Obama Opioid Funding Draws Criticism

Obama Opioid Funding Draws Criticism

By Ed Coghlan

“We need to take chronic pain, as a disease, at least as seriously as opioid abuse.”

That’s how nationally recognized pain physician, Dr. Richard Radnovich, described President Obama’s Proposed $1.1 Billion in New Funding to Address the Prescription Opioid Abuse and Heroin Use Epidemic with the National Pain Report Tuesday night.

“While I am glad there is going to be more research on opioid abuse, where is the proportional investment in pain research?”, the noted Boise Idaho physician asked. “Most reliable data suggests that less than 5% of pain patients abuse their opioids. The Institute of Medicine Committee on Advancing Pain Research, Care, and Education estimates the economic costs resulting from chronic pain are at least $261 billion, in 2010 dollars.”

The President has made clear that addressing the opioid overdose epidemic is a priority for his Administration and has highlighted tools that are effective in reducing drug use and overdose, like evidence-based prevention programs, prescription drug monitoring, prescription drug take-back events, medication-assisted treatment and the overdose reversal drug naloxone.

A well-known and articulate spokesperson about the nation’s health care system and its approach to treating chronic illness is skeptical about President Obama’s proposal.

Terri Lewis, Ph.D, told the National Pain Report:

“What is missing from this approach? Funds to address the distinct need for research into effective continuation of treatment protocols for persons who suffer from the more than 200 readily identifiable health conditions that generate chronic pain syndromes are strikingly omitted from this budget. While a mention of CDC’s effort to implement guidelines for primary care support to persons with chronic pain is given a nod, in fact there is no mention of funding for the need for medical education of health care professionals, continuing education for practitioners currently in place, and no mention of the fact that skilled treating providers with broad skills across disciplines are needed – particularly in rural areas where integrated services are largely absent.”

The President’s FY 2017 Budget takes a two-pronged approach to address this epidemic. First, it includes $1 billion in new mandatory funding over two years to expand access to treatment for prescription drug abuse and heroin use. This funding will boost efforts to help individuals with an opioid use disorder seek treatment, successfully complete treatment, and sustain recovery. This funding includes:

  • $920 million to support cooperative agreements with States to expand access to medication-assisted treatment for opioid use disorders. States will receive funds based on the severity of the epidemic and on the strength of their strategy to respond to it. States can use these funds to expand treatment capacity and make services more affordable.
  • $50 million in National Health Service Corps funding to expand access to substance use treatment providers. This funding will help support approximately 700 providers able to provide substance use disorder treatment services, including medication-assisted treatment, in areas across the country most in need of behavioral health providers.
  • $30 million to evaluate the effectiveness of treatment programs employing medication-assisted treatment under real-world conditions and help identify opportunities to improve treatment for patients with opioid use disorders.

This investment, combined with other efforts underway to reduce barriers to treatment for substance use disorders, will help ensure that every American who wants treatment can access it and get the help they need.

Second, the President’s Budget includes approximately $500 million — an increase of more than $90 million — to continue and build on current efforts across the Departments of Justice (DOJ) and Health and Human Services (HHS) to expand state-level prescription drug overdose prevention strategies, increase the availability of medication-assisted treatment programs, improve access to the overdose-reversal drug naloxone, and support targeted enforcement activities. A portion of this funding is directed specifically to rural areas, where rates of overdose and opioid use are particularly high. To help further expand access to treatment, the Budget includes an HHS pilot project for nurse practitioners and physician assistants to prescribe buprenorphine for opioid use disorder treatment, where allowed by state law.

