Tag Archives: pain advocacy

CDC Opioid Prescribing Guidelines–A Threat To Pain Patients’ Lives

21 Sep

by Heather Grace IPJ Staff Writer

On September 16, the Centers for Disease Control and Prevention (CDC) did something dubious. What’s frightening… it’s likely to have a life-altering impact on all chronic & intractable pain patients. Was this a deliberate act? I’ll let you be the judge.

They decided to release/discuss the CDC Opioid Prescribing Guidelines that will go into effect in 2016. These guidelines were designed to further curb opioid abuse. But in fact, they seem to be about arbitrarily curbing treatment.

In order to even view the CDC’s draft of opioid prescribing guidelines, you had to attend the webinar. They were not downloadable. They recorded the webinar, but are not releasing it to be watched for those who missed it.

And to comment on the CDC’s hard-to-access proposed guidelines, you had just one day. No–that was not a typo! Just one day was allowed for comment! Comments had to be in by 5pm eastern on September 17th, which meant people like me and other west coast advocates did not get to comment. Unfortunately, I didn’t find out until it was too late that it would close at 2pm my time. How many others wanted to comment, but were unable to?

A final version of the CDC’s guidelines will go into effect 2016 onward. Based on what I’ve read/heard from an expert in the field, drastic changes are ahead. We should anticipate a very low arbitrary limit on pain medication for all patients nationwide, even the most seriously ill. What’s most troublesome–the CDC intends to set that limit even lower than the 100mg/day now in effect in many states. (See #5, below.)

The draft guidelines are outlined below thanks to the Pain News Network–thankfully. They will not be available in draft form on the CDC’s website, despite the fact that guidelines will be discussed from now through December.

CDC Draft Guidelines for Opioid Prescribing

  1. Non-pharmacological therapy and non-opioid pharmacological therapy are preferred for chronic pain. Providers should only consider adding opioid therapy if expected benefits for both pain and function are anticipated to outweigh risks.
  2. Before starting long term opioid therapy, providers should establish treatment goals with all patients, including realistic goals for pain and function. Providers should continue opioid therapy only if there is clinically meaningful improvement in pain and function that outweighs risks to patient safety.
  3. Before starting and periodically during opioid therapy, providers should discuss with patients risks and realistic benefits of opioid therapy and patient and provider responsibilities for managing therapy.
  4. When starting opioid therapy, providers should prescribe short-acting opioids instead of extended-release/long acting opioids.
  5. When opioids are started, providers should prescribe the lowest possible effective dosage. Providers should implement additional precautions when increasing dosage to 50 or greater milligrams per day in morphine equivalents and should avoid increasing dosages to 90 or greater milligrams per day in morphine equivalents.
  6. Long-term opioid use often begins with treatment of acute pain. When opioids are used for acute pain, providers should prescribe the lowest effective dose of short-acting opioids and should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids. Three or fewer days will usually be sufficient for non-traumatic pain not related to major surgery.
  7. Providers should evaluate patients within 1 to 4 weeks of starting long-term opioid therapy or of dose escalation to assess benefits and harms of continued opioid therapy. Providers should evaluate patients receiving long-term opioid therapy every 3 months or more frequently for benefits and harms of continued opioid therapy. If benefits do not outweigh harms of continued opioid therapy, providers should work with patients to reduce opioid dosage and to discontinue opioids when possible.
  8. Before starting and periodically during continuation of opioid therapy, providers should evaluate risk factors for opioid-related harms. Providers should incorporate into the management plan strategies to mitigate risk, including considering offering naloxone when factors that increase risk for opioid-related harms are present.
  9. Providers should review the patient’s history of controlled substance prescriptions using state Prescription Drug Monitoring Program data to determine whether the patient is receiving excessive opioid dosages or dangerous combinations that put him/her at high risk for overdose. Providers should review Prescription Monitoring Program data when starting opioid therapy and periodically during long-term opioid therapy (ranging from every prescription to every 3 months).
  10. Providers should use urine drug testing before starting opioids for chronic pain and consider urine drug testing at least annually for all patients on long-term opioid therapy to assess for prescribed medications as well as other controlled substances and illicit drugs.
  11. Providers should avoid prescribing of opioid pain medication and benzodiazepines concurrently whenever possible.
  12. Providers should offer or arrange evidence-based treatment (usually opioid agonist treatment in combination with behavioral therapies) for patients with opioid use disorder.

