The so-called “prescription pill epidemic” has been making headlines in the U.S. for years—and much to the consternation of chronic pain patients and their advocates, few media outlets or government bodies have focused on the effects that the “pain pill panic” has had on people who need access to opiate pain medications for legitimate reasons, such as chronic or acute post-surgical pain.
A group of U.S. Senators, led by West Virginia Senator Joe Manchin (D), recently introduced a piece of legislation that would establish permanent funding for opiate addiction treatment by collecting a federal tax on all opiate pain medications. The legislation, dubbed the Budgeting for Opioid Addiction Treatment Act, or LifeBOAT Act, would be the first of its kind to tax consumers directly with the aim of fighting the opiate epidemic by establishing more funds for addiction treatment. Depending on the medication dose, patients would have to pay anywhere from a 75-cent to a 3-dollar fee for a 30-day supply of opiate medications, along with their co-pay or out-of-pocket payment.
Certainly, proposing more funds for drug addiction treatment is an admirable goal, but taxing consumers—including chronic pain patients, who, like many people with disabilities in the United States, tend to be economically poorer than people without chronic pain or other disabilities—is not the way to go about fulfilling such a goal. The 75-cent or $3.00 fee every month might not be a problem for someone with chronic pain who has a steady job or other income, but for someone with chronic pain for whom every penny counts, such a “small fee” could add up.
According to CNN, the LifeBOAT Act would offer rebates on the proposed tax for opiate medications prescribed for people with cancer-related pain, those who need pain management for end-of-life care, and patients for whom opioids are prescribed as “part of medically assisted treatment;” however, a clearer definition of “medically assisted treatment” is needed. Do people with chronic pain on short or long-term opiate therapy count as patients who are going through “medically assisted treatment?” Without stricter guidelines as to who gets the rebates and under what circumstance(s), this part of the legislation might end up hurting chronic pain patients, many of whom already deal with enough frustration and bureaucratic roadblocks to get their medications refilled every month.
Furthermore, the collapsing of two separate issues—opiate abuse and addiction versus the correct use of opiates in treating chronic pain—into one seems problematic. Ignoring the differences between these issues is not a new thing; politicians, heads of government agencies such as the CDC and FDA, and the media have been turning the focus to the pain pill addiction that, we are told, has been affecting “ordinary Americans” for years, while leaving out Americans with chronic pain who use opiate medications to responsibly manage physical pain.
Most “ordinary” people with opiate addictions do not start with correctly prescribed pain pills; a 2014 study indicated that 75% of opioid abuse starts with “nonmedical use” of pain pills on the part of the addict, usually with medications that are not prescribed to them, but to a family member or friend. For people with chronic pain who utilize their medications responsibly, the chance of getting addicted to opiates is slim. The problem with collapsing the opiate addiction and opiates for chronic pain issues into one—and making consumers who are prescribed opiates pay more for their medication, as the LifeBOAT Act proposes—is that it puts the burden onto people with chronic pain who receive opiate medications legally. These patients will end up paying a high cost for something that will not benefit them unless they are addicted to their medication. People with chronic pain who need opiate medications did not create the “pain pill epidemic,” but are being made to clean up a mess that has little to do with them.
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