In 2016, more than 42,000 people died from opioid overdoses — a fivefold increase from 1999. Overprescription and easy access led to the skyrocketing epidemic in the United States. There’s a new level of government scrutiny on opioids, but one of the unintended consequences is that patients have found it increasingly difficult to access prescription drugs needed to manage daily chronic pain.
We’ll examine the new regulations to see what exactly they mean for patients and what you can do to find the treatment you need.
What are the new laws?
Laws vary by state. In many cases, the use of opioids for chronic pain conditions such as long-term illnesses or hospice care is still permitted. Depending on the state, however, these laws can be quite specific.
For example, someone suffering from severe arthritis may not be able to access opioids. However, someone with fibromyalgia may be able to. Be sure to check your state’s specific laws to know what exactly they mean for you.
Furthermore, acute pain opioid treatment has been limited to a maximum of 7 days in many states. The rationale is that 7 days should be a long enough supply for all acute pain even including surgery. In other states, the maximum is 3 days.
Getting a prescription now generally requires more work for both physicians and pharmacists. In some states, they are mandated to take courses on opioids and to check digital registries that show whether a doctor has already prescribed opioids to a given person or not. Do note: it may not be possible to receive an opioid prescription over the weekend if states use offline databases.
What does this mean for patients?
Unfortunately, it’s going to require more doctor’s office visits, examinations and other steps for pain sufferers. In many cases, you may have to go to your doctor’s office in person to get a refill or new prescription.
Even if you can arrange a refill over the phone, you may have more copayments and trips to the pharmacy. While such changes will likely make your life more difficult, doctors and pharmacies can be sanctioned or worse if they don’t follow these laws.
Will these laws even help?
Nobody is sure yet. Most of these laws have only been in place a year or two.
One example is Massachusetts. Governor Charlie Baker signed opioid regulation in 2016. In 2017, the opioid death rate decreased by 8%. But it’s hard to prove yet whether the law directly is responsible for this.
Both patients and healthcare providers are now much more educated on the dangers of opioid abuse. This may have played an essential role in the decreasing number of drug overdose deaths.
What should patients do?
There’s now a much larger burden on patients to do their research. For acute pain and surgeries, patients are advised to find out beforehand what types of painkillers doctors will use, how long the prescription will be for and what options will be available should pain continue.
When it comes to chronic pain, things are more complicated. It’s a good idea to ask your doctor to refer you to pain management specialists. These specialists have specific training to help you find the best treatment strategies for any condition.
They can also breakdown both opioid drugs and non-opioid drugs. These days, there have been many breakthroughs in a range of non-opioid painkillers, different types of physical therapy, cold laser therapy and other options.
Even with the many recent advancements, some chronic pain patients can only find relief through opioid medications. If this is the case, you may want to look to specific networks to talk you through your options.
For instance, the Arizona Department of Health Services and the the Poison and Drug Information Centers of Arizona teamed up to create the Arizona Opioid Assistance and Referral (OAR) Line. It works with patients to navigate between pain management, addiction and other factors to find the best options.
Chronic pain as a public health and legal concern
The Centers for Disease Control and Prevention notes that they commend states’ efforts to “improve opioid prescribing and reduce opioid misuse and overdose.” However, the centers want to reiterate the importance of health care providers to:
- avoid misapplying their Guidelines for Prescribing Opioids for Chronic Pain to patients with other painful conditions
- maintain proper dosage and discontinuation guidelines
- differentiate between patients who need opioids for chronic pain and those who need medication-assisted treatment for opioid use disorder
Ultimately, this restrictive government scrutiny on opioids is part of a plan to:
- reduce the number of drug-abusing individuals
- eliminate heroin overdoses and drug dealers
- end the opioid epidemic
Overall, this is a good thing for the United States. But unfortunately, it puts real chronic pain sufferers in a difficult position. Federal and state governments now follow a much stricter drug monitoring program along with other new Department of Justice guidelines, including criminal charges for doctors over-prescribing opioids.
In fact, there’s been a large spike in doctor’s who won’t prescribe opioids for fear of sanctions. This is likely due to increased police efforts such as the recent multi-state drug enforcement effort that resulted in the arrest of 60 health care providers, some of whom face up to 50 years in prison.
Efforts like these are vital steps in holding not only drug companies but also health care provider more accountable. Unfortunately, the flip side is that it may result in serious conditions like cancer and other diseases not getting the pain management they need.
The bottom line
After years of lax regulation, the government scrutiny on opioids is making sweeping strides to make access to opioids much more difficult. This may prevent drug abuse, but it also puts chronic pain sufferers in a tough position.
Within a few years, the federal and state legislators may seek to provide more balance. In the meantime, people with chronic pain will need to do a lot more work to find the right pain medication for themselves. Begin by researching the specific laws for your state. Then talk to your care provider and discuss what options you have available.
In some cases, you may want a referral to a pain management specialist. It’s essential to remember that even if opioids are the only effective treatment option for your pain, they are addictive. Now may be a good time to re-examine your options to see what new treatment choices might be available for you.
It may be tempting to view these legal changes as inconveniences. But it may be more helpful to frame the circumstances as opportunities to refresh your pain management program. Having a better, safer and more effective therapy that addresses your needs and fits your lifestyle is the primary concern.
How has the government scrutiny on opioids impacted your pain management options?
What topics related to opioids for chronic pain would you like to see us explore?
Email us at info@painresource.com with your ideas.
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My mother is 84 years old and suffers from chronic pain. She has had 3 back surgeries, one knee replacement, and needs the other knee replaced. She also suffers from arthritis, walks hunched over and has bunions on her toes which she will not have surgery for because of the pain. I take her to a pain clinic every 3 months in order to get her prescriptions. She takes 2 pain meds to get through the day and night. One is for chronic pain and the other is for breakthrough pain. For the last few months, we have had trouble getting both at the same time due to government restrictions on the pharmacies on how much pain (opioid) medication they can have in stock. It is constantly on ordeal as you can imagine. She has to take the breakthrough pain medication much more than before because she is out of the other. They are supposed to be taken daily as needed. Of course, she is now addicted to the medications and starts to have withdrawal symptoms when she is without which are absolutely horrible. How can the government justify not giving medicines to the elderly when they need it. My mother would not ask for the medicine unless she needs it. She is a retired RN and understands the reasoning why, but is having to deal with the reality. Her doctors’ hands are tied by government and there is not a thing she can do. Thank you for taking the time to listen. I sincerely hope our government will let the doctors do what they do best and help their patients without having to explain why their patient needs the medication.
Have you heard of the dont punish pain rally on Facebook??