Congress Is Writing Lots of Opioid Bills. But Which Ones Will Actually Help?

If my doctor were unable to prescribe tapentadol (Nucynta), an opioid, for my idiopathic peripheral neuropathy that has been getting consistently more painful for the past 15 years, my alternative would be suicide. Which is better? ~fss

One major problem in the tri-state area of WV/OH/PA is patients that are using medicine assisted recovery programs have a variety of clinics to go to for help but no pharmacies that will carry the medication! There are patients that can walk to a clinic from home but have to travel 2 hours to a pharmacy that will fill prescriptions for Buprenorphine. This is not because of lack of local pharmacies, they are on every street corner, but because they don't have to carry these medications if they choose to not do so. These are chain, large retail store pharmacies and locally owned that refuse to fill this medication. You can walk into ANY of them and get oxycodone, fentanyl patches, etc. It is something that needs to be brought to attention.

I cannot imagine why they are worrying over "the tracking of prescribing" opioids at this point. Where I live (and have long required the use of oxycodone in small doses in order to function through my chronic low back pain and now the wait for a hip replacement), NO doctor would dream of prescribing any narcotic pain medication, period. The administration would now prefer to see us old, injured, damaged by work or just life, members of society, suffer intolerable pain than perhaps become addicted. There is considerable evidence that people who take narcotics for genuine pain relief do not become addicted, but let's throw all that out in favor of saving addicts, by all means!

All they have to do is reverse the Bill that Congressman Marino Pa and congresswoman M Blackburn Tenn wrote and passed to stop rhe DEA from doing their job in 2016. See,60 minutes story June,17. This BILL TOOK all power away from the DEA. The real drug criminals are the congress and lobbyists for big pharma. Trump nominated Merino to be the new drug czar but withdrew two days. after 60 minutes story How many Merino and Blackburn constituents know that they demanded Joe Ranessi a Senior DEA person be investigated because he was exposing the real criminals, Congress,Major Drug Companies,distributors, Chain drug stores , pharmaceutical manufacturers etc...(AmerisourceBergen,Cardinal Health, McKesson, J&J to name a few who spent 106 Million lobbyists congress claiming the DEA was wrong because they were exposing their criminal activities. Ranessi was demoted under pressure from the bribed congress.

Portugal has over 25years experience doing this very well. #1- Recognize addiction as a disease not a crime #2- Have many "clinics' where drugs are given to combat the addiction and there are rehab treatments offered for free. #3- Clean sterile environments to use needles #4- offer free drugs to those who are unable to quit. #5- A program to get these users back into society with some forms of follow up help. In the case of the USA restrictions on who is allowed to prescribe opioids and transparency on this. Key to all of this is adequate funding , long term and assured. Can we afford it? The cst of this problem is well over 100 billion a year so yes we must and can.

If “I didn’t really see that many groundbreaking proposals,” said Joshua Sharfstein, a vice dean of public health at Johns Hopkins University and the former health and mental hygiene secretary in Maryland, who reviewed the dozens of bills." then here's one that goes to the bottom of the epidemic of pain: Fix the psychic/emotional pain. Pain, of course can be traeted with pills, but so it is with the placebo effect: Looking at your situation in a less pain-inflicting way. How do you do that? For one create more opportunities for pleasures that are free, such as that Richard Feynman reminds us in his book, the pleasure of finding things out. American are too narrowly focused on money or resources, forgetting there is a world out there that can provide immense plesaure -- to numb pain.

Please, please, do not make it even more difficult for me to order opiates for my cancer patients.

Drug rehab has never been shown to be better than nothing. There is simply no good “intent to treat” study that has ever been done. It would not be hard to do such a study but the “rehab” crowd does not want it tried. The findings would devastate the profitable industry.-I mean, the average druggie is on his 4rth or 5th sojourn through the mill at how many thousands per cycle? The buprenorphine may or may not work as advertised. The studies that I’ve seen are just treatment comparisons, that is to say that addicts who may be about to quit on their own seek out the latest fad, and when they quit, the buprenorphine is given credit. Once more, an intent to treat study is called for before we spend a lot more money on, what even I admit, to be a potential game changer. But even then, the addict has to want to quit. In the year 1900, any 10 year old walking down the streets of Detroit or wherever could go into a pharmacy and buy as much heroin or cocaine as he could afford; KIds did not bother to buy these drugs. Those who did were folks, mostly wealthy, often creative or artistic who used narcotics and cocaine regularly, who worked and took care of their families. Picture Abe Lincoln who used opium to get to sleep every night. (It caused constipation and everyone in Washington knew when and what kind of laxative Abe used-it’s a small town that way.) The War on Drugs makes dealing in these drugs incredibly profitable, so borderline personalities get involved, and addicted...

