New Jersey is being Reactive Instead of Proactive

New Jersey is being Reactive Instead of Proactive

By Shaina Smith


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.

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Authored by: Shaina Smith

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I live in NJ and have been a responsible legitimate chronic pain suffering patient since 1989 after a failed spinal fusion in which the misaligned pedicle screws protrude from the skin on my back. More recently stage 4 cancer. What’s going on with this failed opoid war is a disgraceful episode in the history of medicine. I believe the miscommunication stems from government not understanding what a true legitimate chronic pain suffering patient is. Sometimes there are no alternatives for many people. No surgeries to repair sometimes the very surgery to repair makes you worse. This Turn the Tides government war on opoids has become a TIDAL WAVE of a costly failed war. We have a HEROIN EPIDEMIC not a legitimate responsible pain suffering patient EPIDEMIC! Do you really believe addiction is an issue for many whom suffer endlessly? I can tell you after all these years I have never doctor shopped snorted injected sold or overdosed on my medication. I have been with the same pharmacy for 35 years. I would never consume alcohol with my medication. Pill mills and over prescribing physicians have been dismantled. We have implemented a pharmacy monitoring system we are subjected to very strict pain management contracts pill counts and urines yet we continue to be blamed for the cause of heroin addiction? Our medications do not get us high they just help us to survive and lead a more productive life to eat sleep exercise shower garden play with our grandchildren work ect. The simple things that most take for granted. The government created this mess by locking our physicians hands. We have a failure of a Surgeon General whom has sent millions of letters and pocket pamphlets to physicians and clinicians worldwide and while he was busy inflicting needless pain and suffering upon legitimate chronic pain suffering right under his nose.. the worst illicit drugs and HEROIN EPIDEMIC in history. He left millions of suffering with no backup plan intact to perish in the ebb like snails in his huge failed Turn the Tides war. What a disgraceful mess .. these politicians need to realize that cancer surgical traumas disease ect is real and we the suffering deserve some compassion.. not this inhumane barbaric treatment we are made to endure needlessly! I challenge these politicians to include the legitimate chronic pain suffering at the table and to stop ignoring our cries for help. We have so much we can teach them but they choose ignorance! The time has come to stand up to the bullying and stop this ignorant mess. Too many lives have been lost already to suicide due to needless pain and suffering when essential medications are available. The cost of this opiate War is huge!



Adele Casden

So where is the petition, that needs to be sent to the White House. President Obama may be able to do something about this, still.

Bob Schubring

What needs to be recognized about the present Chronic Pain Crisis, is that the 5 Mexican Organized Crime Cartels make enormous profits by selling mixtures of heroin and fentanyl on the streets, that cause the majority of opioid overdose deaths. Politicians like Senator Lesniak, either by ignorance or by malice, have made the billionaire Cartel kingpins wealthier and more powerful, by promoting these anti-patient attacks during the Bush and Obama administrations. Shutting off the supply of prescription pain medicine, forces people in pain to buy medicine from illegal sources, namely, the Cartels. As the Cartels sell more of their substandard, illegally-made and toxin-adulterated medicine, deaths from the toxins in the medicine and from the varying potency of the medicine, mount. The American politicians use the rising death count, to justify further reductions in the legal supply of medicine, thereby sending even more money into the pockets of the Mexican crime bosses.

These crime bosses do horrible things to their poorer neighbors in Mexico. Cartel violence drives people to flee into the US illegally. Most of these economic refugees end up working for a competing cartel, in an illegal business that cartel built in the US, that systematically breaks the Minimum Wage Law, the Workers’ Compensation law, the Unemployment Compensation law, the Social Security Act, and of course, the Obamacare law. The workers can not sue their employer for breaking these American laws because their employer will have them deported (or shot).

Mr Trump has said much about the problem of illegal immigration. He has not made clear that he understands the political dynamic of how the Cartels systematically make Mexico poor by using violence to intimidate small business owners there, which causes unemployment and poverty, which causes the poorest of Mexico’s poor to flee the country and take illegal jobs at illegal businesses that illegally exploit them, here in the US.

Whether the President-Elect actually understands the crime bosses with whom he’s tangling, need not concern us.

What does concern every pain patient and every person at risk of becoming a pain patient, is the fact that the Cartels appear to have corrupted the US Drug War apparatus, and the politicians and corporate media people who give it cover, and are using the Drug War to inflate their illicit profits from the sale of toxic, adulterated drugs to pain patients.

