These are dynamic times in the pain management world.
The National Institutes of Health released the National Pain Strategy, what most pain providers and patients believe is a long overdue effort. Public comment is welcome until May 20.
The backlash from the DEA’s decision to reschedule hydrocodone continues unabated. Has the DEA action had the unintended consequence of denying patients legitimate pain relief in the interest of trying to address an addiction issue?
During the course of our work at the National Pain Report, we meet a number of interesting and concerned people who think, about the issues facing the identification, treatment and education about chronic pain.
As a result, we are going to start to ask some experts about their opinions. We start with Dr. Richard Radnovich, who runs the Injury Care Medical Center in Boise, Idaho. Dr. Radnovich, who is an osteopath, is nationally known and has been involved with numerous clinical studies on pharmaceutical and medical devices that treat chronic pain. He’s involved with studies on lower back pain and on fibromyalgia currently.
He agreed to share his thoughts to some questions we had.
National Pain Report: How would you characterize the state of pain management today from the
physician’s point of view?
Dr. Radnovich: “We are in an interesting and challenging time. We have more awareness and acceptance of pain as a disease state, we have more medications in more formulations than ever before, and most of our patients have access to a range of potentially effective medical and non-medical interventions. But was also have drug policies that suppress access to effective treatment, insurance companies that do not want to cover a range of medications or treatments, and anti-drug messages that confuse issues of pain treatment and substance abuse.”
National Pain Report: “What impact has the DEA’s emphasis on pain med usage had on the
physician and the patient?*
Dr. Radnovich: “The problem is not the DEA doing its job. The problem is that we have blurred the lines between 2 distinct problems: chronic pain treatment and substance abuse. The DEA is concerned with the latter. Medical providers just need to do a good job with the former: that is, show that they are using opioids for a legitimate medical purpose; and provide adequate medical care and supervision. I think there are some medical providers that are concerned about the DEA, and it may have caused some mistrust between the prescriber and their pain patients. That is both unfortunate and unintended. Local law enforcement and state boards of medicine can be a much bigger problem.”
National Pain Report: “On the National Pain Report, there’s been a firestorm of commentary
about basic access to pain meds–Has the government gone too far?”
Dr. Radnovich: “In most jurisdictions, hydrocodone products were the most frequently abused prescription medication. Many prescribers did not recognize that hydrocodone was such a popular drug of abuse, which perhaps led them to prescribe more freely. This was fueled, in part, by hydrocodone products’ classification as a CIII. That classification also allowed the drug to be called in. The ability to ‘phone in’ a prescription became a huge avenue for hydrocodone to be diverted for illicit use. While the change has resulted in hardship for many patients, as a policy decision, I believe it was not unreasonable.”
Editor’s Note: We had additional questions for Dr. Radnovich which we’ll publish at a later time.
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