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Putting an End to Oregon’s Opioid Woes

It’s time for Oregon policymakers to stop whistling past the graveyard and fast track much needed legislation to end the opioid abuse epidemic, according to the author.
March 21, 2017

OPINION -- It will take more than wishful thinking and good intentions to end Oregon’s opioid abuse epidemic. The genuine progress made over the last five years to curb opioid misuse, abuse, and painkiller addiction in our communities should not be stymied by the deep pockets of special interest groups. Thankfully, a trio of bills before the Legislature can provide patients and clinicians the necessary tools to bring this epidemic to its close.

Everyone agrees that the abuse of opioids is a serious problem that affects our health and social and economic welfare. In 2015, an estimated two million people in the United States suffered from substance use disorders related to prescription opioid pain relievers. The number of unintentional overdose

deaths from prescription opioid pain relievers has more than quadrupled since 1999.

From porous borders to permissive prescribers, the real drivers behind the opioid epidemic have forced communities to the brink of their tipping point. Alongside the unraveling of oversold science, unearthing of deceptive marketing practices, and closure of profiteering pill mills, both honest patients and legitimate medical providers have felt disoriented by the administrative fallout caused by the epidemic.

Meanwhile, the hurried rollout of a hodge-podge of professional, organizational, and community guidelines for the treatment of pain and related conditions have strained doctor-patient relationships. In spite of attempts by bean counters to spin murky concepts like “quality,” “risk,” and “satisfaction” into key performance metrics and actionable professional recommendations; these bromides have proven to be poor substitutes for actual common sense and sound clinical

judgement. In other words, forcing doctors, by hook or by crook, to take medication away from patients who use them for legitimate medical reasons does not deter the criminals, drug cartels or addicts.

House Bill 2114 and Senate Bill 270 preserve access to medically necessary opioid therapies for patients with intractable pain, cancer, and chemical dependency while holding prescribers accountable for practicing good medicine. In addition, the bills would require that health care providers involve parents and legal guardians in the decision-making process when prescribing strong painkillers to patients under the age of 18.

Complementing HB 2114 and SB 270, swift passage of Senate Bill 818 will kick the insurance company executives out of the exam room. This bill removes formulary refusals, onerous insurance industry authorization requirements, and other barriers to access abuse-deterrent “smart pills.” Today, crafty

health plan executives rely on slick “benefit design” features to adversely tier abuse-deterrent drugs against cheaper, more abuse-able pills. Their schemes fly in the face of good science.

Federal agencies, medical professional societies, and drug abuse experts agree that making available drug formulations that are more difficult to tamper with is a key tactic in stemming the tide of unintended overdose and death. Simply put, this means that insurance companies shouldn’t be allowed to prioritize cost over patient safety. Preventing just one overdose death saves our health care system up to tens of thousands of dollars of unwanted costs and a pays a priceless dividend to others who get a second chance at life.

It’s time for Oregon policymakers to stop whistling past the graveyard and fast track much needed legislation to end the opioid abuse epidemic. Preserving medication access for sick and injured patients, enhancing provider accountability, and relieving patients from the burden of penny-wise and pound-

foolish health plan formulary policies are pillars of a wise public policy platform to end the opioid epidemic in our time.

Dr. David Russo is a physiatrist and interventional pain physician with Columbia Pain Management P.C. in Hood River specializing in regenerative medicine and cellular treatments for musculoskeletal conditions.