“Not Allowed to Be Compassionate” – Human Rights Watch on Chronic Pain in America

In December 2018 the internationally- renowned non-profit Human Rights Watch organization published a comprehensive report on the state of chronic pain care in light of the current overdose crisis, and the resulting unintended patient harms in the United States.

According to Human Rights Watch researcher Laura Mills:

The investigation emerged out of our international palliative care program, which focused on the right to palliative care (including essential medications such as morphine) at the end of life, which is now recognized by WHO and others. Most of that work was in the developing world, from Kenya to Ukraine to Mexico. We then learned through those palliative care networks that due to backlash from the overdose crisis, chronic pain patients (and some cancer/palliative care patients too) were experiencing similar difficulties in accessing medication, so we decided to dedicate research funding for this topic.

From the Human Rights Watch Press Release dated December 18, 2018: In the last decade, hundreds of thousands of Americans died of drug overdoses. By some estimates, nearly half of these deaths have involved prescription opioids. To stem this crisis, government authorities have mounted aggressive attempts to reduce the use of these medicines. They have investigated physicians who prescribe them for no legitimate medical reason and increased monitoring of prescribing by physicians. Some state governments and Medicaid programs have imposed strict upward limits on the dosage physicians are allowed to prescribe.

Maria Higginbotham, 57, holding screws and bolts removed from her back in a recent surgery above x-rays of her body.
Maria Higginbotham, 57, holding screws and bolts removed from her back in a recent surgery above x-rays of her body. Higginbotham, a chronic pain patient diagnosed with degenerative disc disorder and a number of other painful conditions, has had twelve operations to prevent the collapse of her spine. © 2018 Will Miller for Human Rights Watch

The 99-page report, “Not Allowed to Be Compassionate: Chronic Pain, the Overdose Crisis, and Unintended Harms in the US” documents how some of these actions have had an unintended and harmful chilling effect, making doctors fear repercussions for prescribing even to patients with severe chronic pain who have a legitimate medical need for prescription opioids.

This comprehensive and thorough report focuses primarily on patients and medical providers interviewed in two areas: Tennessee, and . .. Washington State. Coincidentally, seven members of the anti-opioid PROP group are based in Washington state – fully 40% of its members including the PROP President and two Vice Presidents live in the Evergreen State – which is perhaps why the state was one of the first to implement statewide rules more tightly regulating opioid prescribing (back in 2011).

Human Rights Watch went on to make a written appeal to Oregon’s Governor Kate Brown in the Spring of 2019 to express “serious concern” over a policy proposed by the Oregon Health Evidence Review Commission (HERC) which would have mandated involuntary opioid dose restrictions for Medicaid patients with certain chronic pain conditions.

Where would Oregon get such a draconian idea about chronic pain and forcibly tapering patients off of medically-appropriate prescription analgesics? Just one guess, folks … .