Dr. Chad Kollas has spent more than two decades challenging myths and misinformation about opioids in pain care. In this episode, he joins us to break down the FDA’s latest opioid label changes, explain why they matter for patients, and share his perspective as a palliative care physician who has been on the frontlines of this debate since the early 2000s.

We talk about:

• The significance of the FDA's new opioid label

• The ethical failures of randomized controlled trials (RCTs) in pain patients

• How propaganda has shaped the narrative around opioids

• What patients and providers need to know moving forward

If you’ve ever wondered how we got here and what hope there is for change you won’t want to miss this conversation.

Dr. Chad Kollas' study: https://pmc.ncbi.nlm.nih.gov/articles/PMC10790545/

🎧 Listen now and share to help us keep exposing the system and supporting the people in it.

Find us on Patreon.com/thedoctorpatientforum

The information in this podcast is not to be considered medical or legal advice

🎙️ Episode 56

Scored. Flagged. Medically Abandoned. Forgotten.
Unveiling NarxCare: The Hidden Scoring System in Your Medical Records

This is a rerelease of a 2022 podcast episode featuring attorney Jennifer D. Oliva.

In this powerful conversation, Bev Schechtman and Claudia Merandi of The Doctor Patient Forum sit down with Professor Oliva to expose the implications of NarxCare and Prescription Drug Monitoring Programs (PDMPs) on patient care — particularly for those living with chronic pain.

They explore the secretive nature of risk-scoring algorithms, the lack of transparency in PDMP data, and the systemic discrimination embedded in these tools — especially for marginalized and disabled populations. Together, they make the case for regulatory oversight, algorithmic accountability, and why advocacy is essential to protect patient rights and restore ethical care.

• NarxCare is a secret risk-scoring algorithm embedded in electronic health records.

• Most patients cannot access or correct their PDMP data.

• These scores disproportionately flag patients with complex conditions as “high risk.”

• Errors in PDMP data can result in abrupt care abandonment and harm.

• Providers face pressure to under-prescribe due to fear of red flags.

• The opioid crisis has redefined pain care around liability, not compassion.

• There is little to no regulatory oversight of NarxCare or PDMP systems.

• Legislative action and public advocacy are urgently needed to protect patient safety and autonomy.

Professor Oliva’s research and teaching interests include health law and policy, privacy law, evidence, torts, and complex litigation. She has served as a peer reviewer for the American Journal of Public Health, Yale Journal of Health Policy, Law, and Ethics, American Journal of Law & Medicine, Journal of Law and the Biosciences, and Big Data & Society.

Her scholarship has been published by or is forthcoming in the Virginia Law Review, California Law Review, Duke Law Journal, Northwestern University Law Review, UCLA Law Review, North Carolina Law Review, Ohio State Law Journal, and online companions to the University of Chicago Law Review and New York University Law Review.

She lives in Bloomington, Indiana.

The Doctor Patient Forum has joined advocates nationwide in filing a citizen petition demanding that the FDA regulate NarxCare and all clinical algorithm software that scores patients.

🛑 This affects patients with pain, addiction, and complex conditions.
🗣️ Your voice matters. Help us hold the system accountable.

👉 Submit your public comment today:
🔗 https://www.regulations.gov/document/FDA-2025-P-0701-0001
📅 Deadline to comment: May 10, 2025

Clips taken from:

1. NPR 1A – “Against the Pain: The Opioid Crisis and Medication Access”
   https://the1a.org/segments/against-the-pain-the-opioid-crisis-and-medication-access/

2. Cato Institute – “Patients, Privacy, and PDMPs” (Dr. Jeffrey Singer & Kate Nicholson)
   https://www.youtube.com/watch?v=YXVXShMASJ4&t=4357s

3. Duke Margolis – “Strategies for Promoting the Safe Use of Prescription Opioids”
   https://www.youtube.com/watch?v=AFUkAi8Coyw

4. NPR – “To End Addiction Epidemic” (Kolodny quote)
   https://www.npr.org/2014/05/09/311119395/to-end-addiction-epidemic-states-focus-on-stopping-doctor-shoppers

5. Cover 2 Resources – Gary Mendell (Podcast)
   https://open.spotify.com/episode/33OosEC2hutlE9y6Cogmne

6. Jennifer Oliva’s Paper – “Dosing Discrimination: Regulating PDMP Risk Scores”
   https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3768774

Find DPF at thedoctorpatientforum.com

patreon.com/thedoctorpatientforum

[email protected]

Dr. David Alfery's Bio

Dr. David Alfery was raised in the North but moved to Louisiana to attend Tulane University where he graduated with a BA degree in English.  He then attended LSU Medical School in New Orleans.  After graduating, he took the Louisiana State Medical Licensing Exam where he received the highest grade out of approximately 400 new doctors from the three medical schools in the state.  He spent a year as a surgical intern at the University of Kentucky in Lexington, Kentucky and then did his residency in anesthesia at the University of California in San Diego.  He stayed on there for an additional year of fellowship training in cardiothoracic anesthesia.

