On Opioids, One Year After DEA Reforms

It’s been nearly one year since my researched article on the heroin epidemic (link) in my city, and I’ve been keeping tabs on the results of the DEA’s new prescription opioid reforms. How have things have panned out for pain patients, and opioid and heroin addicts in the past year?

poppies2

“My Little Chinese Book”, by Mary Audubon, 1912. Image courtesy of The British Library Catalogue

Two years ago, National Pain Report, a patient advocacy group, published an article predicting what might happen after the DEA’s reforms were passed.

“Pain management experts say the rescheduling of hydrocodone by the U.S. Drug Enforcement Administration could have many unintended consequences, including higher healthcare costs, as well as more suicides, addiction and abuse of opioids. Many physicians may also refuse to write prescriptions for hydrocodone products, fearing fines or prosecution.”

All they predicted has happened, and more. Drug rationing (see here and here) for pain patients, some of whom are cancer patients, has been a major problem especially in Florida, which in addition to having a higher (nationally) number of opioid abusers, also has a higher number of elderly and sick. *Update: I recently heard a rumor that a documentary is being made about the Florida issue.

“[Pharmacist] Bill Napier, who owns the small, independent Panama Pharmacy in Jacksonville…says he can’t serve customers who legitimately need painkillers because the wholesalers who supply his store will no longer distribute the amount of medications he needs. “I turn away sometimes 20 people a day,” says Napier.

Last year Napier says federal Drug Enforcement Administration agents visited him to discuss the narcotics he dispensed.“They showed me a number, and they said that if I wasn’t closer to the state average, they would come back. So I got pretty close to the state average,” Napier says. He says he made the adjustment “based on no science, but knowing where the number needed to be. We had to dismiss some patients in order to get to that number.”

According to Napier, DEA agents took all of his opioid prescriptions and held on to them for seven months. Napier hired a lawyer and paid for criminal background checks on his patients taking narcotics to help him decide which ones to drop.” (source)

In this one-year post report from Northern Ohio, another state that has been hard-hit with opiate addictions, a lot of facsimile changes were made in local laws, which resulted in anywhere from no changes, to an increase in heroin use. Thankfully, this report specifically mentions heroin as the drug to be battling against, rather than other articles and news reports, including recent comments from President Obama, that have made pain patients out to be drug abusers, by default. They group heroin use/abuse with anyone taking an opioid for any reason (see here and video here).

While the DEA has succeeded in reducing the number of opioid prescriptions by strong-arming doctors and pharmacies, they have condemned chronic pain and surgery patients to depression, exhaustion, high levels of mental and physical stress, brain shrinkage, trouble concentrating and making decisions, insomnia, and anxiety, all side effects of uncontrolled chronic pain. As a result of these stressors, it remains to be seen (for lack of hard numbers) if the suicide rate among chronic pain patients, already known to be twice the rate of non-chronically-pained patients, has indeed gone up (source). But what has the DEA done about opioid abuse on the street? What have they done to stem the ever-rising tide of heroin trafficking and use? What have they done to reduce the rate of prescription abuse, not just use? Not one thing. What viable alternatives for pain patients have been produced in the past year?

New York Opium Den

New York Opium Den, 18__


In the middle of all this madness, is a push for new (supposedly non-addictive) drugs and treatments. Unfortunately, these new treatments tend to be very expensive, are more invasive, have mixed rates of effectiveness, and are rarely covered by insurance. One news article blithely claimed (using new CDC guidelines) that boosting endorphins via exercise was on par with taking narcotic pain medicine. What they failed to keep in mind is that those who are elderly, sick, or disabled, or those recovering from surgery, may not be able to exercise, especially if they’re in pain! While this same video also recommended OTC pain meds like Tylenol or Motrin, one main reason chronic pain patients are prescribed opioids in the first place, is to avoid the associated and well-documented kidney, liver, heart, or stomach damage from high and/or prolonged use of OTC medicines.

“The misguided, insensitive and inhumane policies of our government and the DEA in particular, have led us to create a Facebook page called Patients United for DEA Reform.

…All of us are only one injury or diagnosis away from being crippled with pain.  Think of living every day with a toothache that won’t stop, an untreated broken bone, or surgery with no post-operative pain relief.

