National advocate caring for those with chronic, severe, long-standing pain - for patients, clinicians, researchers & scientists.
Joined March 2012
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1. My #RealPainStory: in 2006, I jumped down a mountainside to stop a child from going over a cliff. I herniated a few discs. 6 months later, a neurosurgeon confused me with a different patient, & cut out the back of my lumbar spine. That plunged me into my first 15 years of pain
Andrea Anderson retweeted
As an advocate and an experienced writer, I’m noticing that the media is trying to majorly downplay how much kratom is helping consumers.
They are trying to minimize and silence the power of our collective voice by making it seem like our real-life positive experience of kratom is nothing significant and should be ignored.
Yet the opposition such as endkratomaddiction continues to have the loudest mouthpiece in this room.
And I say: To hell with that!
There are millions of us and our voices can get much LOUDER. We can turn the tables by working together.
I recognize this evil because it's the same damn playbook that they used to cause massive devastation in the chronic pain patient community by withholding opioids.
But this time it will be DIFFERENT. We will make sure of that because as advocates we have no other choice if we are trying to save millions of lives.
#Kratom #KratomBan #KratomAdvocacy #KratomSavesLives #KeepKratomLegal
Andrea Anderson retweeted
Opioid settlement funds used to pay off government debt rather than help the public. How typical.
#ChronicPain @CMerandi
share.google/VVV6fqZaIcqXGQX…
Andrea Anderson retweeted
The irony is astonishing. But I celebrate this change. To appreciate the history of this medication and how we got here, one must look back roughly fifteen to twenty years to the major litigation involving gabapentin (then marketed as Neurontin). The manufacturer faced substantial penalties for *illegally promoting the drug for numerous conditions beyond its FDA-approved indications.* Those approved uses are limited primarily to:
1. The management of postherpetic neuralgia in adults
2. Adjunctive therapy for partial-onset seizures in patients with epilepsy.
Off-label prescribing still remains permissible when supported by sound clinical judgment, appropriate documentation, and consideration of risks and benefits.
However,, gabapentin has surged in use extensively for postoperative pain, acute pain, and long-term chronic non-neuropathic pain—uses for which it was never approved and for which supporting evidence is often limited or mixed. Its unscheduled status may contribute to the perception that it is a “safer” alternative, even when it is not the most appropriate therapy for a given patient and even when it conflicts with a careful, individualized assessment of efficacy and risk.
Although gabapentin may have a limited role in selected neuropathic conditions or in efforts to reduce the risk of developing complex regional pain syndrome after certain injuries or procedures, its side-effect profile warrants careful consideration. Observational data, including a 2025 study published in Regional Anesthesia & Pain Medicine, have associated repeated gabapentin prescriptions with elevated risks of dementia and mild cognitive impairment. Patients receiving six or more prescriptions showed a 29% higher risk of dementia and an 85% higher risk of mild cognitive impairment within ten years compared with matched controls; risks were notably higher among adults aged 35–49 (more than double the risk of dementia and more than triple the risk of mild cognitive impairment).
Additional concerns include depression, suicidal ideation, significant weight gain, and, in many patients, inadequate pain relief. These risks are unnecessary when more appropriate, carefully selected analgesics—consistent with current evidence and FDA labeling—are available and legally prescribable in every state.
There is no clinical justification for denying patients adequate pain relief solely as a risk-management strategy for the prescriber. When this occurs, the focus shifts from treating the patient to managing the clinician’s anxiety or institutional pressures. That is not consistent with the professional responsibilities of a physician.
The continued preference for an anticonvulsant in settings where evidence of benefit is weak illustrates the lasting influence of earlier enforcement actions and the current climate of heightened scrutiny. Compounding the difficulty for prescribers is the growing reliance by certain federal agencies on decision-support algorithms that flag “high prescribers” without context. These tools have not been independently validated for clinical validity across specialties, and the personnel interpreting them frequently lack the depth of pharmacological and medical training possessed by physicians and pharmacists.
