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‘It’s time’: How the politics of addressing Minnesota’s opioid crisis changed at the Capitol

photo of white pills
REUTERS/Bryan Woolston
The changing politics of the opioid epidemic at the Capitol have gotten the attention of the pharmaceutical industry.

Supporters of bills to fight opioid abuse and addiction think they have the votes at the Minnesota Legislature to pass a comprehensive response to the crisis.

That, in itself, isn’t new. Back in 2018, a similar bill failed to get through the Minnesota House after  easily making it through the state Senate, even though the basics of the legislation had widespread support.

At the time, the measures included treatment, education and grants to local governments for expenses related to opioid addiction — provisions for which it is hard to find opponents. Yet lobbying by the pharmaceutical industry blocked passage of increased registration fees for drug makers and distributors that would have raised $20 million a year to pay for the programs. Those lobbyists argued that prescription drugs that are vital to many people in the state should not be taxed for health-related programs.

Last year, such opposition mattered. This year, it likely does not. The politics of the issue have changed at the Capitol, thanks to the DFL takeover of the House from Republicans.

That has gotten the attention of the industry. “They didn’t even come to my office last year, at all,” said Sen. Julie Rosen, R-Vernon Center, who has been the lead lawmaker on the issue in the state Senate. “This year they’re coming to the office, bringing people from their home office and they explain they want to be a part of the process, to help. And I ask them what does that look like, and I have not received an answer.”

“My plea to them is you can be part of the process, you can help us with this,” she says. “Help us figure out how we are going to help the next family and child. They have not done this yet.” Rosen’s bill, Senate File 751, and its counterpart in the House, HF 400, have significant support from lawmakers from both parties.

Sen. Chris Eaton, DFL-Brooklyn Center, said she too has drawn the attention of industry lobbyists. “They’ve come to my office and I’ve asked them to put some skin in the game, and they explain to me how small their profit margin is and how they can’t afford this bill,” Eaton said. “Well, I don’t buy it. It’s time.”

The DFL leader on the House’s version of the bill, Rep. Liz Olson of Duluth, also noted a change in tack by the industry. “The Senate passed a great bill off the floor,” she said of the 2018 efforts. “Rep. [Dave] Baker put forward a good bill that had bipartisan support that didn’t get anywhere. I think you can look behind what happened there and see it’s a new day. There is a shift in a split government now. A new reality is upon us.”

Even Gov. Tim Walz has joined in the effort to get the industry to see that new reality. At the urging of legislative leaders, Walz convened a conference call with representatives of drug makers and distributors to, as he put it, give them “the lay of the land.”

“It was my expectation before this session started, and it has been reinforced now, that a piece of meaningful legislation will wind up on my desk that I will sign,” Walz said after the private conference call. “This affects all of our families. These are our children dying, these are our neighbors dying. It is taking an incredible human toll as well as an economic toll on our state. We’re not alone in that.”

How the drug industry is responding

The impact of industry lobbying last year was top of mind for Walz. “We had the hearings, we had some potential solutions, we had ways to start to address this, and then we had a lobbying blitz and we had confusion and we got nothing, we got nothing out of that. I do not want that to happen again,” the governor said.

So what if it does? What if the industry brings in a phalanx of lobbyists to work lawmakers, or — as several drug companies did last year — they threaten to stop selling opioid medications in Minnesota?

“I did not get assurances,” Walz said. “But I made it clear that one of the things that I know is reputation management. One thing I need to be fairly good at is understanding public will. There will be no tolerance this year for that. It is my best estimate that these pieces of legislation will pass the House and the Senate and they will end up on my desk. And I think it is in their best interest to engage now in a constructive manner to improve these bills, not just for their bottom line but to improve them. …”

Unlike last session, the industry is talking publicly, not just with proponents of the bills but at public hearings. Its basic position, however, hasn’t changed. Industry representatives agree that the addictive drugs have created massive problems. But they also outline the steps they’ve taken so far to address the issue, and remain opposed to assessments on the industry’s revenue stream to raise money for state programs.

