Updated: Aug 24, 2020
Photo by Dan Meyers on Unsplash
Did you know that an estimated 100 million Americans suffer from chronic pain? Pain is one of the most prevalent and costly chronic diseases in our country, with an estimated direct cost of $560 billion each year. In some cases, pain could be so debilitating that victims debate suicide to put themselves out of misery. One may ask why these facts are so important to highlight, especially in a time where one of the worst pandemics is ravaging through our entire world. Well, it’s exactly because of that. Chronic pain patients have lost their voice as a result of the heightened attention that pandemics like COVID-19 are getting. Specifically, the opioid crisis that ravaged families and communities over the last decade. The epidemic has made it much harder for chronic pain patients to advocate for what they need; adequate and stigma-free pain management and in some cases has led to increased sucide rates and overdoses as more patients contemplate illicit substances to quell their pain.
As a result of the opioid crisis, chronic pain patients have lost access to a crucial aspect of their pain treatment; opioids. It is prudent to mention that studies have shown that opioids are not an effective long term solution for pain management and can increase the risk of addiction if mismanaged, however, it has also shown to be effective at managing short term pain. It can also provide immediate relief and increase overall satisfaction for patients struggling to cope with their excruciating pain. More importantly, patients who lost access to their pain medication became dependent on it over the last decade as a result of overprescription during the height of the crisis. When these patients suddently get off, they lose a crucial aspect of their wellbeing, satisfaction, and in some cases, contemplate suicide.
Jon Folkes is one of them. An ex law enforcement officer, he was abruptly cut off from his pain medications after his physician couldn’t cope or bear the risk of prescribing these medications. He spoke with his wife and at some point they both agreed on the type of gun to be used to end his life. Luckily, he eventually found a physician that agreed to safely prescribe the opioids that he needed to cope and bear with his pain. But he isn't alone. Over 25 million Americans are in his shoes today. The consequences of opioid hysteria resulted in millions of patients faced with the quintessential ‘yellow boot’. Kicked off their meds that were once a key aspect in their overall wellbeing, regardless of its efficacy, they are faced with an ethical dilemma; to live a life of everlasting pain or put an end to it all?
For someone like myself, who has gone through addiction and is aware of its devastating effects, I understand where prescribers and policy makers are coming from, addiction is a virulent disease and could be exacerbated by long term opioid use. However, the very same crisis that was intended to be addressed with policies around reducing opioid prescriptions is creating an entirely new issue; high suicide and depression rates that could lead to more deaths. It also indirectly leads to increased overdoses as more chronic pain patients go to heroin or fentanyl to get their treatment.
A viable solution to this crisis needs to be balanced with the needs of all stakeholders. Physicians must feel safer while prescribing opioids. Compliant patients need to access their prescriptions, free of stigma. Pharmacists need to reduce their liability when dispensing controlled substances. Policy makers need to be urged to look into solutions that leverage the power of connectivity and accountability in the prescription cycle. A policy that saves lives yet (unitendenly) creates more deaths isn’t an effective policy. Rather, when creating these policies, we as stakeholders need to account for the unintended consequences that they may create and aim to reduce its risks before implementing. At Pilleve, we aim to provide chronic pain patients with a platform to safely access their pain medications and increase the trust between them and their providers, leading to better health outcomes for all.