Medication decisions are best made by clinicians who understand individual patient factors, including comorbidities, concurrent medications, and metabolic considerations, working in collaboration with pharmacists. They should not be driven by unvalidated algorithmic thresholds applied without corresponding clinical expertise.
In short, optimal pain management requires individualized assessment by trained physicians and supported by pharmacists rather than the substitution of unproven algorithms or risk-averse practices that leave patients undertreated. Prescribers should adhere to evidence-based principles, document their reasoning thoroughly, and prioritize the patient’s needs over external pressures.
This process might be familiar to all who follow my work explaining how mass tort and class action litigation works. The media is a key component of how the (false or misleading) attorney-crafted narrative is spread. The media is complicit in saturating us with these narratives.
The funding to buy column inches, editorials, news stories, “experts” and other elements of this propaganda war are funding through a war chest designated for this purpose. Currently, a great deal of this funding is through VC or middle eastern countries. For example, the UAE is heavily invested in the most lucrative suits of our time, such as the 72+ billion dollar opioid litigation, multi-billion social media litigation (just beginning), glycopvhosphates, talcum powder, “ultra processed food.” This one is worth watching, because they’ve created a term with no definitions, no actual meaning, but billions of dollars owned by the manufacturers of all these products - from McDonalds to Froot Loops - the litigation targets are unlimited. Watch the early stages of winding up: government “guidelines” developed by secret litigation experts upon which the narrative will be built; citation cartels, in which these “experts” will parrot the narrative, then cite to one other in journals to build the appearance of scientific consensus on concepts that don’t exist in the scientific literature or health care system. One good example of this is the fake term COPD - a term created by PROP-adjacent “experts’ and now repeated in their cartel’s literature quite frequently, without ever being defined, tested, replicated, proven, or receiving an ICD-11 code - essentially, totally made up.
These suits are won first in the media by persuading us that it true, usually through one sided Hulu or Netflix “fake-umentaries” which are designed to contaminate all jury pools. The goal is to elicit billion dollar verdicts, which is almost always successful. Yet they never benefit the supposed victims, those they claim to have “deeply cared about” for the purposes of the litigation. Yet in truth, the billions are shared by the lawyers and governments and mere pittance, if anything, are received by the person who were supposedly the harmed individuals.
This individual’s story is a micro-version of a macro-process that changes our worlds in ways that harm millions, while the rich get even richer off our backs, while always searching for their next target.
Hoping for a good outcome for the subject of this article.
Andrea Anderson retweeted
So the medical board just sent out a notice that due to their opioid regulations gabapentin use has increased-and docs should use more long acting opioids. Can’t make this shit up.
Andrea Anderson retweeted
A new investigation authored by China researcher Sarah Cook and published by the International Coalition to End Transplant Abuse in China (ETAC), reveals how the Chinese Communist Party (CCP) is embedded throughout China’s organ transplant sector.
“Every entity that Chinese officials present to international audiences as ostensibly independent or as a ‘third party’ is in fact a node in the same Party-controlled system.”
Doctors who are CCP members pledge to carry out the Party’s decisions, observe its discipline, protect its secrets, remain loyal to the Party and “never betray the Party.” Violating these commitments can carry more severe personal and professional consequences than breaching medical ethics.
Distinguished Professor Wendy Rogers, clinical ethicist and Chair of ETAC’s International Advisory Board said, “Chinese transplant doctors are placed in an impossible situation. Their professional ethical obligations can be overruled by state-enforced demands for CCP fealty. In this CCP-controlled system, we cannot accept assurances of reform, as no part of China’s transplant oversight system operates independently of the Party-State hierarchy.”
A former internal medicine doctor, now outside China, told researchers:
“Chinese people live in an environment filled with the CCP’s culture. Under the terrifying pressure of the CCP, everyone knows—if you yourself dare to speak up, you’d be the next to disappear.”
@ETAC_Global @MDsAgainstFOH @JanJekielek @Eastofethan
Andrea Anderson retweeted
I have Crohn’s disease and inflammatory arthritis. I do everything right. I eat healthy, consume very little sugar, exercise, drink a gallon of water a day, and take my medications. Biologics, methotrexate, prednisone when needed.