In 1980 he moved to Nashville, Tennessee where he spent a thirty-six-year career in private practice.  He has served as a Chief of Anesthesia, President of the Tennessee State Society of Anesthesiologists, and was a founding member of Anesthesia Medical Group, one of the largest anesthesia practices in the United States.  For twenty years he served as an Oral Examiner for the American Board of Anesthesiology, ending his tenure as a Senior Examiner.  While in practice, he held an academic appointment at Vanderbilt University Medical Center as Adjunct Associate Professor of Anesthesiology.  In addition, he participated in numerous medical missions with Operation Smile.  Following his retirement from work in the Operating Room, he co-founded the AMG Ketamine and Wellness Center in Nashville.

Dr. Alfery has authored ten chapters in medical textbooks and 41 peer reviewed articles in anesthesia medical journals.  He has invented several anesthesia devices that are sold worldwide and for which he has been awarded 17 US and International patents. 

He has been married to his medical school sweetheart, Joyce, for over forty-five years, and together they have produced three daughters and five grandchildren.

Find Dr. Alfery at https://savinggracebook.com or on TikTok at @drdavidalfery 

The audio of this podcast was originally posted on 11/2/23. This is the video version. We are posting this again because one of the most common questions we get have to due with drug testing.

We often hear from pain patients who were dismissed from their doctor for failing their drug test. They say there is no way the test is right. Ed Brown gives some possible explanations.

Edward Brown's Bio:

Edward G. Brown is a chemistry expert with over twenty-five years of laboratory research experience, over 5 years of patent work experience and over twenty years of experience assisting attorneys in chemistry cases as chemistry expert and expert witness.  His technical

B.S. degree in chemistry from the University of California,

Dr. Brown has also worked in a number of biochemical and pharmaceutical companies during his career as a research chemist, staff scientist and senior research scientist; he currently provides clients with in-lab

He is a coauthor on over twenty chemistry articles and is a

His expertise as a medicinal chemistry expert in criminal

methamphetamine and amphetamine analysis, manufacture, possession and sale; fentanyl, opioid and opiate analysis, possession and sale; cocaine analysis, possession and sale; LSD analysis, possession and sale; MDMA and MDA analysis, manufacture, possession and sale; benzodiazepine analysis, possession and sale;

analysis, possession and sale of synthetic cannabinoids;

and in hemp, THC and marijuana cases.

Dr. Brown currently advises attorneys and other clients in

His webpage can be found at: ⁠www.ExpertChemistryServices.com⁠

The Doctor Patient Forum is a national non profit

⁠https://www.patreon.com/thedoctorpatientforum⁠

⁠https://www.thedoctorpatientforum.com/⁠

#thedoctorpatientforum 

The information contained in this podcast is not to be considered medical or legal advice

Dr. Joe Parker is our guest. Listen to what led to his prison sentence.

Dr. Parker's Bio

Dr. Joseph Parker’s career spans the fields of science, military service, and medical practice. He has used his rare blend of scientific expertise, military leadership, and medical acumen to contribute significantly to the advancement of science and the betterment of human health and safety. He writes as an advocate for physicians and patients and for the humane treatment of those suffering from addiction and the incarcerated. His journey towards this impactful role began with four years of dedicated service in the US Marine Corps, where he earned accolades such as the Meritorious Unit Citation and Good Conduct Medal. His exceptional service led to acceptance into the US Air Force Officer Training School and a subsequent role as a Minuteman II ICBM Commander within US Space Command, earning further recognition, including the Presidential Unit Citation, National Defense Service Medal, and the Air Force Achievement Medal. Transitioning into the medical field, Dr. Parker pursued studies at Mayo Medical School and joined the US Medical Corps, ultimately achieving the rank of Captain. Having personally suffered wrongful convictions gives him a unique perspective on the American justice and prison system, and he has dedicated himself to advocacy for the wrongfully prosecuted. He is currently serving as the Chief Science and Operations Officer at Advanced Research Concepts LLC, a pioneering company dedicated to biomedical research to alleviate pain and addiction, and to the development of innovative solutions for the complex challenges of space travel, including spacecraft propulsion systems, energy storage, radiation shielding, artificial gravity, and space-related medical issues.  He is also active in biomedical research, space science, and the study and treatment of addiction.