Patients: Prepare to Decrease Pain Med Dosages

Despite the fact that I have to be on pain medication for the rest of my life due to severe constant pain from a central pain syndrome / a spinal cord injury, I was advised by my doctor to prepare to decrease my dose, as it is a likely outcome. I’m really worried. I know people I’ve gotten to know like family will die if we’re forced to conform to the these guidelines.

As for me? As strong as I’ve been, I see myself back “on that ledge” between life and death, contemplating suicide, just like I did before adequate pain care in 2006… if it ever gets to that. If the CDC decides they want us dead, and if they indeed force me back to *that* point in 2016 with these guidelines — the twisted, ugly dark place most people come back from — the world would know exactly why I took my life. I won’t allow stats-massagers to list me as an opioid death.

The thing is, I don’t *want* that to happen. I don’t want pain care to get any worse for anybody! But I’ll be silent no more about the fact that I’m terried… truly terried. Neither should you, if you’re reading this and feel the same.

The CDC said the guidelines were developed after a series of meetings with a core expert group and independent peer reviewers that the agency did not identify by name. However, I believe I have found the names of the peer reviewers, thanks to a hidden PDF on their site:

PEER REVIEWERS

Jeanmarie Perrone, MD
Professor of Emergency Medicine, Hospital of the University of Pennsylvania Director, Division of Medical Toxicology, Department of Emergency Medicine University of Pennsylvania
Expertise: medication safety, emergency department prescribing, substance misuse, use of prescription drug monitoring programs, toxicology, provider education

Matthew J. Bair, MD, MS
Associate Professor of Medicine, Indiana University School of Medicine
Expertise: pain management, geriatrics, non-pharmacologic treatments, mental health, veterans’ health

David Tauben, MD
Chief, Pain Medicine
Clinical Associate Professor, Department of Anesthesia and Pain Medicine
Department of Medicine Division of General Internal Medicine
University of Washington
Expertise: medical education, primary care, pain management

You can view the rest of that PDF on my site, in case they remove it.

CDC officials have long been critical of opioid prescribing practices and have repeatedly cited a study that claims over 16,000 Americans are killed annual by overdoses linked to pain medications. But is that true?

Those numbers are grossly overstated, according to my research. I have reviewed many documents on many sites other that Pain-Topics.org, but they have great data on *WHY* the stats are inaccurate/inflated. From my review of this issue, it is clear statistics on a growing problem means more money to fight that problem each year, when the “pie” of government funding is carved up. Perhaps a larger share will go to the CDC next year, thanks to this unreasonable set of rules they plan to force upon people in pain? How terrible that dollar signs are more important than American citizens–even those of us in severe, unending pain.

From my research, I’ve found that pain medication is being sited as a cause of death merely because it exists in people’s systems, even if they were a passenger on a 747 that crashed. Also, to increase numbers of supposed “opioid-deaths,” statistics are inflated by including deaths caused by dangerously mixing of illicit/prescription substances with the intention of getting high. These are not patients who are being treated for serious pain-related illnesses. These are, sadly, people trying intentionally to harm themselves–to create a chemical reaction in their bodies that is unnatural and dangerous.

Not to mention, despite the hype, pain medication abuse is not anywhere near the top 10 causes of death in the U.S.! So why are we the scapegoats? It has to be money… what else could it be? We aren’t hurting anyone. We avoid illicit substances. We beg for help. Repeatedly. Isn’t it time this “war on drugs” stopped making *us* its casualties?

MY QUESTION IS: ARE WE GOING TO LET THE CDC STEAL OUR PAIN CARE AND KILL US ALL?

They claim they will be using evidenced-based material in forming these guidelines, but they don’t talk about all the people who kill themselves because the pain is too much to bear. Nor do they mention all of the people with intractable pain who die due to lack of appropriate care in the emergency room, despite cries for help and pleading with ER docs to call their pain management physician. It’s happened 3 times this year, to people I know!

I suspect a lot of this so-called data comes from PROP (Physicians for Responsible Opioid Prescribing), an extremely controversial organization that has lobbied Congress and criticized the FDA for not doing more to limit access to opioids. Why do I say this? There’s a link to PROP literature calling for “cautious, evidence-based opioid prescribing” on CDC’s website, on a page discussing safe prescribing tools” (See it here, at the bottom of the page.)

