Pain drug stigma stops patients from getting meds but opioid side effects, fatalities muddy waters

Chronic pain can be an unbearable burden for many patients. And while there are pain medications out there to help, stigma and concerns over addiction and abuse are getting in the way of patient access.

People with chronic pain often feel their healthcare providers are not equipped to manage their pain, according to a new report out by the U.S. Pain Foundation, which is backed by several pharma companies that sell pain drugs, including Eli Lilly, Johnson & Johnson and Salix.

In a survey of just under 2,400 people either living with or providing care for people in pain, more than two-thirds (69%) either did not feel or only "rarely" or "sometimes" felt that their provider was “on a team” with them. Instead of prescribing medicines to help ease the pain, many doctors were in fact prescribing non-medical interventions instead.

Nearly all (94%) of those taking opioids said they attribute these barriers to the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. The CDC report found that opioid pain medication use “presents serious risks” including overdose and opioid use disorder. The agency found that from 1999 to 2014, more than 165,000 people in the U.S. died from overdose related to opioid pain medication.

The top strategies include activity restriction or modification (73%), stress reduction techniques (42%), heat therapy (41%) and meditation and mindfulness (40%), the U.S. Pain Foundation found.

When it comes to medications, a majority (77%) said prescription drugs are the “most helpful treatment” in managing their pain.

While around half of respondents take opioid medications (47%), three-quarters said they have “faced significant barriers” obtaining their medications. And even those taking opioid medications encounter hurdles including decreased doses, stigmatization and providers “refusing to fill medications or outright refusing to treat the person with pain at all,” according to the report.

For long-term chronic pain patients, the CDC in its 2016 report said: “Although opioids can reduce pain during short-term use, the clinical evidence review found insufficient evidence to determine whether pain relief is sustained.” Combined with the risks of the drugs, the CDC is trying to better communicate the risks of these meds when used longer term.

Cost is also a major barrier to pain care. According to the survey, nearly half (49%) said price tags got in the way, with 41% saying they felt insurance coverage decisions are driven by cost and not by what was in their best interest medically.

Nearly half the respondents (41%), when asked about their top policy issues, reported wanting increased pain education for healthcare providers and new medications for chronic pain.

The U.S. Pain Foundation, according to its latest annual report, has some major pharmas as its Council members. Lilly, which markets migraine pain drugs Emgality and Reyvow, is the Foundation’s Council’s senior leader, while members include Johnson & Johnson, Amgen, Salix, Primus Pharmaceuticals, Boston Scientific and Centrexion.

J&J has a long and troubled history selling opioid drugs, last year inking a settlement worth $230 million to avoid a New York opioid trial, while Amgen sells migraine drug Aimovig. Boston Scientific markets Cognita to help patients manage pain, while Centrexion is working on non-opioid, non-steroidal medicines in pain.

All will of course want any barriers to access for pain medications removed.