THAT IS SIMPLY A LIE.

No, they don’t.

It is insulting that they think people are THAT stupid.

However, they sure do have a lot of really smart people not paying attention to a whole lot of other stuff while they waste their time chasing Puff the Magic Dragon in Oregon.


I have to ask, what was the point?

The point of even asking for public input?

The point of having meetings?

Why even bother?

Why ask what we think?

You clearly do not care.

The FDA does not care.

The CDC does not care.

No one dealing in the deceit presently does.

There is something more important to ALL OF YOU than us and our quality of life, our very lives, fact, science, data, logic and truth running this thing.