Archive for the ‘Pain Management’ Category

NSAIDs: Unsafe for Chronic Pain

https://www.paintreatmentdirectory.com/posts/nsaids-unsafe-for-chronic-pain

NSAIDs: Unsafe for Chronic Pain

NSAIDs: Unsafe for Chronic Pain

The Problem

If you take any of the following nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief you are putting your life at risk: aspirin, celecoxib (Celebrex), diclofenac (Cambia, Cataflam, Voltaren-XR, Zipsor, Zorvolex), ibuprofen (Motrin, Advil), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), oxaprozin (Daypro), piroxicam (Feldene). This may come as a shock to you. After all, these drugs have been around for decades and many are available over the counter.

It has long been known that NSAIDs increase the risk of potentially fatal stomach and intestinal adverse reactions including bleeding, ulcers, and perforation of the stomach or intestines. These events can occur at any time during treatment and without warning symptoms. Elderly patients are at greater risk for these adverse events. Aspirin alone causes over 3000 deaths annually in the United States.

NSAIDs, except for aspirin, increase the risk of a potentially fatal heart attack or stroke, according to an FDA advisory issued in July, 2015. The FDA warned that “those serious side effects can occur as early as the first few weeks of using an NSAID, and the risk might rise the longer people take NSAIDs”. “There is no period of use shown to be without risk,” says Judy Racoosin, M.D., M.P.H., deputy director of FDA’s Division of Anesthesia, Analgesia, and Addiction Products. People who already have cardiovascular disease, particularly those who recently had a heart attack or cardiac bypass surgery, are at greatest risk. However, “Everyone may be at risk – even people without an underlying risk for cardiovascular disease,” says Racoosin.

Heavy or long term use of NSAIDs can also cause kidney damage.

Unfortunately, another widely available over the counter pain reliever, acetaminophen (brand name Tylenol) also carries significant risks. If used long term at higher than recommended doses or in individuals whose liver function is compromised, acetaminophen can cause liver failure. Liver failure is fatal without a liver transplant. Acetaminophen is the most frequent cause of liver failure in the United States today.

The Solution

With prescription opioids becoming increasingly restricted due to concerns about addiction, as well as growing evidence that they may cause more pain over the long term, what can a chronic pain patient do?

Fortunately, there are many safe and effective natural treatments for chronic pain. Here are some things you can take for pain relief: medical marijuana, CBD oil, kratom (a Southeast Asian herb that the FDA and DEA are currently trying to ban based on false allegations that it is unsafe), wild lettuce, turmeric, omega 3 fatty acids, homeopathic remedies such as arnica, ruta or hypericum, magnesium, vitamin D3 and many other herbs and nutrients. Here are some things that you can do: acupuncture, biofeedback, chiropractic, EMF treatment, exercise, hypnotherapy, low level laser therapy, massage, nutritional therapy, physical therapy, psychotherapy and much more. Some combination of these treatments can not only reduce your pain, they just might heal the underlying problem and eliminate your pain for good. 

To find out more about safe alternatives for pain relief, visit the online Alternative Pain Treatment Directory

Check out our recommended pain relief products HERE

Check out our alternative pain treatment providers HERE

To continue receiving important information about pain treatment, sign up for our free e-newsletter HERE

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**Comment**

Lyme/MSIDS patients often cope with intractable, grueling pain.  The stuff that stops you in your tracks & brings life to a grinding halt leaving you a shell of your former self.

I have found the following to be of great help:

For more: 

Unrecognized Lyme Disease Leads to 16 Joint Surgeries

https://www.lymedisease.org/misdiagnosed-lyme-joint-surgeries/

Unrecognized Lyme disease leads to 16 joint surgeries

Sept. 19, 2022

By Meghan Holohan
Today.com

When Meghan Bradshaw began fainting and experiencing joint pain, she visited many doctors. At first, they suspected that she might have a vitamin D deficiency or that she was anemic.

By her early 20s, her symptoms became “debilitating” and she passionately searched for answers. After years of being misdiagnosed, she learned she has Lyme disease, which caused arthritis, leading to 16 joint surgeries before the age of 30.

