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Amir Farsud, who suffers from constant agony due to a back injury, has applied for medically assisted dying (MAID) because he can't find affordable housing. He survives on Ontario disability support payments of just over $1200 a month. Farsud meets the criteria for MAID, as his physical suffering cannot be relieved. His doctor has already signed off on the application, and he is waiting for a second doctor to do the same. Farsud doesn't want to die, but being homeless is not an option for him. He hopes to access MAID in about a month.

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Dr. Natalie Sinyantou, a family physician with 17 years of experience, highlights the crisis in Alberta's healthcare system. She emphasizes the long wait times for essential services like MRIs and knee surgeries, which negatively impact patients' well-being. Dr. Sinyantou mentions the additional efforts and unpaid hours that physicians invest in advocating for their patients. The mounting administrative burdens and moral injury faced by healthcare professionals leave less time for patient care, causing burnout among family physicians, specialists, and hospital colleagues. She urges the Alberta government to address these issues, as the health of both Albertans and doctors depends on it.

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Since 2016, euthanasia has been legal in Canada, with plans to extend it to mental health conditions next year. In June 2019, Alan Nichols, 61, requested euthanasia after being hospitalized in Chilliwack and died by lethal injection. His brother, Gary, shares that while assisted dying can be compassionate, its loose application can put families in difficult situations. Before hospitalization, Alan faced challenges from a benign brain tumor diagnosed at age 12, which led to surgeries that impaired his right side and hearing. Despite these challenges, he lived a relatively normal life, engaging in daily activities, and was not completely incapacitated. Gary emphasizes that Alan's life was still worth living, raising concerns about the criteria for euthanasia.

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Speaker 0 recalls a case: “patient, he was sick. He looked like he was dying, but they just, like, pushed morphine. He had no pain. You know, they do a pain score, so zero to 10. This guy had zero pain.” Then, “they pushed insulin to drop his sugar, and his glucose was fine. And then he died three minutes later.” He says he “turned him into medical board. I reviewed this chart and turned him into medical board. Nothing.” “But, yeah, they definitely that definitely went on during COVID.” Speaker 1: “Jesus. That is such a terrifying thought that someone would just decide so many people are dying. This guy's definitely gonna die. Yep. This is 100% real?” Speaker 0: “Yeah. Definite. Definite.” Speaker 1: “It's It seems like something” Speaker 0: “they would call it tell euthanasia. They don't call it euthanasia.” Speaker 1: “It seems like something I would tell me, and then I would have to ask you. Like, this is something someone told me. I'm sure this” Speaker 0: “is send you the record that I read to you.” Speaker 1: “It seems like something I would be bringing up to you as a ridiculous thing, and you'd shoot it down.”

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A family practice physician in San Diego recounts a bizarre experience where her patient's insurance denied a wheelchair request for a double amputee, citing a lack of documentation on how his walking was affected. This highlights the problematic prior authorization process, which often delays necessary treatments. One case involved Kathleen Valentini, whose MRI for hip pain was denied, leading to a delayed cancer diagnosis and ultimately an amputation. Reports show that 80% of doctors say patients abandon treatments due to prior authorizations, which can result in life-threatening situations. Insurance companies claim these processes prevent unnecessary procedures, but many argue they are more about profit than patient care. Legislative efforts are underway to reform prior authorization, but the system remains flawed, with some suggesting a return to a "pay and chase" model that allows doctors to make decisions without insurer interference.

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I'm Karen DeVore, a dermatologist in South Carolina. I've been prescribing hydroxychloroquine and Ivermectin for over 30 years, off-label. In 2020, the FDA called Ivermectin horse medicine and doctors couldn't prescribe it. I knew these drugs were safe and effective, and I saw great results in my patients. None of the patients I treated with these drugs were hospitalized or died from COVID. They had no side effects and felt better within hours. It's frustrating that insurance companies and pharmacies denied access to these drugs. Even terminally ill patients on ventilators couldn't try them. How many lives could have been saved?

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A nurse practitioner in pain management reports that insurance denied their request to start a patient on tramadol for chronic pain. The denial stated that the insurance company believed the patient should be tried on fentanyl first. The nurse practitioner expresses surprise, stating they have never seen a preference for fentanyl over tramadol.

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I was paralyzed by my COVID shot and face losing essential care due to a lack of support workers in Ontario. The healthcare system is overwhelmed, leading to potential long-term care placement. Medical assistance in dying is seen as a cheaper alternative. Doug Ford cut early breast cancer screening, risking lives. We must address these issues and pressure politicians for change. Visit www.opkayla.ca to support. Healthcare in Canada is not as advertised, and we must unite to ensure everyone receives proper care. Thank you for listening.

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The speaker discusses concerns about Medical Assistance in Dying (MAID) in Canada, highlighting issues with the drug sodium thiopental and its potential for causing drowning during the procedure. Autopsies reveal troubling details about the process, contradicting claims of a painless death. The speaker also mentions cases of families being denied access to autopsy reports. These revelations raise questions about the ethics and transparency of MAID practices in Canada.

