Thursday, October 19, 2017

In Honor Of Natalie Wood



This is a new fragrance collection in honor of Natalie Wood. (I haven't tried this yet but, I am anxious to!)

Click here to try this new fragrance and don't forget to use code: 10OFFNF for 10%!

I would love to know what you think!

Thursday, September 28, 2017

SnackPals Giveaway

SackPals Giveaway

Hosted By
~ 1 Winner~
Open to US
9/28 12am ~ 10/12 11:59pm

~Prize~
SackPals Starter Kit
RV $39.95

Check out our review for the SackPals Starter Kit.


Check out our giveaway host and see what other events we have coming up.

Find Amy & Aron's Real Life Reviews on 
Facebook, InstagramPinterest, Youtube, and Twitter

Thank you to all of the bloggers promoting this giveaway! I appreciate all of you for your hard work and helping our readers get really awesome prizes!

Now for the fun stuff. This giveaway is open to US. There are daily bonus entries so please check back tomorrow. Share it with your family and friends, they'll want to enter to win too!!

I can't ask you to "Like" our pages but, if you see something you like, let us know so we can bring you more of it.
We LOVE it when you "LIKE" our pages.

a Rafflecopter giveaway

If you have any questions about this giveaway,  reviews, or any of our other giveaways, please feel free to email us directly at grovesamy81@gmail.com or amy@aarlreviews.com

Sunday, September 17, 2017

Cujo Smart Firewall At Best Buy

** The reviewer has been compensated in the form of a Best Buy Gift Card and/or received the product/service at a reduced price or for free. ** 




One of my most favorite back to school items for the 2017-2018 school year is Cujo Smart Firewall. Sure, it may not be a lunchbox item or a new pair of sneakers or lead pencils but, it is a definite must-have for any family who uses the internet. (Cujo is also great for businesses and anyone who is connected!) 

This one device will secure all devices connected to your WiFi router. Cujo detects and blocks malicious sites, viruses, and hacks. Cujo and his cute, smiling face is like an antivirus for your entire network! But, there are so many other advantages to having Cujo around! 


Cujo's Main Features


Cujo will guard every device that is connected to your network, bring you business level security, connect directly to your router, has a super handy and very easy app to control, has parental controls, and is built with 1GB ethernet so it is blazing fast! 

My favorite main feature is how easy it is to set up. All you need to do is plug Cujo in, connect to your modem and your router if needed and install an app. This process takes just a few minutes and everything you need to know is right on your phone. After everything is plugged in, Cujo does all of the work for you! (I waited maybe 2 whole minutes for the app to sync with Cujo and he started learning immediately! 

One cool thing to note is that Cujo comes all bundled up in a package that is easy to open, instructions that are easy to understand, has a website to visit to start the process and has a window sticker to let everybody know your house and every device in it is protected by Cujo. 



Parental Controls 


One of the most impressive benefits to having Cujo around is the fact that I can control and monitor what each device that is connected to my network, is doing. Each of our children uses tablets, 1 has a phone, we have laptops, game consoles, and a desktop. There are limits to screen time and depending on the circumstances, screen time must be earned. (Especially during the school year!) We do respect our children's privacy however, we do what we can to monitor what they can access online. Cujo makes this so much easier and I feel much safer knowing that I will get alerts on my phone if one of them clicked on something that is malicious. 


You can create profiles for everybody in your home directly through the Cujo app. You can even choose your color and avatar! Once Cujo has been connected, he starts learning and finding devices. This could take a few hours up to 48 hours. Once Cujo notices the devices, you can assign them to a profile. From here, you can set restrictions if needed and you can monitor activity. 


You can also filter the different types of websites each profile can access! This is great for families with children of different ages! 



If you offer screen time or game time as a reward or if you allow game time only after homework and chores are done, you could filter gaming specifically and then remove the block after chores are done. 




Cujo will start keeping track of threats and alerting you every time anything happens. The above screenshot was taken shortly after connecting Cujo however, a few hours later and a few devices later, we did receive 1 threat. The alert will actually show you which device and what time the threat was detected. 

I am really loving the parenting control features! I think it is important to set time limits for children (and adults!) and I can do this all remotely. I am also grateful for the filter options and the alerts I receive if my 14-year-old decides to get online to start playing games before finishing homework and chores. (Yes, this happens sometimes!) 

If your children use any social media networks, Cujo will help you monitor that as well. You really don't have to be super duper tech savvy to use Cujo or the app. It is easy enough for everyone! 









Friday, September 15, 2017

Red Copper Pans Giveaway

Red Copper Pans Giveaway


Hosted By
~ 3 Winners~
Open to US
9/15 12am ~ 9/30 11:59pm

~Prize~
1st Place- 5 Minute Chef
2nd Place- Brownie Bonanza
3rd Place- Flipwich

Check out our review for the Red Copper Pans.


Find Amy & Aron's Real Life Reviews on 
Facebook, InstagramPinterest, Youtube, and Twitter

Thank you to all of the bloggers promoting this giveaway! I appreciate all of you for your hard work and helping our readers get really awesome prizes!