Episode 51

Stigma Part 3 - "The Goal is to Force Taper Every Single Pain Patient Down to Zero"

We show using clips the disparity between how experts teach doctors to treat pain patients and how they teach doctors to treat people w SUD.

⁠If you missed part 1, here it is⁠

If you missed part 2, here it is

We took clips from the following videos/podcasts:

We used clips from the following links:

1. https://youtu.be/JjGfimiRZmk?si=CnrIAflx07hjwVV2 - Alyson Smith

2. https://youtu.be/_Gkw9l0ykd0?si=SLgfKIRUA1sUGfAi - MOC Stigma OUD

3. https://youtu.be/1Tra4IfdKgY?si=RN8cS7AGbopfngEO - Formulation of Bupe

4. https://www.youtube.com/live/QxtA1fWuHtk?si=L0GkKSkjfaLlhUrL - Arkansas Pain Committee

5. https://youtu.be/haf0uo4oYfE?si=hPTfhLSprPEvfPSO - Colorado Abatement Panel

6. https://youtu.be/hmrptecd98Y?si=NJDQ3ggdC4sM3A4v - AMDG Panel

7. https://youtu.be/cepCYjCx8fs?si=nqarmmXmK4C__1v- - Stages of Change

8. https://youtu.be/s5Dj1m_YrMU?si=O3MGoUemT2yTlrML - ASTHO 3

9. https://youtu.be/a208G9OzZFk?si=4dfzFEmu4jxMRZQt - Hotshot Panel OPG

10. https://youtu.be/_Wg1jTTi4pQ?si=zqROd6LITZTPnJ9p - Addiction Med Journal

11. https://youtu.be/wclGvrpQQy4?si=zRNO0kjFnsOxJ14S - IPRO 1

12. https://youtu.be/U_cMr3kK5ZY?si=ltM45_mFwe9qU4my - Difficult Conversations - Oregon Tapering Conference

The Doctor Patient Forum is a national nonprofit organization fighting for the rights of pain patients and their providers. We bring awareness to the untreated pain and patient abandonment crisis. We are also knows as Don’t Punish Pain Rally.

⁠https://www.patreon.com/thedoctorpatientforum⁠

⁠https://www.thedoctorpatientforum.com/⁠

The information in this podcast is not to be considered legal or medical advice.

Episode 50

We interview Kara Cook about her study about the Controlled Substance Act and unintended harms. Kara's brother-in-law, Darren, tragically lost his life at 40 years old due to lack of access to opioids.

The Doctor Patient Forum is a national nonprofit organization fighting for the rights of pain patients and their providers. We bring awareness to the untreated pain and patient abandonment crisis. We are also knows as Don’t Punish Pain Rally.

⁠https://www.patreon.com/thedoctorpatientforum⁠

⁠https://www.thedoctorpatientforum.com/⁠

The information in this podcast is not to be considered legal or medical advice.

This is Part 2 of our stigma series. "Pain Patients Are Lying Manipulative Malingerers Who Need a Priest, Not a Doctor."

We show an addiction doctor discussing stigma in SUD patients, and compare what's happening to pain patients.

If you missed part 1, here it is:

We took clips from the following videos/podcasts:

1. May Arkansas Pain Community

2. MOC SUD Stigma

3. CDC Guidelines - Dr. Paul Coelho

4. Curbsiders Podcast - Dr. Daniel Clauw

5. AMDG Panel

6. Shatterproof and Pacira Lobbyist

7. Frank Sweeny -Anna Lembke

8. Anna Lembke Presentation Slides

9. AAED - Don Stader

The Doctor Patient Forum is a national nonprofit organization fighting for the rights of pain patients and their providers. We bring awareness to the untreated pain and patient abandonment crisis. We are also knows as Don’t Punish Pain Rally.

https://www.patreon.com/thedoctorpatientforum

https://www.thedoctorpatientforum.com/

The information in this podcast is not to be considered legal or medical advice.

Bev talks to Beth Steckler about the large amounts of patients who are newly abandoned in North Dakota.

A clinic's prescriber lost her ability to prescribe due to the Feds. This is a huge crisis happening nationwide.

Here is our previous podcast with Beth.

If you're a patient and lost your prescriber, here are some steps to take.

The Doctor Patient Forum is a national nonprofit

https://www.patreon.com/thedoctorpatientforum

https://www.thedoctorpatientforum.com/

#thedoctorpatientforum 

Disclaimer: The information in this podcast should not be considered medical of legal advice