Chronic pain patients and their doctors have been sharing their worries with the Observer since the Trump administration announced it was escalating the war on opioids.

Some have appeared in articles, more in front of a judge. Some have taken to the streets to secure their needed medication for unbearable pain, paying triple for their prescribed pills or rolling the dice with heroin. Others have ended their lives because opioids were the only thing that made the pain bearable.

Now patients are gathering April 7 at state capitols and city halls around the country for the Don’t Punish Pain rally. In Texas, they’ll be meeting at 11 a.m. at Dallas City Hall plaza to discuss how the opioid crackdown is affecting chronic pain sufferers.

But don’t expect a turnout like Saturday's March For Our Lives gun control rallies, where thousands of students descended upon the Capitol in Austin and other states. Most people seem to agree the opioid epidemic is an issue that the government needs to control, and Texas legislators are shy about supporting patients seeking access to the drugs.

Rhonda Posey from Texas Pain Advocacy, part of a coalition of 50 such groups, is one of the organizers behind the Dallas rally. Posey said the Texas group reached out to more than a dozen legislators in Austin to get sponsorship for the permit needed to host the rally at the Capitol. The rally is in Dallas, she said, because the group couldn’t find a legislator in Austin to sponsor it.

“The Trump administration has had a tremendous impact,” she said.

Trump recently called for the death penalty for drug traffickers in order to curb the epidemic. Standing behind a backdrop that read “Opioids: The Crisis Next Door” at the White House on March 19, he praised countries like China that have laws that “don’t play games on drugs.”

“Some countries have a very tough penalty, the ultimate penalty, and they have much less of a drug problem than we do,” Trump said.

When Trump refers to drug traffickers, he isn’t simply talking about cartel mules and bikers trafficking drugs. He's also talking about pain doctors with prescription pads. In a memo issued to federal prosecutors Wednesday, Attorney General Jeff Sessions said the death penalty can be sought for certain racketeering cases and for dealing extremely large quantities of drugs.

Trump plans to reduce the opioid demand and overprescribing, stop the supply of illegal drugs and boost access to treatment.

Since 1999, opioid sales have quadrupled in the U.S., and the Centers for Disease Control and Prevention estimates that 11 percent of adults experience daily chronic pain. It recently changed its guidelines for dealing with long-term opioid therapy, but they’re not intended for patients who are receiving cancer treatment, palliative care or end-of-life care. Some of those guidelines include using immediate-release opioids when starting, prescribing no more than needed, following up and re-evaluating risk of harm and tapering or discontinuing if needed.

“Opioids are not to be used as the first-line or routine therapy for chronic pain,” the CDC's opioid guidelines sheet says.

The CDC says that more than 180,000 people have overdosed using opioids, but four researchers within the CDC recently published a paper in the American Journal of Public Health that stressed the importance of differentiating between prescription pill overdose deaths and deaths from illicit heroin or fentanyl overdoses. They say it's necessary in order to craft appropriate prevention and response efforts.

“Unfortunately, disentangling these deaths is challenging because multiple drugs are involved,” the researchers wrote in the March 7 article. “Additionally, death certificate data do not specify whether the drugs were pharmaceutically manufactured and prescribed by a health care provider, pharmaceutically manufactured but not prescribed to the person or illicitly manufactured.”

In the meantime, chronic pain sufferers say they are being victimized and considered junkies when they go to their doctors seeking medication to manage their pain. It’s why they’re gathering April 7 at Dallas City Hall plaza.

“Chronic pain patients are cast out and left behind,” Posey said.