Now for the fun stuff. This giveaway is open to US. There are daily bonus entries so please check back tomorrow. Share it with your family and friends, they'll want to enter to win too!!

I can't ask you to "Like" our pages but, if you see something you like, let us know so we can bring you more of it.
We LOVE it when you "LIKE" our pages.

a Rafflecopter giveaway

If you have any questions about this giveaway,  reviews, or any of our other giveaways, please feel free to email us directly at grovesamy81@gmail.com or amy@aarlreviews.com

Monday, September 11, 2017

Tips For Improving Your Blog's Content Marketing Strategy



I know there are a gazillion lists and pointers out there to help bloggers from all ends of the spectrum and some require you to download books or buy programs that you never seem to finish. If you're a blogger or are thinking of becoming a blogger, you're probably endlessly searching for tips and suggestions. I try to learn something new each day whether I'm actually researching or something ridiculous happens that ends up being a 10-hour learning experience!

I keep lots of notes and like to jot down pointers I come across while searching for help for digital marketing and how to earn a decent income with my blogs. So, I created this little list for you. Hopefully, some of my tips will resonate with you!

Quality or Quantity? 

I may not be an expert like Charles Lubbat, but, I have seen so many bloggers and social media influencers and content creators with hundreds of thousands or even millions of followers! Of course, there are some exceptional content creators out there who have a good, solid audience who actually interact with them. These are the types of bloggers I try to follow and even take notes on what they are doing and how. 

I've been blogging for a little over 7 years and while I haven't been 100% FT since the beginning, I have been the past couple of years since my disabilities progressed and I ended up having to switch to a stay at home/work at home mom. I have been watching the bigger bloggers even more closely now. Not so much to copy them, but to see how they interact with their readers and where they share their content. 

Over the years I've noticed that bloggers with a smaller following tend to engage more with their readers. They engage conversation and reply to their reader's comments regularly. (I have also seen bloggers who are far bigger than I am who will take the time out of their day to have conversations with their readers!). Often you will find them thanking other bloggers or their readers for sharing, retweeting, or leaving comments. As time-consuming as that would be, this is a very effective way to keep your readers coming back and attracting new readers. A personal note will be remembered! 

I've come to the conclusion that when you have 3 million followers but very rarely a Retweet or a share or even a "like", something is wrong. Whether it's a possibility that some of these followers were bought or they all came in through a group giveaway, it's likely that they aren't going to help your blog grow. Google is pretty slick and can start to notice if you purchased blog hits or even Google Adsense clicks. Not to mention, if this is the route you take, the possibility of being blacklisted gets closer each and every day. 

So, how do we obtain quality readers? Again, this is time-consuming but will end up paying off in the long run. Focusing on learning and understanding your audience is a big step in growing your blog. You can write and write and write but if it isn't relevant to your readers, they will stop coming back. I'm all for writing about anything and everything you're interested in but, you have to throw a post out there sometimes too. Your readers are counting on you to share recipes, how to do lists, DIY projects, movie reviews, whatever it is they are into. They are trusting you to bring them quality content. Share some memes on social media, USE HASHTAGS, check the trending lists each day and even throughout the day to see what people are interested in, and you could always ask them for ideas! 

At the end of the day, the fact remains that there are millions of bloggers out there and a vast amount of excellent influencers and it's getting harder to stand out in a crowd. You've probably heard, "You just gotta find your niche!" so many times by now but it's the truth. I like to also add that it's also very wise to be kind, considerate, thank your readers, thank fellow bloggers for sharing your posts and Tweets and figure out some way, somehow, somewhere where you stand out and use that! 

Prioritize Your Precious Time

While there are a lot of fabulous bloggers out there with a huge fan base, there are also some very brilliant, very creative bloggers with a lower follower count. Sometimes, I find a content creator with just 400 Twitter followers but they might have over 60,000 Instagram followers and over 100,000 Pinterest followers. There are so many social networks and while it is crucial to claim your name on all of the most important and popular networks, it isn't as crucial to be a major success on each and every one. If you're a food blogger and you take professional looking photographs, you're probably going to excel on websites like Pinterest and Instagram. Twitter is still a must have so you can share your content. But, if your website is pulling more traffic in from your dinner photos on Pinterest, spend more time pinning your recipe posts! 

I'm sure many of you know exactly what I mean by spreading yourself too thin! This is something I have a real hard time with and it's taken me a few years to find a schedule that works for me. Especially since I started homeschooling our youngest and have a chaotic schedule with doctor appointments, our older children's schedules, sports, housework, and everything else busy moms and dads do. I had to finally sit down and devise a list of every blogger group, review community, little reward websites I joined at the very beginning and started to keep track of what kind of income I was receiving from each one. I was shocked to see how many of these "daily check ins" I had in my planners! Some of these things don't pay at all and some pay only in gift cards and of course, I will always offer "pro bono" campaigns for charity and small business. But, some of this just had to go if I was going to keep my sanity! I was stealing from my own blogs and for what? A $25 gift card per year or even every 2 years? No thanks! Our time is too valuable for nonsense like this! Content is what matters and you owe it to yourself to spend that extra time on your own blog. 