For nearly a decade, I was mostly in remission.
Then, two months ago, everything changed.
Out of nowhere, I developed a fever, ended up hospitalized, and had surgery the next day. I still need another surgery. After a decade, my biologic stopped working. I'm starting a new treatment this week.
And right now? I'm in pain.
Some mornings I wake up and can barely walk. I can barely use my hands. Crohn's is flaring. Inflammatory arthritis is flaring. Despite doing everything "right."
Because that's the reality of chronic illness. You can do everything right and still get incredibly sick.
I can't take NSAIDs because of Crohn's.
Yet somehow, we've reached a point where the prevailing narrative would have you believe that opioids don't help chronic pain, and conditions like mine shouldn't require them.
I'm here to tell you that Crohn's HURTS. Inflammatory arthritis HURTS. And opioids absolutely CAN help.
I cannot believe how far off the rails we've gone. Patients are suffering, losing access to medications that help them function, and there are STILL people pushing to restrict opioid prescribing even further.
How much more do chronic pain patients have to endure? How much more access needs to be taken away?
When will it EVER be enough?
I will never stop fighting for patients like me. Because I know firsthand what it's like to live in a body that hurts despite doing everything you're supposed to do.
And I refuse to let anyone pretend that pain isn't real or that relief doesn't matter.
Andrea Anderson retweeted
My 1st book is out!
It's FREE on Kindle til Oct 24.
It's Not All in Your Head… or Your Body.
Patients say it's all in their body.
Too many doctors & researchers say it's all in your head.
Almost no one counts the damage done by the systems we navigate.
It's all 3.
Link👇
Andrea Anderson retweeted
“Your opioids are making your pain worse.”
That claim has been used to justify forced tapers, treatment cutoffs, and switches to Suboxone.
But where’s the evidence?
We expose the opioid induced hyperalgesia hoax, the experts, and the FDA's role.
Our full investigation is NOW PUBLIC!
youtu.be/P0U_UCjB6No
Andrea Anderson retweeted
I met Dr. Robert Jackson at the recent Association of American Physicians and Surgeons meeting in Atlanta, and was so honored to record this podcast with him!
“A warm body with a beating heart is brought to the operating room, labeled “brain dead,” and still requires anesthesia that looks exactly like the care we give the living. That moment changed Dr. Heidi Klessig, a retired anesthesiologist and pain specialist, and it launched her deep dive into the ethics of organ donation, organ procurement, and the medical meaning of death.
We walk through how “brain death” entered modern medicine, why the 1968 Harvard proposal mattered, and how the dead donor rule is supposed to protect public trust. Along the way, we compare the legal standard in the Uniform Determination of Death Act to the realities of bedside testing, including what guidelines do and do not measure, what counts as “irreversible,” and why families may be making life-and-death decisions without true informed consent. We also talk about the high stakes: if a patient is declared dead, basic human rights protections can vanish in an instant.
Then we get practical and specific. Dr. Klessig explains cases of recovery, including Zach Dunlap, and the physiology behind “global ischemic penumbra,” a brain “power outage” where function can disappear before tissue is destroyed. We also discuss the 2023 American Academy of Neurology brain death guideline, the subjectivity of interpreting movement, the risks of the apnea test, and what recent events like the TJ Hoover case and Kentucky’s pause law suggest about where policy may be headed.
If you’ve ever checked the organ donor box, faced an ICU decision, or simply want ethical clarity on organ transplantation, this conversation will challenge your assumptions. Subscribe for the next conversation, share this with someone who needs it, and leave a review with the question you want answered next.”
Andrea Anderson retweeted
A Hidden Cause of Low Back Pain
•Stanford pain scientists Einar Ottestad and Anthony Machi highlight a little-known cause of low back pain: superior cluneal nerve entrapment.
•This happens when small nerves near the lower back get trapped, leading to pain in the back, buttocks, or upper leg.