“This crisis is too broad and complex for any one group to solve alone,” Kristina Moorhead, senior director of state policy for the industry group Pharmaceutical Research and Manufacturers of America (PhARMA), told the House Commerce Committee last week. “It’s being driven by a confluence of factors that must be addressed holistically, with solutions that bring everyone — including manufacturers, prescribers, distributors, government, law enforcement and nonprofits — to the table. And that’s why we’re here today.”

She said that only about 4 percent of the opioids sold in Minnesota are name-brand drugs, the types represented by PhARMA. The bulk are generic versions. Still, PhARMA has a grant program for local governments and local programs to help pay for treatments and interventions. It also distributes kits to safely dispose of unused drugs and funds public education efforts.

The industry also supports changes that would cap the length of opioid prescriptions to 30 days and increased state monitoring of the volume of prescriptions by doctors and pharmacies “while assuring appropriate patient access to needed medications.”

photo of four legislators at press conference
MinnPost photo by Peter Callaghan
Sen. Chris Eaton (DFL-Brooklyn Center), Sen. Julie Rosen (R-Vernon Center), Rep. Liz Olson (DFL-Duluth) and Rep. Dave Baker (R-Willmar) are sponsors of legislation aimed at tackling the opioid epidemic.
Yet the drug companies disagree with the proposed funding mechanism included in the current legislation. Those bills increase the state licensing fee system to collect $20 million a year — $12 million from drug manufacturers and $8 million from drug distributors — to help pay for the state’s response to the opioid crisis. Those fees, which now top out at $235 a year, could reach as high as $500,000 for the largest players in the opioid supply chain.

“Taxing prescribed medicines intended to treat legitimate medical needs to raise funding will not help in this committee’s efforts to address the opioid crisis,” PhARMA’s Moorhead said. “Patients in hospice care, battling cancer or other diagnosis that have a legitimate need for these prescribed medicines.”

“PhARMA believes it is bad public policy to fund programs based on taxing any type of health care services — be it prescription drugs or physician visit or hospital visit,” she said.

Instead, PhARMA believes the state should use existing Medicaid rebates that it receives from all drug manufacturers, which helps states pay for Medicaid programs by requiring rebates on drug prices in exchange for those states including coverage of those drugs in its Medicaid program. In 2017, $270 million was rebated to the state from drug manufacturers under the program.

Todd Hill, a Minnesota contract lobbyist who is representing the Healthcare Distribution Alliance, told the Commerce Committee that the companies he represents “do not market, do not prescribe, are not providers or prescribers and don’t influence prescribers.”

Therefore, Hill said, it is unfair to assess what he termed a punitive tax on distributors. “This is a no-win situation that could raise health care costs or deny medical experts’ requested orders, decreasing access to treatments and denying activity fueled by legitimate prescribers,” he said.

Some lawmakers remain skeptical of funding mechanism

There remains some opposition among legislators, too. At the end of the Commerce Committee hearing last week, Rep. Greg Davids, R-Preston, objected to the funding plan. “If this bill is so important, which I think it is, why aren’t we going just for general fund money?” Davids said. “If you plan works, which I hope it does, and we eliminate or greatly reduce the problem, are we still going to be charging $20 million for something that’s been taken care of?”

Bills such as HF 400 will make many stops along with way, with any committee that oversees any aspect of it getting to weigh in. After leaving the Commerce Committee, for instance, HF 400 went to the House Government Operations Committee, where it passed on a voice vote, and now goes to Ways and Means, where the financing aspects of the legislation will take center stage.

During its stop Tuesday in Government Operations, similar concerns about the funding mechanism were raised by GOP committee lead Rep. Nick Zerwas of Elk River. The licensing fees, he said, are different from anywhere else in state government in that the system starts with a desired dollar amount and then sets license fees to get there. It is also based on volume of sales, which would be akin to setting doctor license fees based on how many patients are seen.

Zerwas said the goal of the program — reducing the use and abuse of opioids — could either reduce the amount of money raised by the fees or increase the cost of the drugs. “As this is more effective and the companies become more responsible, the per unit cost goes up,” he said. Like Davids, he said the money should come out of the general fund.