Make a list of some of the best affiliates out there so you can take advantage of affiliate marketing too! If you feel something isn't working out or you notice that you don't seem to have much engagement on those posts, the possibilities for affiliate marketing are endless! 

If you find that you still don't have time, revise that list again. Keep what works and get rid of what doesn't. 

Your blog is your business and you need to schedule yourself some time off. Set a daily schedule when your doors are open. You could also have a weekly Facebook Live event or a weekly Periscope event, whichever one you see fit! (Your followers will be notified when you pop up live, so that is an added bonus!)

Email Newsletters

I don't know how many times I have heard the experts say that your email list is where the money is. For the longest time, I thought my RSS feed would suffice. It turns out, that isn't true. You should actually have an email newsletter so you can share your content with your readers and grab new subscribers as often as you can! How do we do this? 

I like to add an entry option for giveaways but I've also noticed that those subscribers don't necessarily always open and click those emails. That's fine. As long as they aren't unsubscribing, right? I guess if you just want the numbers. But, you'll need more subscribers, quality subscribers. (I must mention that I have found quite a few quality subscribers through group giveaways and my own giveaways!) Finding subscribers who really want to read what's on your mind may be a little tricky. 

Are you a DIY blogger? Do you post a lot of recipes? Maybe you post a lot of tips for bloggers? Whatever it is that you do, you could offer a free eBook with a signup, create a checklist, offer daily planner pages, whatever it is that you do well! Readers love bonuses! Some of my personal favorites that I have received are menu pages, menu plans, cute shopping list pages, worksheets and coloring pages for kids, and most recently, I subscribed and received a PDF file of "The Top 100 Affiliates For Bloggers". 

Do you have any tips for boosting your blog's content marketing strategy? Please share in the comments! 



Sunday, September 10, 2017

Win A Nursery Makeover

This information is brought to you by EvgieNev Wall Decals. All opinions are my own.





Having a baby is an amazing and life changing event! There is so much to do to prepare for the arrival and so many things to buy! That's why EvgieNev Wall Decals wants to make it easier for you to get your nursery ready or to just redo your current nursery! Evgie Wall Decals are more than just decoration for nurseries; they are detailed themes with animated characters, live illustrations, and designs. The decals are very educational and help to develop your child's imagination and cultural knowledge of the world around them.

About EvgieNev Wall Decals:

  • Decals are customize-able: they can changes sizes, colors, add or remove elements to facilitate any ideas and styles
  • Incredibly great feedback from their customers, many re-ordered multiple times
  • Easy to remove and redecorate at a later time
  • They have literally hundreds of themes, animals, landscapes, setups coming from books, historical facts, and well-recognized charters
  • Vinyl decals they use feel like smoothly painted on the wall after application but easily removable should you choose to redesign
Here are some of their most popular wall decals:


Charming King of the Jungle with Lion, Giraffe Elephants and Monkeys

Baby Nursery Wall Decals with Lion, Giraffe, Elephants, and Monkeys.

Teddy Bears Wall Decals

This decal has 541 reviews and has a 5-star rating!

Custom Flag Name Outer Space Wall Decals

Children Wall Decor that includes Astronauts and Aliens, Rocket, Planets, and UFO.

Terrific Tropical Heaven

A Breath-Taking Rainforest Scene that includes Animals and birds in Tropical Landscape.


Birches and Owl Wall Decal

This theme includes Three Large Birch Trees and Seven Cute Owls, Leaves and Two Birdhouses.

TeePee Camp Wall Decals

TeePee camp Wall Decals with Canoe, Campfire, Eagle and Mountains, Indigenous People and First Nations.

Amazing Ocean Friends

Cats Scuba Divers and Submarine Monkeys with Sunken Pirate Ship, Octopus, and Shark. It is a fun underwater scene.

Giant Noah's Ark Wall Decals

Their NEW Noah's Ark Theme Decals is packed full of playful animal pairs, including Elephants, Lions, Pandas, Owls, Giraffes, Monkeys, Squirrels. As you can see, there are so many to pick from! You can visit EvgieNev to check out all their wall decals. Now for the giveaway! One lucky person is going to win a few items that will get you some essentials for your nursery!
  • $150 credit to EvgieNev Wall Decals
  • Baby Crib (Appx Value: $110)
  • Glider (Appx Value: $120 - may not be actual glider)
Please note if you live outside the US or Canada you will be awarded the $150 credit to Evgie Wall Decals and an Amazon Gift Card or PayPal for $230) Please see the giveaway terms for more information. Enter below: a Rafflecopter giveaway

Wednesday, September 6, 2017

A Few Hurricane Tips (Just In Case You Need Them!)

