There are personal stories of Utahns losing family members to drug addiction, with conditions like migraines leading to pain pills, dependence and sometimes death. And then there are people who suffer debilitating pain, scared their one comfort will be taken from them.
Dozens of Utahns commented on proposed guidelines by the state health department meant to help doctors know when and how to prescribe opioids for chronic pain. The recommendations include random drug tests and for doctors to consult pain specialists for patients who need high doses.
The guidelines were written as part of a state effort to restrict the overprescribing of pain pills -- nationally, prescriptions have increased eight-fold in a decade -- because of the 200 percent increase in overdose deaths in Utah since 1999.
Utahns report being in so much pain from chronic conditions they cry through the night or consider death. They say the pills are the only way they can function.
"The proposed guidelines will make it difficult, if not impossible, for us to obtain these medications when we clearly benefit from their use," wrote Lee Stokes, who said he has a nerve disorder. "Were it not for hydrocodone, I would have a very difficult time holding down a job -- my feet are too painful to stand or walk on otherwise. And, at age 53, I'm far too young to consider retirement or disability."
"I believe the proposed restrictions on prescribing opioids to be an ill-conceived, poorly planned, and outright cruel and unusual punishment of those of us with legitimate need for these medications," wrote Morgan Wolf, who said he has spinal arthritis. "Leave us chronic pain sufferers alone, and go after the teenagers holding 'pharm parties' and overdosing on medications that they stole from one of us!"
But others plead for more restrictions.
"This needs strong language stating that such prescribing hasn't been shown to be effective, kills and disable[s] people and ruins families, lives and communities," wrote a nurse practitioner anonymously.
Robert Rolfs, state epidemiologist and moderator of a panel of doctors -- at least one of whom has research funded by drug manufacturers -- who wrote the recommendations, plans to spend the next several days fine-tuning the guidelines based on the comments.
Like many who wrote him, Rolfs was bothered by the recommendation that patients who are prescribed opioids for chronic pain have random drug tests to ensure they are taking their prescription correctly (not selling it or taking too much) and that they aren't on illegal drugs. Some who commented, called the idea demeaning and an invasion of privacy and said it would lead them to seek drug dealers.
"This will discourage people from seeking medical attention because doctors will become members of the police force instead of medical providers," wrote Andrew Howells, who said he has needed pain pills after surgery.
Rolfs, who believes the drug tests would interfere with the doctor-patient relationship, hopes to find a way to make the tests a "positive" tool.
"We're trying to be a little more restrictive than things have been in the past," he acknowledged. "That perhaps is going to make it somewhat difficult for some people to get treated. I want to minimize that."