Three spinal surgeries. Five fused vertebrae. Severe degenerative disk disease. Severe arthritis. Severe scarring from the surgeries that were supposed to help and did nothing. And, to top it all off, a birth defect in my spinal column that makes any comprehensive repair and relief impossible. And I'm going to be the one who pays the price for the abuse created by heroin addicts, not people like me. You take away my pain medication and you will take me out of the work force. I will become a cripple and a liability on the system. Want to know what it's like to live with chronic pain? Get up tomorrow and smash your thumb with a hammer. Then do it again three or four times throughout the day. Get up in the middle of the night and do it then too. Do that for 9 straight years and then let me know how you feel about pain relief medication.

Nowhere in this article is there any mention of Perdue Pharma which is responsible for the manufacture and marketing of opioids to the medical profession as "non-addictive". There should be some form of severe redress for a pharmaceutical company that knowingly and deliberately marketed medication as non-addictive and then placing vulnerable people coming out of surgeries with pain meds / opioids that are highly addictive. Where is the legal culpability for Purdue Pharma and the owners, the Sackler family, in this crisis? The number of lives they have ruined and those who have died from overdosing on the painkillers manufactured by this firm need to be held legally responsible and class action lawsuits along with the Attorneys General -for as many states who want to join in -is the beginning of righting a very serious, deadly wrong. And the Sackler family continues to cash in on their manufactured opioids over bodies dead from overdoses. They are laughing all the way to the bank - unscathed through it all! Why do US taxpayers have to foot the bill for a pharmaceutical company's fraud and subsequent addiction crisis from their products? Levy significant fines on Purdue Pharma - better yet - shut them down.

Opiods cause more harm than good. Plus we don't need them as there are effective alternatives. See the following piece which appeared in The Times earlier this year. Opiods are good only for making their manufactures, who are lower than the lowest drug pushers, rich. Shut them down. Try and jail their makers. They are worse than El Chapo. Think El Chapo killed over 60,000 people a year? https://mobile.nytimes.com/2018/01/27/opinion/sunday/surgery-germany-vic...

Republicans help? Surely, you jest. The only help Republicans wish to offer those suffering from drug addiction is a ride to the polls in November with their names plastered all over the place. Help? Yeah, right. Can't wait to help boot their be-hinds out the doors of Congress, with a good tar and feathering bidding them a fond adieu, and good riddance. DD Manhattan

I don't remember politicians parading pictures of families and victims during the crack epidemic. I guess they were too busy stiffening the sentences.

The best law that could be passed to stop the opioid epidemic is to legalize cannabis at a federal level. Let the FDA study cannabis as medicine. Allow drug companies to formulate cannabinoid-based medications for pain management. I have an intractable, systemic genetic condition that causes chronic, widespread, intractable pain. Opioids only distract me from the pain. Cannabis actually relieves it. The choice, for me at least, is obvious.

If there ever was an issue the exposes the limitations of government the opioid crisis is it. All of old anti-government bromides ring true. Slow to respond, lumbering, etc. I think whats missing here is the role of the States. Instead of sitting around waiting for Federal funds they could do more themselves. They're not. A good example of this is Ohio. Some call it Ground Zero for the crisis. The State of Ohio has been completely ineffective in dealing with the crisis. Slow to recognize the scope of the crisis. Slow to respond. Everyone knows the Counties with the biggest problem. Yet the Sate can only pass sweeping legislation for the entire State and not zero in on the most troubled areas. It's not only about treatment either. The entire community struggles to deal. It's sad that there is so little help.

