Wednesday, April 25, 2018
Opinion

Don't punish pain sufferers

People living with chronic pain and the doctors who treat them have become victims of new policies in Florida intended to deal with the out-of-control prescription drug abuse crisis. While quick to prematurely declare victory in the war on drugs, policymakers have run roughshod over millions who deserve better: disabled, elderly and chronically ill people who live with pain.

Unquestionably, the abuse of prescription medications is a huge problem, and Florida has become a breeding ground for unscrupulous drug dealers masquerading as physicians, pharmacists and "patients." Their pervasiveness has led to suspicion of all prescribers as dealers and all patients as addicts. In an ill-conceived effort to right the wrongs brought by this scourge of prescription drug abuse, Florida policymakers have unintentionally stopped good pain care in its tracks.

Dramatically increased scrutiny from regulators and law enforcement means legitimate physicians and pharmacists fear being put out of business and even arrested for prescribing or dispensing medications to a drug dealer posing as a patient. Federal and local law enforcement agencies simultaneously have pressed to deliver results by taking the most direct and overly simplistic route: cutting off pain medication supplies. In this atmosphere of fearful providers and artificially short supplies of medications, people with pain who benefit from these medications are sometimes forced to drive hundreds of miles to find a doctor and visit dozens of pharmacies to get medication that will loosen the unrelenting grip of pain.

Last year, the Institute of Medicine issued the groundbreaking report "Relieving Pain in America: A Blueprint for Transforming Pain Prevention, Care, Education and Research." The report estimated that more than 100 million American adults live with chronic pain, translating to more than 5.5 million people in Florida. These are our neighbors who can't mow their lawn anymore; our co-workers who show up to work but miss deadlines and important meetings; our relatives who opt out of family events.

"Relieving Pain in America" details how our current treatment model for pain, a biomedical approach focused on medications, nerve blocks and steroid injections, has largely failed. The IOM report calls for a "cultural transformation" in the way pain is perceived, judged and treated. It defines the undertreatment of pain as a national challenge and asserts that there is a "moral imperative" to address it. "Relieving Pain in America" calls on governmental agencies, health care providers, professional organizations and patient advocacy groups to take the lead in this transformation.

The report calls for a new approach to pain management — a "biopsychosocial approach" — one that may include medications and interventionalist approaches but may also include diet, exercise, physical therapy, counseling, chiropractic care and other treatments. It acknowledges, too, that clinicians have not been taught how to manage chronic pain and that patients have been conditioned to expect a pill to "fix" everything.

Relieving pain and suffering is a fundamental duty of all those in the healing professions. State legislators, regulators and law enforcement agents are obligated to create and enforce fair and equitable policies and laws that protect the rights of their citizens and promote the well-being of all, especially the most vulnerable. While medical professionals and officials worry about protecting their reputations and livelihoods, patients have been shrugged off as an inconvenient afterthought that will sort itself out in time.

Left to live with physical and emotional anguish, their undue suffering has been chalked up to an "unintended consequence" of knee-jerk policy decisions based on heated emotion — not fact. Recent efforts to address prescription drug abuse have created an environment in which health care providers are being encouraged to walk away from their moral imperative to treat pain. How are policymakers fulfilling their obligation to reflect the interests of all of their constituents, including the millions who live with unrelenting daily pain?

There has never been a better time to work together to transform the way that we care for each other. "Relieving Pain in America" provides a unique road map and opportunity for all of those who are a part of the pain community — policymakers, patients, providers, pharmacists, insurance companies and others — to consider. Chronic pain patients should not be punished for the behavior of criminals. They should not become "collateral damage" in the war on drugs.

Lennie Duensing, far left, is executive director of the American Academy of Pain Management. Bob Twillman is director of policy and advocacy for the American Academy of Pain Management.

Comments
Editorial: As USFSP consolidation task force meets, openness and collaboration are key

Editorial: As USFSP consolidation task force meets, openness and collaboration are key

Writing a new law that phases out separate accreditation for the University of South Florida St. Petersburg and folds it back into the major research university was the easy part. The hard work starts today when a new consolidation task force holds i...
Updated: 2 hours ago

Correction

CorrectionCircuit Judge John Stargel of Lakeland is a member of the Florida Constitution Revision Commission who voted against a proposed amendment that would have stopped write-in candidates from closing primary elections. An editorial Saturday inco...
Published: 04/23/18
Editorial: Pruitt sets new low for ethics at EPA

Editorial: Pruitt sets new low for ethics at EPA

Not too many people took then-candidate Donald Trump seriously when he famously campaigned to "drain the swamp" as president. But that shouldn’t give this administration a free pass to excuse the behavior of Scott Pruitt, the administrator of the Env...
Published: 04/22/18
Updated: 04/23/18
Editorial: Allegiant Air still has safety issues

Editorial: Allegiant Air still has safety issues

Allegiant Air’s safety record remains troubling, and the Federal Aviation Administration’s reluctance to talk about it is no more encouraging. Those are the key takeaways from a 60 Minutes report on the low-cost carrier’s high rate of mid-flight brea...
Published: 04/21/18

Editorial: Women’s work undervalued in bay area

Even a strong economy and low unemployment cannot overcome the persistent pay gap affecting full-time working women in Florida. A new report shows women in Florida earned 12.5 percent less on average than their male counterparts, and the disparities ...
Published: 04/21/18
Editorial: Florida’s death penalty fading away on its own

Editorial: Florida’s death penalty fading away on its own

Florida lawmakers may never take the death penalty off the books, but stronger forces are steadily eroding this inhumane, outdated tool of injustice. Court rulings, subsequent changes to law and waning public support have significantly suppressed the...
Published: 04/20/18
Updated: 04/24/18

Editorial: A missed chance for open primary elections

The Florida Constitution Revision Commission did a lot of things wrong this week by combining unrelated or unpalatable provisions into single amendments that will appear on the November ballot. It also wasted an opportunity to do one thing right. The...
Published: 04/20/18
Updated: 04/23/18
Editorial: New Cuba president is chance for new start

Editorial: New Cuba president is chance for new start

For all the symbolism, Raul Castro’s handoff of the Cuban presidency this week amounts to less than meets the eye even if his handpicked successor, the Communist Party functionary Miguel Diaz-Canel Bermudez, is the first person not named Castro to le...
Published: 04/20/18
Editorial: When they visit Nature’s Classroom, kids are right where they belong

Editorial: When they visit Nature’s Classroom, kids are right where they belong

The Hillsborough school district planted a fruitful seed with the opening of Nature’s Classroom five decades ago on the cypress-lined banks of the Hillsborough River northeast of Tampa. • The lessons taught there to some 17,000 sixth graders each yea...
Published: 04/20/18

Editorial: Equality pays off on Southwest Flight 1380

The passengers of Southwest Flight 1380 can be thankful that, 33 years ago, the U.S. Navy took the lead on equal opportunity.Capt. Tammie Jo Shults was piloting the flight from New York to Dallas on Tuesday when an engine exploded, blowing out a wind...
Published: 04/19/18
Updated: 04/20/18