In case they remove the link on this page, I’ve included a screenshot of the page, here (click to see larger image):
CDC-Safe-Prescribing

The email used to comment on this atrocity created by the CDC was opioidcomments@cdc.gov. I got an error message when I tried to comment after 5pm on 9/17. But I suggest you flood the CDC with complaints, anyway! Call the Centers for Disease Control at
800-CDC-INFO / (800-232-4636) or TTY: (888) 232-6348, Monday-Friday
8am-8pm eastern. Email them using their contact form: https://wwwn.cdc.gov/dcs/ContactUs/Form. Write them at: Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329. View http://www.cdc.gov/contact/index.htm for more options.

Even Better: If someone has time, why not post a comment with the contact info for the peer reviewers, listed above? Let THEM know we’re mad as hell and not gonna take this… It’s time we united for the common good. It’s time ALL PAIN PATIENTS became PAIN PATIENTS/ADVOCATES.

Are you with me?


About The Author

Heather Grace is an Intractable Pain Sufferer, Writer & Advocate. She’s Co-Director of the 501c3 nonprofit Intractable Pain Patients United (http://www.ippu.info), has been a Speaker/Conference Planner at For Grace’s (http://www.forgrace.org) annual Women in Pain Conference and is a Pain Ambassador for the U.S. Pain Foundation (http://uspainfoundation.org).

© 2011-2015 Intractable Pain Journal & Heather Grace. All rights reserved.

2014 INTRACTABLE HERO Award Winner Doug Cook Gives His All

11 Jul

By Heather Grace, IPJ Staff Writer

Doug and Radene Marie Cook

 met Doug Cook through his wife Radene Marie Cook, a fellow patient with severe constant pain who became my best friend. Yes, Doug is her caregiver. He has helped Radene navigate the hell that is Intractable Pain since 2000. Unlike most spouses, he stayed after her injury instead of fleeing in terror. The vows they exchanged actually meant something. Though it’s truly sad, loved ones leave when someone gets seriously ill and doesn’t get better. But not Doug. For that reason alone, he is exceptional.

That’s just where the story begins, however. Doug Cook has a quiet way about him that somehow speaks volumes, the more you get to know him. I’d know him for a while before I really saw Doug in action, at the 2010 Women In Pain Conference. Though Radene & I helped put the conference together and were also speakers, Doug Cook was the one who was a huge part of the success of the event.

He arrived hours early, bringing art and other supplies. Doug backed up his SUV, unloading and arranging everything, including beautiful art that was created for the event by For Grace’s Artist in Residence, Radene Marie Cook. Afterward, he spent at least 90 minutes aiding CEO John Garrett with conference design/setup, moving the large conference tables and nearly 200 chairs, ensuring there was plenty of room for everyone to move freely through the space. Even as the event was about to begin, Doug focused on helping people get from the parking lot to the registration area. (Myself included!)

At that point, it hit me. Doug was caring for everyone–ensuring all the people who needed help got it. He continued his efforts throughout the day, helping anyone who needed it. Holding doors for people, moving chairs so that anyone with a wheelchair did not have difficulty getting where they needed to go… doing anything people needed help with.

In his quiet way, Doug has helped make the event a seemingly-effortless success. Not because he was paid to do so–in fact he has volunteered his time. Doug Cook is one of those people with a huge heart; a natural-born caregiver. This innate quality is extraordinary in today’s world, to be sure.

And the conference is just one day among the thousands where Doug gives and gives and gives. When he isn’t assisting Radene, his parents or mother-in-law–or working a full-time job–Doug dedicates a great deal of his time to helping others. He’s been active in his community for many years, doing things like painting over graffiti and ensuring the neighborhood is safe. He spends much of his free time making the world a better place, because that’s who he is.

In 2011, Doug Cook received a Shire BRAVE Award for caregivers. The BRAVE Awards are the first and only to honor the courage and dedication of non-professional caregivers, the everyday heroes who provide regular and consistent care for other people. Out of nearly 400 nominations, Doug and 14 others were honored. Read more about the annual award at http://www.shirebraveawards.com.

In addition to being an award-winning caregiver, Doug has also become a dedicated advocate and speaker. Doug spoke about caregiving at two national conferences in 2012, including the Woman In Pain Conference.

Caregiver. Advocate. Speaker. Award-Winner. Community Leader. Doug Cook is an ‘unsung hero’ that deserves to have his praises sung today and everyday.