1. Start running your ice makers now and bagging the ice in freezer bags. Fill as much space in between your freezer items as you can.
2. Freeze regular tap water for pets, cleaning or drinking in Tupperware-type containers. REMEMBER to leave a small bit of space between the top of the water & the lids so the ice expands but doesn't crack the container.
3. Start using up your perishables to make more room for ice in the freezer.
4. Fill up all vehicles & check tires & oil.
5. Cash from ATM, at least enough to get you through tolls and gas out of town. Call your bank if you plan on leaving the state so they don't freeze your card for out-of-area "suspicious" transactions.
6. All important docs screenshot & send to your email. Take originals in sealed bags or plastic bins.
7. Pet & livestock food & supplies. Vet records in case you need to shelter than at a storm-safe facility.
8. Evacuation plans and share with family members so they know where you're headed.
9. Consider putting heirlooms & photos in plastic bins in a high place, second floor, or safe room if you don't plan on taking them with you.
10. SECURE ALL FIREARMS & AMMUNITION PROPERLY.
11. Old rags & beach towels on your windowsills. Even with the best windows & shutters, water seeping from the wind pressure happens. A few damp towels are better than soaked drywall or floors!
12. Shutter windows and doors and bring everything outside into your garage or house NOW. Do not wait until the day before. Better to get done early and relax than wait until it's too late, ESPECIALLY IF YOU ARE MANDATORY PERSONNEL (hospital employee or first responder).
13. If you don't already have your hurricane supplies, you might want to get them now. Shelves are already empty in most places.
14. If you have special needs call 311 and register
15. Have a bucket in the bathroom & fill the tub. Use this water & bucket for flushing.
16. Charge your phone & keep it charged. A car charger is handy for when you lose electricity.
17. Do your laundry now. Everything gets dirty during the cleanup & aftermath. You can't wash clothes
w/o electricity.
18. Stock up on plenty of alcohol, as this will help to calm you before, during and after the storm.
Be safe. If you plan on leaving town do it now! 

Blogger Opp Red Copper Pan Giveaway ARV $80

 Blogger Opp Red Copper Pans Giveaway



3 Winners
Sponsored by:
Bulb Head

Hosted By
Amy & Aron's Real life Reviews
Each blogger will receive up to 3 Free links  
for posting and promoting this giveaway 
Giveaway Date
9/15 to 9/29
Open to US
 Giveaway will be 2 weeks long. Make sure if you are purchasing links they will be valid that long. We don't want blank entries.

Prizes: 
5 Minute Giveaway ($39.99)
Brownie Bonanza ($19.99)
Flipwich ($19.99)

The more bloggers promoting ~ the bigger the results ~ the more giveaways we get to do together.

Sign Up Here or Below

Co-Hosts spots are unlimited, Co-Hosts Needed

Co-Hosts
$5 for 5 additional links (up to 8 total) plus backlink to your blog.

Custom links available:
Adding social links $1 each limit 3
 (link to specific post required)
This includes Facebook, Twitter, Instagram, Pinterest, Youtube, etc
Daily links $2 each or 3 for $5 (Limit 3)
Daily Comments, retweets, post shares, email sign ups, secret word, etc
(link to specific post required)

Any payment needed please send to grovesamy81@gmail.com as a friend/gift, RED in the notes

Posting will be required within 24 hours of launch.


I hope to see you there.
If you have any questions about this giveaway please email Amy at grovesamy81@gmail.com or amy@aarlreviews.com

Monday, August 28, 2017

Research Before Buying A New Car

** Sponsored post **



One of the most annoying things in life is making a large purchase. Whether it's a car or a house or anything that requires several days worth of phone calls, gathering paperwork, signing your name on 100 pages of a contract, and shopping for the best rates. Of course, after it's all said and done, relief and enjoyment kick in! (Not to mention, that new car scent is really hard to beat!)

I've had to sit in several dealerships over the years. Most of those visits lasted several hours and I don't know about you but, I'm just too busy to waste an entire day at a dealer, waiting for paperwork to sign! Luckily, we found a dealership that is very quick, professional, precise, and has snacks, drinks, and restaurants nearby! They even allow you to borrow a vehicle to run for something to eat or you can have it delivered there! (It's those little things that win me over.) So, we purchased our last 3 vehicles from that same dealership.

In this day and age, we have this thing called the internet which comes in handy for many things. Including shopping for a new vehicle. You can do most of the work from the comfort of your own bed, sofa, or kitchen table and you can sometimes submit your financial information if you are also shopping for a loan. It could still take a few days before deciding on the right vehicle and finding the right price. If you aren't already loyal to one make and or model, you may have a little more research to do before making your decision.

Where You Should Research Before Buying A Vehicle

Sometimes it is hard to trust a dealer when it comes to honest answers about a purchase. (I found this out the hard way!) You could visit the manufacturer's websites, social media pages, read reviews on their Facebook page, and even check Twitter to see if there are any Tweets from people who already own what you are thinking of buying. It's also best to find some unbiased opinions and reviews and some facts. One of the best sources I've come across is Cars.com

Cars.com has updated information on virtually every make and model of any vehicle there is. You can find consumer reviews, MSRP, specs, service and repair advice, recall notices, and much more. If you have a vehicle you are selling, you could even list your ad on their website! They also offer advice on what to do before selling your vehicle and help you find the right price using their valuation tool. 