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Amir Farsud has applied for medically assisted dying (MAID) due to constant agony from a back injury and the impending sale of his rooming house, leaving him unable to find affordable housing. Surviving on over $100 a month from Ontario disability support, he faces the reality of homelessness. Although he meets the criteria for MAID due to his physical suffering, his true motivation stems from the fear of being homeless. His doctor has signed off on the application, and he is awaiting a second approval, with a potential access to MAID in about a month. Despite his pain, Farsud expresses a desire to live, emphasizing that he does not wish to die.

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A patient who looked like he was dying was given morphine despite having zero pain, according to the pain score. Insulin was also administered even though his glucose was fine, and he died three minutes later. The speaker reported this case to the medical board after reviewing the chart, but they did nothing. The speaker states that this definitely went on during COVID. The speaker refers to this as euthanasia, though it is not called that. The speaker offered to send the record that was reviewed.

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Experts say the CDC's opioid crackdown has failed, with overdose deaths rising. Courts are questioning the arguments used to justify the crackdown. Millions of chronic pain patients who depend on prescription opioids have suffered since 2016 due to the war on legal pain meds. Lawsuits against drug companies, alleging they caused the opioid epidemic, are faltering. A California court dismissed a lawsuit, finding no support for the claim that 25% of opioid patients become addicted. The Oklahoma Supreme Court reached a similar conclusion, stating opioid benefits outweigh risks. The narrative that prescribed opioids cause deaths is false. The majority of overdose deaths are from illegal street drugs like fentanyl and heroin, not prescription medication. Less than 1% of legal pain patients become addicted, contrary to lawsuit claims. Millions have been cut off from medication, leading to a 470% increase in suicides among these patients. Patients are suing doctors and hospitals for denying medications. Anti-opioid crusaders who crafted the CDC's 2016 crackdown are also under scrutiny.

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A parent shares their experience with their daughter's cancer treatment. The doctors offered two options: let her die or undergo intense chemo and radiation. They chose the latter, but it caused severe burns and other complications. After six months, the standard treatment didn't cure her cancer, and they were told she had only a few months to live. Desperate, they discovered Dr. Brzezinski's treatment, which the FDA deemed nontoxic. They took their daughter off the standard treatment and tried Brzezinski's, and within nine weeks, the tumor disappeared. Sadly, she later died from radiation damage, but the autopsy showed she was cancer-free. The speaker questions why the bureaucratic process for accessing this treatment is so difficult, preventing many patients from receiving a potential cure.

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You want to speak with her? I can get her on the call. We're dealing with numerous denials weekly. My name is Julie, and we face significant challenges with insurance companies. Despite our efforts, we receive cease and desist letters for speaking out on social media. Patients share their struggles with chronic pain and the impact of insurance decisions on their treatment. We work tirelessly to secure necessary medications, often spending countless hours on appeals. Even experienced healthcare administrators find the process exhausting. Recently, an insurance company reversed a denial after our appeal, highlighting the importance of persistence. Patients question how insurers determine their treatment needs, especially when it affects their quality of life. The current health insurance system in the U.S. is deeply flawed and needs reform.

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A young woman, aged 23, is suffering from a severe head injury and has been denied surgery. She is currently in critical condition and experiencing seizures. Medication is being administered to control the seizures, but there are no other treatment options available. It is a harsh reality for someone so young.

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Nicole Valens, a pharmacy manager at Safeway, store 18/92 in Cortez, announces her immediate resignation. She refuses to dispense what she refers to as poison to people, urging everyone to wake up to the harm it causes. Having witnessed customers die, she strongly advises against taking it.

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You want to talk to her? I can get her on the call. We're dealing with a lot of denials—about 50 a week. My name is Julie, the practice manager. We’ve faced backlash from insurance companies like Aetna and Cigna for speaking out on social media. Patients describe their struggles with chronic pain and the impact on their lives. After starting treatment, one patient felt relief, only to face insurance denials for necessary infusions. We work hard to appeal these decisions, spending countless hours on cases. Even experienced administrators find the process exhausting. However, we’ve had success in getting approvals after appeals. Patients deserve better; insurance companies shouldn’t dictate their quality of life. The health insurance system in the U.S. is fundamentally flawed and needs change.

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The speaker received a call from a care home stating her father had fallen and was agitated, and would be given morphine. She was shocked he was on an end-of-life path of injecting to stop his issues. She later learned midazolam, one of the medications being used, is considered by some practitioners to be like being waterboarded because it floods the lungs. The speaker was not advised about a specific end-of-life care plan for her father. She expressed concerns to the care home manager about what she had seen and the way end-of-life care was being administered. Despite a DNR in place from the first care home, she learned her father had been mobile and trying to get to the toilet. She felt it was a random decision to keep him quiet, in isolation, in a comatose state.