That drew a response from Rep. Aisha Gomez, DFL-Minneapolis, who said she has lost many friends to opioid addiction and knows others battling the disease. “I’d like to express my frustration about some of the conversations that are happening around the funding source,” Gomez said. “It feels very much like all those folks representing the pharmaceutical industry who are here today and were here last year are influencing this discussion.”

She then started to suggest that opponents of the licensing fee are being influenced by campaign contributions, but was interrupted with a point of order by an angry Zerwas. “This, Mr. Chair, is out of line,” Zerwas said. “I think at any point that a member would suggest that there is a quid pro quo or anything of the such, you are dangerously close to coming up to an ethical boundary. I think you should advise your members to take a moment to reflect on where they’re headed.”

The Legislature’s rules do not allow members to address each other directly — they have to go through the chair — and do not allow members to “impugn” the motives of one another, and Zerwas called Gomez’s comments “highly inappropriate and unprofessional” and “beneath this body.” Committee Chair Mike Freiberg, DFL-Golden Valley, later told Gomez to refrain from references to campaign finance. 

Comments (12)

  1. Submitted by Paul John Martin on 02/13/2019 - 02:20 pm.

    I am glad more of our lawmakers are treating this crisis as the emergency it is.
    I admire those who want to hold Big Pharma accountable for its years of profiteering and denial.
    I don’t admire those in St Paul who say “Take the funds from general funds” without saying what programs they would cut to do so, but at the same time oppose any tax increases.

  2. Submitted by John Kaul on 02/14/2019 - 08:13 am.

    Good piece of reporting!

  3. Submitted by Cara Schulz on 02/17/2019 - 08:41 am.

    This Bill is premised on false assertions: that patients under the care of their doctor are addicts. That the Minnesota Senate is more qualified than medical teams to decide how, when, and what medications a doctor prescribes for their patients. That addiction to illegal street drugs should be treated by threatening doctors and withholding medication from cancer patients, chronic pain patients, and veterans.

    Less than 1% of those who were screened for drug problems developed new addictions during pain care.

    Drug related death rate for people who take opioids prescribed for them in Minnesota is 2 per 100,000. Taking daily aspirin has a mortality rate of 6 per 100,000.

    The insurance industry looked at roughly 1 million insurance claims for opioid prescriptions. They found that just less than five percent of patients misused the drugs by getting prescriptions for them from multiple doctors.
    Scientific American, Opioid Addiction Is a Huge Problem, but Pain Prescriptions Are Not the Cause, Maia Szalavitz, May 10, 2016

    90 percent of all addictions—no matter what the drug—start in the adolescent and young adult years. Typically, young people who misuse prescription opioids are heavy users of alcohol. This type of alcohol abuse, not medical treatment with opioids, is by far the greatest risk factor for opioid addiction, according to a study by University of Michigan. Monitoring the Future survey

    We all agree there is a problem of addiction to illegal street drugs in Minnesota, but the solutions proposed in this Bill will have many unintended, but not unforeseen, consequences. Very similar to the 2016 CDC guidelines on opioid prescription – the horrific consequences we are already experiencing, which the CDC acknowledges, the President of the American Medical Association is also now warning about, and this is also why Human Rights Watch has opened a file on the US regarding the “torture of patients through withholding of pain medications.”

    Here are the unintended, but not unforeseen, consequences of the 2016 CDC guidelines.

    An estimated 6070 people kill themselves each year due to unmanaged pain. The CDC acknowledges this number is climbing after their guidelines, which were supposed to be voluntary and ONLY for primary care physicians, were adopted by state and federal agencies and codified into law.

    Veterans, injured in service to their country, have been cut off prescription pain medication cold Turkey. Due to backlogs, they can’t get an appointment with a VA pain specialist to even look at options for 6 months or longer. Veterans were told the CDC guidelines would not affect them, as it would only be used as a general guide for new patients. Not existing patients who were managing well, following their doctors orders, and had good quality of life. They were lied to.

