“We want to help the public understand the difference between legally prescribed prescription medication and illegal, illicit, street drugs.”
—Amy Withrow, Louisa County
The “Don’t Punish Pain” rallies that were held in Richmond and in other cities across the country last week aimed to bring attention to the major distinction between opioid medications that are legally prescribed to people who suffer chronic pain and those sold on the black market for recreational use.
Pain patients are simply trying to get through today as comfortably as they can, while opiate abusers’ top priority is finding that next fix. In many cases, they are both victims of the opioid crisis and deserve help—albeit a very different kind of help.
The abusers have given opioids a bad rap, but it’s important to understand that many of them—including some of the most heartbreaking cases of opioid addiction—were prescribed to them for pain resulting from injury, surgery, or illness. Use of the drugs was not intended to be open-ended.
But perhaps the regimen was not tightly controlled, and many were provided refills despite a consumption rate that suggested excessive use. Or they sought out other doctors willing to supply the pills.
Then an oxycodone addiction may have evolved into a heroin addiction. In many cases, their lives were left in ruins. Jobs lost. Families lost. Homes lost.
Others caught in the trap have been recreational drug users, not seeking pain relief but rather the high that opiates provide, and they, too, became statistics. In 2017, according to government reports, 49,060 Americans died from opiate overdoses, a significant increase over the year before due in part to the broadening use of fentanyl, a more powerful synthetic opioid. Suddenly, overdose deaths far exceeded highway fatalities that year (40,100) and deaths from gun violence (39,773).
The spike in overdose deaths has actually lowered Americans’ life expectancy, according to the Centers for Disease Control and Prevention.
These are the stories that get people riled up. The priority becomes getting these drugs off the street by making them harder to get.
Then come the reports about doctors who allow their practices to become “pill mills,” places where opioids are prescribed pretty much for the asking. Attention then turns to the pharmacies that fill those prescriptions, and the story of a depressed Appalachian county of 21,000 people in eastern Kentucky where prescriptions for nearly 3 million opioid doses were filled during a 12-month period—some 150 pills for every man, woman and child.
Moving up the supply chain, accusations of profit-making and an obliviousness to the abuse and addiction crisis are leveled at large pharmaceutical companies that continued to flood the market with these drugs—in some of the most economically depressed areas of the county—despite the well-documented human and economic consequences of excessive opioid use.
But often lost in this web of scandalous activity and reckless disregard for public health are the people for whom these medications are intended—those with chronic, debilitating pain. Oxycodone and the extended-release brand OxyContin can provide these patients with the ability to move around, enjoy their families and maybe even hold a job.
They should be afforded these quality-of-life opportunities without being treated as drug addicts or being made to feel like criminals.
Part of the solution are the prescription monitoring programs that are up and running in Virginia and 36 other states, with similar confidential databases being developed in 11 more states. They require doctors to look up a patient’s name before prescribing, then report every opioid prescription they write and the name of the patient who received it. The program deters pill-peddling doctors from writing excessive prescriptions, and identifies users who go “prescription shopping” from doctor to doctor.
The need for reform is obvious. The Don’t Punish Pain rallies send a message to federal and state lawmakers to write legislation that clamps down on illicit use while not depriving access to those who are truly suffering. Meanwhile, some doctors may prescribe more non-addictive medications or try alternatives such as low-voltage electrical current therapy to relieve pain.
We are indeed battling an opioid crisis that’s leaving a tragic trail of addiction and death in its wake. But for those who need these drugs to help mitigate their relentless pain, making them next to impossible to get only worsens their suffering.