If you are buying a used vehicle, it is a good idea to find out if there have been any recalls and if there are any issues that may cost a bit down the road. For instance, I recently owned a pickup truck that was perfect in every way. Except for the fact that when this truck needed a tuneup, it required special tools made by the manufacturer and yes, they cost a lot more than the usual tools, spark plus, and coil packs! It was a DIY project because the dealers were aware of the hassle and the lengthy process so, the price was more than 10 times a regular tuneup service price! Had I known this prior to making this purchase, yes, it would have changed my mind. It only affected a certain engine in certain models for a 3 year span so, I would have purchased a different year. 

For the DIY people, YouTube is a great place to visit sine there are so many mechanics and car guys who will post easy to follow videos of anything from changing spark plugs to a simple oil change to fixing a transmission or rebuilding an engine. You can also find videos and step by step instructions on Cars.com. You can even put the vehicle you are shopping for or one you already own into search bar and then choose from a variety of different repairs and services ranging from easy to hard. I checked this list before purchasing my most recent pickup truck so I could see if there were any surprises before buying it. 

Of course, when you get to the dealer, you should always take a test drive. My husband always drives to a parking lot and lifts the hood to double check everything before we get back to the lot. This is also a great time to see where the blind spots are and make your final decision on whether this is what you want to drive for the next few years or several years! Returning isn't always an option! 

What are some tips you have for research on a new vehicle purchase? 


Wednesday, August 16, 2017

The Money Savvy Pig Giveaway

Money Savvy Pig Giveaway


Hosted By
~ 1 Winners~
Open to US
8/16 12am ~ 8/30 11:59pm

~Prize~
One winner will receive their own Money Savvy Pig piggy bank of their choice (pink, blue, green or purple). 

Check out our review for Money Savvy Pig Piggy Bank

Find Money Savvy Generation on
Facebook and Instagram

Find Amy & Aron's Real Life Reviews on 
Facebook, InstagramPinterest, Youtube, and Twitter

Thank you to all of the bloggers promoting this giveaway! I appreciate all of you for your hard work and helping our readers get really awesome prizes! 
Now for the fun stuff. This giveaway is open to US. There are daily bonus entries so please check back tomorrow. Share it with your family and friends, they'll want to enter to win too!!

I can't ask you to "Like" our pages but, if you see something you like, let us know so we can bring you more of it.
We LOVE it when you "LIKE" our pages.

a Rafflecopter giveaway

If you have any questions about this giveaway,  reviews, or any of our other giveaways, please feel free to email us directly at grovesamy81@gmail.com or amy@aarlreviews.com

Monday, August 14, 2017

Is Your Family Prepared For The Unexpected?




One of the most important things in life is to think ahead and prepare just in case an emergency happens. You probably have an evacuation plan for your family in case of a fire and you probably have a savings account of some kind in case your roof caves in or you or a family member needs emergency surgery. There are so many things we need to prepare for, it's so easy to forget about the fact that you should always have a good supply of food for each person in your home.

Emergency And Disaster Kits

You can find a lot of great, printable lists online to help you create your own emergency and disaster kit. Some common items you will find on these lists will be:

Flashlight
Batteries
NOAA Weather Radio (Preferably a battery operated or a crank radio.) 
Water (1 gallon per person per day.) ( 3 days worth for evacuation and 2 weeks for at home.)
Non-Perishable Food ( 3 days worth for evacuation and 2 weeks at home.) 
Personal documents
Cash
Matches
Whistle
Medications
First Aid Kit
Sanitation and personal hygiene products
Cell phones and chargers
Emergency blankets
Maps
Hand sanitizer
Family and personal contacts
Multi purpose tools

Extra Supplies Needed On A Personal Basis 

Every family is different and we all live in different places that have their own common disasters that would require additional items. 

Families with children should include coloring books, crayons, puzzle books, small toys, maybe even have a backpack or knapsack for each child! You can even fill them books and snacks or have your children help fill their own. (This is a great way to also discuss the importance of preparing for an emergency with them!) 

You could also pack extra clothing, towels, sleeping bags, anything else you think your family may need. 

If you have a baby, you may need to include things such as baby formula and diapers. 

Storing Your Kits

There are 3 main places you should store a kit. Home, vehicle, and work. Disasters and emergencies don't usually happen at the most convenient times so it is best to think about the places you frequent and be sure you are taken care of in any case. 

Of course your work and vehicle kit will be much smaller than the one you have for your home. Typically the best thing to do is keep a grab and go type case for work and pack a condensed version of the above list. Plan to need supplies for at least 24 hours. 

