Newest from Dr. Forest Tennant and FIPR: March to 90!

1-March to 90-  New Protocol from Dr.Tennant to Reduce your Opioid Dose

2.-Essential on Your March to 90-Troches- TERRIFIC TROCHES

3.-Research Sources on Natural Pain Relievers- Research Studies

4.-Biggest Barrier to Reduction to 90-  Long-Acting Opioids

5.-Centralized Pain and Neuroinflammation-  Centralized Pain

6. Morning Program -Start your Day Right for Less Pain Morning Program

7. Baseline Pain- How to Deal with Baseline Pain

8. Three Kinds of Pain- Baseline, Descending, and Flares

9. Natural and OTC Pain Relief- Natural-and-OTC-Pain-Relief

10. Step Down Protocol and Self-Treatment of Opioid Withdrawal Symptoms:  Self-Help for Withdrawal and Opioid Dose Reduction 

Check back for more updates!

Urgent Letter Writing Campaign:

Emergency Proposal for Non-Standard Pain Care

We are asking for your help in a very important letter-writing campaign once again…this time, to ask our US Senators to support 2 specific actions we are requesting:
1)      To support the establishment through regulation or legislation of a Federal program that would allow interested qualified physicians to register and be certified to prescribe higher doses of opioids above the 90MME “suggested standard that has become a de-facto limit” for severe intractable pain patients for whom all other treatments have failed.  This program would authorize trained physicians to treat severe intractable pain as needed without restrictions on opioid dosing or duration of care, and without restrictions on non-oral routes of administration or the off-label use of non-opioid medications.
2)      To initiate or support an investigation by the Senate Judiciary Committee, in partnership with the Senate Health, Education, Labor, and Pensions (HELP) Committee, into the unintended consequences of the DoJ/DEA war on opioid drugs campaign and the use of their data analytics program to target physicians and pharmacies based solely on a 2-year snapshot of prescribing data with no contextual information about the physicians or the patients they treat.

The details of our proposed “Federal Certification and Registration Program for Physicians to Provide Non-Standard Pain Care” are provided in a 4-page Position Paper and Program Concept document in the link below.  Please read the 4-page document provided below carefully.  The first 2 pages, Position Paper, provide the problem as we see it, the background, and our rationale for proposing a program to help intractable pain patients get the treatment they need.  Pages 3-4 provide a sample concept of how this program could be implemented. Also sample letters to senators and various senate committees to write to are provided!! Kristen Ogden and Ingrid Hollis have been working closely with Dr. Tennant to develop the Position Paper and Program Concept.

In order to get more attention and support for the proposal, it is critical that we also push it out and sell it to Senators involved in healthcare issues and policy.  That is why it is so important that we all join in this letter-writing effort to bring attention to the specific situation that all of us, patients of Dr. Tennant and family members, and others across the nation,  are facing at this time and that we do our very best to send as many letters as we can.  We are asking the government to acknowledge the problems that the war against legally prescribed opioid medications has caused for us, and our family members and to take specific action to HELP US!!

FIPR Position Paper and Proposal to Establish a Certification and Registration Program for Physicians to Provide Non-Standard Pain Care Including Opioid Analgesia


Sample letters to US Senators and Members of the Senate Judiciary,  HELP, and Finance Committees

Congressional-Directory-115th-Updated 2018-04-23 -Excel


1. Don’t send letters by postal service mail to the Senators at their Washington D.C. addresses.  All mail sent to Senators in D.C. is diverted to a special post office to be screened for toxic substances, etc, and it takes about 4 weeks for a piece of mail to get through this process.  If you want to mail a copy, send it to the Senator at their address in the capital city of their home state.  You can find this info on any Senators’ website.
2. The 2 quickest and most effective ways to send the letter and attachment are to fax them and to use email to send them to a Senator’s healthcare staffer in Washington D.C.
3. The 3rd way to send your letter is by submitting to our Senators’ email portals on their websites.  You can write your letter off-line, using the sample, and then copy and paste the words into the email form on the websites.  This is a quick way to send the letter but, most of these portals have character limits and don’t allow attachments, so you can probably only send the letter this way, not the detailed attachment.
1.Call the Senators’ offices in D.C. and leave a message stating what you are asking for.
2.Call the Senators’ offices in D.C. and ask to speak to their healthcare aid. Tell that person what we are asking for.
3.Try to make an appointment to meet in person with your home state Senators’ staffers at one of their offices in your home state.
Stay tuned for more action steps in the coming days and weeks for more ways you can help.  We will be sending out more suggestions and more sample letters to bring attention to other aspects of the problems for intractable pain patients.


