Local pain sufferers need our help

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In four years as a legislator, I’ve come to depend on neighbors and friends to be the barometer for decisions made at the Capitol. While I appreciate the flood of enthusiastic emails and phone calls that precede legislative debate, it’s the follow-up conversations that tell how much my votes really affected the life of one person.

Transforming a bill into law – no matter how seemingly benign or common-sense – is hard work. By the time legislation is on the governor’s desk for his signature, it has been dissected, discussed and thoroughly vetted; it’s all the more frustrating, then, to realize that a law carries unintended consequences.

My friend Paul began calling about three years ago. Paul is in his 60s, clean-cut, well-spoken, smart – and a long-term chronic pain sufferer. After a bill designed to regulate chronic pain management and reduce opioid deaths was signed into law in 2010, the state’s health department was directed to write new pain-management rules. The rules took a few years to create and implement, and that’s when Paul’s trouble began.

As physicians wrestled with the guidance the state was suggesting, many threw up their hands and decided that continuing to see chronic pain patients was – well, too much of a pain.

Other physicians carefully tried to follow the guidance and set up complicated and costly “compliance testing,” most of which was not covered by the patient’s insurance. Paul’s physician fell into this group. She was trying to follow the rules, care for her patients and, quite understandably, cover her backside.

Paul had been seeing his doctor for nearly a decade. They had a trusting doctor-patient relationship. Now she was telling him to submit to compliance testing, with its greater scrutiny, or move to a pain clinic.

After sticking with his doctor for a frustrating year, Paul began seeking pain clinics in southwest Washington. He made the shocking discovery that the closest pain clinic was 150 miles away, in Seattle.

In our zeal to reduce prescription-drug misuse – a truly worthy goal - we have forced  folks who are legitimate pain sufferers to jump through a lot more hoops.

During my journey to find out why every Southwest Washington pain clinic had shut its doors, I discovered a promising tool in the fight against prescription-drug abuse that doesn’t add to the red tape constraining physicians or patients: Pain medications with abuse-deterrent properties.

Pharmaceutical companies have developed new pill formulations that resist crushing, cutting or melting. The results are staggering. An international study showed drug-abuse deaths tied to one popular pain medication decreased 82 percent following reformulation.



It’s one in a host of compelling studies indicating this relatively small step represents a giant leap in the fight against drug abuse.  

Given its verifiable and tangible reductions in prescription pain-medication deaths, overdoses and abuses, this development surely would be embraced throughout our nation’s health-care system – right?

Unfortunately, no.

Many health plans that cover prescription drugs will not cover abuse-deterrent versions. Because of that disconnect, I introduced Senate Bill 5695, which would have allowed for coverage of this safer medication. While it appears this legislation has stalled in Olympia this year, it at least starts the conversation and sheds light on a relatively simple way to fight prescription-drug abuse.

The Bree Collaborative – a group of statewide public and private health-care stakeholders formed by the Legislature to develop evidence-based recommendations on health-care issues – is working to address opiate guidelines. I’m hopeful it will consider abuse-deterrent formularies in its recommendations.

Other issues need to be addressed, especially in our area. For instance, it’s heartless to force local veterans and seniors who live with chronic pain to undergo expensive and invasive tests or drive for hours, just so they can function normally.

While I understand we need good parameters around prescribing opioids, those truly in pain should have local access to pain specialists with the tools to make the best decisions for these folks. 

Ann Rivers,

Washington State Senate (R) 18th District