Where are the GOP’ers with their “zero tolerance” “Just say No to Drugs” “lock-em up” “Use illegal drugs, go to jail” policies? Those laws were so effective against crack cocaine and locking up inner city people of color for the past 30 years. Oh yea that’s right, these are white people addicted to illegal opioids, that’s a disease and must be treated with compassion and not jail time. Common you GOP’ers, just enforce the laws as written, lock the illegal opioid addicts up, go ahead and rip their children from their arms, place their kids in cages...... after all “I’m just following the laws and the will of the people. I wash my hands of this.” P. Pilot / D.Trump

Portugal has a 25 year history of what to do. 1- Recognize drug addiction as a disease not a crime. Drug selling is a crime. 2- Arrange treatment centers throughout all cities. You can get clean needles, drugs a s needed and health care advice. 3-Allow easy and free treatment programs for those who want them 4- Use the effective drugs available to n block the effects of Heroin and opioids. The savings in health care costs are above 60%, less crime, less deaths, and no increase in the rate of new addicts. We have this info, it works. As far as money we are losing well over 100 billion a year on costs ($90,000 per addict hospitalized) and for 10 billion we could do all the above. See letusbeawarefolks.blogspot .com-Our increasing drug problem for details

Human beings; having been lords of the universe for what, a few hundred years? Is creating problems to solve our purpose in life? Forgive me for rambling. The opioid problem is a medical problem, not a law enforcement problem. The opioid problem is a medical problem, not a government policy problem. Drugs and alcohol are coping methods for life. Life where most wish for more. Life where parents want the best for their children. To a starving man a rat is a luxurious fest. Drugs provide instant synthetic comfort. Therefore, we give people dying of cancer all the drugs they want. We want them to enjoy the last seconds of life. We need more philosophers and theologians – not to tell us what to do but encourage open minded thinking. There is no gift the universe has given us greater than the ability to think. However, considering everything requires courage and an intellectual mind. “Remember the universe is big. Really really big.”

The opioid crisis -- like so many other national problems -- could be solved by four smart people in 20 minutes, but for the money in politics. We need mandatory public campaign financing. We need government to work for us, not for the money.

Of course it’s hard to put the genie back in the bottle with opioids-you’re talking about going to war with the Sachlers, who created the market for the Oxys and the medical advertising practice in general. They quietly spend a lot of money to make sure it doesn’t get fixed. I don’t know if it’s done in the rest of the US, but the simplest solution going forward is what’s done in NYS: prescriptions can solely be issued electronically. Doing this in a nationally integrated manner would eliminate doctor shopping, and would allow regulatory authorities to flag doctors who write excessive opioid prescriptions in general or to a particular patient, or audit a pharmacy that purchases or distributes excessive amounts of the meds. There’s no reason why it’s not possible to account for the purchase and distribution of every gram of opioid produced and distributed. As for those already battling addiction-treatment has to be covered. You can’t unravel the ACA. If you want to, you have to replace it with something significantly better-which really means you have to regulate the pharma market and profit margin, and eliminate pharmacy benefit managers. You have to free up the resources to cover the needs of all Americans.

Pain patients are suffering the agonies of the damned because politicians need reputations as anti-opioid warriors to get elected. Fewer than 1 percent of chronic pain patients who take opioids become addicted to them. The government's opioid-related death statistics are based on whether the dead had ANY opioids in their bodies at the time of death, not whether the opioids actually killed them. The real killers are illegally imported fentanyl and contaminated heroin, but current draconian opioid restrictions are forcing pain patients and addicts to turn to these deadly substances. All this misery and suffering -- motivated by false statistics and moralizing -- is occurring so politicians can get reelected. The only way to end the illegal drug trade is by legalizing recreational drugs like alcohol. Did the national disaster that was Prohibition teach us nothing?

We also have to see life as a continuum, and realize an addiction to drugs at 20 or 30 is often related to that child's life at 2 or 3. We have to stop creating addicts by neglecting or traumatizing kids. Addicts are nearly always people in serious emotional pain, who lack the ability to relieve or self-regulate it. Traumatized kids have a much higher incidence of addiction and mental illness. Emotional self regulation skills are learned (or not) in early childhood. We have changed childhood too profoundly. We need to provide more nurture and more presence to small children. They need external emotional regulation, provided by us, to develop internal emotional regulation. Dr Gabor Mate says "the opposite of addiction is connection."

