September 2018 is National Drug-Free Pain Management Awareness Month, a designation championed by the Foundation for Chiropractic Progress (F4CP) to raise public awareness about the dangers of prescription and over-the-counter pain medications, and to educate and inform consumers, health care professionals, and patient referral sources about non-pharmacologic options to safely and effectively relieve acute, subacute and chronic pain. It’s a compliment to the latest push to curb the devastating effects of the opioid epidemic, which takes tens of thousands of lives each year.
But some suffering from acute or chronic pain are feeling left in the lurch.
Opioid painkillers are the most abused prescription drugs in the country, according to the National Study on Drug Use and Health. In 2016, opioids killed more than 42,000 people in the United States – an average of 115 opioid overdose deaths each day, according to the Centers for Disease Control and Prevention (CDC). The number of opioid prescriptions dispensed by doctors increased in step with more than 112 million prescriptions written in 1992 to 282 million in 2012, according to the market research firm IMS Health. The fight against opioid abuse helped drop that number to 236 million in 2016.
The opioid crisis has grown substantially in the past decade, fueled by drug companies that pour these powerful painkillers into the health care system that misled the public about the safety of these drugs, how they can cause dependence, addiction and overdose. Some opioid manufacturers even promoted the drugs for off-label uses in order to increase their own profits.
Fighting the opioid epidemic
But the people and the government are fighting back. Not only are individuals filing lawsuits against these powerful drug companies holding them accountable for their loved ones’ addiction and death, several local governments across the country are suing opioid manufacturers, distributors and pharmacies for their increased economic burden and ongoing significant financial burdens caused by the opioid epidemic. Many of the lawsuits filed by cities, counties and states across the country have been consolidated into a multidistrict litigation (MDL).
In July 2017, President Donald Trump declared the opioid epidemic a national public health emergency and, six months later, Attorney General Jeff Sessions announced a new opioid initiative to support jurisdictions that have filed lawsuits against prescription drug makers and distributors. In 2016, the CDC published guidelines for prescribing opioids to patients with chronic pain, and offered recommendations in lieu of opioids including prescribing over-the-counter painkillers and other alternatives such as exercise and behavioral treatments.
In more recent months, some states like Michigan, Florida and Tennessee have significantly reduced the amount of opioids that doctors are allowed to prescribe to patients in an attempt to curb the number of people who are or will become addicted to the painkillers.
Patients left behind
These restrictions and drug-free pain management alternatives are aimed at preventing the tremendous abuse and overdoses caused by opioids, but they are putting some patients in a painful situation, literally.
The Food and Drug Administration (FDA) has taken on the fight against the opioid epidemic through various measures including more access to opioid overdose antidotes and medications to treat opioid use disorder. But there has been an outcry from those who truly rely on opioids to relieve their pain.
In July, the FDA held a hearing on chronic pain at its headquarters in Silver Springs, Maryland to listen to people’s stories about their pain and how they might handle the new restrictions. Needless to say, there were plenty of angry people in the crowd.
“Suicide is always an option for us,” said Mariann Farrell of Pittsburgh. She suffers from fibromyalgia and post-herpetic pain, which can linger after shingles. She was one of dozens in the crowd begging the FDA to ease up on opioid prescribing restrictions so she can continue to get the opioid treatment she needs for simple quality of life.
“We don’t want to perpetuate practices that led to the misuse of these drugs, and the addiction crisis,” FDA Commissioner Dr. Scott Gottlieb later said in a statement. “At the same time, we don’t want to act in ways that are poorly targeted, and end up disadvantaging legitimate patients.”
The other victims of the opioid epidemic
“To be perfectly clear, I didn’t take illegal drugs and I never abused, gave away or sold my prescriptions,” said Michael Emilio, a guest columnist with Pain News Network. “I passed all my drug tests, never had a record of drug problems, or even a DUI. I didn’t even drink alcohol. I did NOTHING to give (doctors) any reason whatsoever to take my medications away.”
Emilio, 53, has severe disc degeneration in his spine and scoliosis in his lower back, as well as fibromyalgia. In 2001, he was prescribed opioids to deal with his chronic pain and allow him to work a full work week, which included some heavy lifting. In 2013, his doctor was shut down by the Drug Enforcement Administration (DEA), forcing Emilio to find a new pain management provider. His new doctor refused to continue his usual painkillers and cut his opioids by more than 90 percent. Emilio was left disabled and unable to work.
When Emilio asked his doctor why he wouldn’t keep him on the opioid medication he’d been taking for years, his doctor said that he was pressured by the government to cut back on his opioid prescribing. Instead, he recommended other alternatives, including steroid injections. But nothing seems to help, he said. Now, he just feels helpless in his pain.
“Don’t get me wrong. I’m not against fighting drug abuse and addiction, I’m just against the way it’s being fought,” he said. “Taking these medications away from people who have proven they need and use them responsibly will fail to have any impact whatsoever on the addicts who are abusing them. It only serves to punish the honest and innocent.”
American Chronic Pain Association
Pain News Network
Drug-Free Pain Management
FDA News Release