Chronic Pain Patients Should Leverage Election Year

THIS IS AN ELECTION YEAR!  Why is this significant? The answer is obvious.

Introduction

Politicians seeking to be re-elected or vying for higher office, as is the case for the three congress members vying to fill the late CA Senator Diane Feinstein’s temporarily filled US Senate seat, tend to listen to their constituents and/or potential voters with the ballot box on the near-term horizon.  We must not squander this fleeting opportunity.

Currently, Dr. Mark Ibsen and Dr. Red Lawhern have issued two distinct but highly synergistic “Calls to Action” (CtoA).  I and others are working in support of both of these CtoAs.  We believe ALL in the chronic pain patient, physician, AND pharmacist (CPP) community should be similarly engaged for these CtoAs to succeed in the scheduling of congressional hearings on the plight of the CPP community.

Dr. Ibsen’s CtoA requests the CPP community reach out to their two US Senators and their Congress member, via USPS certified mail, addressed to their Washington DC offices.  I have done so.  I also made these same mailings to the three CA congress members, none of whom are my congress member, currently vying for Senator Feinstein’s CA senate seat.

Dr. Lawhern’s CtoA requests the CPP community reach out to the House of Representatives, Energy and Commerce Committee’s Subcommittee on Health, by placing a phone call to each of the 30 committee members’ Washington DC offices.

The remainder of this article provides my approved “template” for a letter to your two US Senators and Congress member (Dr. Ibsen’s CtoA), and Dr. Lawhern’s “script” and instructions for your phone calls to the Health Subcommittee (Dr. Lawhern’s CtoA).

The Letter “Template” Introduction

My letter/template, which has been recently shared in Facebook posts on multiple CPP community forums, has received positive reviews from Dr. Ibsen and Dr. Lawhern.  The template, which benefited from suggested edits by Dr. Lawhern, has already been properly addressed and mailed to my two current CA Senators and my Congressman Ken Calvert. A slightly edited version went to the congress member candidates for the “open” CA US Senate seat.  Only the template’s first and last two paragraphs need to be edited to make this template your “own”. (I highlighted in bold italics the words that must be checked and changed as warranted.)  My motivation in sharing this “template” is, I am convinced we must somehow rally a large percentage of the CPP community this election year.  I want to help make that happen. Please use this template, amend it, or draft your own letter, as you see fit. Just be sure to submit the certified USPS letters, not emails!  This is a convenient link to obtain your US Senators’ and Congress member’s name, DC office address, and phone #.  Just enter your city and state:  Who Represents Me: Elected Officials Lookup. – 270toWin

The “Template”

“My wife and I are your constituents and are earnestly seeking your help.  Please push for Congressional hearing(s) on the civil rights tragedy of our time which is currently affecting millions of Americans.

The following selected quotes provide a succinct synopsis of this national tragedy.

“During 2021, an estimated 20.9% of U.S. adults (51.6 million persons) experienced chronic pain, and 6.9% (17.1 million persons) experienced high-impact chronic pain (i.e., chronic pain that results in substantial restriction to daily activities).” Chronic Pain Among Adults — United States, 2019–2021 | MMWR (cdc.gov) – April 2023

“The United States currently faces two opioid crises, an evolved crisis currently manifesting as widespread abuse of illicit opioids, and a crisis in pain management largely manufactured by the Centers for Disease Control and Prevention …”  The Two Opioid Crises Problems, Causes, and Potential Solutions: An Analytic Review | Medical Research Archives (esmed.org) – December 2023

Well respected NY Times contributor Maia Szalavitz captures the problem thusly.

