PAUL GILENO

Keep in mind those in pain

Fight drug abuse without cutting off needed medications

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Two bills are moving through the Pennsylvania Legislature that would create a prescription drug monitoring program. Both are intended to address the prescription drug abuse epidemic facing Pennsylvania by creating a database that would enable doctors to determine whether patients are “doctor shopping” — seeking multiple doctors to write prescriptions that aren’t medically necessary — or are legitimately in need of the medicine.

Like much of the country, Pennsylvania faces a critical challenge — how to combat the rising opiate abuse epidemic plaguing the state while simultaneously protecting those who constitute another epidemic: namely, the many Pennsylvanians living with chronic pain whose lives depend on access to prescription pain medication.

It’s a fine line to walk. Both epidemics are health crises.

Unfortunately, pain is endemic in our society. Federal health officials say more than 100 million people in the United States suffer from pain — that’s one in three Americans, tens of thousands of whom live right here in Pennsylvania.

Imagine pain so strong it never goes away, even with the best medical treatments. This pain affects your life, your work, your family and relationships. 

It prevents you from doing things you used to love, such as hiking, skiing, even walking. It’s difficult to sleep. Depression often hits hard. That’s what living with chronic pain is like.

There’s no doubt the state needs to do something to stem the tide of drug abuse. 

As recently reported in the Post-Gazette, Fayette County in southwestern Pennsylvania has one of the highest death rates from prescription drug overdoses in the country. As a state, Pennsylvania ranks 14th in drug overdose deaths.

But to be successful will require a multi-pronged approach so that those who need access to pain medications just to get through their daily lives can get it. Data show 70 percent of medications that are abused are not prescribed to the individuals abusing them.

Last October, the Pennsylvania House passed H.B. 1694, which would establish a confidential prescription drug monitoring database for professionals who prescribe or dispense prescription medication. In March, S.B. 1180 passed the Senate Health and Welfare Committee and will be considered by the full Senate.

Other state legislators’ efforts, which have also included resolutions aimed at curbing prescription drug abuse, have been laudable, but as evidenced by multiple separate efforts, a coordinated, measured approach is missing.

Some proposals would create barriers for patients to access appropriate medications. For example, Schedule V drugs, which are rated as having the lowest potential for dependency and include drugs to treat everything from epilepsy to fibromyalgia, would be included as part of the monitoring program, forcing doctors to mine a database when they prescribe these drugs.

Based on my experience, the added administrative hoops would be such that doctors often would choose similar yet less effective drugs not included in the database to avoid disrupting already hectic days. 

It is more important that the lives of patients who need these medications not be disrupted.

We must address the prescription drug abuse epidemic. But we must not do so at the expense of those who suffer chronic pain.


Paul Gileno, who suffers from chronic pain, is the founder and president of the U.S. Pain Foundation.

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