My intention is to use the public curiosity that’s been aroused by Mr Trump’s bombastic rhetoric about illegal immigration, to create public recognition that many officials of our own government are, either through stupid ignorance or in exchange for bribes and payments, assisting the same Mexican Cartels to make increasing amounts of money by ripping off America’s pain patients.

Sue Donas and others,
if you are interested in advocacy efforts within New Jersey, including this newly proposed bill, I welcome you to send me an email and/or sign up to become an advocate on the U.S. Pain Foundation website!


Don’t all governments react rather than act? Sadly the powers that be have an agenda that in no way intends to do anything other than commit genocide and job security!

I think until these people who voice there opinion about opoids have probably never experienced pain physical pain. I am in so much pain right at this very minute it’s just constant tears rolling softly down my cheek and wondering when will this end. They told me degenerative spondollathesis usually burns itself out in about 15 years it’s been 6 so far and I just sit here wondering were my life went. I also wonder why I was implanted with two defective devices for me to have to have had a second surgery now with scar tissue so bad along with inflammation and other things that they don’t dare touch me again. Why aren’t these devices be held accountable or the doctors? I cleaned out my savings over this it’s a sad state of affairs when a individual has to pay the price for corporate companies and doctors. It’s sad to hear these horrific stories of young people overdosing. I’m 49 and I cry everyday. I would certainly give my life to have them all back. They had there whole future ahead of them. It’s a tough dilemma to decide about opoids, but like me with chronic pain were I’m pretty much housebound can’t sit in a car or drive because the bumps move my spine and it’s sad. We must come together to reach a agreement that will help all people living with different diseases. Hopefully this will happen, we just have to have faith.


Even with insurance, none of my pain meds have been covered. My asthma inhaler isn’t covered. Until a real cure or effective treatment for CRPS is found, opiates are the only option. I also find it frustrating when “complementary” treatments are suggested. Even if they significantly helped, which most do not, when was the last time insurance paid for massage, acupuncture or any non-medical procedure. Pain patients are suffering the brunt of the heroine crisis. Yes, the heroine crisis. Maybe step one should be to stop using the term opiate when speaking of heroine. This has thrown everyone in the same basket. Because legislators can’t handle the illegal drug trade, they go after law-abiding patients. Addicts are still finding drugs on the street, while I go through drug tests, pill counts, stigmatazation and under-treatment. And one more thing, insurance doesn’t cover marijuana (synthetic Marinol for one month is $300)
so please stop telling me to smoke it.


Thank you, Shaina. As one of the persecuted pain doctors, now with a spinal cord injury, and neuropathy, I appreciate your article. I appreciate your advocacy.

DEANNA Gibbons

I’m So Sick of Being Treated like an Addict!! Took me 20+ to ASK For HELP!! AFTER Being Hit n Ranover by A CAR. On top of Having Scoliosis & DEGENERATIVE DISC DISEASE”Hereditary” Living in MISERY!! Took Another 5 YEARS!! Of Crying Out For HELP!! No One Would BELIEVE ME!!! That I Was Hurting!! Every Dr. That I Talked Too Looked at Me Like I had 10 heads!! I FINALLY got a Dr. To give me an MRI!! AFTER 6 Yrs And 1 Neck Surgery/FUSION.And I Need Lower Back Surgery to Go! So After My Pharmacy is Out of Stock!! On My Medications!! SINCE Saturday!! And still have to wait till Thursday!! And No Promise On That!!! I’m Still In MISERY!!! Thanks for letting me Rant!!

Sue Donas

Perfectly stated! I’ve been successfully using opiates to help manage my chronic pain for the past five years. I do believe we must all begin speaking with our local communities and governments to advocate for ourselves- sharing our daily lives will bring our realities to the public. Those who can, must, share their stories, not from a role of victim but as advocates. I have worked so hard to mask my face, to hide my pain, so I would not see pity in people’s eyes and feel embarrassed for my situation. I will contact local bloggers, journalists and voices in my community and show them my truth and ask that they help spread the voice of a almost forgotten group. We have advocated for ourselves as individuals before. Anyone who takes opiates regularly knows the circus hoops one must jump through to be allowed the regular prescriptions and maintenance involved to achieve a livable quality of life. We must come together and systematically blanket the state with the voices of people who have a right to life,liberty and the pursuit of happiness, which I say, implies a relatively low pain life!

Is there someone in our community who has journalist relationships and someone else willing to stand up (or sit, whichever rocks your boat) and share their story with the world? I am willing to be one of us to go public.