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Opioid regulations hurting people in need, critics say


Opioid addiction is a nationwide crisis, but critics say some guidelines aimed at curbing abuse also prevent patients who desperately need relief from agonizing pain from getting the medicine they need.

A few years ago, the Centers for Disease Control created a set of guidelines to regulate opioid pain medication, in the hopes it would reduce the critical issues of addiction among patients. But now, patients who are chronically in pain say they are having a hard time accessing medication.

According to long-time public health nurse Karen Yeargain, the guidelines were created with good intentions. However, people are speaking up nationwide in a Don’t Punish Pain movement.

Don’t Punish Pain is a private citizen organization spurred by the CDC guidelines. Those who support the group believe the guidelines are not meant for long-term pain conditions.

Yeargain said Monday the original data used to make the guidelines was skewed because prescribed pain medication and illegal street drugs were lumped into the same category. That made the numbers look inflated.

She said the Drug Enforcement Administration is using these inflated numbers from the CDC to crack down too harshly on how much pain medication is provided.

It’s creating a pain patient care crisis, Yeargain said, because patients are being cut off, which causes them increased pain and decreased function.

“Doctors are not the villains in this. Doctors are feeling the crunch just as much as chronic pain patients. People say exercise, eat right, get good sleep and if you are in pain it is hard to do,” Yeargain said.

“We’re not talking about someone who says ‘my lower back hurts.’ We are talking about people with multiple sclerosis, people with connective tissue disorders, (and) they are not going to get better. We are talking about people with fibromyalgia. We don’t have all the answers, but we know we have some meds that can help.”

Yeargain said fewer than 1 percent of people who chronically use opioids have addiction problems.

She said the organization wants to help the public understand the difference between legally prescribed opioid medication and illegal, illicit street drugs.

St. Charles Redmond emergency room physician Dr. Matt Eschelbach said part of the issue is the longstanding problem of opioid dependence. From his perspective, a balance is hard to find, because everyone’s pain threshold is different.

“Walking the balance of keeping their pain under control and being empathetic to them and understanding their condition and treating them is a hard balance,” Eschelbach said. “It takes a very deft hand at controlling people’s pain, and that’s why some people might be shy to prescribe pain medications, because they’ll have somebody else looking over their shoulder.”

He said it’s his job as an emergency physician to try and treat a patient’s pain without violating a contract they might have with their pain specialist.

Yeargain said, “Pain patients are left with being cut off of meds, being cut off of care, and doctors are afraid to take them on and because of that, pain patients are losing their ability to be productive citizens. And many have come to what they feel is the end of their options. The suicide rate among chronic-pain patients is going up.”

She said people shouldn’t wage war against chronic pain patients because they aren’t winning the war against illegal street drugs.

“it’s like having a toothache that never goes away, and you look and you know it’s never going to go away,” Yeargain said. “It’s like having the flu where your skin hurts — only it’s not for three or four days, that’s how it is and you look forward in your life — it’s not going to away.”

A Don’t Punish Pain rally will be held in Bend on Tuesday, Sep. 18, from noon to 2 p.m. at the corner of Neff Road and Medical Center Drive.

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