Progress?

What would progress in the opioid war look like? For the government, progress is a decrease in the supply of opioids, along with the number of doctors prescribing (treating pain). And of course it means a decrease in the number of drug overdoses and deaths. In this Bloomberg article, New Mexico is highlighted as a state that’s making progress, but that’s not the reality.

Unfortunately, any “progress” in the opioid war is bad news for patients.

http://www.bloomberg.com/news/articles/2016-06-23/opioid-crisis-draws-failed-response-from-most-states-group-says

Kentucky, New Mexico, Vermont among states making progress

States were evaluated on six criteria, including the availability of treatment; mandatory education for doctors who prescribe opioids; and access to naloxone, which can reverse the effect of opioids. Michigan, Missouri and Nebraska didn’t meet a single one of the standards, according to a report from the council. Twenty-four other states were labeled as “failing” because they meet just one or two of the six objectives. While Kentucky, New Mexico, Tennessee and Vermont passed at least five, no state had a perfect score…

Does this look like progress to you?

https://nmhealth.org/publication/view/marketing/2117/

In 2014, there were 540 deaths to drug overdose in New Mexico.

New Mexico has the 2nd highest drug overdose death rate in the U.S.

https://nmhealth.org/publication/view/help/1832/

In 2014, 450 New Mexicans died by suicide (21.1 deaths per 100,000 residents)

The New Mexico suicide rate is more than 50% higher than the United States rate

http://www.practicalpainmanagement.com/resources/ethics/new-mexico-approach-improving-pain-addiction-management

However, New Mexico decided not to establish a “trigger” dosage threshold because of concern that such a policy would interfere with the patient-provider relationship. Instead, the state requires a mandatory continuing medical education course covering both prescription drug abuse prevention and the treatment of pain…

Opioid prescribers are mandated to sign up with the New Mexico Board of Pharmacy prescription monitoring program (PMP) and obtain a patient PMP report for the preceding 12 months when initially prescribing chronic opioid therapy (ie, ≥10 days) and every 6 months thereafter…

https://painkills2.wordpress.com/2015/09/06/unm-project-echo-bites-the-dust/

New Mexico is one of 16 states that successfully competed for the four-year grant from the U.S. Centers for Disease Control and Prevention. The grant is from a new program called Prescription Drug Overdose: Prevention for States that helps states address the ongoing prescription drug overdose epidemic.

It appears that a bucket load of education and the PDMP were not enough to make a real difference in the number of overdoses in New Mexico. In fact, after a few years of seeing a small decrease in overdoses, the latest statistics show an increase.

Which leaves me to wonder what is being taught in these continuing education classes and seminars on chronic pain and addiction. Since this education is being funded by the government — and disseminated with the help of the medical industry — I assume everyone is learning to comply with the new CDC rules. And treating pain according to the CDC rules is not going to work for very many patients.

http://amarillo.com/news/2016-02-04/new-mexico-lawmakers-look-curb-opioid-addiction

More New Mexicans died in 2014 of drug overdoses than in any other year on record…

Neurologist Joanna Katzman, president of the American Academy of Pain Management and head of the University of New Mexico’s Pain Consultation and Treatment Center, said continued education for medical professionals who prescribe opioids as well as better access to care for patients dealing with chronic pain must still be part of the equation.

“Chronic pain overlaps with addiction. Chronic pain overlaps with mental health,” she said, pointing to higher incidences of depression, anxiety and even suicide. “We need to really think about increasing treatment for chronic pain, increasing access to treatment.”

Dr. Katzman can talk a good game, making it seem like she could be on the side of pain patients. But I can’t imagine that too many pain patients would agree with her view of what constitutes treatment:

https://painkills2.wordpress.com/2016/03/18/addiction-clinics-masquerading-as-pain-clinics/

http://santafepreventionalliance.com/wp-content/uploads/2016/05/Michael-Landen-Prescribing-and-Drug-Overdose-Deaths-in-NM-May-7-2016.pdf

Council leading joint process to develop common language for the 7 licensing boards to use in developing their chronic pain management rules by 1/1/17

If you’re a pain patient in New Mexico, you should keep a watch out for these new rules. I assume they will mostly be in line with the new CDC rules, but I also assume that they will include a lot more restrictions on what doctors can prescribe.

I’m sorry, but I think things are about to get a lot worse, not only for patients in New Mexico, but in every state.

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