A Rhode Island Legislator Shows the Way for Chronic Pain Treatment

A Rhode Island Legislator Shows the Way for Chronic Pain Treatment

A Rhode Island bill is halfway home to becoming a model for legislation for chronic pain—particularly for chronic pain patients who depend on opioid medication to help them cope.

Rep. Gregg Amore’s bill, that would exclude chronic intractable pain from the definition of “acute pain management” for the purposes of prescribing opioid medication, was passed by the House of Representatives.

Amore, whose wife has been battling breast cancer, is a neighbor of Claudia Merandi who has been the architect of the national Don’t Punish Pain Rallies that have been drawing attention for over a year, is convinced that the nation’s opioid policy is missing the point.

“We want to make sure that our public policy regarding addressing the opioid crisis does not have the unintended consequence of hurting patients who are trying to manage chronic pain. These patients are not addicts, they are suffering with pain associated with cancer, palliative care, and in many cases, chronic intractable pain. We need to let physicians determine how best to manage their patients’ pain,” said Representative Amore.

In an interview with the National Pain Report, Merandi said that she has already lined up a State Senator who can support the bill when the Legislature reconvenes next year—his name is Frank Lombardi.

The bill has attracted significant support from the Rhode Island chapter of the American Civil Liberties Union, the state’s Nursing Association and, importantly, the Rhode Island Medical Society.

“Advocacy is something I do every day,” said Merandi. “Our efforts are paying off in Rhode Island because I’m persistent.”

Merandi pointed out that she was able to convince Amore about the importance of the legislation by convincing him to listen to what chronic pain patients were saying on social media.

Merandi added that her first efforts were around getting a resolution passed by the Legislature….”a resolution has no teeth,” she said.

Her advice to those who want to advocate—or importantly who don’t advocate—is direct.

“Get in the game,” she said. “Find someone in elected office or public policy you can email, talk to and convince that the chronic pain issue is important not only to you but to thousands of people like you.”

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Authored by: Ed Coghlan

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Rosalind Rivera

All I can say is Kudos to this very wise and courageous politician. All others in government office should heed and learn from this representative of the chronic and intractable pain community!

Lori Bonebrake

No matter that the CDC says in there back tracking until the DEA agrees and sends letters to their drs no dr will go against what DEA says as they are all to afraid!

Holly

Honestly the depression has set in big time as I just had another cutback of my pain meds. When u feel this low how do u try and do anything?

Patricia Bradley

Its still a year away..what are people supose to do when the Dr just stops treatment and keeps sending you to have infusion. Or implants etc. All of these are still experimental cost thousands of dollars and can’t guarantee they will even help. How many more of us have to die how many lives is the cost of help?

It’s going on 7 months now after having hip surgery which ended up in a complication. Finally I get a MRI but I have to wait two weeks to find out bc my surgeons on vacation. Meanwhile as I’m suffering with excruciating pain from this complication I was told keep icing / to take CBD oil for the pain. What an absolute joke , it doesn’t work it’s not regulated. I can’t take NSAIDs . PT has not helped . So I just continue to suffer after having surgery with a complication & continue to be ignored about the insufferable pain that I’m going thru. This is absolutely patient abuse. Insurance will not allow me to get a second opinion until I go through the process w/ this surgeon. Who is for the patient? It’s like I’m a piece of paper & they sit me a side until they can get to me. The CDC guidelines never should have been wrote. I suggest think long & hard before you have surgery before you end up in no man’s land w/ more problems. Thank you to all those that are fighting. If I get over this I plan to do it more. I’ve done some but it’s gone nowhere. I think if more surgeries were turned down then the doctors might start to fight for us. When their wallets hit they may wake up & realize what good is a license if there’s no one to practice on.

I'ma trd

Chronic pain should never have been defined with acute to begin with.

Dick fort

Thank God I really can’t explain how much u guys that advocate mean to me I wish I could do more I wish people could hear my story, I’m from New Jersey last month my injury flared up worst then it’s been in ten years or so and IV been bed ridden for over a month my 63 yr old father is taking care of his 31 yr old son me, my internal med doctor has been taking care of my meds and at first it was great I agreed to a cut which I should of never done but I did it to help her and she’s reduced my med every month since I’m in extreciating pain can barely walk need a cane I can’t even get to my appointment to see a nuro and specialist my insurance sucks so it’s nearly impossible to get into a pain management place to control my pain at the moment I’ll probably whind up in a serve detox this month honestly at this point I’m at the point where I hope I don’t even make it out of it it’s be best at this point between to depression and feeling worthless what even the point anymore can’t find a new doctor what my options go to a methadone clinic and be labeled a drug addict the rest of my life instead of a legit cronic pain paitent pretty [edit] I hope u guys keep fighting and don’t give up pretty sad I’m 31 and won’t see future things, sucks to think a few months ago my pain was controlled and I was doing much better could do things and had a will to keep going

Thomas Kidd

To little and too late.

Dave Acevedo

So proud of Rhode Island Representative Gregg Amore and Claudia Merandi. Please attend your State’s Don’t Punish Pain Rally October 16.