Meghan Bradshaw has had the joints in her lower extremities completely replaced. A late diagnosis of Lyme arthritis plus a connective tissue disorder likely contributed to the severity of her joint deterioration and the need for so many joint replacements before turning 30. (Courtesy Meghan Bradshaw)

“While it’s extreme, my story really highlights a lot of the things that other people experience, like delayed diagnosis and misdiagnosis and having a general unawareness of the dangers of ticks,” the 29-year-old told TODAY.

READ MORE

https://www.insider.com/young-woman-needed-16-joint-surgeries-lyme-disease-2022-9

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Important quote:

When Lyme disease goes untreated, the chance of developing arthritis increases. Lyme arthritis often starts in the knee, Gaston said.

About 60% will end up with some arthritis,” Gaston said.

Yep. 

I am currently dealing with this now.

While I am not a doctor, it is my experience and opinion that the quicker you deal with this inflammation/pain the better.  Allowing this process to fester could lead to irreversible damage.  The root, of course, is inflammation which must be addressed and dealt with.

Things that have helped tremendously:
  • MSM & DMSO
  • Proteolytic/Systemic enzymes
  • LDN
  • CBD
  • Niacinamide/vitamin C protocol
  • Curcumin
  • Diet can have a huge impact.  Gluten was my problem, but never appeared to be a problem before.  Removing it has made all the difference. I’m not celiac.  Some also struggle with dairy or the nightshade plants as well as alcohol and sugar.  Do an elimination diet to determine if getting rid of these things can help you.
  • Staying hydrated with water
  • Various laser therapies
  • Heat therapies
  • Massage therapy
  • Chiropractic care
  • If you are willing to spend $50, you may want to read a brief testimonial from someone who used  “The Arthritis Strategy” by Shelly Manning.  While I have not used it myself, it appears to be sound advice – although as always “buyer beware.”  It’s always wise to run things by your LLMD to make sure.  What’s nice about this is it’s about a month long strategy that will educate you fairly quickly on the things you can tangibly do yourself that could make a world of difference.  Sometimes it’s overwhelming to attack all these issues on your own.  With this strategy, you will have someone who has been there, giving you advice that worked for them.

You can also check out these resources:

Curcumin for Pain

https://takecontrol.substack.com/p/curcumin-helps-patient-recovery

Curcumin Helps Patient Recovery

Curcumin, the pigment that lends turmeric its yellow-orange color, has been recognized for millennia as a healing spice.

curcumin helps patient recovery

STORY AT-A-GLANCE

  • Studies show curcumin’s ability to repair and regenerate damage caused by strokes, enhancing verbal, visual and memory abilities and improving patients’ attention spans and other brain functions
  • Studies show that people who eat lots of curcumin-containing foods show fewer incidences of Alzheimer’s disease and sharper cognitive function and suggest meaningful cognitive benefits over time
  • Researchers have found several powerful health effects from curcumin, the active compound in the spice turmeric, particularly in relation to treating and preventing several common disorders
  • Eating foods and spices such as turmeric, which have high amounts of antioxidant compounds, may increase cognitive and mitochondrial function and mood, while decreasing depression caused by brain inflammation
  • Because the curcumin in turmeric is poorly absorbed through your gastrointestinal tract, it’s more effective to use a high-quality bioavailable curcumin extract

For those who appreciate the unique spiciness of turmeric, it’s serendipitous to learn there are several layers of extraordinary health benefits included with the active ingredient known as curcumin. One of the latest was revealed in a study in which scientists tested the powerful compound for its effects on heart failure patients.

Heart failure, experienced by over 6 million people in the U.S., weakens your heart and affects its ability to pump sufficient oxygen. Patients no longer have the ability to participate in activities and exercise like they once did, which could be described as life altering.

Heart failure is also described as chronic, progressive and incurable, although a change in lifestyle, such as eating a balanced, healthy diet and performing regular exercise can decrease feelings of fatigue and enhance their mood enough to help people resume their lives to a large degree.

Research published in the Journal of Applied Physiology reports that curcumin may help patients with chronic heart failure by increasing skeletal muscle strength, endurance and exercise capacity. Although mice were the subjects used in the trial, the scientists are hopeful their research can eventually be translated to human patients in a clinical setting.

