For people living with chronic pain access to proper treatment comes with unnecessary barriers. These barriers are the result of an overcorrection in the form of regulation for the controlled substance opioids. These restrictions have been made to address the rise of opioid addiction and overdose. Although work to address opioid addiction and overdose must be appreciated, we must acknowledge the ways in which the fight against misuse of the medication has caused a decline in overall care for a population most in need.
Opioids are used to control severe chronic pain and are a sometimes-necessary part of the pain management process, but the restrictions placed on the medication and its users are significant in their harm. Those living with chronic pain are living with a disability and it puts them at a disadvantage when treatment is not regulated on their behalf and with them in mind.
The process of even getting a referral to a pain management specialist is a difficult one due to the reluctance to accept patients seeking pain therapy in the form of opioids. This does not work to resolve the inequity within the healthcare system that serves certain groups such as people of color and people with disabilities. Disproportionate harm is likely to be done to these groups who are already facing difficulties when it comes to their pain management, and in some instances are found to be denied pain medication by providers.
Among other barriers to access are the halting of a full spectrum of treatment, along with research to develop new treatments that would improve the quality of life for pain patients. Even still, there are major concerns about accessing prescriptions with the reintroduction of telemedicine restrictions. These restrictions would create a loss of flexibility in prescribing controlled substances through virtual visits. This would result in many people, especially those with disabilities in rural areas, to face unnecessary barriers due to transportation and travel time to adhere to the mandatory in-person visit required to maintain their prescription.
Recently many policies have been put in place, contributing to difficulties in accessing pain management treatment. These policies lead many clinicians to reduce dosage or stop opioid prescribing in patients who benefit from the medication out of fear of oversight. This only leads to negative outcomes in patients such as increased suffering, loss of function, overdose, and suicide. There is no reason for patients to experience these outcomes when controlled prescriptions are already subject to numerous safeguards, including mandatory prescription drug monitoring (PDMP) programs in every state. Patients in pain treatment also must undergo monthly urine drug screens, psychological screening, pill counts, prior authorizations, behavior contracts, and pharmacy lock-ins.
While opioid addiction and overdose are significant issues, we must not go without addressing the needs of the patients most vulnerable to opioid medication’s changing policies and restrictions. It is important to reduce the stigma associated with opioid use as its prescribed variant is a well-regulated and viable treatment to remedy pain and allow patients to have a better quality of life.
For more information please visit:
- Protect Access to Opioids for People with Chronic Pain: Barriers to Accessing Prescriptions and Telemedicine – NCIL Member Center
- Protect Access to Opioids for People with Chronic Pain: Fees and FDA approval – NCIL Member Center