Why is it that 10 People get the same dosage of the same medication for the same medical procedure and one becomes addicted and nine don't? Similar statistics for alcohol and other intoxicants. Is it as simple as the common wisdom believes, that the 10% are Moral-Failures? Are the 12-Step programs, that address moral-failure, 100% successful? No. Do we really understand addiction? No. Do we want to study and understand addiction? No, because classifying it as a moral-failure is what we have always done and it is so much easier and uncomplicated. Nobody wants to study moral-failure, we just want the moral failures to straighten-up. Passing a bunch of laws that have no basis in science and medicine is politically expedient but useless. However, spending taxpayer dollars to study what most consider a moral-failure will never get through congress. If addiction is a disease, how do we treat a disease that we don't understand? Yet, we continue to follow that same path, again, and again, and again...

We can always use new and better treatments for just about every disorder. However, many readers of the article might think that we lack for non-opioid treatments for pain. In fact, we already have multiple medications and non-pharmacologic treatments for the most common forms of chronic pain including low back pain and headaches that are as effective and, in many cases, more effective than opioids. That many physicians are unaware of these reflects the inadequate education most receive on pain management and it doesn't appear any of these proposed laws address this problem. In members of Congress really understood the opioid problem they would be aware it is really two different problems which need different solutions. The importation of illicit opioids like heroin and illegal fentanyl is a criminal justice issue. The problem of the misuse of prescription opioids is something different as over 80% of these people receive the drugs from family members, friends, or physicians. I don't see how you solve a problem if you don't understand the nature of it which Congress clearly does not.

Opioids have been around for a while and used properly until Purdue did their Oxy thing. Until then opioids were rarely used and therefore did not help the bottom line. That was not good enough for Purdue and suddenly kids having their wisdom teeth removed were getting a month’s worth of Oxy to take home. That’s more than enough to get you addicted. Those who suffer from great pain and can no longer get them are just as much a victim of the Purdue’s greed as are the addicts. Our politicians will do nothing because that would mean messing with the so called “free enterprise” system. Shutting down the bastards would cost thousands of jobs, they would claim. Never mind the thousands of deaths. Consequence? Total confusion. I suffer from chronic pain and was prescribed Oxy in 2007. It almost killed me. I started with 5mg and 10 years later was at 200mg. I was slowly dying. In 2017 I detoxed. Cold turkey but with wonderful support. I spent 4 weeks at the clinic and didn’t sleep one night. However, detox is but the first step. Fact is, Oxy (and, opioids in general) rewire your brain and it can take up to two years to completely rewire the brain back. The first year, though, is hell. I was extremely tired and had endless flus and fevers. Oxy scares the living daylights out of me but if you think you need it and can’t get it, well, you know who to blame.

It's actually pretty simple. Make that oxy junk illegal and prosecute the people who make it, like those who run PurduePharma, which should be shut down. These people are the worst pushers around. They know what they're doing. They kill 60,000 people a year. They should be in jail in downtown Manhattan with El Chapo.

Did the author read the referenced paper? For the many of us who have severe pain mamageent issues, the laws being created matter greatly. "A recent study cited by the Department of Health and Human Services suggests that over half of those in treatment for opioid-use disorders began by using prescription medications." From the paper, Increased use of heroin as an initiating opioid of abuse. "RESULTS: In 2005, only 8.7% of opioid initiators started with heroin, but this sharply increased to 33.3% (p<0.001) in 2015, with no evidence of stabilization. The use of commonly prescribed opioids, oxycodone and hydrocodone, dropped from 42.4% and 42.3% of opioid initiators, respectively, to 24.1% and 27.8% in 2015, such that heroin as an initiating opioid was now more frequently endorsed than prescription opioid analgesics."

When did opioid addiction become a crisis? What were the contributing factors? What was the crisis doing to people and their families? Please remind the readers when you report on the crisis.

