Online Program

Health in all policies: Quality of life of chronic pain patients vs regulations to stop opioid abusers

Monday, November 2, 2015

Barbara L. Kornblau, JD, OTR/L, School of Health Professions, Division of Occupational Therapy, Florida A& M University, Arlington, VA
According to the Institute of Medicine (2011), chronic pain is a national public health issue affecting tens of millions. Experts agree the “opioid crisis” is also a public health issue. The CDC (2013) reports opioids cause nearly 3 of 4 prescription drug overdoes -  more deaths than cocaine and heroine combined. A recent NIH report (2015) asserts a lack of evidence to prove long-term opioid use works, while chronic pain patients report positive outcomes from opioids. See ie  

Despite an unknown root cause, the FDA responded to the opioid crisis by changing the classification of hydrocodone - the most prescribed opioid - from a Schedule III to a Schedule II drug. This restricts access to abusers, as well as chronic pain patients who rely on prescribed drugs to decrease pain and improve quality of life.

Before the regulatory change, previous studies have shown drug access issues. Using secondary data from a hydrocodone survey of access since the regulatory change, currently underway by the National Fibromyalgia and Chronic Pain Association, with a team of experts, and more than 3650 subjects to date, this paper looks at a theoretical problem in public health law. What happens when we address one public health issue through regulation without first exploring the consequences to another? How can evidence play a role in creating public health policy that considers the health of all populations involved? What role does public health law research play?  This proposal targets an audience with some familiarity with law and/or policy.

Learning Areas:

Chronic disease management and prevention
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Describe the competing interests and epidemiology of chronic pain patients and regulators seeking to curb opioid abuse. Discuss the role evidence, and patient-reported outcomes can play in the development of regulations.

Keyword(s): Health Law, Chronic Disease Management and Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an attorney, and professor of Occupational Therapy,(previously public health). I am a certified pain educator. I was a Robert Wood Johnson Health Policy Fellow. I am currently or have been on the advisory boards of several professional pain organizations. I have lectured nationally and published articles and book chapters on pain policy. I advised Senator Rockefeller on opioid issues. I am an ambassador and reviewer for the Patient Centered Outcomes Research Institute (PCORI).
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.