Guest Blogger Kyle Simon is the Director of Policy and Advocacy for the Center for Lawful Access and Abuse Deterrence. After a recent clash between Phoenix House and CLAAD, as outlined in detail below, Mr. Simon agreed to provide insight on their dispute that surfaced about three months ago. We of course invite Phoenix House an/or affiliates to comment herein or propose a rebuttal guest blog. CLAAD Director Simon had this to say…
Can We Agree to Agree? The prescription drug abuse epidemic has impacted Americans in every state and among every age group and race. The Centers for Disease Control and Prevention(CDC) recently reported that overdoses involving prescription medications increased four-fold between 1999 and 2010,with 22,810 deaths relating to prescription drug overdoses in 2011.
While there is much work to be done to stem this epidemic, we have made progress at reducing prescription drug fraud, diversion, and abuse. The efforts of policymakers and countless health and safety organizations have contributed in a meaningful way to a reduction in nonmedical use of opioids in at least 10 states and a nationwide reduction in nonmedical use of prescription drugs among young adults aged 18 to 25.
States at the forefront of prescription drug abuse reduction policy, such as Kentucky and Florida, have enacted mandatory standards for prescribing certain schedules II and III controlled substances, and 49 out of 50 states have implemented prescription monitoring programs. The Affordable Care Act and the Mental Health Parity and Addiction Equity Act, coupled together, expand access to treatment for substance use disorders. Federal and state policy makers and stakeholders are rising to the occasion and creating a landscape with better systems to ensure safer, healthier communities.
The National Prescription Drug Abuse Prevention Strategy, published by the Center for Lawful Access and Abuse Deterrence (CLAAD) and endorsed by some 30 public health and safety organizations, incorporates the viewpoints of the public and private sectors, medical and legal professions,and the abuse-prevention and pain care communities. Among its many policy proposals, the National Strategy calls for better prescriber and consumer education and state standards for prescribing controlled substances to ensure improved quality and safety of healthcare. Since 2008, some 95 percent of CLAAD’s even-handed proposals have been supported by federal policy makers,and numerous state leaders have worked collaboratively with CLAAD to advance reasonable policies to reduce prescription drug abuse.
While there have been marked gains in advancing better and more effective public policies, there have also been distractions. Earlier this summer, two California counties and the City of Chicago filed lawsuits alleging that several major pharmaceutical companies improperly promoted opioid pain relievers.Additionally,despite a new federal law allowing more widespread community drug disposal including at pharmacies, the Alameda County (CA) Board of Supervisors this spring enacted the nation’s first ordinance requiring pharmaceutical manufacturers to pay for programs to dispose of expired and unused drugs. It is the FDA’s role to vigilantly regulate the approval, labeling, and promotion of pharmaceutical products, not that of counties or municipalities. County and municipal lawyers are inadequately qualified to make or enforce federal drug policy, and these lawsuits serve as a vehicle for local governments to seek revenue through ill-informed measures under the guise of drug abuse prevention. In a May 30,2014, interview with FDA Week, a CLAAD spokesman voiced these positions and expressed concern that these lawsuits are part of “a trend that will distract us from the real meaningful approaches to reducing prescription drug abuse.”
After reading the interview, Dr. Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing (PROP)and Chief Medical Officer of Phoenix House, contacted CLAAD via telephone to condemn its comments. During this conversation, Kolodny threatened that the Internal Revenue Service would revoke CLAAD’s tax-exempt status when alerted to the comments, which he believes conflict with CLAAD’s charitable mission. CLAAD takes these false allegations and threats very seriously, and responded in a letter which is publicly available for view on our website.
Critics who categorically dispute the motives of organizations like CLAAD and its diverse coalition members are, at best, narrowly focused. Their zealotry reveals their otherwise undisclosed health insurance industry bias. At worst, they endanger the lives of people who live with pain and other conditions that can require controlled substances by stifling access to quality care. Countless personal stories, plus many more on this site, have highlighted how curbing access has the potential not only to prolong suffering, but it can also be costly when the individual must make unnecessary duplicative office visits or is hospitalized. Even worse, a recent survey by the National Fibromyalgia & Chronic Pain Association found that nearly 40 percent of people with chronic pain and without access to pain medication have considered suicide.
The most perplexing aspect of Phoenix House’s false allegations and threats is that Phoenix House and CLAAD could catapult a positive difference by focusing on their numerous commonalities and harmonizing their efforts to avoid conflict and duplication. CLAAD shares Phoenix House’s commitment to supporting individuals, families, and communities affected by substance use through prevention,treatment, and recovery programs.
Stakeholders committed to reducing prescription drug abuse must identify common ground and share the limited resources available to promote, among other measures, prescriber education, prescription monitoring programs, and early interventions and treatment for substance use. To have a meaningful impact on stemming this epidemic, we must work together and devote efforts and resources to their most productive uses.
As always, comments are welcome!
Kyle Simon is the Director of Policy and Advocacy for the Center for Lawful Access and Abuse Deterrence. His background includes several years of health care policy, advocacy, and political experience. He has worked with policy makers on Medicaid and regulatory issues, served members of Congress, managed a statewide political organization representing the President of the United States, and held leadership roles in multiple political campaigns.
In addition to his work with CLAAD, Kyle is an adjunct professor of U.S. Government at one of the nation’s best community colleges. He holds a Master of Science in Applied American Politics and Policy and a Bachelor of Science in Political Science from Florida State University.