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Authored by: Ed Coghlan

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Lynda

Call me confused call me crazy but this plan is insanity this is discrimination this inflicting torture on millions of pain patients that because of this have already started killing themselves because of their unrelieved pain. Pain that had been relieved with opioid pain medications until the war on pain patients. Patients living decent pain relieved lives were wiped out taken away left to suffer. People are dying people are left suffering like they never have before all because of the few that abused opioid pain medications & everything legal and not. Did I miss something but how exactly does any of this help chronic pain as a disease be recognized as serious as the disease of addiction? If I understand correctly addiction is now considered a disease and since chronic pain is caused by over 200 diseases or is a symptom of disease or injuries makes chronic pain a disease or because chronic pain attacks all the body’s systems makes it a disease I don’t know exactly. What I do know is everything that can be done to restrict chronic pain patients access to opioid pain medications is being done and new ways to prevent chronic pain patients access to opioid pain medications is in the works at every level it seems. So this is how looks to me. We have 2 diseases the disease of addiction that abuses opioid medications and the disease of chronic pain that depends on opioid medications to relieve their severe chronic pain. So how does it help to restrict chronic pain patients with the disease of pain be restricted access by the CDC,FDA DEA & other state rules & laws at every turn from opioid medications? There are so many restrictions it has left so many pain patients without any way to relieve their pain and many without even a doctor. This is helping chroni pain patients how? Even though out of millions of pain patients only 1 to 2% ends in addiction is fact but as a country everyone is willing to force millions of pain patients back into unrelieved suffering because of the few that abuse. 1.1 Billion is being put out for addiction those with the disease of addiction to narcotics, diverted opioid pain medications or Heroin are getting over a Billion dollars to ensure drug addicts that abuse opioids are able to get better access to opioid pain medications because they are addicted but not the pain patients because we only have pain. They ensure addicts have continued access to receive strong opioid medications like Suboxene & Methadone that are also used for pain medications. This is all so they don’t abuse opioid medications to help them to not abuse street narcotics or Heroin. Not even one cent of this 1.1 Billion dollars will be used to help the 106+ millions of responsible law abiding honest chronic pain patients that lost their medications lost their doctors that are loosing the adequate doses of these opioid pain medications to find… Read more »

HOWARD H HEROLD

I have suffered with Chronic-Pain for over 10 years, i dont abuse my meds, it is locked up in two different safes, because my meds were stolen and i was the one that had to suffer for that whole month. Ive had TWO back surgery’s one Laminectomy and a Fusion and in Pain 7 days a week 24hrs a day. My meds are given to me by my spouse she has the key for one safe and the combination to our main safe. Let someone deal with the pain i do everyday and see if they can deal with it………….A CHRONIC PAIN SUFFERER AND NOT A DRUG ADDICT !!!

Jean Price

Once again addiction hampers care for those with chronic pain! When they decide not to allow a generic because of abuse…they increase the financial impact on patients who have already been impacted severely with loss of jobs/income due to illness, insurance costs increasing, health care costs increasing, and rising medication costs for other health care needs. Most people in chronic pain have multiple health issues and take other medications, besides those for chronic pain. Most addicts don’t! So…is there some way to separate those who use opioids illegally based on this? Would beg the question of common sense being used, wouldn’t it? For the doctors, and pharmacists, and for our government! I am so very tired of abuse and chronic pain being lumped together…and abuse receiving the lion’s share of support and money! At the expense of those in long term, daily pain whose only wish is to live more productively and rejoin society and participate in their families life! That our president doesn’t address this before he addressed abuse is truly criminal! We are looking for care…most addicts are not! And that’s why a lot of people who abuse drugs go back to that even after treatment! Yes, they do deserve our help…but NOT at the expense of ignoring the crisis of people in pain being abandoned by the system! This has to stop…we are already at the edge of the cliff! Stop trying to push us over!!!

I’m one of those people whom has chronic pancreatitis. Did not get it from being an alcoholic, nor from street drugs because I am proud to say that I’m 49 years of age and have NEVER done but one drug in my life. And that drug is what has pulled me thru 27 major surgery’s. It’s called,God and praying to him. Never ever needed to come home and take the pain meds that doctors would give me. Two aleve worked fine and dandy. That is up until I got the pancreatitis on top of bone and disk problems. Now I’m on a daily Pain regimen or opioid so to speak. And no I have to admit, without them I spend time in the hospital with BAD flare ups. Or I just can NOT do to well on my daily life. But however,I do get sooooooo angry at people out there whom abuse these opioids. Because that makes it difficult for people like me to be able to get these medications that we truly need for just being able to do for ourselves our daily living. But I thank God for the chronic pain specialist that are able to monitor us and keep us on a pain regimen. It does not bother me in the least having to go every so often for a pill count,or a pee test. Just as long as my body does not have to deal with that nerve ending pain. It’s a pain that’s worse than giving birth. But my whole point is that because of drug abuser, people like me have it rough. But I want to say that I pray daily for those that have became addicted. Because a humans body can get very depending on these drugs/opioids. I myself am on two a day of a time release. And I never need more or more mg. Thank God for that after all my body has been thru. Just wanted to share my opinion on this. But as far as medicaid,I have so many problems with that and getting my meds and it makes it hard on people who REALLY DO NEED this. I did not ask to be born into this world with BAD health but I feel like sometimes the government thinks I did. Crazy huh?

ron

We need something done now if not sooner. People without neuropathy pain. you dont have it you dont want any. … something People just can’t seem to get our dr to really understand what we really need .i think medical marijuana is a must in Missouri now ….. my feet pain is 9-10 every day non stop Obama ,,, help us now…..

Terri, spot on. Perhaps the NIH should consider a staffer, like yourself. It all goes back to the lack of a fair and balanced committee of stakeholders from every aspect of pain care.

