News: CJ Exclusives

STOP and HOPE acts shut down pill mills while leaving chronic pain patients few options

New laws and tougher federal enforcement turn pain patients toward more lethal, often illegal substitutes

For Cathy, opioids are part of the blend of medications that keep her functioning. After she caught polio as a baby — just three years before the vaccine was invented — she suffered from fibromyalgia, she developed arthritis as a teenager, and her nerves started to die as a 40 year old.

“I am a chronic pain patient, I have been on pain pills for 30 years. It has allowed me to raise a child, be a good wife, and to retire gracefully with money of my own,” said Cathy, who didn’t want her last name used. “Without them, I would be a ward of the state. … I have never, never upped my dosage or abused the drug.”

A growing number of chronic pain patients say they are caught in the crosshairs of the war on drugs, where legislators’ good intentions to limit overprescribing have made the lives of actual chronic pain patients hellish.

“It’s insane,” Cathy said. “We are an infinitely easy target in the war on drugs.”

Chronic pain patients are the anomalies in a system designed to target a nationwide epidemic.  North Carolina exempted chronic pain patients from its chokehold on opioid prescriptions, but with legal crackdowns and controversy over using opioids to treat long-term chronic pain, more doctors are reluctant to prescribe them.

Thomas Kline, a retired North Carolina physician, has begun to keep a list of suicides he believes were caused by forced tapers of chronic pain medication. The list has grown to 33 names, spanning middle-aged workers, young mothers, and wounded veterans.

“These people are no longer with us due to the policy of ‘you are better off without pain medicines,’” Kline wrote at the end of the list. “Not treating a person in pain is negligence. Abandoning people with painful disease to the streets, with no doctor, is negligence.”

In 2016, enough prescriptions were written in North Carolina for every person to hold more than 65 pills, according to the Centers for Disease Control and Prevention.

The STOP Act and the HOPE Act prioritized shutting down pill mills. The bills limited prescriptions, mandated the use of the prescription database N.C. Controlled Substances Reporting System and gave law enforcement restricted access to the NCCSRS.

“Smarter, safer prescribing is one tool among many that we’re deploying to combat the opioid crisis,” said Gov. Roy Cooper in a 2017 news release. “Setting initial limits on these powerful drugs can help reduce the number of people who become addicted to opioids and it can ultimately save lives.”

Law enforcement doesn’t track the number or type of patients a doctor treats, but the number of opioid pills prescribed. For doctors looking to cut down their pill counts or their paperwork, the easiest option is not to treat chronic pain patients, said Cato Institute Senior Fellow Dr. Jeffrey Singer, a surgeon.

“This crackdown on docs with the subscription monitoring program — everyone is under surveillance for how many prescriptions they write — it’s really frightening doctors,” Singer said.  “This has had a chilling effect that has made all doctors afraid to prescribe opioids.”

Pain is so subjective that doctors fear enabling addiction when they try to treat chronic pain.

This frustrates Kline, who says he restored the lives of some of his patients by putting them back on their medicine.

“Anybody who takes opioids is likely to become an addict. That’s an important myth,” Kline said.

When Nancy Henson’s primary care doctor saw the dosage of her medication for chronic pain, she “freaked,” Henson said.

“When you have pain from back surgeries (two fusions) that will never go away, pain from fibromyalgia, and the weird pain from neuropathy, it takes a combo of pain meds to make life bearable,” Henson said by email. “If they do not make exceptions for severe pain patients, we’ll be seeing more suicides. That’s a fact. Not me, but I can understand the frustration that leads to it.”

Critics say that the crackdown on the legal prescriptions has driven patients to more deadly street drugs.

“Lots of patients tell me [doctors] stopped their pain meds,” Forsyth County Emergency Service Captain Tara Tucker said. “We’ve actually seen older folks who have been on chronic pain medications for years that their doctors stopped giving them switch to heroin and overdosing.”