Sandra Pepper-Hill

Faith and Perseverance

ElizabethR

I would absolutely like to see the CDC “Guidelines” scrapped, but that’s not likely in the current anti-pain medication environment. This bill would be a step forward. Overdoses that occur in my state almost always involve illicit drugs such as heroin/fentanyl and young males between 17-30. Yet, an 82 Y/O female living with long-term pain, who takes a low dose of a mild opiate responsibly (me), continues to suffer the consequences of the War on Pain. How does this make sense?

Kristen

Thank you Thank you so much Claudia Merandi and Rep Gregg Amore’s and Frank Lombardi.I live in Rhode Island and though I have a wonderful Dr,I live in fear that the day will come when my wonderful Dr says she can no longer prescribe.This is very hopeful.

Reece

Certainly this is good news. I do believe that media attention is important. They continue to send the wrong messsge. Someone who is knowledgeable needs to get on CBS,NBC., ABC etc. and broadcast the truth. No more Kate Snow’s, etc. Real journalists . Please. Thank you

I’m glad Claudia got a bill advocating change in front of the RI legislature. It is a good start.

However, as long as doctors are attacked for treating patients with opioids, we will not see a change. People need to learn that drugs do not cause addiction, and then what does. We need to stop attacking physicians for doing their job. We need to get government overreach out of the doctor’s office, period. Otherwise, we are simply destroying the doctor/patient relationship even more.

Bill Viverito

Ed – That’s truly a small but significant language change and I support it 100%. Im currently managing my pain with an SCS and an intrathecal morphine pump. But one day I will exceed the limits of the pump capacity. What then I don’t know. Luckily in Texas, the doctor treating those in palliative care for non cancer chronic intractable pain are not subjected to cdc guidelines for opiates. Their mission is to keep the patient comfortable at all times. I do realize this could lead to a zombie like existence, but after 14 years and battles fought it might not be that bad. Keep fighting the good fight. Thanks for your service.

Praise God! Hopefully this is the beginning of something beautiful for the chronic pain patient. Finally someone in office is getting it. Here in Tennessee it seems as though NO ONE will budge at all! Robert Rose, our tireless veteran took their crisis which turned into our injustice to the courts in Greenville Tennessee. It was to no avail, but at least he took it and did his very best! Praise God for those that simply refuse to give up. At the moment I’ve stopped for I don’t know what more to do
with the exception of taking it to our Lord and Savior Jesus Christ. Having faith and trying to leave it with the man that “can still” move mountains. My prayer today is that He bless every single one of you sending His peace, wisdom, strength, patience and healing.💞

Marty

Get in the Game. Advocate everyday. Thank you Claudia Merandi !! We are literally fighting for our lives, it’s an uphill battle loaded with land mines and snipers. But we WILL fight, and protest. Please attend a rally in a city near you. If you personally fight thru pain to see your doctor once a month, you must travel to a rally on the 16th on this month. Don’t allow pain to silence your important voice. Many of us don’t know how long our bodies can continue to survive,,, thru the obvious planned discriminatory based medical care.
#DONTPUNISHPAINRALLY.COM
#PAINPATIANTSVOTE
#PAINISPAIN

This is what we’ve said would happen all along: somebody in legislation would either be personally effected or have a close family member effected, causing a REASON for SOMEONE to finally understand the legislation in place was causing more harm than good. This is a start as those with ACUTE obtain cannot be ignored either but a start is a start.

Denise H

Reading this gives me so much hope.

The Amore Bill is dangerously deficient in one important respect. It treats the CDC Opioid Prescribing Guidelines as a legitimate document.

While it serves the valuable goal of preventing CDC’s Guidelines for treatment of acute pain, from use in Intractable pain and puts state authorities on notice that they are not to stretch the CDC Guidelines beyond CDCs intent,it also does the disservice of legitimizing ex-Director Tom Frieden’s grab of pretended authority over an area of medicine outside CDCs subject matter expertise.

CDC remains the Government’s infectious disease research laboratory . It is one of the operating units of the National Institutes of Health (NIH). Two other units of NIH have subject matter expertise in the function and use of opioids. They are NIDA and NIMH. Neither agency was willing to endorse the Guidelines. Analysis by Dr Richard Lawhern of CFCs own mortality and morbidity reports disproves the Kolodny psnel’s conclusions, therefore we must conclude that CDC research played no role in creating the Guidelines that the Kolodny panel wrote and Director Friedan signed.

It’s not advisable for Rhode Island to legitimize the Kolodny panel’s conclusions by incorporating them into state law. Rhode Island is bound by the Americans With Disabilities Act to allow people to ameliorate a disability with legal opioid medication. Adopting the CDC Guidelines by state law, makes Rhode Island vulnerable to lawsuit for disability discrimination, which it could avoid by rejecting the CDC Guidelines totally and recognizing that other NIH agencies have expertise in the field and FDA has regulatory powers.

The bill is a distinct improvement over nothing at all. But I recommend that it allow for the eventual repeal of the CDC Guidelines and their replacement.