Gababout Health!!  New web-Blog


Newsweek Article-Pain Patients-Genetics- One Size Doesn’t Fit All!

Dr.Tennant Announces his Retirement

Families for Intractable Pain Relief Co-Founder Kristen Ogden presented at the latest FDA Hearing Jan.30, 2018!

New! Here’s the video of Kristen’s presentation on behalf of FIRP to FDA Jan. 30, 2018:
View Slide Presentation-link here:

Final – Families for Intractable Pain Relief 1-30-18 Policies for Opioid Prescribing Intervention-5

Veract Intractable Pain and Palliative Care Clinic mission, goals, and operations and new protocol for medication reduction-links:

VIPC Mission Goals and Operations

VIPC Opioid reduction program 2-28-18

Dr.Tennant’s Latest Statement on Treating Intractable Pain:

By Forest Tennant M.D., Dr. P.H.

January – 2018

The current attempts by a number of parties to castigate and humiliate pain patients and their medical practitioners is not just pathetic and mostly false, it is dangerous to the fate and life of many IP patients. If it wasn’t so serious, some of the claims, biases and beliefs would make good comedy.

First and foremost there has been no discussion about the difference between intractable pain and chronic pain. There really is no bigger issue. The proper identification and treatment of the IP patient is not only essential for the health and well-being of the IP patient, it is a major key to the prevention of overdoses and diversion of abusable drugs. IP patients must have special care and monitoring.

The basic definition of IP is a “moderate to severe, constant pain that has no known cure and requires daily medical treatment”. Chronic pain, on the other hand is a “mild to moderate, intermittent, recurring pain that does not require daily medical treatment”. While there are millions of persons with chronic pain, only about 10% are intractable.

The cause of “intractability” is two-fold: (1) the initial injury or disease which initiated IP was severe enough to cause a pathologic transformation of the microglial cells in the spinal cord and/or brain. It is this transformation that produces neuroinflammation and the constancy of the pain. This process is known as “centralization” or “central sensitivity”; (2) to have enough injury to cause “centralization” one must have a most serious disease or condition of which the most common are: adhesive arachnoiditis, traumatic brain injury, reflex sympathetic dystrophy, post-viral encephalopathy, or a genetic disease such as Ehlers-Danlos Syndrome, porphyria, or sickle cell disease.

Medical practitioners must have minimally-restricted prescribing authority and autonomy to adequately treat IP. For example, the proper treatment of IP not only requires analgesics, opioids and non-opioid, but specific anti-inflammatory, hormonal, and corticosteroid agents that will cross the blood brain barrier and control inflamed and pathologic microglial cells. Treatment of IP has to be individually tailored and may require non-standard, off-label, or an unusual treatment regimen.

Make no mistake about it. The new treatment approach to IP is quite effective in reducing pain, controlling neuroinflammation, and allowing patients to biologically function well enough to have a good quality of life. Also be advised that the new IP approach is not just reducing pain but treating the underlying cause of pain. Consequently, a lot of expensive procedures, therapies, and opioids are no longer needed. As long as I am practicing I will continue to push forward this new approach.



  1. Any overdoses?
  2. Any malpractice suits?
  3. Too many patients?
  4. Makes too much money?
  5. Trades sex and money for drugs?
  6. No physical exams?
  7. No records kept?
  8. No justification for high dosages?
  9. No diagnoses?
  10. No consents given?
  11. Unprofessional hours, unsanitary clinic?
  12. California and CDC guidelines not followed?
  13. Anyone harmed or rendered non-functional?
  14. Drug diversion occurring?
  15. Medical Board has taken disciplinary action?

The answer to all of the above:  No.  No beef so far.  But what about…

  1. Non-standard treatment regimens used? Yes, after all standard treatments have failed.
  2. High doses of opioids prescribed? Yes, if required to effectively manage a patient’s pain.
  3. Patients crossed a state line? Yes, if they can’t get pain care in the state where they live.

So what?  Still no beef.

  1. Treating too many patients suffering from failed surgery, epidurals, and medical mismanagement?
  2. Providing comfort to patients who have only a few months to live?

Yes, sad but true.