The article totally misses the point. No mention is made of figuring a way to limit access to opioids so they are less available for abuse. Are we so afraid of pain we are willing to put up with a flood of opioids and do nothing until people are addicted and it is almost too late and a lot more difficult? Why promote addiction by making opioids so easy to obtain? Limiting access to opioids should be the first option considered. Figure out a way to limit marketing and distribution of opioids so they are less available to be abused while still being available for those with real chronic pain. Waiting until AFTER people are addicted and not stopping people from becoming addicted seems an exercise in futility and an admission addiction is a given. Loading up on addiction cures while ignoring marketing and distribution rules that make opioids so easy to get seems lazy and cowardly a non-solution that will effect only the symptoms of the disease and not cure the cause. Such a strategy says we are willing to accept addiction as a byproduct of pain relief and I for one think that attitude is unhealthy and not one I want to promote. Put strict limits on the marketing and distribution of opioids while still making them available for those with chronic pain. And strictly enforce those limits. We must attack the opioid problem from all angles and be proactive and do all we can to stop addiction from happening rather than wait until it has occurred.

Once again there are many comments from chronic pain sufferers lamenting that the opioid crisis is restricting their access to pain medication. While I am empathetic to their plight, they are victims of Big Pharma too. Sadly, they don't know they are, and unwittingly advocate for the painkillers that enslave them. Many recent studies have shown that opioids are not any more effective in treating chronic pain than other medications and treatments. These pain meds build dependency and would require the same detox to stop taking them as an addict. Side effects include opioid induced neuralgia where pain receptors become permanently damaged, chronic constipation, and increased dosage levels to achieve the same effect. Muddled thinking and an obsessive preoccupation with themselves and their pain are other hallmarks of long term painkillers use, as evidenced by these commenters seeming inability to care about the appalling number of tragic deaths. Instead they cite a supposed increase in pain related suicides with no data to back it up. Amazingly, the rest of the world isn't killing themselves in droves due to pain as they don't use opioid painkillers at anywhere near the rate in America. This opioid crisis is huge and includes both addicts and painkiller users. Big Pharma has to be held accountable and forced to pay to help all those whose lives it has ensnared for profit.

My fear is the temperance movement against opioids like all temperance movements will harm millions of pain suffers who rely on a drug that has been used for millennium. Doctors prescribe less opioids in part because the DEA has been shuttering doctor practices, as one doctor told me when he wouldn't prescribe opioids for a broken toe. All premature deaths are tragic, but half the cohort that overdose are street addicts and many others purchase opioids through the black market. Doctors are obligated to provide appropriate care, care that is impossible to provide when their livelihood is in jeopardy because the DEA can shutter practices for a suspicion as I noted above. Pain sufferers need relief from pain and the subsequent stress that increases blood pressure. I crushed my L4 disk, so the vertebrae above pinches the nerve going down the front of my left thigh. The wound cause a hematoma to lodge in my spine that crippled me for months. My nerve pain is from the realignment of my spine not inflammation. Opioids are the only medication that blocks nerve pain and helps take our mind off the stress that increases blood pressure. High blood pressure will be the new epidemic as the temperance movement bans or severely curtails opioid use. High blood pressure increases the likelihood of premature death from stroke and heart attack, completely preventable deaths if we don't reign in this temperance movement politicians are using irrationally for personal gain.

There is no opioid crisis. When I was on Fentanyl and it said one patch daily, I used one patch. It did not alleviate my pain but instead of adding a dozen patches daily and dying, I was moved to the -codones. One pill daily, take one pill. Those didn't work, so morphine. When I worked with models and later was an executive in Hollywood, I went to parties where coke was everywhere. But when I saw the blood from sneezing, the nose sinking,, I never went near it. We have a problem with suicide not opiates. Our true advance is legalizing pot where I can find the strain that helps my pain. I do not want this faux opioid crisis to be used as an excuse to prevent bringing relief to those in pain.

Oh, come on. "A recent study cited by the Department of Health and Human Services suggests that over half of those in treatment for opioid-use disorders began by using prescription medications." The NCBI publication link leads to a study that concludes that heroin has dramatically increased as the initial drug, from 9% to 33% of users, while common prescription opioids have dropped from 42% to about 25%, during the period 2005-2015. In addition, other studies have shown that most of the prescription "abusers" are not the people the legal drugs were prescribed for. This is NOT a crisis of innocent people getting hooked after legal use of pain killers.

