There have recently been a few minor stories about the closing of comprehensive pain specialists clinics across Tennessee due to financial issues and a federal criminal investigation. Some have even mentioned that an estimated 45,000 pain patients are now without a pain management doctor or on restrictions on opioids.
If this were 45,000 cancer patients not receiving treatment in the weeks to come, it would be headline news. People would be up in arms over that denial of care.
Keep in mind that we are all just one car accident away from long-term chronic pain.
If you or somebody you love have not been directly impacted by long-term chronic pain, then you are very fortunate. Keep in mind that we are all just one car accident away from that condition.
A car accident in the early 1980s is the reason my husband, Jay, developed chronic pain. The backlash against opiate addiction and the ill-conceived U.S. Centers for Disease Control response to that is what caused him to end his life.
Jay was young and strong enough not immediately to need pain medications to manage his back injury. He dealt with his pain until his condition degenerated, and he was forced to have three back surgeries in 2007 and 2008. It was at this point that he was started on low dosages of pain medications. As time went on, he developed some tolerance to these medications.
He worked with a doctor to make sure that he was on the lowest possible dosage that would allow him to maintain some quality of life. He also allowed them to do any other procedure they thought necessary beyond just prescribing medications. This included implanting a device in his side that delivered a constant dosage of medication.
The back injury did not allow him to work, and it severely limited him in many ways. A good day was as simple as being able to take our dogs for a walk or to go to the grocery store with me. A bad day would leave my strong, fiercely-independent husband in so much pain he would sit in his chair and sob.
Turn to Illegal Drugs, Restrictions on Opioids or Suicide?
We were introduced to the CDC guidelines after Tennessee adopted their version of these in early 2017.
These were guidelines only, not laws (Tennessee passed an opioid law in 2018), that outlined that patients on long term ongoing care with opioid medications must be seen by a pain care provider. The CDC guidelines go further by recommending a lower dosage a pain care specialist can prescribe.
My introduction to these guidelines came when comprehensive pain specialists told my husband they were cutting his medications by 75%. The reason that we were given was that eventually the guidelines might become law. The last thing the doctor said to my husband was “My patients’ quality of life is not worth risking my practice or my license over.”
It did not matter to them that my husband was not abusing his medication or that he had been their patient for over five years. It did not matter how drastically they were reducing his quality of life.
Rather than face the unbearable pain that losing his medication would cause him, my husband chose to end his life, and I supported that decision.
What concerns me most about the closing of these pain clinics can be summed up in what my husband told me after they reduced his medications. He told me he felt like he had been given three choices. He could turn to illegal drugs, he could suffer unimaginable pain or he could end his life.
These are the choices now faced by the 45,000 impacted by these closures. Imagine if just 1 percent of these people choose the same option he did. That would mean 450 deaths, 450 families without a loved one, 450 funerals.
Is that what we really want for people with chronic pain? Is that what you want for yourself or somebody that you love? What other options are there for these 45,000 patients?
Looking at it now, seeing these clinics closing, you can see that the patients just do not mean anything to the doctor’s or some of our legislators.
My question for you, the reader, and our legislators now is quite simple. What are we going to do to prevent any more suicides?
What are we going to do to take care of these patients?
How are we going to provide them treatment before any more lives are lost?
This article was originally published by The Tennessean on July 24, 2018. Republished with permission.