    Likewise, cancer patients were told these guidelines would not affect them. We were lied to. Right now, late stage cancer patients are being denied any pain management stronger than over the counter pain relievers. Cancer patients, cut off from pain medications, are entering hospice early so they can have their unendurable pain managed. To enter hospice care, you have to stop active treatment. You have to stop fighting your cancer – just to get pain relief. They, and their families, are being robbed of time. Time to live, to make memories. Time to see your child graduate or get married. Time to hold your spouse’s hand. This is already happening.

    Cancer patients are also turning to street drugs. A man I know, Mike, is an older gentleman. He’s led a fairly normal life and is now retired. He has stage 4 cancer and wants to keep fighting. He wants to live long enough to see his grandchild be born. So he’s going through surgery and chemotherapy and radiation. He can get prescription pain medication, but he can’t always get a pharmacist to fill it. So he did something he never thought he’d do. He bought heroin. He doesn’t even drink alcohol and never smoked a cigarette. But the pain is that bad, that unrelenting. In telling me about it, the shame and puzzlement…he asked me “How did my life become this?”

    We recently lost one of our support group members. She killed herself once she was forcibly tampered and then cut off from pain medication. She had survived cancer, but surviving surviving can be just as challenging. She had gone through 12 operations, 68 rounds of chemotherapy. The treatments had left her in pain levels which had her bedridden most days. She wasn’t going to get better, that was her life. But she had some good days, while she had access to pain control. That ended when her “active treatment” ended. Since she was no longer in active treatment, CDC Guidelines – and this Bill you are proposing – cut her off. She left her doctor’s office and killed herself.

    She’s not unusual. More and more discussion among members of cancer support groups is focusing on suicide plans if…when…our pain medications are taken away and we are abandoned to suffer. I understand these plans. It’s not just the actual torment you will endure. What really drives these discussions is what our families will endure. They will be forced to watch our pain levels grow. To where we rip our own hair out. To where we can’t talk, but can only make sounds. They will watch us beg them to do something to help us. And they wont be able to do anything. Our spouses, our children…will see that and be helpless. And once we die, and rest assured they will be praying we die, they will live with the guilt of being helpless to reduce our suffering.

    These consequences are already happening. Despite veterans, pain patients, and cancer patients being promised these unintended, but foreseen, consequences would not happen. This is why, when proponents of this bill say “trust me, that wont happen” no sane person can put any faith in that promise.

    But this Bill goes even farther in its harm.

    It raises costs on pain medications through a fee on manufacturers and wholesalers which will be passed down to patients.

    It creates an advisory board and I noticed there is no one on the board advocating for pain or cancer patients. No one on the board who is a pain patient. How can you create an advisory board regarding prescription pain medication and refuse to have a single pain management advocate on it?

    By creating more regulatory compliance for doctors and medical centers, this Bill increases healthcare costs for everyone. They will need additional staff to comply with the reporting mechanisms this Bill puts in place which are over and above the new Federal SUPPORT FOR PATIENTS AND COMMUNITIES ACT reporting mechanisms and regulatory procedures. Why not wait for the federal regulations to come on line and see if those are sufficient?

    The tide is turning. Media coverage of this issue is changing. As more pain patients, rare disease patients, and cancer patients come forward to show how this well intentioned, but misguided War on Pain Medications – which is really a War on Patients – has hurt and killed people…news coverage is shifting. Reporters are realizing when “opioid death stats” are pushed, that the numbers are conflating prescription pain medication with illegal street drugs.

    They are realizing that existing guidelines, regulations, and state laws are causing misery, pain, and death. We are now seeing headlines like:

    “Crackdown on opioids has it’s own victims,people who need them to live.” Yahoo News
    La times “ Dont drown out the voices of chronic pain sufferers amid the opioid crisis.”
    NYTimes “ When the cure is worse than the disease.
    Fox News has been running a three part, in depth series on how pain and cancer patients are harmed by the misguided focus on prescription pain medication.