  • chappy50

    As a patient who has had spinal fusion surgery, I am one who’s primary care physician has forced me off hydrocodone and pretty much pawned me off to a spine and pain clinic. My PCP had little to no regard for me, the patient. I believe he was afraid for his licenses, which I appreciate. I had to enter into a contract agreeing to use only their services for pain management, which I am fine doing.

    My point is this; I broke my back in a fall and fractured four ribs, crushing two, and broke all four off my lower spine. I also had spinal fusion surgery on the four discs at the top of my spine (C 2-6). The resulting nephropathy in my left arm and hand have never gone away.
    Any reasonable person knows that there is virtually nothing that can be done to alleviate my constant pain other than pain medications.

    I am not averse to trying medications other than opiates, but I need to take something that actually works. And at an appropriate dosage.
    I’m not a danger to society. I’m not a drug addict. If you knew me and talked to me at any time on any given day, you would never know I was taking meds for pain. I am a high functioning professional worker, husband, father, grandfather, in an office full of professionals, who is employed full time and I have never abused my pain meds.

    I just need a bit of help with my ever present pain in my neck, back, arm and hip. That pain will never go away or be better. If the medical field can come up with an alternative treatment to make that happen, I will be thrilled to participate in that program.

    Leave people with medically verifiable chronic pain alone. We are not a problem for society.

    • Junius Daniel

      Brother, it is so that you can reduce your pain by your dietary choices.

      Your gut is in a relationship with your back, neck, hip , and arm, and , if you eat the right things, you can definitely improve it, which will improve you.

      Eat Walnuts, Pecans, Strawberries, Blueberries, Raspberries, Pineapple, Melons, Bananas, Apples, Dates, Figs, Prunes, and stay away from all other sugars, and carbohydrates that turn to sugar, because sugar is what your pain loves to pain you with.

      Moreover, experiment with fish oils – Cod Liver oil being the best, because it supplies the Prostaglandins which aggressively go about your system seeking out and annihilating Leukotrenes. (the building blocks of pain)

      To that, add a once a month 36 hour fast, during which time you drink an herbal cleansing tea of Red Clover tops, Slippery Elm, Dandelion, Thistle, and Uva Ursi.

      Never eat porcine, bovine meats, or fried foods.

      With each meal take 1,500mg 2,000 GDU tablet of Bromelein enzyme, it made of concentrated pineapple.

      Many add either Circumen, Turmerick, and or Boswellian in addition to that. Experiment.

      Juice green cabbages and drink two 8 ounce glasses daily.

      Drink two 8 ounce servings of Aloe Vera juice daily

      AND, stay away from all Nightshade Vegetables – which means never consume white, red, or yellow potatoes, tomatoes, eggplant, and peppers.

      If you do these things, for even a week, you will see your pain drop noticeably down.

      I promise – it works for everyone.

      That said, your pain will never disappear entirely.

  • civilwar 12

    Proves the point that government meddling and laws have consequences.

  • Junius Daniel

    The Good Lord gave us The Holy Ghost, Opium & Spirits because terrible things happen to the body & mind, in this life.

    Sometimes it takes a combination to get through – something which is an unpublicized aspect of our history.

    Out here in Hertford County, it was not so long ago that The Moonshiners were selling their wares out the back of the hardware stores, and many a Baptist man, and otherwise, regularly consumed it.

    Though I regret the many unnecessary addictions that exist in this society, I think it is better to respect their choices to be that, and make sure that those in pain have adequate pain relief.

  • Lisa Skaggs

    Leave chronic pain sufferers out of the count! I think it should be law that everyone involved in pain medication rules & laws should have to go through simulated 10 pain for a full week, every 5 years. During the 1st 5 days, give them Tylenol. Let them groan & rock in bed & puke in pain. The last 2 days, they may have true medication. Once they see that narcotic medication is the only thing that works, they’ll have an understanding.

    • chappy50

      Amen Sister Skaggs, Amen indeed!!