Categories: News, Opinion, Schenectady County

Tucked in Gov. Andrew Cuomo’s budget is a proposal that seems unlikely to generate much opposition: a surcharge on opioid prescriptions.

The pharmaceutical companies that produce these powerful painkillers have been blamed — rightly, in my opinion — for fueling the terrible drug epidemic that has killed tens of thousands of Americans.





Which is why it makes sense to tax them, right? After all, shouldn’t they pay for the damage their painkillers have caused?

As the governor’s budget briefing book explains, the surcharge of 2 cents per milligram prescribed “is expected to provide a financial disincentive for the use of these drugs, and generate roughly $125 million to support ongoing efforts to address the opioid crisis.”

This sounds good.

I’m all for addressing the opioid crisis, which clearly needs addressing.

But I question how well this surcharge, which will be imposed on the manufacturers and distributors of opioids, will work in practice.

It will generate new revenue, for sure.

But there’s also a strong chance the surcharge will eventually be passed on to consumers — to the people who obtain prescription painkillers legally, because they’re suffering from either short-term or long-term pain.

Demonizing pharmaceutical companies is easy enough, but it’s worth taking time to consider the needs and concerns of people who use these drugs as intended.

A few weeks ago, I met with Clifton Park resident Tara Didonna, who suffers from chronic back pain caused by muscular dystrophy. She relies on a fentanyl patch, prescribed to her by a doctor, to relieve this pain.

One of her big worries, Didonna told me, is that tighter restrictions on opioids will make it harder for her to access fentanyl, and that she’ll once again find herself struggling to live with debilitating pain.

“I am scared because of everything I read in the news,” Didonna said. “People are afraid of pain meds and they think everyone who takes them is a junkie and an addict and it’s just not true. …. I’m not an addict. I don’t want more.”

“There’s a difference between an addict and someone who’s in chronic pain,” Didonna continued. “I don’t want to be in pain.”

Didonna stopped working about four years ago, but she said the fentanyl enables her to “walk, move, function, think.”

There isn’t a lot of evidence about the benefits or consequences of using opioids to treat chronic pain, in large part because of a lack of research.

But a number of articles have documented the concerns of people like Didonna, who suffer from chronic pain and believe opioids are helping them maintain their quality of life.

Earlier this month, an article about Massachusetts Gov. Charlie Baker’s proposals for combating the opioid epidemic detailed the concerns of pain patients, who fear losing access to painkillers as doctors become more reluctant to prescribe them.

“Pain has taken away almost everything in my life,” a patient named Becca West told the Massachusetts Legislature’s Joint Committee on Mental Health. “I’ve tried every single treatment available to me. Opioids are my last choice to have some semblance of a normal life, but I can’t find a doctor who will prescribe them to me on a long-term basis.”

Given the enormity of the opioid crisis, the concerns of pain patients might not seem all that important.

But it should be possible to balance the needs of people suffering from acute and chronic pain with the need to come up with new solutions and strategies for reducing the abuse of prescription painkillers. An opioid surcharge might make it harder for law-abiding pain patients to access the medicine they need.

I have no sympathy for the pharmaceutical companies targeted by Cuomo’s proposed surcharge.

But I do sympathize with people in pain.

Whatever steps we take to address the opioid crisis, we should make sure Didonna and others like her aren’t caught in the crossfire.

Reach Gazette columnist Sara Foss at [email protected]. Opinions expressed here are her own and not necessarily the newspaper’s.