Recently, I attended a National Forum on Prescription Opioid Abuse in Tampa, Florida convened by Trust for America’s Health (TFAH) and the Community Anti-Drug Coalitions of America (CADCA). There were about two dozen participants, including leaders from addiction advocacy groups, Florida’s Attorney General, academics, representatives from CDC, the National Institute on Drug Abuse, the Office of National Drug Control Policy, the National Governor’s Association and other important prominent organizations and me. I was invited to represent PAINS.
We all know that both the under-treatment of chronic pain and the rising problems associated with addiction are both important public health issues. We also know that as prescribing rates for opioids to treat pain have increased so has abuse of and addiction to prescription pain medications. There is a clearly a corollary relationship. Unfortunately, many have attempted to argue that increased efforts to treat chronic pain have caused increased addiction. There is no data to substantiate these claims, and in fact, in the last two years we have seen a decrease in the abuse of opioids but not in addiction.
From my perspective, these two important public health issues have often been pitted against one another and there has been a certain amount of tension between those advocating for better chronic pain care and those advocating to reduce the supply of opioids in an effort to reduce their abuse and unintended deaths associated with them. When I accepted the invitation and saw the list of attendees, I promised myself that I would listen carefully, learn all that I could and try to identify common ground from which we might work together.
A matrix of possible policy strategies was distributed at the meeting that had been developed from a survey participants had completed prior to the meeting. There were 16 strategies in five categories. When I reviewed it, I was struck by the fact that at least a third of them are policy matters PAINS is interested in, e.g., “improve data collection and analysis surrounding abuse-related deaths to better understand the full scope of the problem,” “enhance Prescription Drug Monitoring Programs (PDMPs) to improve interoperability and ensure they display real-time information,” and “develop non-opioid-based pain medications.” In addition, with minor modifications, I believe many of the other proposed strategies would be embraced by the pain advocacy community.
During the meeting, I commented that I was reminded of a book by political commentator Morton Kondracke titled Saving Milly written more than a decade ago. In it Kondracke tells a compelling story about his wife’s 13 year battle against Parkinson’s Disease; he also described the battle between members of the Parkinson’s Action Network and other disease activists competing for public attention and badly needed research funding.
I heard Morton Kondracke speak more than a decade ago and still remember tender details about the love story between two unlikely partners, Millicent Martinez — a Mexican-American-Jewish radical liberal and Morton Kondracke — a fiery and ambitious conservative, and the challenges that they faced together after her diagnosis. However, I also remember his compelling story about how when advocacy groups quit competing with one another and joined hands they were actually able to convince Congress to double NIH’s budget. They all won. I am convinced that it is time for those of us advocating for better pain treatment and those of us fighting hard to reduce the number of unintended deaths associated with opioid abuse to join hands and work together for a healthier society. We are pleased to share with you that Jeffrey Levi, CEO of Trust for America’s Health, will speak at PAINS’ conference in June to share his ideas about ways we ought to work together to promote the National Pain Strategy Report and advance both of these important causes.