Sarah Fudin is the community manager for the George Washington University’s innovative online Masters in Public Health program. Sarah enjoys working with public health graduate programs as a way to positively effect change and become a life long learner. Follow her on twitter at @sarahfudin and @GWonlineMPH.
Public Health has a deep connection with pain management that is sometimes forgotten or unrealized. It is important that we draw the association between public health advocates and pharmacists, health practitioners (MD’s, NP’s, PA’s, dentists, podiatrists), nurses, and others for people dealing with the challenges of acute and chronic pain. If public health advocates and pain management specialists join together, there will be a more integrative approach to confronting the challenges that patients face.
Over the past few months there has been a lot of attention around certain pain management activities resulting in media frenzy. It seems like now is the perfect time to alert the public of these issues, if they aren’t already in the know, to help create policy and knowledge around pain management.
If you’ve missed the news, here’s what’s going on:
Mayor Bloomberg’s New Task Force
In response to the increasing abuse of prescription painkillers, Mayer Bloomberg created the multi-agency Task Force on Prescription Painkiller Abuse. The task force is co-chaired by Linda Gibbs, Deputy Mayor for Health and Human Services and John Feinblatt, Chief Policy Advisor, and was created to develop and apply integrated strategies to respond to the increase of opioid painkiller abuse and distribution in New York City. The abuse of opioids has become a public health threat with a massive increase in abuse over the last decade.
The problem herein lies with the patients that are actually prescribed these opioids and need them to manage in their every day lives. Medical doctors and pharmacists have been portrayed in a negative light and have come to fear prescribing and dispensing opioid painkillers for patients that truly need them. As public health advocates, we must understand both the people in need of these painkillers and the people abusing them to find the best way to monitor and mitigate this problem while still providing essential care to legitimate pain patients.
Check out this campaign launched by the NYC Health Department to shed light on this issue to the general public:
Meningitis Outbreak Investigation
In response to a multi-state fungal meningitis outbreak by New England Compounding Center (NECC) patients, the Center for Disease Control and Prevention (CDC), state and local health departments and the Food and Drug Administration (FDA) have teamed up to investigate. The CDC has received reports of spinal epidural abscess and arachnoiditis among a number of patients who were receiving treatment for fungal meningitis.
In response to this outbreak, the NECC voluntarily recalled all of the products from their Framingham, Massachusetts facility as did other facilities as more contamination was identified. The teamwork of public health officials to continue to announce updates as well as the medical worker’s vigilant efforts to remove contaminates and continual research is commendable. There is much work to be done to figure out the reason for this outbreak and how we will prevent future outbreaks. Government officials have been working diligently with ASHP and other national pharmacist groups to establish workable polies moving forward.
For more updates, follow the CDC’s investigation.
Rescheduling of Hydrocodone in NYS from CIII to CII
What we’ve found is that the medications that work best for treating pain are also the ripest for abuse. Because of this, drug safety policy is skewed towards making these medications more difficult to acquire and stockpile.
A few weeks ago the FDA Drug Safety and Risk Management Advisory Panel voted in favor of rescheduling hydrocodone from CIII to CII. But just last year, the FDA decided not to reschedule hydrocodone after much pressure from certain advocacy groups and the DEA. Those suffering from these decisions are patients in chronic pain that have little resources to make a public stand, and who are less likely able to make a trip to Washington to advocate for their position because of inability to travel and/or work regularly. As public health advocates, we must take their voices onto our shoulders and champion for their positions to be heard. We must make sure patients who are in need of medication are able to receive it while at the same time monitor those who are abusing these medications. This effort will take hard work from pharmacists and prescribers – patients must be monitored closely!
For more insight see Dr. Fudin’s article: Effect of Rescheduling Hydrocodone is Unknown. Also see Hydrocodone: Potency, Popularity, Politics, & Practicality.
There are a ton of policy creators, advocacy groups, patients and healthcare providers working diligently to provide the public with the best medications, treatments and updates. It is important that we continue to work together to shed light on current issues and lobby for important causes.