Here’s the real “meat” of Dr. Tennant’s intractable pain practice:  providing compassionate care to patients for whom all standard treatments have failed. There are rare, extremely ill persons treated in the clinic and many near the end of life.  We have examined the California and CDC Guidelines and do not see any deficiencies or non-compliance issues.  Dr. Tennant is hardly a “pill mill” and only about 150 patients are enrolled in the clinic.  His nonprofit charitable organization, The Tennant Foundation, helps subsidize the clinic.  What is the “complaint” or “beef” about the clinic?  We sincerely want to know.  At least some patients will die within weeks if the clinic is not available.



Freedom from pain, to the extent achievable, is the most fundamental of all human rights.


Please help Dr.Tennant and his patients–write your legislators and the DEA DOJ and let them know what you think!

Write your Congressperson-Representative Finder by State

Write your Senator-Find Your Senator by State

Thank you for all the letters of support..feel free to copy the 20 Beefs and any other articles about the over-reach of the DEA /DOJ on innocent doctors and patients. Lives hang in the balance.

Dr. Tennant’s Patients live in Fear of the DEA

DEA Tactics Questioned in Raid on Tennant

The Feds Can’t Tell Pill-Pushers from Honest Doctors! 

Dr. Forest Tennant: An Industrious Career Forged in Good Faith

Dr. Tennant Legal Defense Fund


Written by: Ryle Holder PharmD,  Dr. Scott Guess PharmD, and Dr. Forest Tennant M.D., Dr. P.H.

1. Above 100 mg of morphine equivalence opioids are ineffective. NONSENSE! They have no ceiling in most patients and may remain effective at dosages in the thousands.

2. All pain patients who take over 100 mg of morphine equivalence are diverting or selling part of their prescription allotment. NONSENSE! Most patients who have a bad enough pain problem to need this much opioid don’t usually want to part with it.

3. All patients who use the “holy trinity” of an opioid, benzodiazepine, and muscle relaxant are either selling their drugs or will shortly overdose. NONSENSE! The original “holy trinity” was a simultaneous ingestion of the combination of the short-acting drugs hydrocodone (Norco®), alprazolam (Xanax®), and carisoprodol (Soma®). A different, (e.g. long-acting drug from either of the 3 classes (opioid, benzodiazepine, muscle-relaxant) markedly lowers the risk. So does taking the drugs separately. Many severe, centralized pain patients have to take a drug from the 3 classes and do it safely and effectively. In other words, they take the drugs “as prescribed”. Additionally the “Holy Trinity”, originally called the “Houston Cocktail”, is a term coined by law enforcement; addicts tend to use mono-syllabic terms to refer to their poison of choice, “Holy Trinity” is too many syllables.

4. Centralized, intractable pain doesn’t exist. NONSENSE! Much research documents that pain from an injury or disease may cause glial cell activation and neuroinflammation which may destroy brain and spinal cord tissue. Multiple, high dose drugs may be needed to prevent tissue damage and control the immense pain that this condition may produce. As inflammation develops the overall stress on all organ systems increased dramatically and occasionally to a life-threatening level.

5. The risk of an opioid dosage over 100 mg of morphine equivalence is too great to prescribe opioids above this level. NONSENSE! If a severe, chronic pain patient can’t find control with opioid dosages below 100 mg or with other measures, the benefit of the high dose far outweighs the risks.

6. Overdoses occur even if opioids and other drugs are taken as prescribed. NONSENSE! If this even happens it is extremely rare. Overdose victims often take alcohol, marijuana, and other drugs in combination; but, opioids and the prescribing doctors are always blamed.

7. There are no “proven” benefits to long-term opioid therapy. NONSENSE! Simply talk to someone who has taken them for 10-20 years. Never has there been nor will there ever be a double-blind, placebo-controlled study to provide “evidence”. Opioids are a last resort when all else fails. Opioids in doses >100 mg have improved quality of life and prevented death in some instances.

8. Chronic, severe or intractable pain is just a nuisance that doesn’t warrant the risk of opioids. NONSENSE! Severe pain has profound detrimental effects on the cardiovascular, immune, endocrine (hormone) and neurologic systems. Pain must be controlled or pain patients may die of stroke, heart attack, adrenal failure, or infections due to a suppressed immune system.

9. Genetics has no effect on the need for a high opioid dosage. NONSENSE! Bigger and heavier people need a higher dose of medications (just add 1 drop of food coloring to a 1 gallon and 5 gallon bucket and observe). It is well documented that some genetic variations impede opioid metabolism to the active form of the drug, or increase the speed the body excretes the opioid. Both metabolic variations will require a higher dosage.

10. All pain patients can get by on standard opioid dosages under 100 mg. NONSENSE! There are persons who are outliers with all disease conditions such as heart failure, diabetes, and asthma. Same with pain. A few unfortunate individuals will always require high dosages. Remember our friend the bell curve? What if YOU were on the extreme end?