So Doug, thank you for all the things you’ve done and continue to do–great and small, noticed or not. Read more about Doug Cook in the caregiver story by ABC News.

About The Author

Heather Grace is an Intractable Pain Sufferer, Writer & Advocate. She’s Co-Director of the 501c3 nonprofit Intractable Pain Patients United (http://www.ippu.info), has been a Speaker/Conference Planner at For Grace’s (http://www.forgrace.org) annual Women in Pain Conference and is a Pain Ambassador for the U.S. Pain Foundation (http://uspainfoundation.org).

© 2011-2015 Intractable Pain Journal & Heather Grace. All rights reserved.

Portrait of Activism: Pain Advocates Meet with Los Angeles DEA

21 Aug

“Advocating for Another” Carnival 2012 – Day 1

By Heather Grace, IPJ Staff Writer

Being an advocate in the pain community can be challenging. Much of the country has a stigma against pain care. The media teaches the public that lifesaving medications are dangerous and addictive–to be feared.
Often, that requires pain advocates to be incredibly brave. We don’t just speak up, and go against the grain by telling people how much our lives have improved by received adequate pain treatment.

We also act. How many people with pain would willingly walk into their local DEA office and openly discuss their pain care with federal law enforcement? I don’t know how many. But, we did.

Myself & 3 other dedicated advocates met with the DEA in Los Angeles to discuss how we could better work with them to build a bridge of understanding between patients & law enforcement.


Pictured are L to R: Heather Grace, Radene Marie Cook, Gina Libby and Doug Cook (members of the American Pain Foundation’s Action Network/Intractable Pain Patients United). Taken January, 2012.

People who live with chronic or intractable pain just want some semblance of a normal life. And the DEA wants to go after bad guys. Why would patients ever be suspects? You’d think it would be simple to tell the difference between a patient and a bad guy. Year after year, the line just seems to become more blurred.

The truth is, law enforcement isn’t taught what a patient is/does. They’re taught to hunt the bad guys-often deceptive, often going to great lengths to get pain treatments that should go to seriously ill people. So how does the DEA see a person with pain like any other sick person?

That’s where advocacy comes in. It’s our job to help them see us as victims in the drug war. And, that’s not exactly an easy task! Good patients, good doctors and even good pharmacies have been wrongly accused. And it can take thousands of dollars to prove your innocence. (In the case of patients, the degree of stress involved can also be life-threatening.)

It’s an important issue with no easy answers, but I’m glad we all worked together and got our meeting with the DEA. I think we made an impression by telling our stories and sharing our concern for other people, just like us. Obviously, a single discussion won’t change people’s hearts & minds. That’s why we never give up!

My fellow advocates are incredibly dedicated–doing all they can, fearlessly and tenaciously, for the benefit of all people with pain. I couldn’t be more proud to be a pain advocate!

The above blog entry is part of a week-long series created by WEGOHealth “Advocating for Another” Carnival 2012. You may follow my blog here, and see me on Twitter @IntractablePain. Check out other entries: #A4AMONTH.

© 2010-2012 Intractable Pain Journal & Heather Grace. All rights reserved.

September is National Pain Awareness Month–What Will YOUR Focus Be?

21 Aug

By Heather Grace, IPJ Staff Writer

As August is nearing an end, we at IPJ are wondering what people with chronic and intractable pain will be doing to acknowledge the important month ahead. To many, September is just another month. But to people with pain, it can be a very meaningful and important time of year. September is National Pain Awareness Month.

Will you celebrate this month–being thankful for your continued health? Perhaps you’ll think about how lucky you are to have adequate pain care? Or will you focus on pain advocacy, recognizing that so few people have the pain care they desperately need? Maybe you’ll write a blog, share a video about your experience with pain, or make your voice heard in the media?

Please take a few moments to discuss National Pain Awareness Month here. Share what you’re doing to take care of yourself, as well as what you’re doing to help others. We’d also love to hear your hopes/dreams for the future of pain treatment.

And to all people with pain: We wish you a happy healthy September, filled with acceptance, support and understanding.

© 2010-2012 Intractable Pain Journal & Heather Grace. All rights reserved.