Turmeric is in the same botanical family as ginger, another powerful spice with proven, health-beneficial compounds. With that in mind, corresponding study author Dr. Lie Gao, assistant professor of cellular and integrative physiology at the University of Nebraska Medical Center (UNMC), notes:

“This study showed an important proof of principle. Some foods and spices, such as broccoli and turmeric, contain a rich supply of antioxidant compounds. Consumption of these foods or spices may improve skeletal muscle health. For patients with stable heart failure that have limited ability to exercise, compounds like these may be beneficial.”

Interestingly, previous studies proposed that targeting skeletal muscle with antioxidants may be advantageous for heart failure patients, but Gao states that it’s not possible to use curcumin on humans because of the high amounts it would take.

Gao then suggests that “other antioxidants” such as dimethyl fumarate, a drug currently popular for treating multiple sclerosis, could be used for its health-improving benefits. That said, curcumin is one of hundreds of plant-based nutriments, from carrots to tobacco, to be unapologetically sourced and manufactured into pharmaceuticals.

Curcumin: Gingery, Earthy, Healing

Curcumin, taken from the underground rhizome of the plant, is the pigment that gives curry its bright yellow hue, explaining why turmeric is an ingredient used to complement and color stir-fries and sautéed root vegetables, rice, scrambled eggs and braised greens such as kale and collards.

In just the past few years, queries about the spice touted to have a “cult following” have increased exponentially, according to The Guardian. It’s showing up in foods like smoothies and the trendy turmeric latte known as golden milk, a potent blend of organic turmeric powder and coconut milk and/or virgin coconut oil.

Optional flavor additions include vanilla, raw honey or stevia, a stick of ginger and/or cinnamon, and sometimes a healthy dash of black or white pepper. The addition of ghee is used to soothe a sore throat.

In fact, the use of black pepper in golden milk is supported by a study in which the “curcuminoid-piperine combination” addressed the symptoms of metabolic syndrome in 117 study subjects who exhibited both oxidative stress and inflammation. According to the randomized, controlled trial and updated meta-analysis,7 oxidative and inflammatory status showed significant improvement, even with short-term curcumin supplementation.

Tellingly, turmeric is called the “spice of life” in India. Golden milk is becoming increasingly popular not just as a pleasant, warming drink for cool autumn evenings, but as a sleep aid for people who struggle with insomnia. Further, curcumin has been identified as a substance that’s safe, effective and natural.

A plethora of studies point to the anti-inflammatory properties of curcumin (Curcuma longa) and reveal more than 160 separate physiological and cell-signaling pathways, positively influencing arthritic conditions, cancer, obesity, inflammatory bowel disease, and, more recently, metabolic syndrome and dementia.

Studies Reveal Curcumin’s Powerful Potential for Your Brain

In another study from mid-2018, scientists at Texas A&M endeavored to relieve patients suffering from Gulf War illness (GWI), characterized by “substantially declined neurogenesis, chronic low-grade inflammation, increased oxidative stress and mitochondrial dysfunction in the hippocampus.” In the animal study, GWI rats treated with curcumin (CUR) maintained better memory and mood function. In addition:

“Enhanced neurogenesis, restrained inflammation and oxidative stress with normalized mitochondrial respiration may underlie better memory and mood function mediated by CUR treatment.”

The scientists wrote that their use of curcumin was due to its long-recognized ability to positively influence several aspects of brain health. The rats in the study were exposed to low doses of DEET, or N-diethyl-m-toluamide, a common insect repellant, and other chemicals related to GWI, such as pyridostigmine bromide and permethrin. They were also subjected to restraint for five minutes daily for a period of 28 days.

Even more recently, another study shows that chronic neuropathic pain and the cognitive impairment that accompanies it can be addressed with the antinociceptive (reduced sensitivity to painful stimuli) and neuroprotective application of curcumin, demonstrated using rats in a lab setting subjected to cobra venom.

Interestingly, the rats exhibited improvements in spatial learning and memory deficits, as well as increased exploratory activities due to the ability of curcumin to reverse the damage done to hippocampal neurons and synapses. Scientists concluded that curcumin can “alleviate pain, improve spatial learning and memory deficits, and treat chronic neuropathic pain-induced cognitive deficits.”

