Little-discussed ‘collateral’: Patients with chronic pain lose access to needed medications

Hydrocodone opioid pills
Efforts to reverse the country's opioid epidemic haven't taken into account the needs of chronic pain patients who have been left without needed medications. (Getty/smartstock)

There’s been a little-discussed fallout from the country’s opioid epidemic: patients with chronic pain who have lost access to the medications they need to function every day.

Ira Cantor, M.D., an internal medicine physician who specializes in pain management, says he hears stories multiple times every day in his practice from patients who suffer from chronic unrelenting pain who have lost access to the medication they need. “They are in more pain and experiencing terrible deterioration of their quality of life—unnecessarily,” Cantor wrote in the Philadelphia Inquirer.

Patients who have been able to able to function with well-controlled pain are suddenly having their pain medication cut down even though they take them without abuse or side effects, Cantor says. Physicians are backing away from prescribing opioids because they fear they will come under professional and legal scrutiny and also because it is complex and not easy to care for chronic pain patients, he says.

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And it’s not only doctors who are cutting patients’ medications, it’s insurance companies and pharmacies, according to a report in The Frederick News-Post. Chronic pain patients whose treatment has been affected by new regulations aimed at prescription painkillers are part of an underrepresented community, the article said.

RELATED: Express Scripts to place new limits on opioid prescriptions, drawing criticism from AMA

The efforts to reverse the country’s opioid epidemic have taken a toll on patients suffering from chronic pain. In 2016, the Centers for Disease Control and Prevention issued new guidelines for prescribing opioids for pain. More recently, the Centers for Medicare & Medicaid Services proposed that physicians limit initial prescriptions for opioid painkillers to just seven days for Medicare patients.

Different states are also taking action, according to The Fix, which writes about addiction and recovery. In Florida, chronic pain patients may become “collateral damage” in the fight to reverse the opioid crisis, the publication reports. 

The proposed legislation, which is a priority for Florida Gov. Rick Scott, will limit doctors from prescribing more than three-day supplies of opioids, or seven days in special cases, and it will make it harder for chronic pain sufferers to get the medications they need, according to the report.

Attempts to stop excess pain pills from being prescribed to treat acute, short-term pain, have forgotten to consider the effect such limits have on chronic pain patients.

Such reports come on the heels of the news Saturday that Purdue Pharma, the maker of OxyContin, will stop marketing opioid drugs to physicians and other prescribers and eliminated more than half of its sales staff. The Associated Press via Cleveland.com described that as a surprise reversal after lawsuits blamed the company for helping trigger the opioid epidemic. The company issued a statement today saying it has “restructured and significantly reduced our commercial operation and our sales representatives will no longer promote opioids to prescribers.” Oxycontin is the world’s top-selling opioid painkiller.

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