The End of American Pain Foundation–A New Beginning for Pain Advocacy

10 May

The American Pain Foundation may have come to an end, but the advocacy efforts of APF’s Action Network will be reborn.

by Heather Grace, IPJ Staff Writer

While I by no means speak for the American Pain Foundation nor the Action Network Leaders, as a Leader myself, I *do* realize what a shock the loss of APF is to people with pain across America, and worldwide. (See APF notice regarding the closing, released May 9.) I think it’s important to note that in addition to the work that is being done to re-home the vast APF database of articles and information as was noted on the APF web site, the advocacy efforts will also continue.

Please know that there are very capable individuals working toward solutions that will ensure the vibrant pain community that existed on APF’s web site(s) is rebuilt. We, as Action Network Leaders are doing all we can to support the rebuilding efforts, as well as our ongoing advocacy projects. Behind the scenes since Tuesday the Action Network, APF’s grassroots advocacy team, have been discussing future plans. The volume of people who have stood up and asked “What can I do to help?” are a testament to the dedication of this wonderful group of advocates.

Even more importantly, we have continued speaking out for the rights of people with pain, and we will continue to do so in every possible medium. We have come together like never before and are determined to continue our work as advocates via Facebook, Twitter, blog/article and interview, to bring a promote a message that represents all people with pain. Each of the Leaders strongly believes that all people have the right to timely, appropriate and effective pain care.

While the loss of APF will be felt for some time, it does not change the dire situation for all people with pain in America nor the need for pain advocacy. Pain is a national health care crisis, a hidden epidemic, and the problem continues to worsen. This is why the Action Network was formed, and continues to grow. We are a dedicated network of volunteer advocates from over 35 U.S. states and Puerto Rico. We are people living with pain, caregivers and health care providers who work collaboratively with other advocates, professionals and organizations to transform pain care in America through grassroots advocacy.

Yes, this is a difficult time for everyone, but I hope all people impacted by pain will see this as an alarm being sounded. If you have the passion to make a difference—please do so. Join this fight. It’s time to stop believing someone else will do it–it’s your cause just as it is my cause. Please show your support via the Action Network California Facebook page. If you feel strongly about the pain advocacy movement, LEAVE A COMMENT ON THIS PAGE letting the Action Network know you are interested in advocacy. We need your help now more than ever!

With all the passion of an advocates heart,
Heather Grace
California Action Network Leader
http://www.facebook.com/APFCalifornia
Twitter: @IntractablePain


Heather Grace is an Intractable Pain Sufferer, Writer & Advocate. Her intractable pain went from chronic to constant due to medical neglect of a serious yet treatable spinal injury. She now lives with Central Pain Syndrome and underlying illnesses. She Co-Manages Intractable Pain Patients United, has been Technical Director/Guest Speaker at For Grace’s Annual Women in Pain Conference. She is also a California Leader for the American Pain Foundation.

Additional Resources: http://www.thepainstore.com/articles.html
http://thepainstore.blog·spot.com · http://www.ippu.info

© 2010-2012 Intractable Pain Journal & Heather Grace. All rights reserved.

The American Pain Foundation Closes…

9 May

Posted on the American Pain Foundation web site on Tuesday, May 9, 2012:

With deep regret and heavy hearts, we sadly inform you that due to irreparable economic circumstances, APF must cease to exist, effective immediately. On May 3, 2012, the Board of Directors formally voted to dissolve the organization.

The Board and staff have worked tirelessly over many months to address a significant gap between available financial resources and funds needed to remain operational. Unfortunately, the economic situation has not changed in any meaningful way, despite our best efforts.

APF hopes to be able to transfer content from various information, education, and support programs to other organizations so that you may continue to benefit from the value these programs have provided to thousands of individuals and families across the country.

Your personal experiences in living with pain and seeking compassion, empathy and medical care – often against the odds — have driven our efforts over these many years. This includes enactment of key provisions of the National Pain Care Policy Act in the Health Reform Bill that led to a landmark report issued in 2011 by the Institutes of Medicine. This report documents the shocking numbers of US citizens that live with pain and calls for immediate changes to address gaps in care. Despite this, the current climate towards improving the plight of people with pain in the US continues to be precarious and hostile.

As you unfortunately know, the need for public outcry around the needs of Americans struggling with pain conditions is greater today than ever before in light of the multi-front assault occurring daily on our right to dignified care. Misguided state and federal policies are impeding access to appropriate and reasonable medical care for people struggling with pain, and deterring even the most compassionate medical providers from treating anyone with pain conditions.

It is therefore critical that each of you raise your voices singularly and together to demand the care you deserve. It is only by continuing to demand attention to the ever-worsening barriers and unacceptable suffering that change will occur.

