New draft NICE guidelines for chronic pain emphasises exercise, CBT and acupuncture over medication

adambeyoncelowe said:
That was my impression too. Some perverse priorities, one might assume...
Click to expand...
It's my understanding that there are some studies showing that there may be some small short-term benefits, but that it doesn't matter where the needles are inserted whatsoever. This contradicts the entire theory of 'acupuncture' which states that the needles must be placed in specific spots, believes in meridians, energy and other woo woo.

The people I know who are acupuncturists spent about $100K in schooling for it which is a complete scam. It's almost like a religion to them and the things they talk about learning contain very little science whatsoever. Unfortunately the cost ends up being passed along to the patient. I doubt the acupuncture schools want to let the $$$$$$ go.
 
I have a friend whose crumbling hip could not be replaced until her asthma was stabilised. She was taking paracetamol, tramadol and oxycodone. 6 weeks after her operation she had stopped them all. Opiods used as prescribed for adequate pain relief has a very low risk of addiction.

I read a report by a US doctor who felt that patients were dying of heart attacks because of the strain that constant unbearable pain put on the heart. he said that some deaths were being put down to opiod overdose when actual the doses had been so reduced that patients were still in extreme pain which lead to their deaths. Suicide from uncontrolled pain should be taken into account.

It is amazing how much pain is underestimated by people who have never endured it. It is partly training; when my daughter was an orthopaedic trauma nurse junior doctors were forever giving people with broken limbs two paracetamol.

The whole idea of pain catastrophizing has lead us here.
 
So you can sedate a patient up to the eyeballs with tricyclics - are these even proven for pain? but paracetamol and ibuprofen are bad.

As ibuprofen and paracetamol, even the lower dose paracetamol & codeine are available over the counter and quite a lot is even available in supermarkets this guideline is pissing in the wind. People can sort themselves out with otc. Also CBD widely available - if expensive.

I don’t think the “problems” with what people are prescribed originate with the patients. I’ve been only too keen to stop taking medication that I’ve been prescribed that turned out to be unnecessary ineffective or produced unacceptable side effects. Fluoxetine, Amitryptiline, pregabalin.

I agree there’s a problem with polypharmacy eg how many Drs are prescribing tricyclics on top of SSRIs. That’s not down to patients.


ETA have tricyclics ever been properly proven in trials to be effective long term for chronic pain?
 
I saw a description of the make-up of this NICE guideline committee and it was awful - many psychologists etc. Ugggghhhhh politics. Anyway I thought it was on s4me but I cannot find it in this thread. Anyone else see the same thing and have a reference?

EDIT : Here is the list
https://www.nice.org.uk/guidance/gid-ng10069/documents/committee-member-list

Conflicts of Interest Document
https://www.nice.org.uk/guidance/gid-ng10069/documents/register-of-interests-2

All project documents can be found here
https://www.nice.org.uk/guidance/indevelopment/gid-ng10069/documents
 
Last edited:
It's really past time to have that discussion over antidepressants. The logic of arguing that analgesics cause more harm than good while pretending the opposite of antidepressants is completely insane. There are zero safety safeguards to antidepressants and antipsychotics, they are handed out like they are Tic Tacs and their side effects and withdrawal are completely denied. Incredibly reckless and irresponsible.

By far the biggest harm coming from this distorted mental health approach is that there are no safeguards in mental health, it's a complete free-for-all where applying rules is impossible because everything is subject to interpretation. Hence why this approach has been chosen, no accountability means anything goes and ideology can flourish unopposed.
 
Sly Saint said:
Click to expand...

The scientific literature on this topic is mostly centered on the themes of: how to actually make it seem to work, how to convince people that it works and why is it that the patients reject it? This BS has been available for years to widespread failure, at this point the only way to increase its use is to make it even more coercive, DESPITE THE FACT THAT IT DOES NOT WORK.

This is completely insane. These people are obsessed with figuring out how to make their thing work while doing everything they can to push it into practice. They have both thoughts simultaneously in their heads with zero afterthought. And almost no one seems to find fault with that, other than the patients but since there is no accountability or reporting process the patients can be entirely dismissed from all concerns.

Seriously if someone set out, for whatever reasons, to destroy the credibility of modern medicine, this is the most effective way to accomplish this goal. It's completely indistinguishable from deliberate sabotage, a poster child for the post-truth society. And the medical professionals seem to love it. The level of insanity is really hard to comprehend.
 
rvallee said:
By far the biggest harm coming from this distorted mental health approach is that there are no safeguards in mental health, it's a complete free-for-all where applying rules is impossible because everything is subject to interpretation. Hence why this approach has been chosen, no accountability means anything goes and ideology can flourish unopposed.
Click to expand...

And while they're at it accuse everyone else of stigmatizing mental health patients. If subjecting those patients to treatments with such poor evidence of safety or efficacy isn't stigmatizing then what the hell is?

Except that having gotten away with it for so long there's mission creep for what they see as low hanging fruit from other fields.

If other specialities aren't careful then by the time they get to see patients they'll already be beyond help & at death's door.
 
You must log in or register to reply here.
Back
Top Bottom