• Keeping vital drugs available
    January 19,2014
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    Vermont faces a critical challenge ó how to combat the rising opiate abuse epidemic plaguing the state, while simultaneously protecting those who constitute another epidemic ó namely, the number of Vermonters living with chronic pain, whose lives depend on access to prescription pain medication.

    Itís a fine line to walk. Both epidemics are health crises.

    Unfortunately, pain is endemic in our society. In fact, federal health officials say more than 115 million people in the United States suffer from pain ó thatís one in three Americans, thousands of whom live right here in Vermont.

    Imagine pain so strong it never goes away, even with the best medical treatments. This pain affects your life, your work, your family and relationships. It prevents you from doing things you used to love, such as hiking, skiing, even walking. Itís difficult to sleep. Depression often hits hard. Thatís what living with chronic pain is like.

    Thereís no doubt the state needs to do something to stem the tide of drug abuse. But to be successful will require a multi-pronged approach so that those who need access to pain medications ó just to get through their daily lives ó have it. Data shows 70 percent of medications that are abused are not prescribed to the individuals abusing them.

    In his State of the State address, Gov. Peter Shumlin mentioned some things already under way that are part of the solution. The state has opened more treatment centers. And the governor has also asked for more money, so that the treatment centers can increase staff members immediately. Both of these will help diminish the crushing wait lists and allow people to get help sooner rather than later.

    In addition, realizing that even one abuser presents a societal problem, the governor suggests attacking the problem from a criminal perspective. His budget calls for resources to allow law enforcement to determine if a person arrested for a drug-fueled crime would be better off getting treatment rather than going to jail.

    Thereís also another important piece that should be part of the solution, and it has to do with the field of medicine, which continues to innovate. There are already technologies in place, and more in development, that have proven to help stifle drug abuse.

    For instance, pharmaceutical companies have found ways to make it harder for someone to tamper with medications. Itís called abuse-deterrent formulation, and it places physical and chemical barriers in the medication that change the drug when is tampered with, in some instances preventing someone from crushing or melting pain medications so that they canít be snorted or injected. These technologies could, indeed should, be encouraged as part of the solution because they can make a difference when it comes to fighting drug abuse.

    Sadly, those abusing drugs are starting earlier and earlier. The governor also addressed that issue and ways to ensure, right from the start, Vermont children can be set on the right path. Education is a must.

    Ultimately, it takes a team effort from top health and state officials, legislators, law enforcement to local cities and towns, which hold ďtake backĒ events ó at which unused medications can be turned in, rather than winding up in the wrong hands. And scientific innovations such as abuse deterrent formulation should be included as a way to help this sweeping societal problem.

    The people who responsibly use these medications to manage their chronic conditions are not the ones who are abusing them. They are following their doctorís instructions and just hoping to be able to live and function day to day.

    As state officials and legislators work to fight drug abuse here in Vermont, they must do so in a way that doesnít balance it on the backs of those who truly need pain medications.

    Paul Gileno, who suffers from chronic pain, is the founder and president of the U.S. Pain Foundation. He lives in Connecticut.
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