Other Ways To Prepare 

You might be the type of person who is always in survival mode and you want to add more to your kits. (Or you have already watched every Survivorman episode and you are prepared for everything! Even a zombie apocalypse! 

You may want to check into amateur radio. In the case of a disaster, cell towers may become overloaded. 911 may stop working. The only way to contact somebody will be smoke signals or HAM radio. 

HAM radio is very reliable and can connect you with like minded individuals who are capable of helping to organize help for people who are stranded. You can communicate and find shelters, find out about evacuation orders, understand what is happening, and keep in touch with others who may have more information. 

Another way to be sure your family will be OK is with a Survival Seed Vault. These come in handy cans that are easy to store for when you might have to rely on them. They come in waterproof containers. These seeds are extra special because you will continue to harvest seeds from the originals! 

What steps have you taken for surviving a natural disaster or some kind of emergency? Pleasse let me know in the comments! 

Saturday, August 12, 2017

Dear Trump Administration, Signed, Chronic Pain Patients

** Credit for this letter and all information due to Joe Aquilino, a very helpful chronic pain activist. Ever since I have been diagnosed with RSD/CRPS and had a Facebook account, Joe Aquilino was one of my first chronic pain friends. If you are not familiar with him, check out his podcast! 


Here is a letter that you can copy and paste to the Presidents Commission for Opioids. We need everyone involved to fight to get the opioids back. You just need to put their name after the dear and after the sincerely your name and city and state 


Dear [Name],
The published schedule for the Commission calls for review of a draft report to the President just ten days after your first working meeting. This is not a substantial amount of time to review all of the public comments and emails in regards to this issue, nor is it enough time to fully consider the many intricacies of this issue and come up with a solution that does not adversely harm particular populations such as the 116 million Americans suffering from chronic pain (Institute of Medicine, 2011), or the 5-8 million receiving long-term opioid therapy (Kroenke and Cheville, 2017), the majority of whom reap greatly improved function, quality of life, and are even able to work a job and/or go to school. 

With no intention of discourtesy, I must seriously ask whether you wish to have your name associated with such a transparently political agenda that has the potential to harm and even kill 2millions of people if not executed in an extremely precise manner. If the "fix" involves the further restriction of when, where, or how doctors may prescribe pain medication, it will cause a multitude of unintended harm unless doctors who treat pain from a variety of chronic and painful conditions on a daily basis (such as Dr. Forrest Tennant who is also an expert in the treatment of addiction) are not actively involved in the effort to reduce overdose deaths. If people suffering from persistent pain are about to be disregarded and abused by their own government once again, in the name of trying to solve an opioid crisis that isn't their fault, it will result in more overdose deaths from people in pain left with no other options who turn to the black market, and the suicide rates of veterans (and people suffering from persistent pain more generally) will also sharply increase,–the reduction of which the commission discussed as a goal– and the problem of overdoses won't be helped in the least by denying people suffering from persistent pain effective pain management. 

Consider for a moment that many authors, including (Inturissi, 2002) (Fishbain et al., 2008) noted that the rates of addiction in chronic pain patients receiving long term opioid therapy were particularly low (below even the population average) because persistent pain seems to interfere with the intrinsically rewarding nature of opioids.

Much of the stigma against opioids that is driving restrictive prescribing policies is based in doctors’ lack of knowledge about pain (and subsequently the public’s misconceptions), about how to treat it, and about the difference between dependence and addiction (Rich, 2000). These issues can be resolved by simply educating doctors more effectively. 

Dependence is simply the presence of withdrawal symptoms upon the cessation of a drug, (Inturrisi, 2002) which happens every morning to much of America as they make coffee. The grogginess, headache, and nausea are withdrawal symptoms of caffeine, and these are ordinary citizens, not addicts–addiction, which is something that a person must be genetically predisposed to in order to develop–is an entirely different condition that is a neurological disease (Morgan and Christie, 2011) and requires considerations separate from the domain of doctors’ prescribing patterns. In order to have the capability of developing an addiction, a person must have disturbed caregiver attachment bonds, caused by trauma at an early age, and it involves widespread alterations to the reward system in the brain that you simply do not see in chronic pain patients, as well as continuing to obtain the drug despite harm to others, a hallmark of addiction (Flores, 2004).

On the other hand, in chronic pain, although the patients require their medication to avoid withdrawal (dependence) and to avoid severe pain, chronic pain interferes with the intrinsically rewarding tendencies of opioids (Inurrisi, 2002), meaning that because the medicine is being used properly under proper supervision, that in appx. 98% of chronic pain patients receiving opioids long-term, addiction doesn’t occur (Fishbain, et al., 2008) (Burgess et al., 2014). The last conflated term, tolerance simply means that the body is habituating to its environment, the way the human body is designed to (Inurrisi, 2002). There is nothing inherently wrong with this, as it is an important survival mechanism built into the human body.
Another author noted the usefulness of long term opioid therapy in chronic noncancer pain, and the outlandishness of using addiction as the rationale to not to treat pain: 