People are living with untreated pain every moment of every day because of government over reach and inhumane DEA policies. It must be stopped and it must be stopped now.” (Source)

As if this weren’t enough, there have been several politicians in the past few weeks advocating for even further restrictions on prescription narcotics. Vermont Governor Peter Shumlin (D) and Kentucky Gov. Matt Bevin (R), are now pushing for even more legislation that will keep pain patients (who have a difficult time as it is getting around) from receiving more than ten pills at one time. Shumlin wrote, “opioid medications, as we know them, must be made obsolete”.

If this war on opioids has resulted in the predicted effects of more illicit drug abuse, of more patients in desperate pain, of an increase in deaths related to drug overdose and suicide, in more frustrated doctors and pharmacies, and an increase in healthcare costs,  it seems clear these new laws have helped no one, and hurt millions. Or have they?

See also: Strangulation on Medicine: My Life as a Pain Patient

*If you liked this post, please consider subscribing to my blog for just $1.50/month.


Sources in order of appearance

https://llawrenceauthor.wordpress.com/2015/04/06/wackydruglaws/

http://nationalpainreport.com/a-worried-dad-pain-patients-need-to-unite-for-dea-reform-8819510.html

http://www.pbs.org/newshour/updates/americans-spend-much-pharmaceuticals/

http://wellescent.com/health_blog/the-damaging-effects-of-chronic-pain-on-the-brain

http://commonhealth.wbur.org/2015/11/chronic-pain-suicide

http://america.aljazeera.com/opinions/2015/12/dea-crackdown-on-pain-meds.html

Pain Patients Say They Can’t Get Medicine After Crackdown On Illegal Rx Drug Trade

http://abcnews.go.com/US/prescription-painkillers-record-number-americans-pain-medication/story?id=13421828

http://www.painnewsnetwork.org/stories/2015/9/16/cdc-opioids-not-preferred-treatment-for-chronic-pain?rq=preferred

6 comments

  1. Pingback: A Rock and a Hard Place: Pain Patients Suffer from Heroin Laws Fallout | The Rambling Soapbox: Writings and Thoughts of Loura Lawrence
  2. Pingback: Strangulation on Medicine: My Life as a Pain Patient | The Rambling Soapbox: Writings and Thoughts of Loura Lawrence
  3. handselkoan

    This only proves what I already believed: the federal government has less concern for actually addressing the core of a problem than regulating profitable aspects of it, more suitable for oversight on paper, and less applicable to the real issues at the human level.

    Like

  4. Kathi

    This is interesting. I can see both sides. Those in pain need pain relief, and often those in chronic pain are not able to do alternative methods for pain management. Although, in Oregon, with marijuana being legal, it’s easy to get medical marijuana and I know people who live with chronic pain who find relief through medical marijuana – although, I’ve heard that the pain’s still there, the marijuana keeps you from thinking about it.

    I sat in a training with our police department last month where they talked about the huge rise in heroin use, which many link to beginning use of opioid pain killers such as Oxycontin. I guess I can understand the government’s response to trying to control a growing problem.

    Like

    • Maureen Alison Puddle

      And its obvious you have never been in severe chronic ongoing pain Kathi because you speak so superficially and blithely about a problem that for many is a life and death struggle to get through each day because of their severe un-managable pain and this included children! If people cannot distinguish between those who take a drug to get high and are addicted to it and those who desperately need it to just keep living and have their pain controlled, then they should not even be commenting! I have worked with people in severe Pain most with terminal Cancer but not all and I tell you its a terrible even criminal thing to deny narcotics and good pain relief which is possible to them. People with many other conditions as well As Cancer are in terrible daily and ongoing pain and to tell them to take Tylenol or Motrin is not only total ignorance its total lies! I would like those who are advocating for this, to walk a mile in the shoes of a severe pain patient for at least one month and then they may have some truth to talk about instead of the lies they are now peddling!

      Like

      • Loura Shares A Story

        Hi Maureen! Before I approve your comment, would you please consider revising it to reflect more of a teaching tone?

        I completely understand and share your anger, but it is my goal to foster learning and discussion on my blog and I do not believe that angry words accomplish the changes we as pain patients need.

        Thank you so much for reading and commenting! I hope you are feeling pain-free or at least pain-controlled today and every day.

        Sincerely,

        Loura L. 🙂

        Like

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