Elected officials, policy makers, and the media need to keep hearing from each and every one of you so they are not allowed to walk away from the consequences of this over-looked public health and medical problem. Please know that although APF will cease to exist, the resolve and commitment among individuals on the Board and staff remain strong.

Pain Advocacy: United We Stand, Divided We Disappear

30 Sep

by Heather Grace, IPJ Staff Writer

As Pain Awareness Month draws to a close, I’ve been thinking a lot about the overriding message… Why it is we all work so hard and what we are trying to accomplish. Pain advocacy is so important, especially with the many mixed messages out there, always confusing the public about whether there are any actual people with pain, or whether we are all a bunch of wanna-be junkies.

I really think the tide is turning, and this year, 2011, was an important one. The IOM report did a lot to open people’s hearts and minds. And the work of organizations both national and local, helped a lot to foster a positive message.

This is why our fight is so important, and this is the start of something really important, for all people with pain. The future can be a really bright one if we all realize that advocacy isn’t something for someone else to do. Advocacy is important to all the people who have been hurt, mistreated, suffered due to negligence or even ignorance, about the proper way to treat chronic and Intractable Pain.

I heard this quote in a documentary about being deaf in today’s world. It was talking about how easy it was for society to disregard the deaf. That as society grows, deaf people tend to blend in and eventually become outsiders. How true that is, for all people with pain, as well. Just as you cannot tell someone is deaf just by looking at them, you cannot tell—in most cases—that someone has chronic or Intractable Pain. Though our illness may be invisible to many, our passion, our drive and our voices ARE NOT.

I think that the reason this fight has touched us all so deeply, and brought us into advocacy with both feet is simple:

“UNITED WE STAND,
DIVIDED WE DISAPPEAR”

The ways in which we’ve all suffered indignities–and even just indifference–makes it easy to see how small our world can become if we don’t fight for better pain care, as well as acceptance.

We must stand up and be counted, and tell everyone about our experiences… Tell them all how difficult it has been to live in our world. We must keep fighting until the everyone else with pain is able to join the fight, alongside us!

I AM ALREADY AN ADVOCATE

For those of you already doing this important work, I am grateful! To my fellow advocates, I want you to know that I treasure your contributions to this important cause, and understand the difficult choices you face. I see the work you are doing, to make the world a better place for all people with all types of pain. It surprises me, each year, how hard everyone fights, through their own serious illness, to help others… the 116+ million of us with chronic pain.

Thank you for working through your own difficult circumstances, for braving the toughest days, doing what you needed to do, to be there, even the times when you really should NOT have been, because the pain was so severe. It is both heart-wrenching and inspiring, that you would risk your own health, sacrificing for this cause, for all of us. I am so thankful to work with people who are as dedicated as I am, and willing to give their all, literally.

As October approaches, I hope you will all take the time to relax, recharge and renew… Gain back anything that you lost due to the many ways you pushed yourself, to make a difference for the entire pain community. I hope you will stay connected, and be out there fighting, when you can. But please, give yourself a break, when you cannot.

I WANT TO BECOME AN ADVOCATE

For those of you who are interested in getting involved, but do not know where to begin, here are some suggestions:

Not sure what to do or where to do it? If you are looking for a very specific idea, based on your skills, challenges or even just your location, email me. I would be happy to provide you with personalized suggestions, based on your unique situation.

So, Pain Awareness Month is almost over. But, it’s not too late to have a positive impact. Whether it is September 2011, or you are reading this months or years from the time I wrote it, you have the power to act… Right here, right now. Become an advocate, for yourself. Or, for someone you love. If you are already doing this powerful work, there is something else I would like you to do. Though admittedly, I really overdid it this month, I’ve still been doing little things to bring people with pain together—asking them if they would be interested in also doing this important work. I invite you to do the same:

THE INVITATION

Please, reach out to someone you may not have reached out to before. Ask him/her to join this fight. If you see the heart of an advocate in them, tell them so! Also, tell them what you do to make the world better place for people with pain. Invite them to join you! The more we reach out to help others who feel alone and invisible because of their pain, the more we become a powerful voice of unity, speaking out about pain.

Thanks for taking an interest in pain advocacy. I hope this will be the first step among many to come. Remember, there are many of us out here, and we are all working for the same common goal. Isn’t it better to be working together? Let’s do it!

Take care, everyone! xo Heather Grace

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