    This coverage will increase. And if you advance this Bill, the increased coverage will be local. It will be your friends and neighbors in the news. Such as the recent sentencing of a man in Minnesota for helping his wife kill herself. She was a bedridden chronic pain patient and her medications were cut off due to the opioid hysteria. So her husband helped her kill herself and he only received 90 days jail because the woman’s entire family, including her mother, begged the judge to not put him in jail because they supported what he did.

    As elected officials, especially when legislating matters of health, we could do worse than to use First do no harm as a guiding principle. And this Bill will harm Minnesotans. It places government in between doctors and their patients. It threatens doctors livelihoods and medical licenses just for trying to provide individualized healthcare. It raises healthcare costs while the blame for the epidemic is handed off from addicts to doctors to the pharmaceutical industry, chronic pain patients are collateral damage in a fight that leaves doctors wary of treating them.

    If this passes and when the stories of how this Bill harmed our friends and neighbors play out in the news day after day…how easy will it be to undo the harm this Bill causes? How easy will it be to roll back the provisions of this Bill?

    Table this Bill. Let the new federal reporting procedures play out, we can always reevaluate the need for additional, state level regulation later.

    • Submitted by Cheryl Rohner on 02/17/2019 - 02:36 pm.

      please listen to this comment, look at what she is saying. innocent people are being punished because of a panic over a problem that doesn’t involve them. I don’t mind you keeping track of my usage, making sure I use only one pharmacy and only one dr., I commend such measures. But limiting my usage to the point of making me suffer is unfair. Cara Schultz has great things to say here, please take note of her comment!!!

    • Submitted by Jenifer Markoe on 02/17/2019 - 06:30 pm.

      Since 85% of those who abuse opiates never got a prescription for it from a doctor why are we blaming doctors? How about because it is easy then looking at the real cause which is mental illness. In fact most kids get the drugs from the family medicine cabinets. So why the discussion of locking up medications not talk about to parents when they get these types of medication. Probably because it make to much sense, is cheap and to easy. Addiction is a mental health issue that usually deals with deep emotional issues during childhood. Basically taking the drug away never stops a addict in fact all it does encourage them to go get something else that may even be more dangerous. The average age of a addict is a male under the age of 30. Most chronic pain patients are women over the age of 45. However chronic pain patients are being required to do procudures like spinal epidurals which can cause blindness, bone loss, paralysis and even death and are not FDA approved just to get a small prescription. Many of the drugs they are replacing opiates with, have many serious side effects and even those drugs are now being abused. Basically you cannot take every medication off the market just because a few people use drugs do deal with there mental and emotionals instead of see a therapist, but that seem to be the thinking of these politicians. MN has a very low rate of abuse though prescriptions because doctors have alway been careful in prescribing but instead of having trust in the doctors it appear that politicians think they know how to treat patient medical condition better then your own doctor. Basically by denying patients who have taken prescriped opiates for years and have done well should be left alone. Better yet lets start holding people personally responsible and accountable for themselves. By making excused by saying the drug is what got you to be addict just helps enable the addict because you are saying they have no part of there addiction. Well with that view a addict also views it as they are not responsible for there recovery either. Until a addict see his responsible to his addiction and work on past secrets and resentment they will never
      have long term soberity. Until this country does realizes that mental health is a big problem that has been ignored for decades this will never change. Meanwhile patients should not have to live in pain just because a addict cannot get there life in order. But that is exactly what we are doing. Most addicts when you ask them if they want to lie or die,most will tell you they do not care if they wake up or not because they find nothing worth living for. Meanwhile chronic pain patients take opiate medications so they can have a more normal life like sitting down with family to enjoy dinner instead thinking how fast they can leave the table to lie down because there pain is so bad. Doctors are dropping patients even
      though the patient has a real pain issue and is just getting worse because they are so afraid the DEA will go after them because a t is not crossed yet. . It is a mess and people who never did anything wrong but have injuries or have some very painful health issue get to suffer and none of this is stopping addicts from abusing the street drugs as those deaths go up

