By Sujata Srinivasan
Carl Jordan Castro Photo.
Sonya Huber, 48, suffers from
rheumatoid arthritis. She says on some days she needs a cane to help her
walk because of the pain in her joints.
Unable to obtain morphine, Heather Weise, 50, lay balled up in pain
at her home in Milford earlier this year. It took nine days to refill
her narcotic painkiller and she blamed the clampdown on opioid
prescriptions for her woes.
“My pain’s up there with cancer,” said
Weise, an administrative assistant at the sandwich-chain Subway. “I
almost ended up at the ER.”
Weise suffers from adhesive arachnoiditis, an inflammation of
membranes surrounding the brain and the spinal cord, for which she was
prescribed a daily dose of 120 milligrams of the opioid painkiller
morphine. When her prescription ran out in the stipulated 30 days for
refills, she had nowhere to turn to for relief. Her doctor appeared
reluctant to renew the medication and to go to bat for her with her
insurer, she said.
In the wake of the opioid epidemic, doctors are writing fewer prescriptions, following guidelines
from the Centers for Disease Control and Prevention (CDC) issued in
2016, and a Connecticut law that took effect also in 2016, requiring the
daily reporting of opioid prescriptions into the state’s Prescription
Monitoring Program database.
Prescribing rates for opioids in Connecticut fell from 2.5 million prescriptions in 2016 to 1.9 million in 2018, data
from the state Department of Consumer Protection show. The percentage
of refills dropped to 13.6% in 2018 compared to 17% in 2016, per the data.
Now, even with new federal guidelines
urging doctors to exercise caution when tapering opioid medication,
some practitioners are concerned that patients who may need opioids are
not getting them.
“Patients have been caught in the crossfire,” said Dr. William Becker, associate professor at the Yale School of Medicine,
who runs an opioid reassessment clinic. He pointed to the “logistical
nightmare” that prescribers now face to obtain prior authorization from
insurance companies to get the opioid prescription covered.
“Prescribers who might want to continue to prescribe if they believe
the benefit outweighs the harm [on a case-by-case basis] give up because
it’s just more hassle than it’s worth,” Becker said.
Carl Jordan Castro Photo.
Heather
Weise, 50, in her Milford home. While getting ready for work Weise says
she takes morphine to help quell the pain she feels from adhesive
arachnoiditis.
Patients with chronic pain make up an estimated 20.4% of the U.S. population, the CDC reports.
“The vast majority of chronic pain patients do not struggle with
addiction,” said Sonya Huber, 48, professor at the Department of
English, Fairfield University. “But we do really struggle with chronic
pain.”
Huber has rheumatoid arthritis. An opioid analgesic used to help with
the pain but she says she got off narcotics after experiencing
relentless “patient-shaming.” One specialist accused her of popping “too
many pills” when she was taking just one, Tramadol. And last year,
Huber was tested at her primary care physician’s office for illegal
drugs. “I came home crying,” she said. “Once a doctor thinks you might
be seeking pain pills, the conversation kind of shuts off.”
Unable to find a doctor willing to treat her with opioids, and one
with whom she felt she could develop a relationship of comfort and
trust, Huber turned to cannabis oil and electric pulse therapy. “During
the periods when I’ve been on opioids, I had windows where I experienced
no pain or functional limitations. And that’s lovely, just as a break,”
she said.
But some people should never have been prescribed opioids in the
first place, experts say: They did not have cancer, did not require
palliative care, and were not in chronic pain. Yet teens, for instance,
are continuing to get prescriptions for menstrual pain and headaches,
according to research by Julie R. Gaither, PhD, an instructor with the
Department of Pediatrics, Yale School of Medicine.
“Studies for teens who have misused opioids show that in 40 percent
of those teens, their own prescription is the source,” Gaither said.
Connecticut had a total of 948 opioid-related deaths
in 2018. Of those, 760 were related to fentanyl, a synthetic opioid
procured seemingly easily in the streets. The total number of overdose
deaths in 2018 was 1,017.
Among the state’s fatal overdose statistic is Kyle Hufnagle, an RV
technician at Campers Inn in Union, who died in 2016 at the age of 29
after struggling with mental illness and drug use for years. “Our whole
family didn’t realize there was a problem until he had gone past
[prescription]
pills to the illegal stuff,” Kerri Wojcik, Hufnagle’s
sister, said.
Carl Jordan Castro Photo.
Sonya Huber applies CBD oil onto her hands. It is a daily routine for her in managing pain from rheumatoid arthritis.
Meanwhile, families of victims are exploring ways to prevent addiction.
Dita Bhargava of Cos Cob, a financial executive who was a candidate
for state treasurer, lost her stepson, Alec Pelletier, on his 26th
birthday last year to a fatal overdose of fentanyl. A triple-A
ice-hockey player, Pelletier was diagnosed with bipolar disorder and
depression in his teens.
Bhargava said it’s important for students to learn resilience and
coping mechanisms early on to help deal with stress and anxiety. She is
now working on introducing A Life-skills Education Curriculum (ALEC) in
Connecticut schools as a focus on prevention.
Physicians overseeing the state’s Medical Marijuana Program have recommended
adding chronic pain for those 18 and over to the list of debilitating
conditions for which patients can qualify for medical marijuana. The
inclusion is contingent upon approval by the Regulations Review
Committee of the Connecticut General Assembly.
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