The recently-proposed creation of a Maine Pain Institute, to serve patients and families affected by chronic pain, is admirable (“Establish the Maine Pain Institute, a state solution to the opioid epidemic,” column, Oct. 14). But it would unfortunately be years too late to help the estimated 16,000 suffering Maine pain patients who are today still negatively impacted by the state’s wholesale adoption of the 2016 federal “CDC Guideline for Prescribing Opioids,” allowing it to become Maine law.

Many of the provisions in the guidelines are positive, including the establishment of a statewide monitoring system for tracking authorized prescriptions.

But one of its provisions has resulted in the entire aforementioned patient population becoming subject to an arbitrary maximum dosage level. It has allowed the Legislature to come between the doctor and the patient by specifying by law the level of pain control allowed to a patient whom they never met, even if some lawmakers were doctor-legislators themselves, which few are.

There are exemptions for cancer, palliative care, and end-of-life/hospice care, but these were not widely known at the time, and primary care providers in particular are still either not aware of them or don’t want to deal with the added workload with their management. There were reported widespread threats that licenses to practice would be pulled for incidents of unspecified problems, worsening an already growing doctor stigma regarding prescribing pain medication.

In short, thousands of Maine patients who had their chronic pain under some semblance of control for several years, many even for decades, suddenly found themselves being tapered down to the limits of the new law, with an accompanying increase in pain level and a decrease in quality of life.

In 2019, the CDC has finally admitted publicly that its own published guideline was flawed, and that it was never intended to be adopted as legislation in the first place. Despite that federal mea culpa, there now urgently needs to be an amendment to Maine law at least to remove the problematic dosage limits section, and thus return the control of chronic pain to the pain management specialists, who work daily in this field, or to primary care providers with the requisite skills, who also work personally with these patients.

Otherwise, we can expect to see yet another increase in Maine chronic pain patients, many pushed by their suffering to the streets for medication to regain adequate pain control. Some potentially will die from unknown substances mixed with illicit painkillers. Others undoubtedly will not want to risk that prospect, instead choosing to avail themselves of so-called “death with dignity,” now also available by state law.

It’s regrettable that legislators say that they rarely hear from constituents about chronic pain, whether from sufferers or family and friends. That’s problematic, considering the huge outcry voiced on social media regarding the injustice.  The online time and effort might better be invested in a call or visit to their state representatives before the next legislative session.

Perhaps one of our governing officials may even be reading here, and decide to sponsor an amendment on his or her own.

Max Beichert is an Augusta consulting engineer and chronic pain patient with postherpetic neuralgia since 2012. He can be contacted at: [email protected].


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