We are in the midst of a national epidemic concerning opioid misuse and abuse, and lawmakers are rushing to address this concerning situation. However, a recent report finds that only a few states are successfully implementing a balanced approach to curbing opioid misuse and abuse while maintaining access to pain relief for patients in need.
In 2015, there were less than 80 state legislative proposals related to pain management and opioid issues. In 2018, there have been more than 470 proposals introduced across the country. Though well-intended, this flurry of legislation may have unintended consequences, inadvertently creating barriers for patients who legitimately need these pain medications to maintain a quality of life, including millions of cancer patients and survivors.
How Do You Measure Up? A Progress Report on State Legislative Activity to Reduce Cancer Incidence and Mortality is an annual report released by the American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of the American Cancer Society (ACS). The publication illustrates where states stand on issues that play a critical role in reducing cancer incidence and death. In this year’s edition, released August 9, a special section takes a deeper dive on state pain policies and finds that only four states are implementing a balanced approach aimed at reducing misuse while maintaining access to care.
Despite the reality that millions of cancer patients and survivors deal with daily, debilitating pain, the issue remains highly stigmatized. Opioid medications are recognized as an effective method for cancer patients who experience chronic pain in and out of cancer treatment—and for some, it’s the only relief available. Managing pain is crucial for patients to be able to maintain their quality of life. If left untreated, chronic pain can lead to delayed recovery and a weakened immune system, not to mention impaired physical function and quality of life.
The opioid epidemic is a public health crisis that must be addressed. However, we must be mindful that policy changes do not lead to unintended consequences that harm patient access to medications to help address pain. While we must work to address opioid misuse, doing so without considering the need to protect access for those who legitimately need these drugs is irresponsible.
Recent ACS CAN research [PDF] shows that, since 2016, cancer patients, survivors and others living with serious illnesses have experienced greater difficulty accessing needed pain medication. Nearly half – 48 percent – of cancer patients were told by doctors that their pain treatment options were limited by laws, guidelines or insurance coverage. Four in ten cancer patients and survivors reported they were unable to access their prescription pain medication because the pharmacy did not stock it and nearly one third of cancer patients and survivors were unable to get their prescription pain treatment because their insurance would not cover it.
Balanced pain policies that create and maintain prescription drug monitoring programs, fund research to develop non-opioid pain treatments, and increase provider education would ensure cancer patients have access to their prescribed pain management resources while combating opioid misuse. How Do You Measure Up? offers not only an evaluation of whether states are striking this balance, but also a roadmap for lawmakers to improve their state’s score, helping to reduce opioid misuse and abuse while protecting those who need these drugs and would suffer needlessly without them.
In addition to assessing state’s pain policies, the report analyzes eight additional priority issues focused around access to care and prevention. With all of the uncertainty surrounding the future of health care, access to health coverage through Medicaid is crucial. This year, increasing access to Medicaid eligibility was the most-met benchmark, with 34 states, including the District of Columbia, having taken this action. However, that means 17 states still have not provided low-income, working adults access to adequate, affordable health coverage through their Medicaid programs. Research shows individuals without health care coverage are more likely than those with coverage to be diagnosed with cancer at a later stage, when it is more costly and difficult to treat, and when individuals are less likely to survive. Medicaid provides a critical safety net for more than 2.3 million Americans with a history of cancer, including one-third of all childhood cancer patients at the point of diagnosis.
From a cancer prevention perspective, the report also grades states on several tobacco control policies, including comprehensive smoke-free laws, tobacco tax rates, funding for tobacco prevention programs and coverage for cessation services in Medicaid, legislation to prohibit young people from using tanning devices to decrease their risk of developing skin cancer, funding for breast and cervical cancer screening programs, and access to palliative care services.
While many states are making progress, there is still much to be done in the effort to eliminate suffering and death from cancer. Approximately 1.7 million Americans will receive a cancer diagnosis this year. How Do You Measure Up? serves to educate the public and encourage local, state, and federal lawmakers to continue passing and implementing proven public health policies to save more lives from cancer.
