Opioid crackdown hurting Chronic pain patients

PainPills-1If you pay at least some attention to news you might have heard about a growing Opioid epidemic hurting the United States. Opioid addiction has surged since the 1990’s, along with fatal overdoses. Many criticisms leveled towards the NFL are about their draconian marijuana policies compared to their well, less than strict opioid policies. Based on these surges there has been a crackdown on doctors and pharmacies prescribing Opioids to their patients, even those who have had their prescription for years. Legal repercussions have increased for Doctors who are considered haphazard in the pills they give out and doctors around the country are beginning to advocate harder for pain relieving methods that aren’t Opioid based. So all good right? Well not quite, according to a recent story from Chicago Tribune Contact Reporter John Keilman. Chronic pain patients who have been prescribed to opioids for a number of years, and are physically dependent on them, feel as though they’re being left behind and unfairly demonized now that desire to stop Opioid addiction is increasing. They feel like they’re being punished for something others are abusing and to be honest I greatly empathize with them. Here’s Jim Watkins, a 59 year old Chicagoan, who suffers from a debilitating pain disease called Osteogenesis Imperfecta and has been on treatment opioids for about two decades now. “(Chronic pain patients) are being singled out on a daily basis for something that other people have abused,” he said. “Those of us who have legitimate conditions, why are we being treated differently?”

There is no simple way of dealing with this issue. For legitimately treated pain patients who are physically dependent on them just deciding they can’t have anymore is a decision laden with consequences, not so much for the doctors who refuse to prescribe but for the patients who must suffer in debilitating pain while they have people judge them as if they were “junkies.” “I don’t advertise the fact that I take these medications just because of the way people look on it, like I’m a drug addict,” said a 59-year-old Lincolnwood woman who takes oxymorphone for back pain. “You mention it to someone, and it’s like, ‘Oh, you’re going to die; my cousin’s neighbor’s son died.’ They start connecting it with heroin abuse.”

On the other side a number of Doctors are advocating that Opioids are bad for these patients and don’t relieve pain effectively. Doctor Andrew Koldny states, “They’re stuck on these medicines they feel they can’t live without, and many of them may be right,” he said. “The trick is not to get more people stuck on opioids.” However, the premise behind the new crackdowns is suspect; for example, the recent advisory “guidelines” issued by the CDC claiming there are no studies showing Opioids relieve long term chronic pain are not only being used as mandatory by many doctors just not wanting to deal with the increased scrutiny but 2.) are also not based on actual studies. As opposed to numerous studies done by well respected pain experts that show there is a benefit for certain chronic pain patients.

While it’s fair to say that there were some incredibly shady prescriptions from “pain clinics.” the solution is not to leave millions of legitimate pain patients feeling driven to suicidal lengths.  “There were more than 1,000 pain clinics operating just in Florida around 2011,” said John Temple, a West Virginia University journalism professor whose book, “American Pain,” chronicles the rise and fall of a crooked clinic. “They were all churning out these prescriptions every day. I would say the vast majority were not for legitimate patients but for people who just walked in off the street.” According to the article “OxyContin wasn’t the only painkiller to soak into American culture: Overall opioid prescriptions more than doubled over 20 years, from 112 million in 1992 to 282 million in 2012, while per-capita consumption more than quintupled.”

One factor that is stopping doctors from prescribing according to John Temple, is seeing other doctors being arrested for over prescribing. There is also the fact that it’s become tougher and more expensive to deal with insurance companies when prescribing Opioids which obviously Doctors would like not to deal with. The big problem here is that we are not dealing with people who are faking to get Opioids. We are dealing with legit patients who have been given a drug that 1) may be the only thing that works after trying numerous well documented years of other medications; and 2) a person becomes physically dependent which is different from addiction.

Now those doctors are saying no without any actual solutions for the people who now can’t get their treatment. Some doctors literally just cut off their long term pain patients which is absolutely not the standard of the oath doctors are sworn to. It’s all fine and good to say well these drugs are hurting more than helping them, well ok, what are you actually going to do for these patients now that your taking away this drug besides just leaving them writhing in pain? Sure Acupuncture has been show to be an effective pain treatment but many people can’t afford that and it’s not covered by insurance. Plus that doesn’t make people less physically dependent on the Opioids they had been using for extended period. What then? Just tell them too bad? Is this the compassion we strive for from our medical field? There aren’t easy answers but maybe a place to start would be repealing the CDC guidelines and to also start covering other non opioid pain relief treatments for the people who can’t afford them and are having trouble getting opioids now as well as

I’ll leave off on a quote from 50 year old, Oak Park resident Paula Gianfortune.

“Hurting people who need (opioids) to survive day to day is just so wrong,” she said. “You’re going to have people who are truly in pain resorting to doing illegal drugs, and good people will overdose and die. You’re going to be so desperate to get rid of the pain somehow.”

 


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