“A Cochrane Review on long-term opioid management for chronic noncancer pain published in 2010 reported similar findings, with an estimate of opioid addiction of 0.27%, leading the authors to conclude that the risk of iatrogenic opioid addiction is low. [Hojsted, 2007]” Burgess et al., 2014 went on to summarize Boscarino’s 2010 study stating: “One of the most consistent risk factors predicting opioid abuse/addiction, is a history of opioid abuse (odds ratio of 3.81).[Boscarino, 2010] Patients with a history of severe…abuse had an odds ratio of 56 for developing abuse/addiction. [Boscarino, 2010] Weisner et al surveyed patients receiving long-term opioids in two large group health plans and found that patients with a history of opioid abuse had a prevalence rate of opioid use approaching 50%, compared to patients without a prior opioid abuse history of 2–3%.” (Burgess et al., 2014)

The nature of the so called “opioid epidemic” has been misunderstood, and as a result the responses have been directed at the wrong targets. “Heroin and fentanyl have come to dominate an escalating epidemic of lethal opioid overdose, whereas opioids commonly obtained by prescription play a minor role, accounting for no more than 15% of reported deaths in 2015.” (Kertesz, 2016)

"It is commonly thought that opioid dependence often begins through an initial, possibly chance, exposure to a physician-prescribed opioid, although data from studies to empirically evaluate this claim are lacking." (Barnett et al., 2017) In other words, people do not simply become addicted by being exposed to opioids, and there is no evidence to support this claim. There is however limited evidence to suggest that chronic pain patients receiving long term opioid therapy have extremely low rates of addiction (Fishbain et al. 2008) (Burgess et al., 2014) (Hojsted, 2007) and many derive greatly enhanced health, wellness, quality of life, and function from long term opioid therapy (Furlan et al., 2006).
When addiction is looked at as an attachment disorder (that also happens to be neurological disease), it becomes much clearer why some people suffer from addiction upon exposure to drugs and others do not. Those that do are using a drug (it could be nearly any drug) to replace the comfort that social interaction and healthy peer bonding provides to non-addicted individuals (Flores, 2004), this is when addiction develops. This is markedly different from chronic pain patients who are able to socialize, function, and live a fulfilling life because of opioid medications. 

The Furlan et al. literature review on the efficacy and safety of long term opioid therapy for chronic noncancer pain concludes that while the studies are limited, there is sufficient evidence that opioids are beneficial for some individuals with chronic noncancer pain, and considering the complete lack of alternatives with similarly efficacy, there is no rational reason to deny treatment to these individuals, especially considering the deadly consequences of doing so. Leaving pain untreated, as restricting pain medication further tends to do, is condemning the well over 25 million people with severe and intractable chronic pain to a slow, agonizingly painful death, feeling betrayed by their government, their physicians, and life itself. (Grol-Prokopcyzk, 2016) (Epel, 2004) (Mcewen, 2004) (Lohman, 2010) (WHO, 2000)

Restricting opioid prescribing as the CDC recommended for primary care physicians only would have dire consequences if it were implemented as a policy of any kind. It would disable the 5-8 million people currently on long term opioid therapy who are able to live a normal life because of these medications. Those who are not currently on medication have either already been stripped of their dignity and quality of life by needless suffering, due to the immense difficulty involved in finding a physician who is willing to treat their pain, to the point where most are totally disabled (many of whom re receiving social security benefits, who could be made able to work again if they were given adequate treatment that such a policy would completely prevent) because of their pain, and are causing a totally unnecessary financial drain on the U.S. government in the order of $560-635 Billion per year (Institute of Medicine, 2011). The cost of this could be almost entirely eliminated (or at the least greatly reduced) if the availability of opioids were to increase substantially. (Seya et al., 2011) (Sessle, 2012)

Richard Lawhern writes as a non-physician writer, research analyst, patient advocate and website moderator for chronic pain patients, families, and physicians. My wife and daughter are chronic pain patients. His 20 years of volunteer experience has produced articles and critical commentaries at the US Trigeminal Neuralgia Association, Ben’s Friends online communities for patients with rare disorders, US National Institutes for Neurologic Disorder and Stroke, Wikipedia, WebMD, Mad in America, Psychiatric News, Pain News Network, National Pain Report, the American Council on Science and Health, the Global Summit for Diagnostic Alternatives of the Society for Humanistic Psychology, Psychiatric News and Psychology Today. He wrote a piece that is extremely relevant to this issue.

I urge you–indeed, I IMPLORE –to read the article in which this summary appeared. It is titled "Warning to the FDA - Beware of 'Simple' Solutions in Pain and Addiction." It may deserve to become a part of your report to President Trump. It demonstrates that the balance between concerns of people in agony and those of families who have lost children to opioid addiction have become seriously skewed in utterly unproductive and dangerous directions. It also demonstrates that the March 2016 CDC guidelines on the prescription of opioids to adult noncancer pain patients are seriously dangerous due to weak evidence, scientific errors and outright omissions of vital medical science. The guidelines are already killing patients across the U.S. (Webster, 2014). If enshrined as mandatory limits on opioid prescription, they will kill many thousands more.

