By Shaina Smith
While the nation continues hearing tragic stories of families losing loved ones to misuse and abuse of medications, there is a growing population which is often forgotten during opioid addiction discussions: chronic pain patients.
According to the Institute of Medicine (IOM), chronic pain affects over 100 million Americans and costs the U.S. $635 billion per year. It’s an alarming and growing epidemic for families across the country and within the state of New Jersey. Managing chronic pain is a challenging undertaking for prescribing physicians and often requires a multimodal approach (both pharmacologic and nonpharmacologic interventions) and balanced pain management practices.
Each person with chronic pain embarks on a tedious journey to be diagnosed, find a support system, engage in a trial and error process for treatment options and eventually find a treatment plan that best fits their condition. Many pain patients face adversity and societal stigma, particularly when opioids come up in conversation.
There’s a national growing trend that patient advocates are witnessing whereby lawmakers are proposing bills to deter deaths associated with opioid medication. Such legislation has been proposed in New Jersey.
Senator Raymond Lesniak announced a bill (S. 2703) that would restrict medical expense coverage for opioid drugs unless prescribing health care professionals follows certain guidelines. Although I applaud the efforts of elected officials such as Senator Lesniak for attempting to curb misuse and abuse, there are several factors that should be taken into consideration before such proposed bills are filed and voted on.
The first consideration is that of addiction. Addiction, per the National Institute on Drug Abuse, is a chronic disease difficult to control, despite damaging outcomes. Chronic pain is also a complex disease. Both diseases are underfunded, misunderstood and require lifelong management and treatment. Creating a bill such as S.2703 will not eliminate a person with addiction disease from continuing to seek out medications. It does, however, place access limitations on those legitimate chronic pain patients who rely on such life-saving options to manage their condition.
Another issue to consider when restricting medical expense coverage for medically necessary treatments is that of the prescribing physician and existing tools to combat addiction. The state of New Jersey currently has in place a prescription drug monitoring program—an effective tool which can be useful in identifying possible prescription drug abuse. Prescribing physicians make use of this mandated technology to curb abuse within the state. Such documentation takes up the time of the healthcare provider, many of which are faced with the high volume of pain patients to treat. This doesn’t include the time they take to follow-up with insurance companies who may have denied patients a treatment option and/or who are filing an appeal on behalf of their patients.
It is also important to note that the New Jersey State Board of Medical Examiners Regulations on Prescriptions for Controlled Substances includes extensive safety measures for the prescriber; he/she must also comply with all other applicable state and federal laws and regulations.
In the wake of federal guidelines surrounding opioid prescribing, states are being reactive instead of proactive. The guidelines spelled out in S. 2703 increases the power to insurance companies to deny coverage if a doctor fails to submit expansive documentation. As a person living with pain, it appears that this proposed legislation deters doctors from effectively helping chronic pain patients manage their condition. It also fails to address addiction as a disease and instead restricts access to life-saving treatment options for New Jersey patients.
While I understand a lawmaker’s desire to create a safeguard which deters addiction and misuse, a bill such as S. 2703 does not proactively address addiction disease in a fair and balanced approach. Legislation should not impede on the sacred patient-physician relationship, create additional hurdles which disrupts access to treatments or create additional, time-consuming guidelines for healthcare providers.
Shaina Smith is Director of State Advocacy & Alliance Development for U.S. Pain Foundation. Diagnosed with various pain conditions, including Ehlers-Danlos Syndrome Hypermobility Type, Shaina utilizes her Journalism background to mobilize pain patient advocates and engage volunteers to participate in awareness programs.