Mood and Memory Enhancement via Curcumin

The inflammatory and antioxidant properties of curcumin to improve memory and mood were again confirmed when UCLA published results of a double-blind, placebo-controlled 18-month trial in the American Journal of Geriatric Psychology, in which 90 milligrams (mg) of a bioavailable form of curcumin, taken twice a day, “led to significant memory and attention benefits” in people with mild memory loss.

Curcumin has been suggested as the explanation for why senior citizens in India, whose regular diets include generous amounts of curcumin-containing foods, show both a lower incidence of Alzheimer’s disease and sharper cognitive function. Further, the study “results suggest that taking this relatively safe form of curcumin could provide meaningful cognitive benefits over the years.”

Gary Small, director of the University’s Semel Institute for Neuroscience and Human Behavior and the study’s first author, notes that while the mechanisms behind curcumin’s brain benefits aren’t yet known definitively, they might be due to its inhibitory effect on brain inflammation, which has been associated with both major depression and Alzheimer’s disease.

Forty people, including healthy people without dementia as well as those with the characteristic “microscopic plaques and tangles” of Alzheimer’s, ranging in age from 51 to 84 years, participated in the study. Scientists took standardized cognitive assessments at the beginning of the study as well as at six-month intervals, and participants’ curcumin levels were checked in their blood after 18 months. Further:

“Thirty of the volunteers underwent positron emission tomography, or PET scans, to determine the levels of amyloid and tau in their brains at the start of the study and after 18 months. The people who took curcumin experienced significant improvements in their memory and attention abilities, while the subjects who received placebo did not …

In memory tests, the people taking curcumin improved by 28 percent over the 18 months. Those taking curcumin also had mild improvements in mood, and their brain PET scans showed significantly less amyloid and tau signals in the amygdala and hypothalamus than those who took placebos.”

The participants’ amygdala and hypothalamus — regions of the brain known to control several memory and emotional functions, which were positively influenced by the curcumin — were defined as critical areas of the brain.

Curcumin Is Used to Alleviate Stroke Damage

Still another study, this one presented at an American Heart Association International Stroke Conference, uncovered curcumin’s ability to repair damage caused by strokes, which have been called “brain attacks” caused when a blood clot blocks an artery or blood vessel, effectively cutting off blood flow and triggering brain cell death and sometimes brain damage and even death.

Stroke symptoms include an inability for individuals to walk due to a loss of balance, a sudden, severe headache, difficulty seeing, weakness, often on one side only, and sudden confusion. It’s crucial to know that the longer your brain goes without oxygen, the greater your risk of lasting damage.

A drug used on stroke victims, referred to as “clot-busting,” the current and most common intervention, is a synthetic contrast to the curcumin-hybrid known as CNB-001, which repairs damage sustained at the molecular level by the lack of oxygen.

Besides crossing the blood-brain barrier, CNB-001 works by influencing the mechanism responsible for the regeneration of brain cells and offers future stroke victims new hope for more complete recovery.

This is a specific example of a time when a drug can both save your life and prevent the very frequent and devastating outcomes of a stroke. Incidentally, medical intervention is crucial to help prevent such damage from stroke, but must be obtained within 60 minutes.

Curcumin to Help Prevent Cancer

Curcumin has been identified as one of the most powerful chemopreventive and anticancer agents, and recognized for its wide spectrum of pharmacological properties and inhibitory effects on metabolic enzymes, according to PubChem, which notes its wound healing and antimicrobial effects, and states:

“Curcumin blocks the formation of reactive-oxygen species, possesses anti-inflammatory properties as a result of inhibition of cyclooxygenases (COX) and other enzymes involved in inflammation; and disrupts cell signal transduction by various mechanisms including inhibition of protein kinase C.

These effects may play a role in the agent’s observed antineoplastic properties, which include inhibition of tumor cell proliferation and suppression of chemically induced carcinogenesis and tumor growth in animal models of cancer.”

The same study shows curcumin as able to suppress cancer proliferation and apoptosis (programmed cell death), thereby acting as a chemopreventive agent in skin, colon and stomach cancers. Other studies using animal models list breast, bladder, brain, esophageal, kidney, liver, lung, pancreas and prostate cancers, and more.