Trouble is, if the government is going to use our tax dollars, at least get part of it right. If you do not have money, and you are an addict, you do not get adequate care. There is something morally wrong about this. If you are a patient as identified earlier by Michelle, you are treated poorly simply because you have a chronic pain condition. I have said this many times, we are seeing more people seeking pain care and opioids because there are more of us baby boomers than any other population. Medicare coverage for new medications, which may or may not work, is out of reach for us, even though we paid into the system all our lives. Also morally unjust.

Terri Lewis PhD

This 2017 budget allottment is lopsided, unjust, lacks equity , fails to address the social indicators of appropriate healthcare, and will increase the address of both addiction and chronic pain within a forensic framework. It’s insane serving neither population well.

But it will make addiction facilities and local county jails a lot of money.

Terri Lewis PhD

The model of care for acute and chronic, noncancer, musculoskeletal pain management is referenced herein – it is the result of an international work group that views access to pain care as a human right:

Nicolas E. Walsh, MD, , Peter Brooks, MBBS,, J. Mieke Hazes, MD, PhD, , Rorey M. Walsh, BS , Karsten Dreinhöfer, MD, , Anthony D. Woolf, BSc, , Kristina Åkesson, MD, PhD, , Lars Lidgren, MD, PhD, ,Standards of Care for Acute and Chronic Musculoskeletal Pain: The Bone and Joint Decade (2000–2010), Bone and Joint Decade Task Force for Standards of Care for Acute and Chronic Musculoskeletal Pain

http://www.archives-pmr.org/article/S0003-9993%2808%2900393-6/fulltext
Article Outline
Standards of Care
Standards of Care for Acute Musculoskeletal Pain
Prevention
Initial Assessment
Initial Management
Serious underlying condition
Specific musculoskeletal condition
Nonspecific acute musculoskeletal pain
Follow-Up Care
Rehabilitation
Prevention of Recurrent Musculoskeletal Pain
Prevention of Chronic Musculoskeletal Pain
Standards of Care for Chronic Musculoskeletal Pain
Prevention
Initial Assessment
Initial Management
Serious underlying condition
Specific underlying condition
Chronic musculoskeletal pain
Follow-Up Care
Self-Management
Pain Management
Effective Communication
Developing a Management Plan
Components of a Management Plan
Assessment
Management Plan
Evaluation and Review
Supplemental Appendices
References

Let me point out that the addiction model shortchanges this entire process. Any approach to opioid management or pain care for those with either acute or chronic pain that shortchanges a comprehensive, integrated approach to care risks placing the consumer into the wrong care protocol (wrong patient selection) and adds increased risk to the consumer (wrong treatment) – both of which add up to increased medical harms that are iatrogenic (harms caused by the medical intervention itself).

Great article Ed. There are two sides to the opioid coin, one is destructive to the lives of the addict and everyone who surrounds them. The other side to that coin gives people hope for dealing with chronic pain in an affordable manner, and often times relief so they can participate in all the things life has to offer, socialization, accomplishment, and self-worth, all the things opioids destroy in the addict. Both deserve equal attention, but let’s face it, media plays a huge role in the public’s perception of opioids, that is until they need them.

Fear mongering is alive and well. Education is key for both sides of the opioids coin, but it really isn’t all that difficult. Awareness of behaviors of the addict are far more helpful than all the drug screens put together.

Haven’t we witnessed a failed attempt to vet the terrorists of San Bernadino? We can become so reliant on technology and intricate programs that we forget to use our common sense. Now there is a call for citizen’s to see and report “suspicious behavior.” Why can’t the same be done for those who become addicted? I suspect it is because there is nowhere for these people to go once they are identified. How about putting some of this money into programs to help these folks? A place where family members can take them right off the bat instead of trying to navigate a very inept mental health system because of lack of funding. How about using that money for programs to educate folks, including the public on the difference in the behaviors of those who opioids help and those who opioids destroy?

Just my 2 cents.

Michelle

I agree these issues are pressing and deserve prompt and aggressive addressing. Providing it’s not off the backs of the millions of chronic pain sufferers. And if the gov’t truely believes the problem is initiated by treating chronic pain. Where are the funds, as you said, to find the cures? There are massive numbers of diseases, conditions & injuries that cause chronic pain.
And as baby boomers are ageing, we are seeing a spike in chronic pain disorders.
The plain truth about more scripts being written is, there is a greater need. Needing dire Releif & choosing it @ the end of a hypodermic needle is vast and wide.
As a care giver the evidence is crystal clear!
Treat chronic pain with compassionate care! And address addictions compassionately thru mental health!