Patients get trapped in a Catch 22 when they need Schedule II Pain medications.
A Catch 22 can be defined as a situation in which someone is in need of something that can only be had by not being in need of it.
Chronic pain sufferers usually need medication to cope. Their doctors frequently prescribe Schedule II drugs because they help their patients sleep at night and function during the day.
The problem is that the most effective medications are often the most addictive; people who are addicted to prescription opioids can die from overdose or switch to heroin. The problem has reached epidemic proportions and has gained the attention of media, law enforcement, domestic abuse counselors, doctors, hospitals, and state professional licensing boards.
As a Southern Illinois Social Security attorney, I keep current on news about opioids and prescription drug abuse.
The Southern Illinoisan has recently contained heart breaking stories of deaths from overdoses in Jackson, Williamson, Franklin, and Perry counties.
In February, the President of the United States proposed additional funding to curb the problem.
In March 2016, The Center for Disease Control (CDC) published a new Guideline for Prescribing Opioids for Chronic Pain.
Doctors are encouraged to consult the CDC’s checklist and this website that contains additional tools to guide them when they are trying to prescribe the right pain medication at the right time for their patients.
How will these new guidelines affect the ordinary patient in Southern Illinois when he or she needs a refill of a pain medication prescription?
Long term opioid use is going to be the exception, not the norm.
Doctors are going to ask more questions, do more drug screens, and prescribe more alternatives to opioids.
The new guidelines are supported by research that shows:
- Benefits of long-term opioid therapy for chronic pain are not well supported by evidence.
- Short-term benefits are small to moderate for pain; inconsistent for function.
- Insufficient evidence for long-term benefits in low back pain, headache, and fibromyalgia.
Doctors will be taking these steps before renewing prescriptions for opioids:
- Set realistic goals for pain and function based on diagnosis, (eg, walk around the block).
- Check that non-opioid therapies are tried and optimized.
- Discuss benefits and risks (eg, addiction, overdose) with patient.
- Evaluate risk of harm or misuse.
- Discuss risk factors with patient.
- Check prescription drug monitoring program (PDMP) data.
- Check urine drug screen.
- Set criteria for stopping or continuing opioids.
- Assess baseline pain and function (eg, PEG scale).
- Schedule initial reassessment within 1– 4 weeks.
- Prescribe short-acting opioids using lowest dosage on product labeling; match duration to scheduled reassessment.
It is always important to be an active member of your health care team for your health and for your Social Security claim.
- Talk to your doctor about why you think you need narcotic medications to control your pain.
- Keep your medications in a secure location and keep track of when you take them so you don’t run out early.
- Don’t share your medicine with anyone.
- Describe the things you are able to do when you are taking the medications that you cannot do when your pain is uncontrolled.
- Follow up with a pain management specialist if your doctor refers you to one.
- Cooperate with the drug screen tests as soon as they are ordered.
Believe me as a Southern Illinois Social Security Disability representative: This is an extremely important issue in all chronic pain cases.
You could lose your Social Security Disability Insurance claim if your doctor’s comments in your medical records make it appear that he or she thinks you are misusing or abusing prescription medications.
If you are represented by an experienced Southern Illinois Disability Attorney, you can talk to your attorney about how to talk with your doctor about your pain and your medicine and how to explain your condition to the judge in your Social Security hearing.
Joni Beth Bailey is a Southern Illinois Social Security Disability attorney.