      One last thing is to follow the money. One of the most vocal person against opiate is Andrew Kolondy. Basically he thinks if you are on a opiate for more then 3 days you will become a addict. His answer since we are all addicts is we should all be on Suboxone which is just another opiate with small amount of Narcan. The largest dose is 85mme a day (morphine equivalent) when many chronic pain patient need a larger dose. The Narcan stops small amounts of other opiates, but does not to have a effect when someone injects Fentanyl. The drugs is much more expensive then methadone and is now showing up in 10% of the OD and is the third most diverted drug in the u.s.. Also Dr Kolondy basically has made his whole career about the evils of opiates while he got 10k for every doctor who he can get to sign up for the ability to prescribe the drug. Meanwhile police dept are spending $3000.00 a pop just to give a addict narcan in this special injection thing
      Meanwhile to buy the same drug but you put drops in the person nose is about $100.00. A lot of people are using this for there own money making opportunities and that basically the whole problem with our healthcare system. Money is more important then the treatment of the patient.

  4. Submitted by Cheryl Rohner on 02/17/2019 - 02:33 pm.

    I don’t know tons of statistics, I just know that I have been using opioids for 30 years. I have had arthritis since age 7, and was paralyzed in a car accident 29 years ago. since all this ‘hoopla’ over a crisis, my meds are being taken away, and I am suffering daily, all day. I am barely able to take care of my self. I am not an addict, I am dependent. I have NO quality of life on the level of meds I have been reduced to, and the dr’s want to reduce them further. the govt. is over reacting, and ruining lives. I get the crisis, my brother died of Heroin back in 1989, he had been using since 1962. so this crisis has been around for decades. taking away meds, making them harder to get, for chronic pain patience is NOT the answer. please stop punishing me for having chronic pain, I didn’t ask for this. I have NEVER abused my meds, I have never OD’s, but this is NO way to live. the only option for controlling my pain that is being offered is to have the nerves burned, a painful and often unsuccessful procedure. I spend several hours a day crying because of living in pain since this ‘crisis’ started and they dr’s took away my pain meds. If you had to live a day in my body, you would understand. I feel like I was hit by a car every day, all day. please don’t make it even harder for me to get the meds I need!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! please don’t made my pain any worse, please stop listening to just one side of the story!!!

    • Submitted by Sandra McKenzie on 02/18/2019 - 11:03 am.

      I wholeheartedly agree with the comments being posted by chronic pain patients. I’m curious why no one in media seems to be talking about the financial impact of leaving pain untreated or under treated. Many of us chronic pain patients were contributing members of society before the powers that be decided our pain is not worth treating. There has been and will continue to be an increase in disability claims due to lost jobs and income, as well as an increase in other assistance services. I worked effectively as a personal care attendant when my pain was being treated with opiate pain medication, helping disabled elderly to continue to live comfortably in their own homes. Without the pain control from the opiate pain medication, I’ve not only had to give up my job and income, but will sooner than later need the very assistance I was providing to others when my pain was being treated! My potential clients are likely to end up in nursing care facilities, especially due to a lack of home care opportunities in the rural areas where I worked.
      Either the state is going to be responsible for these extra services for the poor and disabled and rise to the demand of multiple disability claims, or we will have not only friends and neighbors left to battle untreated pain, but people unable to survive without basic necessities of life. Job loss and lack of income dramatically increases depression, which will have to be covered as well.
      Making it impossible to access opiate pain medication for the majority of people who use it responsibly is not going to help anyone suffering with addiction, and it’s not going to do any favors for the economy, either.
      Table this Bill.

  5. Submitted by Tina Sanz on 02/17/2019 - 05:28 pm.

    BY KATE NICHOLSON as published in THE HILL 2/16/18

    The other side of the opioid epidemic — we’re people in severe pain

    When I went into the office one Saturday afternoon in August 1994, I planned to spend a few hours finishing a brief that was due in federal court Monday morning.

