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How opioid rules impact chronic pain patients

Some chronic pain patient said new opioid laws are impacting access to medication they need.

DENVER — In our ongoing coverage of the opioid crisis, a Next with Kyle Clark viewer pointed out a perspective that he felt deserved some attention: the impact changing opioid laws are having on chronic pain patients. 

Keith Evans said his journey with opioids started in 2007, a year after other pain treatments and medications weren't helping him with nerve pain associated with his diabetes. 

He said the pain was impacting his sleep and his ability to work. It got to the point that doctors even considered implanting a morphine pump to help him with his pain management. 

Evans said he wishes he didn't have to take the pain pills and wishes he could get back to work, but that it's not his reality. 

He also said the changing rules around opioids in Colorado have impacted his access to medication and changed conversations he has with his doctors.  

"They bring up, 'I'm afraid of the state coming in and auditing me and closing me down,'" he said. 

He also said without help from strong pain pills, the pain brings him to tears and he can't sleep at night. 

A Colorado law from last year focuses on preventing doctors from overprescribing opioids to acute pain patients. It was never meant to take them away from people with chronic pain, which was specifically written into the law. 

However, Evans' concern is warranted according to State Senator Brittany Pettersen (D-Lakewood), who said there has been a ripple effect. 

"Unfortunately some of the unintended consequences are they are cutting off chronic pain patients who desperately need their medications," she said. 

Pettersen said cutting off medication is very dangerous, and that it's not the legislation, but fear among doctors contributing to this problem.

"Doctors are reacting with fear because so many people are dying from overdoses," she said. "There's a lot more pressure at every level to stop overprescribing." 

The Opioid Interim Committee has been meeting with chronic pain patients and listening to their concerns. 

For this upcoming session, Pettersen said they hope to continue funding to educate doctors about the safest way to handle opioids, including how to treat chronic pain patients. 

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Dr. Rob Valuck with the Colorado Consortium for Prescription Drug Abuse Prevention said the intentions of the law may have gotten lost in translation. 

"We're saying use when appropriate, don't overuse it, and don't under-use. We aren't advocating that," he said.

Valuck said the general rule of thumb is that roughly two-thirds of all opioid prescriptions are for chronic pain patients. The other one-third is for acute pain. 

He also said nine out of ten chronic pain patients do not become addicted. 

There is a difference between physiological dependence to manage pain and addiction when someone starts lying, cheating and stealing and carrying out adverse behavior for access to pills. 

"Patients that take it for a chronic pain aren't going to divert it, aren't going to take more than they need. Then they are going to run out," Valuck said.

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However, Valuck added that opioids were prescribed so frequently over the last 25 years that the number of people addicted added up quickly. 

"It peaked at 260 million prescriptions a year seven years ago," he said.

According to Valuck, estimates put anywhere from more than 50,000 to more than 100,000 people have an opioid-use disorder in Colorado. It's hard to get an accurate count because it requires a doctor's diagnosis and for someone to be in a rehabilitation program, which isn't always the case.  

Valuck said another goal of newer Colorado laws was to stop overprescribing opioids because 70% of people with an opioid-use disorder said they first got their hands on them from someone else who kept around leftover pills. 

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