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Sources
Barnett, Michael L., Andrew R. Olenski, and Anupam B. Jena. "Opioid Prescribing by Emergency Physicians and Risk of Long-Term Use." New England Journal of Medicine 376.19 (2017): 1895-896. Web.
Bartleson, J. D. "Evidence For and Against the Use of Opioid Analgesics for Chronic Nonmalignant Low Back Pain: A Review: Table 1." Pain Medicine 3.3 (2002): 260-71. Web.
Baumeister, Roy F. "Suicide as Escape from Self." Psychological Review 97.1 (1990): 90-113. Web.
Boscarino, Joseph A., Margaret Rukstalis, Stuart N. Hoffman, John J. Han, Porat M. Erlich, Glenn S. Gerhard, and Walter F. Stewart. "Risk Factors for Drug Dependence among Out-patients on Opioid Therapy in a Large US Health-care System." Addiction 105.10 (2010): 1776-782. Web.
Burgess, Harrison J., Afreen Siddiqui, and Frederick W. Burgess. "Long-term Opioid Therapy for Chronic Pain and the Risk of Opioid Addiction." DRUG AND ALCOHOL DISORDERS AND TREATMENT (2014): n. pag. RHODE ISLAND MEDICAL JOURNAL. Web.
Epel, E. S., E. H. Blackburn, J. Lin, F. S. Dhabhar, N. E. Adler, J. D. Morrow, and R. M. Cawthon. "Accelerated Telomere Shortening in Response to Life Stress."
Fishbain, David A., Brandly Cole, John Lewis, Hubert L. Rosomoff, and R. Steele Rosomoff. "What Percentage of Chronic Nonmalignant Pain Patients Exposed to Chronic Opioid Analgesic Therapy Develop Abuse/Addiction And/or Aberrant Drug-Related Behaviors? A Structured Evidence-Based Review." Pain Medicine 9.4 (2008): 444-59. Web.
Flores, Philip J. "Addiction as an Attachment Disorder: Implications for Group Psychotherapy." Group Psychotherapy and Addiction (n.d.): 1-18. Web.
Furlan, Andrea D., Juan A. Sandoval, Angela Mailis-Gagnon, and Eldon Tunks. "Opioids for Chronic Noncancer Pain: A Meta-analysis of Effectiveness and Side Effects." Canadian Medical Association Journal 174.11 (2006): 1589-594. Web.
Grol-Prokopczyk, Hanna. "Sociodemographic Disparities in Chronic Pain, Based on 12-year Longitudinal Data." Pain 158.2 (2017): 313-22. Web.
Hojsted, Sjogren. "Addiction to Opioids in Chronic Pain Patients: A Literature Review." European Journal of Pain 11.5 (2007): 490-518. Web.
Institute of Medicine. "National Pain Strategy A Comprehensive Population Health-Level Strategy for Pain." National Pain Strategy. N.p., 2015. Web. 26 May 2017.
Institute of Medicine. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, D.C: National Academies, 2011. Print.
Inturrisi, Charles E. "Clinical Pharmacology of Opioids for Pain." The Clinical Journal of Pain 18.Supplement (2002): n. pag. Web.
Kertesz, Stefan G. "Turning the Tide or Riptide? The Changing Opioid Epidemic." Substance Abuse 38.1 (2016): 3-8. Web.
Kroenke, Kurt, and Andrea Cheville. "Management of Chronic Pain in the Aftermath of the Opioid Backlash." Jama (2017): n. pag. Web.
Lohman, Diederik, Rebecca Schleifer, and Joseph J. Amon. "Access to Pain Treatment as a Human Right." BMC Medicine 8.1 (2010): n. pag. Web.
Mcewen, Bruce S. "Protection and Damage from Acute and Chronic Stress: Allostasis and Allostatic Overload and Relevance to the Pathophysiology of Psychiatric Disorders." Annals of the New York Academy of Sciences 1032.1 (2004): 1-7. Web
Morgan, Michael M., and Macdonald J. Christie. "Analysis of Opioid Efficacy, Tolerance, Addiction and Dependence from Cell Culture to Human." British Journal of Pharmacology 164.4 (2011): 1322-334. Web.
Rich, Ben A. "An Ethical Analysis of the Barriers to Effective Pain Management." Cambridge Quarterly of Healthcare Ethics 9.01 (2000): n. pag. Web.
Sessle, Barry J. "The Pain Crisis: What It Is and What Can Be Done." Pain Research and Treatment 2012 (2012): 1-6. Web.
Seya, Marie-Josephine, Susanne F. A. M. Gelders, Obianuju Uzoma Achara, Barbara Milani, and Willem Karel Scholten. "A First Comparison Between the Consumption of and the Need for Opioid Analgesics at Country, Regional, and Global Levels." Journal of Pain & Palliative Care Pharmacotherapy 25.1 (2011): 6-18. Web.




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