    At the time, I was an attorney for the justice department. After 30 minutes of working at my desk, my back started to burn; it felt as if acid were eating my spine. In rapid succession, my muscles seized and threw me from my chair. I landed on the floor, stunned, as my body seared with pain.

    What I didn’t know then was that the pain would persist, and that I would be unable to sit, stand, or walk unassisted for almost twenty years. Nor could I have imagined that I would take opioids.

    Opioids fill the news with a steady stream of stories of lives lost from overdose and abuse. What we rarely hear is the other side — opioids are also the most powerful pain medication we have. For me, they were life-restoring.

    Appropriate pain management that included prescription opioids lifted me from the desperate circumstances of being bedridden and unable to sleep for months at a time to someone who negotiated major settlement agreements. I argued important cases in federal court, and supervised thousands of matters in U.S. Attorney’s Offices across the country.

    I still could not sit or stand — I negotiated via video-teleconference, argued from a reclining lawn chair, and managed cases from a jerry-rigged, platform bed — but I could and did work and function.

    Pain patients today are not so fortunate. In our effort to thwart the genuine problem of drug overdoses, we are taking life-sustaining medicine away from suffering people.

    Long-term, legitimate pain patients who have relied on opioid analgesics can no longer fill their prescriptions in the many states that set maximum dosage and supply limits, often of three to seven days.

    Even in states that contain exceptions for long-term pain care, insurance companies and pharmacy policies use such laws as a reason to deny coverage or fills. Pain patients are being denied treatment and involuntarily tapered off of opioid medications, even if they’ve never shown any risks of abuse.

    The Department of Veterans Affairs, which sponsored one of the first systematic efforts to discontinue opioid treatment, recently issued an abstract reporting that the results were not fewer overdose deaths but increased suicide mortality.

    While there is no question that looser prescribing of opioids in the 1990s and early 2000s contributed to the overdose crisis, illegal fentanyl and heroin drive overdoses today, not new prescriptions.

    The prescribing of opioids has dropped every year since 2012 and is at 10 year low — and yet drug overdose deaths have skyrocketed. Meanwhile, our public policy looks backward in time, intruding on the doctor patient relationship and burdening patient care.

    The Attorney General recently responded to the concerns of pain patients by telling them to “take a few Bufferin or something and go to bed.”

    His comment shows an astonishing misunderstanding of a condition whose quality of life index (QLI) is akin to that of late-stage cancer. Fifty million Americans suffer from severe or persistent pain, which twenty-five times more than those who misuse opioids.

    Chronic pain is also the primary cause of disability in the US, and it costs the economy half a trillion dollars every year.

    There is an important but often glossed over distinction between using medication for a health condition in a way that restores function, enabling work and participation in family life, and misusing a substance in a manner that destroys function.

    Most people who take opioids for pain do not abuse them: studies show risk for addiction in such patients varying between .07 and 8 percent. And, when opioids are prescribed properly with screening and follow through care, the risk of addiction goes down significantly.

    The substantial majority of people who have misused prescription opioids never received them in a healthcare setting; they obtained them from medicine cabinets, family and friends, or bought on the street.

    Like many pain patients, I initially resisted taking opioids. I exhausted every other possible treatment first.

    Because my condition resulted from a surgery when a doctor severed nerve plexuses in my spine, I tried infusions, nerve blocks and even a repeat surgery. I did physical therapy, acupuncture, and biofeedback. But nothing abated the pain.

    Treatment with opioids and integrative care allowed me to maintain a job, a sense of purpose, and community until I found my way to healing. Mine is a story rarely told of someone who took opioid analgesics for years and went off them without incident when the pain remitted. Given the environment today, such stories may well become extinct.

    Kate Nicholson is a civil rights attorney, a nationally-recognized expert in the Americans with Disabilities Act, and a chronic pain survivor. She is writing a book about pain, and recently gave a TEDx talk on the subject.

    Via public blog at

  6. Submitted by Paul Vallandigham on 02/17/2019 - 07:07 pm.

    100 years ago, on January 29th, 1919, the United States ratified the 18th Amendment to the US Constitution, prohibiting the manufacture, distribution & sale of alcohol because there was a “crisis” of alcoholism.