“For many years I’ve written about people suffering intractable pain, and how their agony and increased risk of suicide and death has been ignored in the rush to end the overdose crisis. … Why is it so hard to get policymakers to address this unnecessary suffering? Why don’t we seem to care about people in pain, who are just as much victims of the opioid crisis as people with addiction?” Opinion | We Need to Rethink Our Treatment of Pain – The New York Times (nytimes.com) – December 2023

The Medical Board of CA has figured it out.  Quoting from their recently released opioid prescribing guidelines:

“It is recognized that between the Board’s death certificate project and the CDC 2016 Guidelines, a chilling effect was felt and physicians became less willing to treat patients with chronic pain. …  As the Board discussed the need to update the 2014 prescribing guidelines, it was emphasized that a change in tone was necessary to provide support and guidance to physicians to prescribe in a way that is effective for their patients and to also have enough flexibility to deal with pain patients that don’t fall into the normal guidelines.” Pain Guidelines (ca.gov) – July 2023

The DEA has not figured it out!  While the Medical Board of CA was updating their guidelines, the DEA, suspended a well-respected Beverly Hills physician’s registration to prescribe controlled substances. This action resulted in the abandonment of 240 pain patients, and within a couple weeks; two suicides and a death from medical complications exacerbated by loss of pain treatment:

““There are millions of chronic pain patients suffering just like me,” Danny Elliott wrote before ending his life. “Nobody cares.”” This Couple Died by Suicide After the DEA Shut Down Their Pain Doctor (vice.com) – November 2022

Further, despite a known shortage of opioid medications, the DEA has cut their production quotas for the eighth year in a row:

“Please do not cut the Rx opioid production amount anymore. There is a severe shortage and many people who have prescriptions cannot get them filled at a pharmacy,” DEA Finalizes More Cuts in Rx Opioid Supply in 2024 — Pain News Network – December 2023

To assist your action on my wife and I’s request, please provide my contact information to your “Health aide”, or Chief of Staff so I can arrange a briefing for you on this critical issue by one or more of the nationally respected medical and technical professionals I am associated with.

Please give this matter the consideration it absolutely warrants.  Millions of Americans lives are at stake.  We eagerly await your thoughtful response.

Very Respectfully,

(Signature & printed name(s))

(Address)

(Phone #)”

The Phone Call “Script” Introduction

In the selected words of Dr. Lawhern (My emphasis added in bold):

“This note is to announce a campaign to plead with a key committee in the US Congress, without whose support nothing will be done to correct the damage now being done to chronic pain patients, their families, and clinicians who treat them. The legislators we need to talk with are members of the Health Sub-Committee of the House Committee on Energy and Commerce.

If chronic pain communities work from the same sheet of music (the same agenda), we will have a much better chance of getting our legislators turned around on public health policy for treatment of severe pain. The only thing that will make a dent in the legislative agenda (I believe) is a great many phone calls to the DC offices of legislators who are specialized in healthcare policy.

Talking to ourselves in social media groups won’t do it. Emails won’t do it. Petitions won’t do it. We instead need thousands of calls over the next several weeks to demand that the Sub-Committee on Health hold hearings in which patients and their advocates are the invited speakers” — and the Andrew Kolodny’s and Jayne Ballantynes of this world are not invited.

I can’t organize this campaign by myself or do it “for you”. I need the help of social media moderators and group administrators to get their members organized, encourage them to make phone calls, and to make follow-up calls and to demand changes under law.” 

Dr. Lawhern’s phone call “Script”

February 2024

What do we say?

Good Morning (Afternoon)  – My Name is ____________.  My call-back number is ____________

To whom am I speaking?  [record the name]  _______________________

I am calling about a needed addition to the hearing agenda of the House Sub-Committee on Health in the coming months.  At the end of this call, I will need an email address to send a written summary of this call and to schedule further online or in-person meetings with members of your legislator’s staff.

I am a (choose one or more)

[Chronic Pain Patient]

[Caregiver for a Chronic Pain Patient]

[Patient Advocate]

[Clinical Professional]

I represent the National Campaign to Protect People In Pain

We are an alliance of 40+ US groups serving chronic pain communities, with  membership over 50,000.  We speak on behalf of millions of people who are now being denied safe and effective treatment for agonizing pain. This is the single most important issue in American healthcare.  It needs to be a top priority in the Sub Committee on Health.

We want your Representative and the Sub-committee on Health to schedule hearings to receive our testimony.  We need legislation this year to correct major misdirection in public health policy that is denying safe and effective pain management to tens of millions of US citizens – thousands of whom are dying of suicide.

