Senator Schumer, Hands Off Our Meds Please

People in chronic pain need help, more options, more understanding.

[the Institute of Medicine (IOM) report Relieving Pain in America:
A Blueprint for Transforming Prevention, Care, Education, and Research
] Issued at the request of Congress as part of President Obama’s health reform legislation, the report calls for a “cultural transformation” — an attitude shift on the level of that seen over the last 50 years toward smoking — to spur more coordinated action to help treat Americans’ pain. Pain patients have long been viewed with skepticism and suspicion, rather than understanding, presenting a barrier to care. Rising rates of prescription drug misuse, addiction and overdose have further led to the establishment of legal and regulatory barriers, such as prescription databases, that can prevent even legitimate pain patients from getting much-needed drugs.

Source: IOM Report: Chronic, Undertreated Pain Affects 116 Million Americans | TIME.com

It seems Congress is not on the side of transforming the way we help people in pain, they’re on the side of the “skepticism and suspicion” and “legal and regulatory barriers,” not to mention the fear mongering over pain medications.

Last month, my Senator, Chuck Schumer made local TV news headlines ranting, not just about abuse of prescription drugs, but “Rails Against FDA Testing Of Super-Potent Painkillers” as NY1’s headline blared atop their story at www.ny1.com. He doesn’t even want these new medications—extra-strong meds that pharmaceutical companies have created to help people in real pain—to be tested and approved for legal prescription and sale by the FDA for fear of abuse. He’s even saying that FDA approval of new pain meds will “add fuel to the fire” of crime and lead to increased robberies, playing up the recent armed raids for oxy and vicodin at two Long Island pharmacies. Absolutely the height of alarmist rhetoric here.

Since I moved to New York City in 2008, I’ve noticed that Senator Schumer tends to make local news across the state with big, scary headlines (in Mobile, AL where I’m from, the U.S. Senators show up as footnotes on the local news, if at all). Team Schumer probably realizes—rightly—that getting his name in the TV headlines that soccer moms and such (i.e. the community-minded folks who tend to vote most, “the likely voter”) might catch as they go through their morning routine or night-time winding down is crucial for his reelection. Schumer

Chuck Schumer, senior U.S. Senator from New York

has evidently always been a “tough on crime”-type of politician, a key supporter of the Violent Crime Control and Law Enforcement Act of 1994 (VCCLEA) that instituted a federal “three strikes and you’re out” life-imprisonment policy, and since the attacks on 9/11, he’s become a big “tough on terrorism”-type of politician. For example, last May, Senator Schumer similarly made the local news across New York State with his plan for a security crackdown on trains, especially pertinent to New York because New Yorkers are some of the train-ridingest people on the continent. See: Schumer calls for ‘do not ride’ list for Amtrak – NEWS10 ABC: Albany, New York News. These are the kind of headlines Schumer gets. People concerned about unnecessary, Fourth Amendment-crushing, possibly gropey, searches every time you board a train, including me, complained online.

His camera-hogging ways, I get it. Salon called him a “incorrigible publicity hound,” and that’s ok. Be what you are, man. Embrace it. But this time “going too far” is especially “too far” because it could accidentally hurt people with chronic pain who are already hurting.

Here are the local headlines I’m concerned with:
Schumer warns FDA on danger of newest painkillers | Democrat and Chronicle (Rochester, NY’s newspaper of record)
Schumer Rails Against FDA Testing Of Super-Potent Painkillers – NY1.com (NY1 is a 24/7 cable news channel for New York metro area news)
Sen Schumer: ‘Super Painkillers Could Lead To Violent Robberies’ « CBS New York possibly the fear mongeriest headline of the year, though it does present an alternative viewpoint in the video report if not the text summary.
Senator Charles Schumer warns FDA on danger of new painkillers | 7online.com (WABC-TV, the ABC affiliate for NYC.) Watch the video report embedded below, doesn’t provide an alternative viewpoint!

Only one of these scary headlines includes a balancing, alternate viewpoint within. That’s their most egregious journalistic failure: they only give audiences the scare monger’s viewpoint, they only offer shock words.

First, they are leaving out important context like these are MEDICINES for people in real pain. The context and tone treats painkillers as no different than street drugs, omitting the therapeutic intent and quality of life benefits (very real.) Note the language used by the ABC-7 reporter Lucy Yang, the term the streets repeated twice. “At least one [pharmaceutical company] is past the lab stage and now trying to get this super-drug on the streets by next year.” “Of course, before any such narcotic could hit the streets it would have to be approved by the FDA.” Stopping just short of calling pharmaceutical manufacturers street pushers, there.