We badly need treatment on demand. Addicts are erratic in their behavior, and their lives are in disarray: they will want help one moment, then their need for the drug takes over, and then they are high again. The system has to recognize this. For those who are arrested for non-violent crimes like stealing car radios, we also need routine diversion to secure treatment facilities, followed by long-term probation with mandatory random checks, followed by re-commitment if and when they slip. And civil commitment of addicts to such a program should be an option for family members, who must currently watch helplessly as their loved ones destroy themselves. I have heard by way of objection that such a program would deprive the addicts of freedom, but the addict is the least free person on earth.

Funding studies to identify alternative pain control measures is a good long term strategy that would address the concerns of chronic pain sufferers over time. In the meantime, better tracking of prescription use would help identify prescription users who are falling into addiction. Finally, treatment quality needs to be addressed alongside expansion. We know most don't use evidence based practices and the fees they charge are astronomical. It's such a shady industry. Try finding a place for a relative. Anyone who is used to researching products will be appalled at the lack of information available to compare facilities. o once called the government funded referral service that SAMHSA runs. This is the agency that studies and disseminates info on evidence based practices. When I asked whether the hotline received payment from providers to promote certain services, the response I got was "I am not allowed to answer that question". Seriously?!?! There is ZERO quality control in this industry.

"Another missed opportunity, addiction experts said, is the legislative strategy to encourage creation of more treatment options for patients who need them. " This article is strongly advocating for the expansion of treatment options without addressing the efficacy of such treatment. From my own antidotal observation from friends and family members who are opioids addicts, their dozens of "treatments" have not been successful, and they all relapsed despite the $100,000s their families scraped together to pay. Why would these treatments be anymore effective if paid for by the government? There is already a growing sketchy industry around drug treatment as desperate families are willing to try all options, even unproven options. Before taxpayers begin throwing large sums of money at opioid addiction treatment, there needs to be strong scientific evidence that the treatment is effective in the long term. As opioid addiction moves from a moral weakness to a medical condition, treatment needs to now comply with the same scientific method that is required of all medical diseases. Once a treatment is proven to be effective, it will be fairly easy to convince political leaders and the general public to support treatment.

For politicians this year "the scourge of opioids" is like "mom, baseball, and apple pie," just another phrase to drop into their speeches and emails to fool their constituents into voting for them. There has been an awful lot of talk and studies, even a presidential commission, and now we have drug expert Kellyanne Conway spearheading the White House effort. Talk is cheap, solving the problem will take real action. Not words.

- The worst thing that the Trumps did with regard to immigration was exactly that - the worst. What makes anyone think that the Trumps will do any better with opioids?

Since drug addict are killiong themselves with Chinese and Mexican fentanyl and heroin it seems stupid to focus on Rx drugs—hard enough to get already for those need them. “Increases in Drug and Opioid Overdose Deaths-US 2000–2014: “...increases in death rates were driven by synthetic opioids (72.2%), most likely illicitly-manufactured fentanyl [IMF] and heroin (20.6%)... IMF production and distribution began increasing in 2013...has grown to unprecedented levels… DEA has not reported…increase in pharmaceutical fentanyl being diverted from legitimate medical use to illegal uses. Given the strong correlation between increases in [IMF] and increases in...opioid deaths and uncorrelated stable fentanyl prescription rates [declining since 2010], it is hypothesized that IMF is driving the...deaths. Findings from DEA state, and CDC...further support this hypothesis...Law enforcement strategies to reduce the illicit opioid supply must...be supported.”

Okay, this is going to sound like I'm joking, but I'm not. What if we legalized marijuana since it is such a far-less-deadly pain reliever? And then do all the anti-opioid measures. I realize that mj is considered a gateway drug, and "yes it can be," but part of that is due to it's black market status. A lot of the "gateway drug" phenom is perhaps the "gateway drugdealer." The ones who sell mj are likely to want to move their buyers onto other drugs that are easier to deal (smaller items at a higher dollar).

This article is like so many others; it has no input from those of us who suffer from chronic pain. Yet there are hundreds of thousands of us who deal with it and manage our opioid use carefully. I have been using opioids for over ten years and will be till I die. (I'm 78) I have hundreds of pages of notebook paper filled with the date and the time I took a Norco, an MS Contin or stronger med. All of this so called concern has only made my life more difficult by making my access to my prescribed drugs more difficult. I worry constantly while the politicians and DEA officials sleep well. Does anyone ever consider the person with chronic pain?

"Another bill would allow Medicare to cover certain forms of addiction treatment for the first time." That statement is rich. My 75 yrs. old husband gets a terrible upper respiratory infection each spring, resulting in a horrible cough which lasts for weeks. One year he coughed so hard and frequently, he cracked a rib. His doctor prescribes a cough medicine with codeine which truly calms the cough. Medicare had always covered this once a year, one time prescription. However, this year, Medicare no longer paid for this medicine because of the opioid epidemic. They said they were cracking down on the use and abuse of opioids. Apparently, Medicare cannot or does not monitor who receives what treatment for how long. Now, for my husband to obtain this medicine from the pharmacy, he has to pay $75 out of pocket. That's insane! Funny how Medicare will suddenly "cover certain forms of addiction treatment" but will no longer cover patients suffering from an illness, through no fault or action of their own.

Laws, education, strong prevention investment and continuing lifetime education. This combination has worked to reduce cigarette smoking and related cancers. A similar approach is indicated for opioids. Prevent, prevent, prevent.

The first thing we need do is to ban or severely restrict the use of commercial opioids. (OxyContin, etc always.) The legal pharma sales of addictive pills keeps growing and is still largest source of sales, epidemic or not. Before the invention of the new opioids, the use of addictive medicines were severely restricted. What happened? Shame is apparently not enough to control the greed. But we should ashamed of letting them get away with it.

Yes, the opioid crisis is important. The occupant of the white house mentioned this last year after his coronation, but didn't start doing anything about it until he needed a way to deflect attention away from the absolute mess he's made at the southern border.

Tragically, and as usual, none of these bills addresses the issue of the necessity of opioid medications for high impact chronic pain sufferers. The policies being promoted, both at a federal and at state levels are, in my opinion, a simplified, one size fits all political solution to a complex and serious problem, having damaging, oftentimes life-threatening ramifications for people suffering from high impact chronic pain. I know, because my daughter has suffered with high impact chronic pain for 11 years. The National Institute of Health, in its National Pain Strategy, stresses the need for a more balanced approach to the problem. As stated in the strategy: “Programs to curb inappropriate prescribing practices and prescription opioid abuse must be balanced with the use of and access to these drugs for appropriate and quality pain management.” Additionally, the strategy indicates that studies suggest that the vast majority (75%-96%) of high impact chronic pain patients take their medications without suffering from opioid addiction. While the intent of the current and proposed policies regarding prescription opioids may not have been to deny needed medication to those with high impact chronic pain, that has certainly been the effect. Suicide rates for persons with high impact chronic pain are steadily rising because doctors will no longer prescribe the medications necessary to control the pain. This suicide epidemic is the other side of war against opioids medications.

The bottom line with the best method to employ with any drug/dangerous object is legality, regulation, responsibility and non promotion. We did best with cig smoking from a high of over 40% in 1960 to a present day low of 14%. We did the worst with things like abuse of the gun and opiate addiction, both at epidemic levels. We kept opiates legal but failed miserably with responsibility, regulation and non promotion. Same with guns.

One essential change would quickly lower the death rate from opioid overdoses. Presently prescribing authority for the rehab medication Suboxone (sublingual buprenorphine with naloxone) is restricted to a very small number of physicians. On the other hand, prescribing authority for addictive opioids is extremely widespread. Rehab prescription authority should be much more widespread. Many addicts would like to quit, but cold-turkey doesn't work for them. Compared to cold-turkey, I have been informed, rehab on buprenorphine is "a walk in the park". Hopefully new rehab medications will emerge, which do not have the addictive propensity of buprenorphine and methadone.