America is in the grip of an opioid crisis.
But, the opioid crisis is not what you see on TV. A man breaks his foot, gets surgery, has legitimate pain, is given an unlimited supply of pain drugs, then becomes an addict willing to lie cheat and steal to feed his new habit. Good drama, but not a widespread reality for most patients in pain.
Many patients living with chronic pain share similar experiences with Anne, a registered nurse who suffers with dystonia and arachnoiditis. Her condition causes her pain all day, every day. No days off. Ever.
“Opioids have been miracle drugs for me,” Anne explains. “I’ve been taking them for 17 years, and I’ve been on a dose that is higher than what the CDC considers to be ‘at increased risk for addiction’ for the last 13 years.”
She adds, “I have no side effects, I have normal endocrine function, and no need to further increase the dose.”
Pain management is a part of her daily routine, and that has become more challenging in recent years as a result of the opioid crisis.
Patient Access Challenge: Finding a Doctor
Across the country, state lawmakers are responding to the opioid epidemic with new restrictions on doctors that prescribe them. The well-intended legislation has made it harder for patients with real pain to find a doctor.
In Anne’s home state of Alabama, regulators and the Drug Enforcement Agency have organized high-profile raids on suspected “pill mills.” The specter of a federal raid along with the additional red tape and mandatory testing has scared legitimate doctors into ending their pain management practices.
Late in his career and living with his own health problems, Anne’s doctor decided to quit pain management with no designated replacement. Anne tried to find a new doctor, but in Alabama’s hostile environment, pain doctors weren’t willing to take new patients.
“What followed was hell on Earth,” Anne says of her experience. “I could barely manage alone at home. I had no quality of life at all.”
After many months of living in pain, Anne found a doctor on the other side of the country, in California, who was willing to take her on as a patient.
Opioid Crisis: The Stigma of Pain Management
Ironically, as society has become more mindful of the medical concerns associated with addiction, it’s grown more hostile and suspicious of patients that try to manage their pain. Chronic pain patients now face a stigma. They’re automatically distrusted and suspected of being an addict seeking the next fix.
“I was a registered nurse,” Anne says. “I understand that we have to protect people who are vulnerable to addiction, but FDA approved opioids are not the major cause of opioid related deaths. Those are from heroin and illicitly produced fentanyl. At this point, it is more likely that the first opioid to be abused by a person is illicitly produced, not a pharmaceutical prescribed for the individual.”
The data backs up Anne’s argument. According to the Centers for Disease Control the death rate from prescribed, natural and semisynthetic opioids, such as buprenorphine, hydromorphone, oxymorphone, hydrocodone and oxycodone, dropped from 29 percent to 24 percent between 2010 and 2015. Over the same period, deaths related to heroin increased from 8 percent to 25 percent — with deaths from synthetic opioids, such as meperidine, fentanyl and methadone, rising from 8 percent to 18 percent.
The opioid crisis is real. Patients addicted to opioids need access to the right treatments to overcome their addiction. And patients in real pain, like Anne, are equally deserving of access to the right treatments.
We need solutions to the opioid crisis that serve every patient.
Are you a patient living with pain? Tell us your story.
Jim Sliney, Jr., a Registered Medical Assistant, writes educational and advocacy articles for patients with rare and under-served diseases. Jim volunteers for G-PACT.org, where he serves on the board of directors as Newsletter Editor. Connect with the Bronx native on LinkedIn or Twitter.