Significantly, the active elements in curcumin attack cancer while leaving healthy cells untouched. For the purpose of disease intervention, while turmeric is available in powdered form, it contains very little of the active compounds in curcumin, or only about a 3 percent curcumin concentration.

Because it’s not easily absorbed through your gastrointestinal tract, it’s more effective to use a high-quality bioavailable curcumin extract, according to a 2013 study. A typical anticancer dose is just under 1 teaspoon of curcumin extract three or four times daily.

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**Comment**

I recently added this form of curcumin to my regimen for arthritis pain.  I was pain free after one pill which is hard to even believe to me.  (I do not receive any payment from this or any supplement company)

I also use many other things for inflammation/pain as well.  I’ve found that all of these things have some benefit.

Good News For Pain Patients & Their Physicians From the U.S. Supreme Court

https://www.paintreatmentdirectory.com/posts/good-news-for-pain-patients-and-their-physicians-from-the-u-s-supreme-court

Good News for Pain Patients and Their Physicians from the U.S. Supreme Court

Good News for Pain Patients and Their Physicians from the U.S. Supreme Court

7/4/22

In a rare unanimous decision, the U.S. Supreme Court recently held that a physician who writes opioid prescriptions for their pain patients is not committing a criminal act. This will hopefully put an end to physicians refusing to treat pain patients due to fear of criminal prosecution.

History of Prosecution of Physicians for Opioid Prescribing

For over two decades the U.S. Drug Enforcement Agency (DEA) has been selectively raiding the offices of physicians who were writing prescriptions for high doses of opioids, seizing their records and assets, and charging them as drug dealers under the Controlled Substances Act (CSA). While a few of these doctors may have been operating pill mills, writing prescriptions or directly selling opioids to recreational users or drug addicts, most were engaging in the legitimate practice of medicine. They were prescribing opioids to help their pain patients manage their pain.

These targeted physicians lost their licenses, life savings and livelihoods, and many ended up in prison, some for terms of 20 years or longer. This has had a chilling effect on other physicians, many of whom abruptly discontinued or abruptly tapered their opioid-dependent patients off their opioids or abandoned them altogether. The practice became much more common after the CDC published opioid prescribing guidelines in 2016 with recommended dosage and duration limits.

This abrupt reduction in opioid prescriptions caused great suffering for pain patients, throwing them into horrific withdrawal and left them with no way to manage their pain. These patients were shunned by other doctors who were afraid to take them on. Some patients committed suicide; others turned to more dangerous street drugs. The rest suffered more and had reduced functionality and quality of life.

The Supreme Court Decision on Prosecution of Opioid-Prescribing Physicians

A unanimous decision of the U.S. Supreme Court issued on June 27, 2022, in the combined cases of Ruan v United States and Kahn v United States may finally put an end to these egregious practices. The Supreme Court held:

“the Government must prove beyond a reasonable doubt that the defendant knowingly or intentionally acted in an unauthorized manner.

Previously the standard of proof being used was a preponderance of evidence, a lower bar that the justices found unsuitable given the harsh sentences that were possible under the CSA. Also, previously the defense that doctors were acting in good faith to help their pain patients as authorized by their licenses was not accepted by the lower courts.

This is not a “get out of jail free card” for Ruan or Kahn. Their cases are being referred back to the lower courts for review or retrial under the new standards. The same holds true for any other physicians currently serving time for similar charges. It remains to be seen at what point other physicians will feel reassured and feel safe to prescribe opioids again.

One Prosecuted Physician Who Has Been Documenting the Abuses

I recently spoke with Linda Cheek, a retired family practice physician who operates a website, www.doctorsofcourage.org, that tracks cases of physicians charged with opioid drug crimes. Her website currently lists over 1800 physicians who’ve been targeted and the outcomes of their cases. Dr. Cheek was herself charged under the CSA and spent 26 months in prison as a result.

At the time Dr. Cheek was arrested, she was in solo practice as a family practice physician in Virginia. She practiced integrative medicine, combining alternative treatments, including homeopathy and prolotherapy, to treat the root causes of her patients’ pain. She was prescribing opioids as needed until her patients’ pain levels decreased and she could safely taper them off their medication. (As an aside, I first met Dr. Cheek at an integrative pain management conference.)