11. All patients started on opioids some time ago can just suddenly stop opioids. NONSENSE! Once a person is on high dose opioids they don’t dare suddenly stop because sudden withdrawal may cause hypertension, tachycardia, adrenal failure, and sudden heart stoppage. Some patients who have stopped too suddenly have committed suicide because they had no way to control pain. Montana reports that 38% of all suicides in the state are UNDER treated pain patients.

12. There are plenty of alternatives to opioids. NONSENSE! Common pain problems are generally mild to moderate and respond to a variety of non-opioid treatments. Unfortunately, there are some severe, intractable pain patients who can only control their pain with opioids.

Pain New Network- 12 Myths Article with Comments 

Great article below from NY Post written by Jacob Sullum about Dr. Tennant’s current situation and the great work he does taking care of rare patients. Please share far and wide, and include it when you write your Senators, Congressmen, etc. Share with everyone! This has to stop, patients are suffering! Thank you Jacob Sullum!

The Feds Can’t Tell Pill-Pushers from Honest Doctors! 

Dr. Lynn Webster comes out in support of his friend and colleague- Dr. Tennant- Thank you Dr. Webster! -Author of The Painful Truth.

DEA Raids the Office of my Friend and Colleague Dr. Forest Tennant 

Thank you Maia Szalavitz! – Author of The Unbroken Brain

DEA Raided This Doctor’s Office for Prescribing High Doses of Painkillers

Dr. Fudin and Dr. Terri Lewis speak out #DropTheTennantCase!

Thank you Dr. Fudin and Dr. Terri Lewis!

Forest is One Tree that will not Fall Without Being Heard


Moral Entrepreneurs Breed Righteous Indignation: The Case of DEA vs Tennant

Great Recent Articles from Pain News Network, Thank you Pat Anson and Pain News Network!

Are My Good Years Over?

The Death of Pain Management

DEA Raids Forest Tennants Pain Clinic

FED Assault on Pain Patients Continues 

I Would Not Be Alive Without Dr. Tennant

Tennant Patients Say DEA Attacked a Good Man

DEA Tactics Questioned in Raid on Tennant

Reporter George Knapp from Channel 8 in Las Vegas has done an excellent job telling the other side of the “Opioid Crisis” -how it is affecting those with disabling pain, in the #ourpain series. Thank you George Knapp and Channel 8 I-Team!

Pain Doctor Who Defends Opioids Under Investigation 

#OURPAIN Watch the entire series-patients, doctors, and  pharmacists tell their stories 

Reason TV did a riveting interview of Dr. Tennant and his patients in July and an update on the raid of Dr. Tennant’s office. Thank you Zach Weissmueller!

Meet the Doctor Who Refuses to Stop Prescribing Opioids to Pain Patients

 DEA Raids California Pain Featured in a Reason TV Video


Stay tuned for more…

Families for Intractable Pain- FIPR- stands in support for the humane treatment of those with rare diseases and injuries that cause intractable pain.

We challenge policies that have been created that don’t include our loved ones or family member’s complex medical needs, and strive that they be included in all policies going forward. 

We speak out against inhumane treatment and policies that may lead to inhumane treatment of those in pain. We will hold responsible all who work to destroy ethical and humanitarian care, and agree with the United Nation’s stance that lack of pain treatment is cruel, inhumane, and tantamount to torture.

We want to spare other families and patients the hardship and stress we have experienced when trying to find meaningful pain care. Timely care is essential.

We have created a knowledge base that enlightens and dispels the myths and bias against pain, pain-care and especially those who are in need of treatments for their painful conditions. There are many misconceptions around timely and meaningful pain care. Those who suffer from complex and rare disorders that cause Intractable Pain and their families can no longer be ignored. Lives are at stake.

We demand further, ongoing research, and remain hopeful for cures for Intractable Pain. 

Our greatest hope is that all with pain be treated with respect and humanely, and no patient will be left to suffer in pain. Ever.

DISCLAIMER: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. We do not recommend the self-management of health problems. We cannot and do not give you medical advice. The information in this website should not be considered complete. Information obtained on this website is not exhaustive and does not cover all diseases, ailments, physical conditions or their treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.  If you think you may have a medical emergency, call your doctor or 911 immediately. FIPR- Families for Intractable Pain Relief does not represent to be an authority, please contact your physician. We share information from other organizations, advocates and or websites.