Managing Pain During the Opioid Crisis
HELP Committee Focuses on Improving Care for Patients in Pain
U.S. Senator Lisa Murkowski (R-AK) this week joined her colleagues on the Health, Education, Labor, and Pensions (HELP) Committee in an oversight hearing to better understand causes of pain, how we improve managing patient care, and the status of developing new medicines and methods to manage and treat pain.
The Committee heard from the following witnesses: Cindy Steinberg- U.S. Pain Foundation; Halena Gazelka, M.D.- Mayo Clinic Opioid Stewardship Program and Mayo Clinic Impatient Pain Service; Andrew Coop, Ph.D- University of Maryland School of Pharmacy; Anuradha Rao-Patel, M.D.- Blue Cross and Blue Shield.
During the hearing, Senator Murkowski explained that many Alaskans that suffer from chronic pain have been caught in a regulatory debate that has prevented them from receiving their prescriptions. Senator Murkowski asked for feedback on opportunities to address the conflict between prescribers and pharmacists who all ultimately want to help patients.
“The big conversation over the Christmas holiday and New Year’s back home is that constituents in our bigger population centers…are being denied prescriptions where the drug is opioid based,” said Senator Murkowski. “Some of it goes to the bias issue, but it’s the pharmacists that are refusing to fill the prescription that the doctor has prescribed. And certainly the involvement that we’ve had with these constituents doesn’t appear to be an abuse situation, but people who have legitimately been prescribed pain medications for these debilitating, long-term pain management issues. And I understand it is related to the recent guidance coming out of CDC recommending restricting how much a pharmacy can do. The guidance isn’t controlling law, but in an abundance of caution the pharmacists are saying ‘no we’re not going to do this.’ So you have a patient in the middle of a regulatory debate and it has caused the lid to be blown off the discussions in my state and I can’t imagine that it’s just in Alaska.”
In response to this issue, one of the panelists, Dr. Coop, stated: “Folks do view guidances as being gospel. So I think those guidances on the quotas, I think they’ve been taken too far and that needs to be rolled back. That’s one thing that could be done…All healthcare professionals could certainly benefit from more education in this area.”
Senator Murkowski also explained that in Alaska patients with pain issues don’t have access to many alternate pain management technologies and therapies, making telehealth and prescriptions drugs a primary method of pain care. Specifically, she questioned Dr. Rao-Patel on whether or not payments for telehealth consults, specific to pain management, can be reimbursed.
Background: Last Congress, comprehensive legislation to combat the opioid crisis, the SUPPORT for Patients and Communities Act was signed into law. This package includes legislation by Senator Murkowski to improve access to mental health services, address a workforce shortage, and to measure what steps are actually working.
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