Our Speakers Bureau will work with your staff to develop the format for these hearings, on the following agenda:

• The US CDC must be directed to repudiate and withdraw their 2023 guidelines on prescription of opioid pain relievers.
• The Veterans Administration and Department of Defense must be directed to repudiate and withdraw their derivative 2023 guidelines.
• Grounds for these actions are that current CDC and VA practice standards are fatally flawed by anti-opioid bias, cherry-picked research, and failure to establish a framework for assessing risks versus benefits of therapy. The guidelines also fail to address the natural variability of minimum effective opioid dose due to genetics of metabolism.  Patients are dying because of restriction of access to pain management, caused by these errors.

At this point, ask the Representative’s staffer if they understand what you’ve said so far.  Add the following material, if they appear to be open to your input. If they argue, then wrap up your call courteously and ask for an email address for follow-up.

• Both organizations must be directed to remove themselves from further participation in development of public health policy on pain management. Practice standards are a job for doctors themselves in their specialty Academies and Certification Boards.
• The US Department of Justice must direct the Drug Enforcement Administration to cease, halt, and desist from further persecution of doctors whose only imagined crime is the treatment of patients with safe and effective opioid pain relievers.
  1. The practice of pre-trial asset confiscation must stop immediately.
  2. The practice of coercing consent agreements with the coerced testimony by clinician’s employees or former DEA defendants under plea bargains must stop immediately. Such testimony is tainted by strong motivations to lie under oath.
  3. DEA authority to set production quotas on prescription opioids must be removed from the Controlled Substances Act.

Wrapping Up: Inform the staffer that you want a follow-up phone call from a member of the legislator’s staff, to arrange briefings for the legislator by subject matter experts in our Speakers’ Bureau.

• You do not want a non-committal “I share your concerns” letter.
• You will not accept statements that translate to “we’ll study the problem until the caller goes away.”
• You do want a commitment by the legislator to act.

Ask “When may I expect to hear from someone in your office?” 

Thank them for their time. “

House Sub-Committee on Health

Ex-officio member (Chair of the House Energy and Commerce Committee)

McMorris Rodgers, Cathy                 (202) 225-2006

Chair

Guthrie Brett                                     (202) 225-3501

Ranking Member

Eshoo, Anna G.                                 (202 225-8104

Vice Chair

Bucshon, Larry                                  (202) 225-4636

Members

Burgess, Michael C.                          (202) 225-7772

Latta, Robert E.                                (202) 225-6405

Bilirakis, Gus M.                               (202) 225-5755

Hudson, Richard                              (202) 225-3715

Dunn, Neal P.                                   (202) 225-5235

Pence, Greg                                     (202) 225-3021

Crenshaw, Dan                                (202) 225-6565

Joyce, John                                      (202) 225-2431

Harshbarger, Diana                        (202) 225-6356

Obernolte, Jay – Hesperia              (202) 225-1815

Sarbanes, John P.                            (202) 225-4016

Dingell, Debbie                              (202) 225-4071

Kuster, Ann M.                                 (202) 225-5206

Kelly, Robin L.                                  (202) 225-0773

Blunt Rochester, Lisa                       (202) 225-4165

Craig, Angie                                     (202) 225-2271

Schrier, Kim                                      (202) 225-7761

Trahan, Lori                                      (202) 225-3411

Carter, Earl L. “Buddy”                     (202) 225-5831

Pallone, Frank Jr.                              (202) 225-4671

Griffith, Morgan                               (202) 225-3861

Miller-Meeks, Mariannette              (202) 225-6576

Cardenas, Tony                                 (202) 225-6131

Ruiz, Raul                                          (202) 225-5330

Diaz Barragan, Nanette                   (202) 225-8220

Final Thoughts

Remember, this is an election year. On my way home from the post office today I saw my first “Re-Elect Calvert” (my congressman) banner of the season hanging on a street corner fence.  We must take advantage of our elected representatives heightened interest in their constituents this election year creates.  To be effective we all must engage.  Please join in both these Calls to Action!

I conclude with this “battle cry” (my words) penned by Dr. Lawhern:

”We are a Nation in Pain and We Will Not Be Silenced!”