Misguided Repeal to Cure Opioid Crisis Ignores Patients’ Pain

Misguided Repeal to Cure Opioid Crisis Ignores Patients' Pain by Lynn R. Webster @LynnRWebsterMD

Once again, I read the Intractable Pain Act (along with the section of it known as the Pain Patient’s Bill of Rights) which was passed by the Tennessee House and Senate in 2001 and repealed in 2015.

I did not see anything in the legislation that supports the statement made by Knox News columnist Frank Cagle that “when a patient was discharged from the hospital, they had to sign a form saying they have been issued all the pain medicine they wanted. If they didn’t get all the pain pills they wanted, the doctor could be sanctioned.”

What the Intractable Pain Act States

Instead, the now-defunct Intractable Pain Act states the following:

  • A patient suffering from severe chronic intractable pain should have access to proper treatment of his or her pain.
  • Opiates can be an accepted treatment for patients in severe chronic intractable pain who have not obtained relief from any other means of treatment.
  • A physician treating a patient who suffers from severe chronic intractable pain may prescribe a dosage deemed medically necessary to relieve severe chronic intractable pain as long as the prescribing conforms with the provisions of this section.
  • The patient’s physician may refuse to prescribe opiate medication for a patient who requests the treatment for severe chronic intractable pain. However, that physician shall inform the patient that there are physicians whose primary practices are the treatment of severe chronic intractable pain with methods that include the use of opiates.

Did Drug Industry Lobbyists Play a Role?

The author of the article claims the drug industry pushed the 2001 legislation through the legislature. I don’t know what role, if any, the “drug industry lobbyists” played in passing this law, but I don’t see anything in this bill that isn’t reasonable in providing relief to people in pain. There is no mandate in the Act to prescribe opioids. The Act, however, enables doctors to treat pain patients with opioids when that is the best available treatment.

The ubiquitous view that treating pain is the reason for the opioid crisis mischaracterizes the problem. Worse, it conflates the needs of people in pain with the efforts to curb illegal drug use, and it leaves chronic pain patients with few treatment options.

Tennessee repealed the Intractable Pain Treatment Act in 2015 in response to a record high of opioid overdoses. But the repeal didn’t address the cause of the problem. According to a recent article in the Tennessean, the increase in overdose deaths is largely due to illegally produced and distributed synthetic fentanyl, not prescription painkillers.

The legislators in Tennessee meant well. They were right in thinking that the opioid crisis is a serious problem that causes far too much carnage.

No Reduction in Overdoses in the Aftermath of the Repeal

However, their effort to curb the opioid crisis has not reduced the availability of illicit drugs nor the number of overdoses, while it has made it more difficult for people in pain to find relief. The lesson to be learned is that most of the harm from opioids in Tennessee comes from illicit or diverted opioids and that repealing the Intractable Pain Act, thus far, has not curbed the opioid crisis or reduced the number of opioid-related overdoses.

Purchase my book, The Painful Truth: What Chronic Pain Is Really Like and Why It Matters to Each of Us (available on Amazon), or read a free excerpt here.

The Painful Truth @lynnrwebstermd Lynn R. Webster

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Copyright 2016, Lynn Webster, MD



  1. Lydia on January 2, 2017 at 4:36 pm

    This was such an interesting article. I wonder what it will take to reduce the number of opioid addicts?

    • Suan on January 24, 2017 at 3:35 pm

      The issue that does not get stressed enough is that there are 2 different diseases that get clumped together.,..
      The Disease of Chronic Pain and the separate Disease of Addiction.
      We are punishing people who have Chronic Pain, by severely limiting or even eliminating the very safe treatment of pain with Opioid Pain Medications.
      Thinking that will solve the problems of illicit use of Street purchased “Opioids”.
      IT DOES NOT!
      The disease of Addiction is not managed this way. It is a very complex and difficult to treat.
      Thinking that you are treating the Disease of Addiction by limiting or eliminating the appropriate use of Opioid Pain Medications does nothing to help people suffering from Addiction, it only punishes people who are suffering from the Disease of Chronic Pain Pain.
      The NIH, National Institute of Health, has run MULTIPLE STUDIES that show the rate of Addiction in people with Chronic Pain who take Opioid pain medications is very rare, it is 0.3 % – 3%.
      These are Significantly low numbers, whch show that treating people with appropriate doses of Opioid Pain Medications does not cause Addiction.
      So,the Government needs to take a different course in the treatment of the Disease of Addiction!
      One that does not unfairly punish people who are suffering from Chronic Pain!
      Their own data shows that it is Not True!
      Someone needs to wake up the Politicians, Law Makers, Physicians and Drug Companies and force them to redirect what they are doing,
      They need to Stop Punishing people who have chronic pain and REALLY LEARN HOW TO TREAT THE COMPLEX DISEASE OF ADDICTION.
      They need to stop the suffering of the people who have the Disease of Addiction and the suffering of their families and friends!
      Spend the money used to treat Addiction in a different ways and stop the futile attempts currently used treat it. It only hurt others!
      Thank you for your time.

  2. Tom Rector on January 2, 2017 at 8:02 pm

    What’s missing from the discussion of the overdose epidemic is the effect of widespread drug testing in the US. Overdose deaths have increased every year since passage of the 1991 Omnibus Transportation Employee Testing Act.

  3. Anne Fuqua on January 5, 2017 at 4:28 pm

    They’ve got to wake up see they are NOT HELPING those with addiction, but they are doing a fantastic job wreaking havoc with the lives of patients with chronic pain. Sure some patients should be managed differently because opioids aren’t effective or cause too many side effects, but that doesn’t mean that is the case for everyone or even most patients. The newspapers statement about discharge requirements is just plain ludicrous. The reporter has either been seriously misinformed by someone with their own agenda – or is the one with the agenda. This isn’t journalism. It’s propaganda or maybe PROP(aganda).

  4. Ariel Y. Deutch on January 12, 2017 at 2:26 pm

    Your recent comments, as recounted in The Hill, are on target and help inform legislators. Pendulums take time to reach a homeostatic range after initially being (over)set.

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