Fear of drugs vs. chronic pain

By Gary Abernathy - [email protected]

A couple of weeks ago, I received several calls and texts asking what we knew about Highland District Hospital possibly opening a new “pain clinic,” as it was described, and expressing concern about such a move in a county and region plagued by overdoses from a variety of drugs, including prescription narcotics.

When contacted, both Randy Lennartz, the new CEO (but vice president of finance at HDH since 2010) and board of governors president Barbara Yochum spoke openly about a plan that is just in the exploration stage. HDH officials have heard from many doctors that patients who truly need responsible narcotic-based pain management therapy are unable to receive it without driving to other communities. For many, including the elderly, this is a hardship, either logistically or financially.

The program HDH is considering is well-respected and widely used across Ohio and other states. And worries expressed to me might have been based on some people confusing two doctors who have similar names, one of them associated with the program, the other, who was of concern to some people, not.

In this day and age, pain management is a touchy subject, and hospital officials are well aware of that fact. The highly-publicized “pill mills” that existed in Ohio until just a few years ago – some not far from Highland County, in fact – are fresh in the public’s mind. Those facilities had basically become unregulated dispensaries for narcotics. If you got in line, you walked away with pain meds that were often either abused by the recipient, or sold on the streets.

Ohio Attorney General Mike DeWine and others led a crackdown on the pill mills from the state level, and U.S. Sen. Rob Portman – whose career has been defined by both fighting drug abuse and providing avenues to rehabilitate those who fall prey to addiction – sponsored federal legislation that made it possible to attack the problem more aggressively across state lines in a way that, shockingly, was not as easily done as you would think in previous years.

When I worked for Portman and, before him, U.S. Sen. George Voinovich, representing their offices for about two years (2009-2011) in numerous counties across southern and southeastern Ohio, much of my time was spent attending meetings on the drug problem and, specifically, the illegal sale of prescription drugs by individuals and pill mills.

If you think Highland County has a serious drug problem, you’re right. But counties like Scioto, Pike and Adams would trade their problem for ours in a heartbeat. In those counties (not coincidentally all served by four-lane highways, which became drug pipelines), the word “epidemic” is entirely appropriate.

As a public health nurse in Portsmouth told me – and the police chief later affirmed – drug dealers were literally chasing people down on the sidewalk to try to hook them on narcotics, both via prescription pills or streets drugs like heroin. The problem there is of such immense proportions that conversations have taken place about sending in the National Guard to police the community.

Aggravating the problem are drug manufacturers who stand to make a profit from the continued proliferation of narcotics. The Associated Press recently examined the campaign contributions made by big pharmaceutical companies designed to tamp down legislation to curb drug abuse.

The AP reported, “The makers of prescription painkillers have adopted a 50-state strategy that includes hundreds of lobbyists and millions in campaign contributions to help kill or weaken measures aimed at stemming the tide of prescription opioids, the drugs at the heart of a crisis that has cost 165,000 Americans their lives and pushed countless more to crippling addiction.”

The story added, “The industry and its allies spent more than $880 million nationwide on lobbying and campaign contributions from 2006 through 2015 — more than 200 times what those advocating for stricter policies spent and eight times more than the influential gun lobby recorded for similar activities during that same period…”

But in addition to meeting with those who were fighting the drug abuse epidemic, I also met many times with hospitals and doctors who were concerned that the crackdown on opioids was making it increasingly difficult to prescribe drugs for patients who truly needed them for chronic pain management.

Sometimes I think it’s difficult for most of us who are not afflicted with chronic pain to sympathize with those who are. We tend to think that people with chronic pain issues – and by “chronic,” I mean unrelenting – are either weak, or outright fakers. And for sure, there are “druggies” who try to game the system and lie about their conditions in order to acquire prescription narcotics. Emergency rooms see it every day.

But for millions of Americans, chronic pain is a legitimate and debilitating condition. Responsible doctors try other means of treatment – surgery, physical therapy, spinal decompression, posture adjustment, even acupuncture – before resorting to a drug treatment plan. In fact, most patients afflicted by chronic pain prefer not to take narcotics. But sometimes, nothing else works.

I don’t think anyone should fear the new pain management program being considered by Highland District Hospital. It will not be a pill mill. HDH has long had a non-narcotic pain management program, and it will continue.

But for cases where a carefully-monitored narcotics program is needed, it would be good to have that option available locally. As Randy said, most patients who will be treated in the new program, if it is approved, will likely be Medicare patients – the older population.

Drug abuse is a scourge that is destroying communities through increased crime, an explosion of foster children, and rampant overdoses, both fatal and non-fatal. But conscientious, board-certified doctors and other medical professionals are trained to tell the “druggie” from the legitimate patient, and they send the former packing (or to the police) while carefully and responsibly treating the latter.

I have no doubt that is how our hospital would operate such a program, which would be an immense benefit to local residents who are trying to live a high quality of life while dealing with a high level of chronic pain.

Reach Gary Abernathy at 937-393-3456 or on Twitter @abernathygary.


By Gary Abernathy

[email protected]