Key points:
•This condition may affect up to 14% of people with low back pain.
Doctors can find it using ultrasound or special X-ray techniques.
•Treatments include nerve blocks, heat treatments (radiofrequency ablation), cold treatments (cryoablation), nerve stimulation, or surgery.
•One patient had an 80% drop in pain after a heat treatment. Another study showed 50–90% pain relief within 10 weeks.
Why it matters:
Many people with back pain never find out what’s causing it. If doctors look for this nerve problem, more patients might get the right treatment and feel better. Scientists still need to study the best ways to diagnose and treat it.
Source: bit.ly/4s81LwX
Andrea Anderson retweeted
Thank you to Fox News Digital reporter Rachel del Guidice for this interview!
People with a severe neurological injury are labeled “brain dead,” and are then used as experimental research subjects while still biologically alive.
foxnews.com/video/6405981468…
Andrea Anderson retweeted
Rebecca Charles Jackson has a well-researched Substack detailing how an anatomical “gift” given by a grieving family is transformed into a billion dollar industry:
“A system built on a gift that is free by law moves hundreds of millions of dollars a year through tax-exempt books, banks nine-figure reserves, and pays chief executives more than most families will earn in a decade. The only party in the entire chain who is told nothing about the money is the family that made the gift.”
For example, according to the 2025 Milliman report, the estimated total U.S. billed charges for a kidney transplant is $446,800.
The Organ Procurement Organization (OPO) that solicited the family and coordinated the transaction receives $135,400 of that amount.
“That is the charge for obtaining a kidney which, by federal law, cannot be bought or sold, and for which the donor’s family received nothing. It is the second-largest line on the bill. It is more than six times what the surgeon is paid.”
Who is paying these OPO fees? Well, mostly you are:
“Medicare is the single largest payer for organ acquisition in the country. In 2016 it reimbursed certified transplant centers roughly $1.6 billion of about $3.3 billion claimed.”
Jackson shows the Indiana Organ Procurement Organization Inc.’s (Indiana Donor Network), IRS Form 990, fiscal year ending December 2024:
Revenue $112.5 million.
Net assets $71.8 million.
Executive compensation $5.56 million. CEO Kellie Tremain paid $830,837.
But, you say, OPOs are supposed to be nonprofit organizations! Jackson reminds us:
“Nonprofit status governs how an organization distributes surplus. It says nothing about how much money passes through it, what it pays its executives, or how much it banks.
Donations to it are tax deductible. The families whose relatives supplied the inventory are not on the payroll and are not in the footnotes.”
The US House Ways and Means Committee is investigating the transplant industry because it’s mostly Medicare and Medicaid — taxpayer funded programs — that are funding OPOs. Says Jackson:
“Congressional oversight and the HHS Inspector General have found OPOs spending it on retreats at five-star hotels and private jets, undisclosed financial conflicts among OPO chief executives, and two OPO executives sent to federal prison for a multi-million dollar kickback scheme.”
I spend a lot of time educating people about the medical ethics problems in the transplant industry.
But undoubtedly the massive profits to be made are a big part of what keeps these unethical transplant practices rolling.
Thank you, @ChadDKollas, for the research, the design, the evidence, and your commitment to relieving pain.
@ChadDKollas gave a great comment at the FDA meeting. I know we feel alone, but there are doctors who do speak up. Long-Term Opioid Therapy Has Evidence—Dr. Chad Kollas Brings the Data to... youtu.be/lIO2vv3ItGg?si=-s4L… via @YouTube
Andrea Anderson retweeted
This was my 3 minute testimony at FDA's meeting last week: youtu.be/VtHfJ2yn4CQ
Andrea Anderson retweeted
“Out beyond ideas of wrongdoing and rightdoing, there is a field.
I'll meet you there.
When the soul lies down in that grass,
the world is too full to talk about.”
~ Rumi
“Encore” & “Lovely Rita” dahlias
ALT Big, bright yellow dahlia with flame petals. “Encore” is a late season dahlia.