Dr. Cheek reported that one day 20 law enforcement agents unexpectedly raided her office on the pretext of Medicare/Medicaid fraud and later charged her with drug crimes under the Controlled Substances Act. This is a common tactic, reports Cheek, as almost anyone can be found on a technicality to have committed Medicare/Medicaid fraud. Although Dr. Cheek has completed her prison sentence, her license to practice medicine is still revoked.

According to Dr. Cheek, doctors, particularly minority doctors, who practice alone, have been the primary targets of these arrests. This is because these doctors do not have large institutions to back them up as physicians do who practice in hospital or other large healthcare settings.

What Happens Next

It remains to be seen what will happen to Ruan and Kahn when their cases go back to the lower courts and what will happen with other doctors who have been prosecuted under the CSA. It will most likely take a while for physicians who treat pain to be reassured that they are no longer at legal risk for using tools they are authorized to use to help their patients, but this Supreme Court decision is at least one step in the right direction.

The Bottom Line

As long-time readers of my blog know, I am not a fan of opioids for pain relief. I believe there are safer and more effective options. However, most physicians are not educated in alternative treatments for pain and those that are find that most of their patients cannot afford to access alternatives due to lack of insurance coverage. Criminalization of opioid prescribing for pain has resulted in significant harm to patients and their physicians and the sooner this stops the better. Patients and their doctors need education about and affordable access to alternative care and the ability to voluntarily taper if and when other methods relieve or eliminate their pain.

Find an Alternative Pain Treatment Provider

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The author, Cindy Perlin, is a Licensed Clinical Social Worker, certified biofeedback practitioner and chronic pain survivor. She is the founder and CEO and the author of The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free. She’s located in the Albany, NY area, where she has been helping people improve their health and emotional well-being for over 28 years. See her provider profile HERE. She is available for both in-office and virtual consultations. 

Non-Funded Study Shows LDN is a Broad-Spectrum Analgesic

https://www.futuremedicine.com/doi/10.2217/pmt-2021-0122

Low-dose naltrexone, an opioid-receptor antagonist, is a broad-spectrum analgesic: a retrospective cohort study

Samuel J Martin, Heath B McAnally, Paul Okediji and Moshe Rogosnitzky

Published Online:https://doi.org/10.2217/pmt-2021-0122

Aim: To evaluate the use of low-dose naltrexone (LDN) as a broad-spectrum analgesic. Methods: Retrospective cohort study from a single pain management practice using data from 2014 to 2020. Thirty-six patients using LDN for ≥2 months were matched to 42 controls. Pain scores were assessed at initial visit and at most recent/final documented visit using a 10-point scale. Results: Cases reported significantly greater pain reduction (-37.8%) than controls (-4.3%; p < 0.001). Whole sample multivariate modeling predicts 33% pain reduction with LDN, with number needed to treat (for 50% pain reduction) of 3.2. Patients with neuropathic pain appeared to benefit even more than those with ‘nociceptive’/inflammatory pain. Conclusion: LDN is effective in a variety of chronic pain states, likely mediated by TLR-4 antagonism.

Plain language summary

Naltrexone has historically been used to treat various substance use disorders, but recent discoveries have sparked interest in using low-dose naltrexone (LDN) to manage chronic pain. This study compared pain levels reported by patients before and after at least 2 months of LDN treatment to those reported by patients with the same painful diseases, who did not take LDN. Overall, patients who took LDN reported significantly more pain relief than patients who did not take LDN. How LDN alleviates pain seems complex, but apparently involves an anti-inflammatory effect on cells in the brain and spinal cord. LDN is extraordinarily safe, with no known risks (unlike most standard pain medications), and should be studied more in the treatment of chronic pain.

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**Comment**

And this has been our personal findings as well.

I wish more offices did this internal research.  The data is all there begging to be collected, organized, and published.  This is a perfect example of how we can get answers without  corrupt, conflict riddled research institutions, government, and government collecting (bought out) researchers.

For more on this:  https://madisonarealymesupportgroup.com/2022/06/29/the-urgent-need-to-break-the-public-health-monopoly/

For more on LDN: