Health care challenge: Helping patients suffering chronic pain

Although science and innovation are the cornerstones of the California economy, patients living with chronic pain have been largely left behind when it comes to significant medical breakthroughs.

Beyond opioids, which can be effective but are also addictive, the choices that patients have available to treat pain remain limited to non-clinical options that only provide so much relief.

For Californians and the one in five Americans who are searching for a new way to manage persistent pain, our lawmakers must prioritize policies that drive innovation, which not only provides hope, but also the chance to discover new, non-opioid treatments that allow patients to lead a life not defined by chronic pain.

In some instances, due to language barriers, the misdiagnosis of conditions has led to prescription opioid treatment plans.

The burden of chronic pain falls disproportionately on Californians living in rural areas, who have both a higher incidence of chronic pain and who experience greater barriers to treatment for their pain. Since the early 2000s, more than a dozen hospitals have closed in areas of the Central Valley and long stretches of Northern California. Without close proximity to providers, some patients have to travel hours to seek medical care. As with many other challenges, the inability to access care has been exacerbated by the COVID-19 pandemic.

Even for those able to seek treatment for their pain, options are limited at the pharmacy counter. Opioids have often been the first line of defense to help patients manage pain, but the stigma, safety, and fear associated with opioids has left many feeling hopeless in the search for something safer and more effective.

In some instances, due to language barriers, the misdiagnosis of conditions has led to prescription opioid treatment plans. For others, opioid treatment has led opioid addiction due to ineffective management of a patient’s condition.

The American Medical Association (AMA) reports that more than 40 states have reported an increase in opioid-related mortality during the COVID-19 pandemic, and California is no exception.

According to a recent study by the California Health Policy Strategies (CHPS), California has seen an even greater increase of overdose deaths than the rest of the country. From the period of May 2019 to May 2020, California reported more than seven thousand deaths from drug overdoses – a 26.8 percent increase, compared to a 21.3 percent increase for the rest of the country. One cause is the use of fentanyl. Experts predict that the rate may further rise as the pandemic continues.

Fortunately, help is on its way.

In 2018, Congress passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (“SUPPORT ACT”), which provided resources and opportunities to discover new approaches for the treatment of chronic pain – including non-opioid options. Critically, the SUPPORT ACT created programs to reduce prescription opioid abuse and deaths and encourage non-addictive, non-opioid alternatives for treating pain.

Those provisions included safer packaging and disposal features, research, and issuance of new regulations on non-addictive alternatives to opioids and guidelines for opioid prescribing.

Recently, then-California Attorney General Xavier Becerra joined The National Association of Attorneys Generals (NAAG) in sending a letter to the U.S. Food and Drug Administration (FDA) to ask for clarification on its plans to implement the SUPPORT ACT– an important action that holds the FDA accountable on their obligation to ensure patient access to non-addictive pain therapies.

It is critical that we ensure aspects of the SUPPORT ACT are fully implemented in order to help more individuals gain access to safer and more effective treatment options for pain and reduce the increasing and recent incidents of opioid abuse in California and especially among those living in rural areas.

On behalf of the more than 28 million Californians managing chronic conditions, we urge FDA and Congress to continue to address challenges to continued investment in innovative and non-opioid treatment options for treating pain.
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Editor’s Note: Bill Remak is founder and CEO of the California Hepatitis C Task Force based in Northern California.