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Today I read a MedPageToday.com article about experts responding to the new FDA Opiod Action Plan. I won’t take the time to paraphrase the article which contains links to the agency’s statement as well as other insights, but you can access it here: http://www.medpagetoday.com/PainManagement/PainManagement/56178?xid=nl_mpt_DHE_2016-02-13&eun=g999342d0r.

Coincidentally I read an article in this morning’s The Dallas Morning News about the widening lifespan gap between the rich and poor. http://www.dallasnews.com/lifestyles/headlines/20160212-life-span-gap-continues-to-widen-between-rich-and-poor.ece While factors like wealthier people smoke less and are less obese were mentioned, the article also stated, “More recently, the prescription-drug epidemic has ravaged poor white communities …”

If you do a Google search, you can find pages of links to discussions about drug abuse and addiction but very few about the actual number of people who are in great pain and who depend on prescription pain relief just to make it through the day. As Time magazine reported in January 2013 after the FDA announced its last revamp of opioid drug regulations (http://healthland.time.com/2013/01/31/fda-action-on-vicodin-may-mean-more-pain-not-less-addiction-or-overdose/), those regulations may result in more pain but not decreased addiction or overdose. Certainly that round of regulations placed considerable barriers for people with legitimate need for these drugs in their chronic battles against pain. However, it does not appear that the regulations made any impact on the number of people who were abusing them. If anything, abuse has continued to rise.

And yes, there is abuse. Unfortunately, there is abuse of all kinds in our society. There is abuse by corporate executives who raid the corporate till, by politicians who take bribes, charities that misspend trusted funds, alcoholics that drink the rent money, teachers that have sex with underage students. The list goes on and on and on. But we don’t comprehensively condemn all executives or charities or politicians or even alcoholics.

Prescription opioid drugs are a tool that makes many people’s daily lives livable – just like a wheelchair does for many people. Just as wheelchairs make people mobile, pain medications are the vehicle that enable people to actually participate in life. So I wondered: what if we substituted the word “wheelchairs” for “drugs” in the conversation.

While I read about many politicians ranting about opioid drug use, I can’t see the same rhetoric coming out of their mouths if the topic were wheelchairs. Instead, I believe there would be a more reasonable discussion about targeting wheelchair abuse rather than making wholesale changes to policies that could condemn deserving people to a life of immobility. Can you hear a politician saying that we should require a patient to go to their doctor every month to make sure they’re still disabled enough to use their wheelchair for thirty more days? It’s a bit ridiculous, but no more ridiculous than thinking that chronic pain caused by an incurable condition like RA or MS or fibromyalgia will magically disappear.

And I have to wonder, just in general, WHY? Perhaps, unlike drug cartels who import illegal drugs into the country or home-grown meth dealers with bathtub chemistry sets, opioid pain relievers in this country are manufactured and/or distributed by American pharmaceutical companies that are already among the most highly regulated businesses in the world. Unlike pouring millions of dollars into the war against drugs, it takes very little effort to tighten the screws a little bit more on an industry you already have under your thumb.

But the fact of the matter is, pain is torture. It always has been. From the medieval torture dungeons and the Spanish Inquisition through potentially illegal activities at Guantanamo Bay, torture/pain is what we use to punish people. By placing barriers and restrictions that inhibit patients in pain from receiving needed medication, we wind up potentially sentencing millions of innocent people to torture. These types of sanctions, as history has already demonstrated, do not impact illegal use, but they do punish people who are already suffering.

In researching some of these facts, I found very few balanced articles or sites that support patients’ rights in this area. One of them is http://www.uspainfoundation.org/. I am not recommending that you join any particular organization. What I am recommending is that one way or the other you make your voice heard.

Wishing you a pain-free day. Thanks for checking in.

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