Dr. Mr. Simon,
I read your piece here, and wanted to let you know how it impacted my recently written, “An Open Letter to Dr. Kolodny,” which can be found here: ramblingsoapbox.com/2018/06/26/an-open-letter-to-dr-andrew-kolodny/
As a chronic pain patient and public policy reformer/advocate, I appreciate your balanced approach and science-based work.
Sincerely,
Loura
As someone who was never temped even as a teenager to take anything to get “high” or feel “good” as I’ve heard othhers say on programs about addicts. I can’t comprehend taking something that you know you could get addicted to. With that said I have been on pain management since 2008 for OA that was diagnosed in 1989 when I was 30 I’m now 55 and my doctor doesn’t want to raise the dosage of my pain med as needed when I know it could make my life so much easier to live and I might actually get enough pain relief to enjoy some life. I’m on the same dosage since I moved here 4 years ago and my desease has progressed to a new level and I’m getting more depressed and feeling more rejected every time I sed him. I’m suffering in the year 2014 that doesn’t seem right or hmane. Animals are put down for the pain I’m in. Does anyone know how I could approach my Dr. with this without him turning cold as ice?
Mr Kolodny is the chief jihadist at PROP. The goal of the PROP jihad is to make prescribing strong opioid pain relievers like morphine illegal. PROP tried to accomplish this goal through a September, 2012, petition to the FDA, Docket ID is FDA 2012-P-0818. Kolodny and company supported its petition with 9 references to studies.
The FDA debunked every one of those references as inconclusive, irrelevant, or producing findings the opposite of what PROP claimed.
So, either Kolodny and his merry band don’t know how to read, or they hoped the FDA appraisers don’t. Either way, it’s surprising that anybody would take PROP “science” seriously. They re much better at propaganda and raw intimidation, such as threatening lawsuits against people and organizations who dare disagree with them.
Kolodny is obviously much more ease with groupies such as Sabrina Tavernise of the NY Times. For demonstrations of groupiness at work, see Tavernise’s Sept 13 reports on the FDA ruling on PROP’s petition.
All this stuff is online. No secrets here.
Keep it up, CLAAD. Illegitimati non carborundum, and all that.
I think Kyle Simon, Director of Policy for CLAAD is doing a very good service for the opioid abuse epidemic that has impacted all states . Back in the 1990’s most doctors didn’t know how to treat chronic pain and where not trained to do so. Certain prescriber’s became too lenient in prescribing to anyone saying they had ongoing chronic pain without checking medical records or having test done for proof of chronic pain. This is how the opioid epidemic spiraled out of control ,it wasn’t the fault of pharmaceutical companies, they don’t prescribe, they found ways to extend certain medication people took many times a day to a medication taken just twice a day . Many people out there suffer from chronic pain and should have access to whatever medications best helps them live as pain free as possible.
Keep doing the job you have been doing Kyle and don’t worry about PROP or Andrew Kolodny . He doesn’t care about those that truly suffer from chronic pain. Dr. Kolodny has proved this to me by saying chronic pain will be the least of the worries for those that take opioids when his Citizens Petition takes effect. This Petition sent to the FDA by PROP traumatized chronic pain sufferers everywhere emotionally for Dr. Kolodny to give the appearance or pretense he had control over something he didn’t. This type of narcissist is prevalent in a lot of people as a personality disorder characterized by the persons overestimation of his or her own appearance and abilities and an excessive need for admiration.
I have never met or spoken to you before, Mr. Simon, but I am standing applauding your response to Mr. Kolodny and hope that others who have been threatened will have the courage to respond as you have and share their own experiences. Important issues deserve public debate, honesty, and integrity not threats. Where does Mr. Kolodny get his funding? This seems a fair question.
I seem to remember Andrew being ill at ease with some of my opinions….
Best of luck CLAAD.
I agree with much of what Mr. Simon of CLAAD has said with one major exception and that has to do with the actions of the Board of Supervisors in Alameda County (CA). Let’s assume for the sake of discussion that the Board’s ordinance requiring pharmaceutical companies to pay for programs to dispose of expired and unused drugs is silly, even stupid, and, possibly, unconstitutional. That said, don’t you think the good people of Alameda County can straighten this out by ousting members of the Board who may have thought this was a good idea? On the other hand, if this were a federal law, the good people of Alameda County would have no chance for doing anything other than to comply with the law.
Elsewhere in Mr. Simon’s piece he appears to laud Florida and Kentucky for being in the “forefront of prescription drug reduction policy.” Those, by the way, are states doing what the feds wouldn’t or couldn’t do. Thomas Jefferson’s notion of the “consent of the governed” remains relevant. When it comes to the laws I live under, I have more ability to grant consent to my local Board of Supervisors than the United States Congress. All things considered, I’ll take my chances with the Board. Members of Congress don’t even answer constituents’ letters any more, much less seek their consent for anything. I’ll bet a public opinion poll would show higher ratings for the Alameda Board of Supervisors than the U.S. Congress. That pretty much says it all. Even so, absent his hit on the Alameda County Board of Supervisors, I do agree with a lot of what Mr. Simon says.
John,
Thanks for weighing in on this. I know for certain that because of your background you have a unique perspective.
Read the Constitution. Congress regulates interstate commerce.
2150 n. clifton av
Indeed Kolodny and PROP have often stepped beyond the pale. Threatening CLAAD is just how scurrilous Kolodny’s become. I believe Kolodny has accused some of having blood on their hands without ever looking at what drips from his. People with pain all over the country have been hurt by this man, especially in Florida, Kentucky, Washington state, and more. where pain patients go without treatment, or been rejected by their docs because of the witch hunt atmosphere that Kolodny and PROP have helped ignite. Kolodny should stick to addictions and leave pain to the experts.