By Ed Coghlan.
As Pain Awareness Month kicks off, the chronic pain community was greeted with another effort to slow down opioid use–in this case focused on high-dose opioids.
A petition was filed this week that formally called on the Food and Drug Administration (FDA) to ban high-dose opioids painkillers, ostensibly to prevent overdose deaths among patients and people who abuse drugs.
The idea is to ban opioid pills, that when taken as directed, would add up to a daily dose of more than 90 milligrams of morphine.
The petition was signed by leaders of the Association of State and Territorial Health Officials, Physicians for Responsible Opioid Prescribing, the National Safety Council and the American College of Medical Toxicology.
While the momentum to ban opioids continues, the state leaders and others aren’t talking much about the impact on millions of people who use opioids to combat chronic pain…something US Pain Foundation President Paul Gileno pointed out this week.
We talk a lot about the opioid crisis, but we don’t talk much about chronic pain,” says Paul Gileno, president and founder, who began having pain after a serious work accident in 2003. “In order to effectively address the opioid epidemic, we should also be thinking about how to address the parallel problem of chronic pain, whether by providing more funding for pain research, encouraging insurers to provide more coverage for nonpharmaceutical treatment options, or creating better support services for people and families affected by pain.”
Elsewhere on the opioid front, it would appear that insurance companies are taking a different view–even when one of the nation’s leading pain physicians wants to try something else. There was news out of Boise, Idaho this week where Dr. Richard Radnovich was scratching his head over the action of several insurance companies.
He wanted to give the patient tramadol. The pain medication is a “Schedule IV” drug, which means it has a “low potential for abuse and low risk of dependence,” according to the federal classification system set up to chart drug risks.
But the insurance company insisted the patient first try morphine. A “Schedule II,” two steps above tramadol on the ranking of addictive drugs, it has a “high potential for abuse, with use potentially leading to severe psychological or physical dependence.”
Dr. Radnovich’s quote in the Idaho Statesman pretty much sums up the inconsistency in the entire opioid debate.
“I don’t want to take the chance that my patient is going to like a drug too much, so I don’t want them to have to be exposed to it,” he said. “It’s insane to me that an insurance company would force me to write morphine [prescriptions] instead of tramadol. … In what world is that a sane response to what’s going on?”
He said several insurance companies have had the same reaction.
On Monday, we’ll have the comments some chronic pain patients have sent us regarding their frustration on this issue.