• Doctors writing fewer opioid prescriptions for chronic pain sufferers

    By: Jim Morelli


    Nationally, opioid prescriptions are down more than 22 percent, according to the American Medical Association and few are feeling the pinch more than the patients who say they depend on powerful painkillers to function. 

    "I have severe, chronic low back pain," said Debbie, who asked that we not show her face.

    Debbie has been living with that pain for some 35 years and gets relief from opioids, but the crackdown means going to extremes to get the medication she needs. 

    "I have to drive 180 miles to see the doctor... the only doctor that I've been able to find who will prescribe for me," said Debbie. 

    That kind of story is not surprising to Doctor Gary Brenner of the Massachusetts General Hospital Center for Pain Medicine.

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    "Many of the primary care physicians who I've interacted with... do interact with... who in the past would have little reluctance to prescribe opioids seem to be attempting to avoid it whenever possible," said Dr. Brenner. 

    Brenner says the crackdown on opioid prescribing may have started with a good intention but may have gone too far, and it may be off the mark.

    The American Medical Association noted last week that the opioid epidemic is being fueled by heroin and illicit fentanyl overdoses.

    For some chronic pain patients, getting opioids is proving virtually impossible. 

    "New primary care came on and she said, the first thing she said to me, I don't give those medications out," said chronic pain sufferer Marissa Perry. 

    Despite their please that they need them.

    "We're trying to live the best lives we possibly can. We're trying to live lives that have meaning. And that is fulfilling and that has value to us. And the only way that many of us are able to do that is if we rely on opioids," said chronic pain sufferer Amanda Votta.

    Late last month, the U.S. Attorney for Massachusetts, Andrew Lelling, sent "warning" letters to an undisclosed number of physicians who, he says, prescribed opioids to a patient within 60 days of that patient’s death or prescribed them to a patient who subsequently died from an opioid overdose. 

    Lelling says letters were not sent to doctors providing cancer treatment or palliative care.  

    Given the U.S. Attorney's concerns were limited to a certain set of doctors, Boston 25 News asked whether the purpose of making the initiative public was  to give other doctors pause about prescribing opioids.

    Lelling says it's part of informing the public about the multi-faceted approach his office is taking to combat the opioid epidemic. "This includes criminal prosecutions, civil litigation, and public outreach," he says. "We want doctors to think hard about prescribing practices, since prescriptions are one way that opioids make it to the street."    

    However, the American Medical Association says that at the moment it isn't prescription opioids driving the epidemic as much as illicit heroin and fentanyl.

    "Prescription opioids still account for a significant portion of the opioid crisis, though that proportion has been trending downward," Lelling says. "In the midst of a national crisis killing thousands a year, we must take all possible steps to stem the flow of opioids – both prescription and otherwise."

    Lelling says the slight positive trend in opioid deaths is tempered by the fact the drugs still killed 72,000 Americans last year. 

    Boston 25 News asked Lelling whether his office had considered the impact his policies might have on those with chronic pain who depend on opioids for relief? 

    "Of course there are patients who need opioids, and no doctor is prohibited from prescribing them," Lelling says. "No doctor properly prescribing should have cause for concern."  

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