By Michael Genovese
July 31, 2018 at 5:00 am ET
As opioid overdoses have spiked to unprecedented levels, growing numbers of Americans see addiction as a major problem in their communities. In 2016, more than 63,000 Americans died of opioid-related drug overdoses. That’s more deaths than from firearms or car accidents.
But how do we address the opioid crisis without overcorrecting for the problem?
With numbers like these, it’s not surprising that both federal and state governments have started to take swift action, namely through new legislation intended to curb the prescription, sale and abuse of opioids. Several states, including Arizona and Pennsylvania, have instituted laws that severely restrict the length and quantity of opioid prescriptions.
It’s encouraging to see our communities and government take steps to reverse this mounting problem, but we must include everyone in the conversation. Just as we must listen to law enforcement, doctors, pharmacists and patients suffering from addiction, we also must consider those left in the shadows — patients managing chronic pain disorders.
At a recent Food and Drug Administration meeting on chronic pain, Pittsburgh resident Mariann Farrell, who lives with fibromyalgia and post-herpetic pain, said she has considered suicide because of the constant distress she lives under, according to a recent NBC News report.
Another chronic pain patient, Sandra Flores, a Tucson, Ariz., resident who suffers from adhesive arachnoiditis, a painful spinal and nerve condition, said she cannot find a doctor to prescribe her the medication she needs. She said doctors fear repercussions for prescribing opioids.
Hundreds of thousands of Americans struggle with chronic pain conditions as the result of arthritis, cancer, multiple sclerosis or fibromyalgia, to name a few. Many rely on opioid pain medications to maintain mobility and improve their quality of life. And ensuring these patients have access to vital medications should be considered an important part of our national discourse.
It is true that there was a prolonged period in which the addictive qualities of opioids were misunderstood. Prescription opioids were prescribed at higher rates and for longer periods of time than may have been clinically necessary.
But, we must be careful not to let the pendulum swing too far in the other direction and severely restrict prescription opioids for patients suffering from chronic pain — a short-sighted approach that will no doubt lead to a myriad of unintended consequences. Just as we treat addiction with a variety of approaches, physicians must also be able to treat chronic pain using available, approved resources.
Laws that overly restrict opioid prescriptions not only prevent doctors from treating patients’ full medical needs, but they also risk pushing people toward the black market to find other, illegal and unregulated methods of pain management. And still worse, some in the pain community worry that long periods of extreme pain can lead some patients to suicide. Of real concern is the rise of deadly fentanyl and heroin, reminding us that patients should receive pain management and addiction treatment in a clinical setting.
FDA Commissioner Scott Gottlieb recently weighed in, saying: “We don’t want to perpetuate practices that led to the misuse of these drugs and the addiction crisis. At the same time, we don’t want to act in ways that are poorly targeted and end up disadvantaging legitimate patients.” He’s absolutely right.
We can find common-sense solutions to fight the addiction epidemic and consider the needs of sufferers of chronic pain like Mariann and Sandra. We all have a responsibility to elevate the voices of these patients — our national conversation and policy outcomes will be better for it.
Dr. Michael Genovese is the chief medical officer for Acadia Healthcare.
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