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I was paralyzed by the COVID-19 vaccine and left without proper treatment by the Canadian government. They offered me MAID, which is not treatment but euthanasia. I live with pain, a spinal lesion, and loss of bodily functions. I need help and ask for support by sharing my story on social media. Visit www.0pkayla.ca for more details, medical records, and a doctor's confirmation that my condition was caused by the Moderna vaccine.

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Pain should be treated; the question is how. "Yes, opioids can cause a lot of problems, from addiction to fatal overdoses. I know this. I'm an addiction doctor." But are the alternatives really better? "Tylenol together with ibuprofen work better than opioids for mild to moderate pain, but for severe pain, non steroidal anti inflammatories and Tylenol are simply not strong enough." If gabapentin and Lyrica could replace opioids, why do we need exceptions for cancer and terminal illnesses for the use of opioids? "They only work for neuropathic pain; they don't work for arthritis and degenerative disc disease." There are no laws or regulatory bodies that prohibit the use of opioids for chronic pain. "Do the right thing, doctors. Relieving pain and suffering is part of our mission as doctors. It's our obligation to patients to at least consider the use of opioids for chronic pain."

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The speaker discusses the challenges of standing up for their rights and the impact on their family. They mention the burden on their spouse and the fear of being forced into a long-term care facility. The speaker contemplates MAiD but their child believes that only God should decide when one lives or dies. The family's struggles and the speaker's determination for change are highlighted throughout the conversation.

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As a psychiatrist in community mental health, I've seen how MAID affects my patients. Some express a desire to stop treatment, feeling they can choose to die instead. This shift undermines our efforts to support their recovery; we're now focused on preventing MAID as much as preventing suicide. I recall a patient, Ray, 62, with metastatic lung cancer, who had long sought MAID. When I confirmed his eligibility, I witnessed a physical transformation in him—his shoulders relaxed, and he smiled for the first time. He decided to proceed with MAID, and during the process, he expressed gratitude, saying, "I think you saved my life." This highlights the importance of providing care for those who truly need and want it.

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A woman shares a heartbreaking story about a 13-year-old girl who had cancer and was convinced by doctors and nurses at a hospital in Edmonton, Alberta to end her own life using medical assistance in dying (MAID). The girl's parents had left her briefly to get some supplies when this happened. The mother, who had come to the hospital the day after her daughter's death, was devastated and felt helpless because the girl had signed the consent form. The speaker expresses anger towards the healthcare system and advises parents to keep their children away from hospitals. They also mention an article from CBC that claims MAID will save a significant amount of money in healthcare expenses.

The Peter Attia Drive Podcast

345 ‒ Chronic pain: pathways, treatment, and the path to physical and psychological recovery

Guests: Sean Mackey

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In this podcast episode, Peter Attia and Sean Mackey discuss the complexities of pain, its definitions, and the evolving understanding of pain management. Mackey emphasizes that consciousness is necessary for the experience of pain, countering the misconception that unconscious patients do not feel pain. He highlights the historical dualistic model of pain, which separates the mind and body, as outdated and argues for a biopsychosocial model that integrates physical, emotional, and social factors. Mackey acknowledges the opioid crisis, stating he is neither pro-opioid nor anti-opioid but pro-patient. He discusses the overprescription of opioids and the societal pressures that contributed to the crisis, while also recognizing the benefits of opioids in certain contexts, particularly for end-of-life care. He stresses the importance of understanding individual patient histories, including factors like early life experiences, depression, and anxiety, which can influence pain perception and treatment outcomes. The conversation also covers different types of pain, including nociceptive, neuropathic, and nociplastic pain, and the challenges in treating them. Mackey explains the role of various medications, including NSAIDs, acetaminophen, muscle relaxants, and antidepressants, in pain management. He highlights the potential of low-dose naltrexone (LDN) as a treatment for conditions like fibromyalgia and complex regional pain syndrome, noting its safety profile and the need for further research. Mackey shares insights on the societal burden of chronic pain, which surpasses that of diabetes, heart disease, and cancer combined. He discusses the importance of addressing psychological factors in pain management and the need for a comprehensive approach that includes physical rehabilitation and emotional support. Attia shares his personal experience with chronic pain and how it shaped his understanding of patient care. He emphasizes the significance of self-efficacy and knowledge in managing pain, illustrating how his journey has informed his practice as a physician. The episode concludes with a discussion on the importance of empathy in treating patients with chronic pain and the need for ongoing education and research in the field of pain management.

TED

The agony of opioid withdrawal — and what doctors should tell patients about it | Travis Rieder

Guests: Travis Rieder

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In July 2015, after a motorcycle accident, Travis Rieder was prescribed high doses of opioids without proper guidance. When he attempted to taper off, he experienced severe withdrawal symptoms, including insomnia, depression, and physical agony. Despite seeking help, he found the healthcare system unresponsive and ill-equipped to manage his withdrawal. Ultimately, he realized that proper opioid management is crucial, as reckless prescribing contributes to the opioid epidemic, which resulted in 33,000 overdose deaths in 2015. Effective tapering plans are essential for patient safety and recovery.