The April 11 article on MaineCare opioid restrictions was appalling, as what the story reported was indefensible (“MaineCare opioid restrictions seen to sharply cut painkiller abuse”).
When MaineCare decided to restrict opioids for pain management, it was originally done to save money. Now the state has concluded that going this route is a good thing because it has reduced the number of opioid prescriptions.
There is no evidence that reducing the number of opioid prescriptions reduces addiction or even availability. People in pain aren’t addicts, and the addicts will just go elsewhere. (Heroin use is way up.) What has happened related to pain is cruel, unjustifiable and ignorant.
While this report mentions a significant increase in the number of prescriptions and pills paid for outside MaineCare (calling it “a troubling trend”), it doesn’t really go into the hardships that people with pain have been forced into.
Paying for their own medication, going to the street for medication or forcing them to use medical marijuana takes money this population can ill afford, taking it from food and/or rent. Going without their medication leads to significant suffering, loss of quality of life, loss of function, depression and anxiety, and, in some cases, suicide.
MaineCare’s non-pharmacological interventions are not appropriate for many pain syndromes, as well as being insufficient. Cognitive therapy was incorrectly described in the article as “pain acceptance therapy,” and problems with this therapy abound.
MaineCare made some exceptions for cancer- and HIV/AIDs-related pain and end-of-life care, yet they’ve pretty much said it’s all right for anyone else to suffer.
No evidence supports the idea that persistent pain in a cancer setting is any different from persistent pain in a non-cancer setting. Why aren’t other states following Maine’s lead? Because it is an unsupportable one in results and the torture it inflicts on people with pain.