By Ed Coghlan.

The problem of patient abandonment is growing…and perhaps accelerating – as the federal government intensifies its pressure on both the supply and the prescribing of opioid medication.

So, here’s a basic question.

“Has your doctor abandoned you or been removed from you by a government enforcement action?”

Terri Lewis, Ph.D., a well-known advocate for the chronic pain community, wants to learn how you are being affected by escalating enforcement actions and the news of widespread closures in multiple states.

Dr. Lewis’ survey of chronic pain patients – which was promoted extensively by the National Pain Report – surveyed nearly 1700 chronic pain patients. Here’s how she described who the patients are that responded to her survey. (click here). Analysis of more than 25,000 lines of comments is continuing.

“Clinics are being closed either because the DEA has raided them or physicians have been intimidated to reduce their opioid prescribing practices, or HHS-OIG has conducted fraud investigations that are closing clinics.” said Dr. Lewis. “Patients are being impacted, and often persecuted, because of the pressure to enforce CDC and state guidelines that have little to do with the reality of effective treatment for chronic pain and its diverse range of causes.”

This is resulting in targeted activity by both DEA and HHS that is reducing the local resources for care of persons with complex chronic pain and multiple comorbid chronic health conditions.

By Dr. Lewis’ estimate, the recent FDA raids of offices around the country – particularly in the Southeast and Mid-Central regions of the country – have threatened over 100,000 patients with the loss of their doctors in recent weeks.

“So, where are people affected and what are they going to do? This is what we’d like to explore through our survey,” she said. “We can both increase the number of people who are responding to the survey and isolate the number of people who are being adversely affected by their location. This will help advocates and physicians determine where the need is great and communications need to be coordinated.”

These closures have downstream consequences including the seizing of medical records that make transition to other clinics nearly impossible given the patchwork of state laws that govern both ownership of medical records, procedures for accessing a range of care protocols, and appropriate clinical supports. HHS-OIG’s actions have reduced clinic options by a significant number in multiple states.

These governmental actions have a cross-cutting dragnet effect on patients that is invisible to government policy makers intent on reducing prescriptions and deaths due to street drugs.

This week, the DEA announced it will update its established procedures for setting production quotas for addictive drugs without heeding a recommendation from medical groups regarding shortages of injectable opioids. A new DEA rule also drew complaints about the general attitudes toward treatment of chronic pain.

And Dr. Lewis – and many other chronic pain advocates – believe that the DEA actions are hurting the millions of chronic pain patients who depend on opioids to manage their own chronic pain because effective options are few and far between. What is trying to be identified is real stories from real people about how the federal government’s decision to crackdown on prescription opioids is impacting the quantity and quality of chronic pain care in the U.S. health care system.

On July 9, the nation heard affected persons tell the FDA that access to approved medications and safe care had become so burdensome due to flawed application of enforcement activities coupled with regulatory overreach that drug development should be put on the back burner. Many expressed that they had already abandoned the use of appropriate opioids due to the headaches associated with the current climate of enforcement and lack of physicians willing to risk caring for patients. Others expressed that their options for medications had become so narrowed as to be ineffective, insufficient, or downright dangerous given individual needs. Many addressed the burden of increased suffering and suicide.

Many expressed their dissatisfaction with the failure of government agencies to account for their needs or solicit input before now.

So, we are reopening this survey in order to offer folks the continuing opportunity to share how they are affected by the increasingly restricted environment.

We will continue to assist with continuing to build the evidence that describes how current government policies and enforcement actions are affecting individuals families and their care providers.

The link is located here: https://www. surveymonkey.com/r/Y8YXRJ9