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Independent Living News & Policy from the National Council on Independent Living

NCIL Opposes Gillibrand and Gardner’s Opioid Proposal

Senators Gillibrand (D-NY) and Gardner (R-CO) introduced the John S. McCain Opioid Addiction and Prevention Act (S. 724) earlier this month, and while the text is not available, the press release says it would impose across-the-board, seven-day limits on opioid prescriptions for acute pain nationwide. Amid widespread efforts to combat opioid addiction and overdoses, this bill is yet another example of aggressive reductions in opioid prescribing that would have unintended, but by now predictable, results for people with serious acute, episodic, and chronic pain. As an organization that represents people with disabilities across the country, many who live with such pain, the National Council on Independent Living opposes this bill.

While S. 724 has exemptions for chronic pain, cancer pain, hospice and palliative care, such exemptions have proven insufficient to truly protect people from harm. Similar laws (derived from the CDC’s 2016 Guideline for Prescribing Opioids for Chronic Pain) are in place in over half of US states, as are policies mandating such limits in major pharmacy chains and insurance companies. Where these policies exist, without fail people with chronic pain have fallen through the cracks because they fail to take into account the full spectrum of conditions and experiences this large category entails. The distinction between acute and chronic pain is convenient, but these are broad categories that often do not match our lived experiences.

Additionally, the vast diversity within the ‘acute pain’ category makes one-size-fits-all policymaking ill-advised. Every common procedure and injury risks complications that may fall outside of the norm, but there are plenty of common – and uncommon – causes of acute pain that may require medication for periods that exceed 7 days as well.

Importantly, this bill would not address the issue it sets out to solve. Prescribing has already dropped dramatically: CDC data describe a drop in opioid prescribing of 74.4% since 2015, and the number of prescriptions dispensed at retail pharmacies has hit a 15-year low. But overdose deaths continue to skyrocket because the crisis is being driven primarily by illicitly produced fentanyl, its analogs, heroin, and increasingly, cocaine. Reducing opioid prescribing has not reduced overdoses. It has, however, had a detrimental effect on countless people with serious pain who benefit from these essential medications.

However well intended, this bill is ultimately another misguided effort to curb opioid addiction and overdoses that would do little to get at the root cause of substance abuse. What it would do is limit access to essential medications for people who already face significant barriers to adequate pain management and have a disparate impact on people with disabilities. We urge Senators Gillibrand and Gardner to withdraw this bill, and we encourage all our legislators to work with their disabled constituents, chronic pain and recovery advocates, and NCIL before proposing new opioid proposals that would impact people with chronic pain. NCIL has developed a Statement of Principles on Chronic Pain and Opioids, which can be viewed at www.ncil.org/cpo.

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Comments

  1. Stephen Blaue says

    This is a topic with very delicate concerns. The truthfulness of the matter lends itself to believe and accept that people with acute/chronic pain often need these prescriptions in order to function normally. It is also true that unscrupulous individuals take advantage of and abuse the system for personal gain. These are the individuals whose efforts must be thwarted. Their actions are similar to a cancer that mitigates the positive effects of life-sustaining treatments.

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