MORGANTOWN, W.Va. – Preliminary data shows that the pandemic has amplified substance use disorder, with reports of more than 80,000 overdose deaths in the United States in the past year, the highest number of deaths ever recorded. Experts at the CDC suspect that the intensification could be due to a disruption of daily life and increased stress.
So, as attention on COVID-19 weans, lawmakers have begun to look again at the opioid epidemic. One of the bills up for discussion in the United States Congress is the NOPAIN Act—which stands for Non-Opioids Prevent Addiction In the Nation.
The bill aims to encourage insurance companies to expand options for pain relief by targeting Medicare. If this bill is passed, Medicare patients would have more access to non-opioid choices. The WVU Medicine Center for Integrative Pain Management in Morgantown, also known as the WVU Medicine Pain Clinic, offers these options to their patients. Dr. Rick Vaglienti, director of the clinic, said this bill could go a long way in helping their Medicare patients get more comprehensive care for chronic pain.
“The problem is, there’s not a whole lot of research about these types of treatments and their long-term positive effects, and so the biggest obstacle that we face is getting the insurance companies to buy in,” explained Dr. Vaglienti, “Because it does cost, and actually, in all fairness and honesty, it’s much cheaper to prescribe opioids than it is to do an integrative pain management program. So that transition has to occur before we’re going to have any success.
Non-opioid pain relief can be anything from physical therapy to ibuprofen. According to Dr. Vaglienti, the WVU Medicine Pain Clinic combines specialties such as massage therapists, nutritionists, dietitians, and counselors to treat the whole person, rather than just treating the pain.
“It’s not just that my back hurts. It’s that my back hurts and I can’t work and I’m having difficulty with my family and friends and therefore I feel down in the dumps and all of that adds together to lead to a bad outcome,” Dr. Vaglienti explained.
Besides financial, there are many reasons why non-opioid options might be overlooked when a patient has chronic pain. Sometimes a patient is unaware of those options in order to request or seek them out.
“I think once people become aware that this is the trend and start to request this type of care, then the payers will have to come along, and when that occurs, then it will be the norm,” said Dr. Vaglienti.
The NOPAIN Act does not limit the prescription of opioids, but supporters hope that by incentivizing non-opioid options, less opioids would be prescribed overall. According to a study from 2019, more than a third of people who misused pain relievers in 2018 got a prescription from a healthcare provider.
But the danger of prescription opioids extends past the people who are prescribed the medication. In the same study, about half of the people who misused pain relievers received the prescribed medication from a family member or friend. A non-partisan coalition called Voices for Non-Opioid Choices believes that more can be done to prevent opioid addiction before it starts.
“Congress, over the last several years, has spent hundreds of billions of dollars on the opioid epidemic, and many of those dollars have been earmarked for things like Naloxone availability, support for first responders, training of the mental health workforce and things that are helpful for individuals who may already suffer from substance use disorder,” Chris Fox, Executive Director of Voices for Non-Opioid Choices, said, “What Voices and our members and the NOPAIN Act really focus on are those opportunities to prevent addiction before it starts.”
U.S. Rep. David McKinley(R-1st District), Sens. Shelley Moore Capito(R-WV), and Joe Manchin(D-WV) were involved in introducing NOPAIN Act bills in the House and Senate. McKinley said this is just one in a series of bills he plans to introduce this year that address the opioid crisis.
“It’s a cancer that has not gone away, and what happened over the last year and a half is we got distracted—understandably distracted with a pandemic of COVID, but at the same time, people were dying across this country from substance abuse,” McKinley said.