Taylor Duane Interviews iPain President Barby Ingle for Thesis Paper

These answers were completed by Barby Ingle specifically for Taylor Duane’s senior thesis.

I’m investigating the question, “Should opiates used to treat cancer pain be rescheduled for cancer patients who are suffering from chronic pain?” What is your position on this and why?

International Pain Foundation (iPain) believes that all options should be on the table when it comes to treatment. That it should be between a provider and patient as to the goals of treatment and for some opiates will be right, for others it wont. But nothing should be taken off the table because we are all created differently and taking options away from patients because it doesn’t work for someone else is not access to proper and timely care for all.

What is your experience that informs that opinion?

I have been a chronic pain patient for 20 years and although I have used opioids myself they are not right for every situation and challenge I have faced with my own personal health. If I need a medication, procedure or durable medical equipment, decided upon by my providers and myself as a team, I would like for it to be available and have open access to it. As far as International Pain Foundation, we have been connected to thousands of pain patients for going on 11 years now and we have seen how important open access to proper and timely care is. We have seen patients give up on life after not receiving adequate pain care. This has made the iPain Board of Directors even more passionate about getting proper and timely care for each individual patient.

It has been argued that new regulations and restrictions on controlled substances have caused the under treatment of chronic pain. Do you agree or disagree and why? If you disagree, what do you think is causing the under treatment?

The new guidelines have created changes in patient care. iPain was involved with a research study in conjunction with our partner Pain News Network. The survey measured the impact of the CDC’s opioid prescribing guidelines. The online survey of 3,108 pain patients, 43 doctors and 235 other healthcare providers was conducted between February 15 and March 11, 2017 by Pain News Network and the International Pain Foundation (iPain).  Many pain patients who took the survey are saying they’ve used opioids safely and effectively for years. They say the guidelines have had a chilling effect on many of their doctors and are being implemented in ways that go far beyond what the CDC intended.

Over the past year, patients reported many negative consequences from the guidelines, with very few positive outcomes – such as finding safer and more effective treatments.

84% say they have more pain and worse quality of life

42% have considered suicide because their pain is poorly treated

22% are hoarding opioids because they’re not sure of future access

20% say insurance refused to pay for a pain treatment they needed

19% say a pharmacy refused to fill their opioid prescription

11% have obtained opioids illegally for pain relief

4% found better and safer treatment than opioids

4% were given a referral for addiction treatment

4% were discharged by a doctor for failing a drug test

1% found that they don’t really need opioids

More info: https://www.painnewsnetwork.org/2017-cdc-survey/

Others have argued that prescribing opiates to manage pain puts more pills into circulation and increases the risk of overdose-related deaths. What is your opinion on this?

My personal opinion is people who are going to abuse something are going to continue to do so until they choose different for themselves. So, if pills are not available other things are such as alcohol, gasoline, crack, etc. are. An abuser is going to abuse, that is what they do. We need to find a way to help abusers as well as people in pain at the same time.

iPain believes we should not take something that helps one away from everyone because it hurts one. There are ways to address abuse challenges and still treat people in pain with all options on the table. Taking options off the table is not something that we recommend. iPain also doesn’t recommend that anyone be in on the decision of treatment for any patient besides the patient and their selected team of providers.

In your opinion, what is the best solution for avoiding the under treatment of pain while still addressing the opioid abuse epidemic?

Leave all options on the table, get better reimbursement for noninvasive options for all patients. We need coverage for chiropractics, mindfulness, counseling, Calmare, infusion therapy. The more options available for all the better everyone’s personal case can be handled.