ALT Bright red button dahlias. “Lovely Rita”
Andrea Anderson retweeted
@mattMD and @ibdgirl76, here is the actual data on this incorrect claim: how many women who had a simple mastectomy went on to develop disordered use?
Answer: This study evaluated over 650,000 patients for over 11 types of surgeries, including mastectomy. The incidence rates for long term use after surgery ranged from 0.12 to 1.41.
The incidence rate, (not “disordered use) ie, addiction, for long term use after surgery ranged from 0.12 to 1.41
In other words, a tiny amount.
Source: Sun, Darnall, Baker & Mackey
JAMA Int Med 2016
Andrea Anderson retweeted
This is the part of tort reform that worries me most.
It’s not just about what an injured patient can recover.
And the focus of tort reform can’t be “How do we make accountability less painful for the defendant?”
Sometimes a malpractice case is one of the only ways a pattern gets exposed.
Peer review can fail. Boards can fail. Hospitals can protect their own. Families often don’t know enough to connect the dots.
And in states with laws like Florida’s “free kill” framework, there have been situations where there was so little financial incentive to bring a case that serious problems could stay buried until the harm became impossible to ignore.
Financial exposure and records are powerful accountability mechanisms.
I’m all for protecting good doctors from garbage lawsuits.
But if you weaken one accountability route, you’d better make d@mn sure the others actually work.
Andrea Anderson retweeted
The 2016 CDC opioid guidelines were followed. Within 24 months, fatal overdoses had doubled.
Charles LeBaron, MD, spent his career at the CDC. He is an internal medicine and pediatric physician, and he learned the second half of this story from an ICU bed.
A staphylococcal septicemia put him in the hospital, then meningitis, then collapsed vertebrae in his neck and lower spine, and then disseminated shingles ulcerating half his body while he was still fighting the first infection. He came out of it with an intimate understanding of severe pain and of the obstacles standing between a person in severe pain and relief, some of which his old employer had helped construct.
The sequence is worth walking through, because it reads as a policy failure and not as a villain story.
In the 1990s, the consensus was that pain was undertreated. Opioid manufacturers read that consensus as a profit environment and promoted accordingly. The result was a prescription overdose crisis.
The CDC responded in 2016 with three restrictions: narrow who gets opioids, cap the dose, cap the duration. Every one of them had evidence behind it. People on high doses for long periods really are more likely to end up addicted.
What the guidelines did not account for was the population that already existed. Addiction treatment was not widespread. Alternatives to opioids were not freely available. So a large group of opioid dependent people lost legal access more or less at once.
Entrepreneurs in Sinaloa had been selling heroin to a fixed customer base. Now there was a much larger one. They moved fentanyl into it, and cartels do not hold to the safety procedures or the dosing an FDA opioid would. Overdose deaths exploded.
The result is the paradox LeBaron describes: severe restriction on prescription opioids for people who need them, alongside wide availability of far more dangerous illicit ones. The worst of both.
LeBaron quotes Churchill on this. However beautiful the strategy, you should occasionally consult the result. Within 24 months the fatal overdose count had doubled. It took roughly five years for the CDC to revise.
And the 2022 revision has a second problem. Insurers, pharmacy benefit managers, Medicaid and Medicare had embedded the 2016 numbers in their own rules by then. Loosening the federal guidance did not loosen the implementation. LeBaron's assessment: it's a piece of paper.
Two practical notes from the episode for anyone still prescribing in this environment.
The DEA no longer treats exceeding the guidelines as inherently criminal, though physicians have gone to jail over this, and the caution is rational.
Naloxone is available over the counter as a nasal spray. Write it as a prescription anyway. Patients get no insurance reimbursement on the counter version, and most plans will cover the prescription. It is a strange recommendation and it is the one that keeps the antidote in the house.
Overdose is now the number one killer of adults between 18 and 45, above guns and automobile accidents combined, above every single cancer.
Listen to the full conversation on The Podcast by KevinMD. Link in the replies.
What is the change to prescribing rules you would make first if the constraint were evidence rather than liability? #ThePodcastbyKevinMD