More language to red-flag from the channel 7 report, including one of the opening lines, “officials report more deaths [from prescription drugs] than heroin, crack, and cocaine”—which officials, Ms. Yang? Please source such a shocking claim. “Despite that, we’re told attempts are underway to introduce a super-drug” “you don’t have to look far to see the violent and punishing reality of addiction to painkillers” “potent and enslaving” “pure painkiller”

Second, why do all these reports reference the robberies on Long Island?  I disagree that the all-too-common oxy and vicodin hold-ups (which are AWFUL, I don’t want to minimize that) would be effected either way whether the FDA approves new narcotics or not. They are linking two completely unrelated stories, echoing Senator Schumer, for shock effect. Journalists should be questioning the Congress critters, holding their feet to the fire, not mindlessly parroting their press releases. Tying past narcotics violence to the unrelated matter of future possible FDA approval of new narcotics seems like pure fear mongering to me.

Third, a look at Schumer’s own language: “the very same people who try to get our kids to use things like oxycodone and vicodin will start peddling this drug, which when abused is poison.” “It would instantly become the most sought-after drug by addicts and criminals.” From the CBSTV-2 story, Schumer said: “Crooks like Oxycontin and Vicodin, yet you leave the doctor’s office, the dentist’s office, the oral surgeon’s office after you have a root canal, they routinely give you 20 to 30 of these pills. That can’t happen with these new powerful drugs.” He’s simultaneously condemning new drugs and old drugs, and nearly finger-wagging at the whole concept of treating post-surgical pain with narcotics. Wow.

The drug in question, according to the CBS channel 2 video report, is Zohydro. Zohydro is hydrocodone like Vicodin, Lortab and Lorset is, but it’s the first long-acting timed-release capsule hydrocodone created. I have chronic pain; I can’t take any of the time release stuff. However, I know numerous people who could benefit from Zohydro and other new medications. This could be a miracle drug for people who’re allergic to—or for whatever reason can’t use—the only other time release painkiller out there, Oxycontin. I’m sure that, for many, this could be a life-changing medicine; long-acting squelching pain, giving people with chronic pain their quality of life back, liberating them to get out of bed. You don’t see that side of the argument on TV, but the benefits of effective pain management are huge, and important.

People can build up a tolerance to pain meds like bacteria can become resistant to antibiotics, and like humans need new antibiotics, humans need new painkillers. We need new pain meds developed and approved for prescription use. People in chronic pain need more options.
Zohydro is also a good step because it isn’t packed with liver-killing acetaminophen that is so commonly combined with opiates. I reported before on the FDA’s bizarre regulation making opioid-acetaminophen combination meds easier to get than purer alternatives because they figure if people know it can destroy their liver they won’t abuse it. This insanity has led to too many deaths, tragedies, and liver transplants, so the FDA itself has been reconsidering recently.

I’m saying consider another perspective (which the media won’t give you). Medication mostly does have a big positive impact. Don’t block or take away pain meds that are giving people quality of life.

Consider this nursing home and hospice facility perspective:

Timely access to controlled medications also continues to be a challenge in the long-term care setting due to drug shortages and what some consider excessively strict federal regulations.

“The Drug Enforcement Agency’s interpretation of the Controlled Substances Act is one barrier that’s impeding timely access to appropriate controlled medications for nursing facility residents and those enrolled in hospice programs,” notes Jennifer Hardesty, PharmD, FASCP, clinical services manager for Remedi SeniorCare.

There is no question that pain’s effects on quality of life are far-reaching. Not only does pain diminish pleasure and interfere with social relationships and one’s ability to stay active, it is also linked to other debilitating conditions, such as depression and anxiety.

Full article: No pain = all gain – McKnight’s Long Term Care News (disclaimer: only includes nursing home perspective)

In the New York metro area, there’s been an oxy crime wave; it has led to a law enforcement crackdown. Doctors are more reticent to prescribe. Visible DEA enforcement actions have created a very real chilling effect that is making it harder for those already having a hard time with chronic pain.

I have nothing against Senator Schumer as a person, I’m sure he’s a great, affable guy, and I’d love to meet him to work on bringing individualized funding, choice and competition to Medicaid/Medicare instead of “one size fits all.” I’m just saying let’s not accidentally snag people in real pain in the “war on drugs” dragnet, let’s be level-headed, let’s not fear monger.

Prior to his 2003 commencement address at the Rochester Institute of Technology, the RIT website lauded Senator Schumer: In the past 25 years, Schumer has become known as a leader on national issues and a tireless fighter for New York. The Rochester Democrat and Chronicle called him “an accomplished, far-sighted legislator,” while The New York Times wrote that he “is a more serious lawmaker with more rooted values, sounder policy positions and a deeper commitment to the common good.”

All I’m asking, Senator, is please live up to your reputation as a committed fighter for the “common good,” include ailing constituents with chronic pain in that common good, and please be “far-sighted” about how federal drug policy can impact the quality of life of the elderly, the terminally and chronically ill, and disabled populations who live with the most severe pain.

Thanks for reading.

Sincerely,

Nick