Uncertainty is an inherent aspect of the human experience. We understand that elements like weather, accidents, and acts of God are beyond our control. However, imagine if the uncertainty you faced in your life was manipulated by political forces. I believe most individuals would find this unsettling. In 2024, as a chronic pain patient, uncertainty will undeniably play a significant role in your life. Every month, you embark on a roller coaster ride, uncertain of whether you will have access to your necessary prescription medications.
Intractable pain is a rare and debilitating condition that has significant impacts on the cardiovascular, endocrine, and autoimmune systems. Unlike simple chronic pain or low back pain, intractable pain is constant and never subsides. There are several underlying conditions that often accompany intractable pain, including Adhesive Arachnoiditis, Stroke, Traumatic Brain Injury, and CRPS. Many patients with intractable pain transitioned from chronic pain over time, with the development of a systemic autoimmune response that affects the nervous system. In order to protect these patients and their treating physicians from anti-opioid movements, states like Minnesota, Colorado, and California have implemented legislation. These patients often face shortened lifespans or tragically resort to suicide when their pain is not effectively managed. Currently, the most commonly available FDA-approved medications for severe pain belong to the opioid class of drugs.
Consider a scenario where an individual is faced with a debilitating condition that causes unbearable pain, only to be informed that their essential medications will no longer be accessible in order to benefit society as a whole. This raises concerns about one’s own well-being and significance. It is important to emphasize that there has been no misuse or distribution of these medications. Furthermore, this person’s medical condition bears no responsibility for the increasing rates of overdose related to illicitly manufactured fentanyl. Unfortunately, facts and the right to receive prescribed treatment have seemingly become irrelevant within certain anti-opioid circles.
When you find yourself questioning every month whether or not you’ll be able to get your necessary medication, it can be disheartening. Seeing your friends in the chronic pain community facing the same struggle only adds to that frustration. The first hurdle you have to overcome is your doctor. What many people don’t realize is that doctors are being influenced by various external factors. Regulators may visit them in person, their malpractice carrier may send a letter, or they may even receive a call from the state medical board. These tactics, while not overtly aggressive, are designed to pressure doctors into reducing the number and dosage of prescriptions they write. Unfortunately, this reduction is often the only metric considered important. Patient outcomes seem to take a backseat in these instances.
When it comes to filling your prescription, there are a couple of hoops you’ll need to jump through at the pharmacy. The first hurdle is the pharmacist themselves. It’s important for them to know and trust you and your healthcare provider. Unfortunately, if you’re faced with a float pharmacist who doesn’t know you at all, it may be difficult for them to have that level of trust. Filling your prescription carries risks for their license and livelihood, so they may be hesitant.
The second hoop involves recent history and medication availability. Since 2015, the DEA has significantly reduced production quotas for opioid pain medications by over 70%, leading to nationwide shortages. Furthermore, starting in June 2022, the nationwide opioid settlement implemented a secretive system where distributors are forbidden from disclosing quotas to pharmacies.
If a pharmacy exceeds their monthly numbers without knowing the quotas, they risk being cut off from receiving controlled medication shipments completely. This can quickly put them out of business. It’s no wonder this process has become such a complex and challenging situation for everyone involved. It has become a circus of folly.
Living with intractable pain is an extremely challenging and distressing experience. Despite the existence of laws aimed at safeguarding both doctors and patients, the situation seems to be deteriorating rather than improving as time goes on. The consequences are dire: patients continue to endure immense suffering, healthcare professionals themselves are burdened by this crisis, and individuals struggling with addiction tragically lose their lives. It is high time for society to recognize this pressing issue, demand a higher standard of care, and show genuine compassion towards those facing these hardships.
Blessings, Laurie