    Banning alcohol didn’t solve any of the “crisis” problems it was alleged to address. All it did was create MORE problems, including the birth of large organized crime networks that still operate to this day. Yet you don’t see bootleg liquor being sold in back alleys today, because the American people finally wised up and figured out that the “cure” was worse than the “disease”.

    100 years later, some people just refuse to learn from history. Meanwhile, in 2001, Portugal de-criminalized drug possession and their rates of addiction and drug-related deaths have plummeted.

    Taxing a medication and cutting off patients from needed pain medication will simply drive them into the black market, where you don’t know what you’re getting. It might be heroin, or it might be Fentanyl — which has a much narrower window between an effective dose and a lethal dose. The result is an increased rate of user deaths and increased violent crime associated with the black market (since black market suppliers can’t rely on the police to protect their business).

    If this measure is implemented, it will solve no problems. It will only create more problems, just as alcohol prohibition did 100 years ago.

    You can choose to learn from history, Minnesota, or you can choose to ignore history.

    Choose wisely.

  7. Submitted by Michael Chastain on 02/18/2019 - 06:13 pm.

    There’s another side to this story: people living with cancer and other chronic, painful diseases. They already have problems getting the pain medicines they need. This bill will exacerbate the problem.

    I talked to a friend today. She’s smart, she’s kind, she takes care of the people around her, she works incredibly hard, and she has had colon cancer. She’s opposed to this bill.

    And, you know, all of us are getting older. The next person who needs pain relief might be my mother, or my father, or me. Or it might be someone in your family. Or it might be you.

    It’s not just an issue between government and pharma companies. It’s an issue for everybody with a body.

  8. Submitted by Mary Backes on 02/19/2019 - 12:55 pm.

    I recently had an infected root canal tooth removed. Dental Surgeon talked about over the counter meds I could buy for pain but not one word about the prescriptions he was going to give me before I left. I was given 2 prescriptions- one for Motrin and one for OXYCODONE (15 pills) – which is very, very addictive – not one word that Oxycodone is an opioid or that it is dangerous. Friend’s teenage son had wisdom teeth removed- presciption for 30 opioids and not a word said the drugs are addictive. Another friend had C-section and given opioids- took them as told by DR – she is now an addict. The TRUTH is over 50% of people addicted to opioids started the drug from a prescription!!! I knew about the epidemic and knew to not fill the prescription. I experienced very little pain and took only a couple Motrin. When people go to a medical “professional” they are counting on their “professional” guidance- they need to tell people what the medications will do. “If you take the Oxycodone –an opioid- you could have a problem with addiction. You may experience more discomfort if you only take Motrin”. NOW would that be too hard to say??? The big problem is not about giving opioids to the dying or to people who really need that medication. The problem is handing them out like candy for any namby, pamby ache or pain.

  9. Submitted by Daisy Mosier on 07/26/2019 - 10:09 am.

    This “war on opioids” only hurts patients. Those of us who have chronic pain are most affected, because we follow the rules, don’t take too much of our meds, are rarely addicted, and suffer greatly. We are now ALL being treated like drug addicts by healthcare providers and pharmacists. And we are paying for other people’s crimes. We don’t buy our drugs on the street; that’s what addicts do.

    Many of us will lose this battle as our drugs will be limited or taken away completely. And MANY of us will choose suicide. Law makers make these arbitrary rules and have no knowledge of our struggles. We get drug tested regularly, have to sign and adhere to pain contracts, and now they’ve only made it harder for us.

    This law that went into effect July 1 will not make ONE bit of difference. Pharmacies already cannot fill prescriptions early, so how is it going to cut down on drug consumption and OD’s if they won’t accept post-dated Rx’s? This is an outrage!

    Just goes to show you that politicians, no matter which party, don’t give a sh*t about us peasants. I’m tired of dealing with consequences brought about by drug addicts.

    There needs to be a class-action lawsuit against those in government or whoever is responsible. Maybe THEN they’ll listen!

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