Pain patients suffer in opioid war
They say they’re ignored in fight to curb addiction
Chronic pain patients and the groups that represent them say the escalating government response to opioid addiction ignores their need for the painkillers and doctors who will prescribe them, leaving some out of work, bedridden and even suicidal.
Tough state laws on prescribing that took effect Sunday, Centers for Disease Control and Prevention dosage guidelines and state and federal charges against doctors who prescribe opioids are an overreaction to addiction, according to several dozen people with unremitting pain who contacted USA TODAY.
CDC researchers said in an article in April in the American Journal of Public Health that they overestimated the number of Americans who have died of prescription opioid overdoses. Because of inaccurate tracking methods, the CDC said, it incorrectly counted many overdoses from illicitly manufactured synthetic opioids, such as fentanyl, as prescription drug deaths.
The CDC had estimated 32,445 Americans died from overdoses involving prescription opioid medication in
2016. The new estimate of fatal overdoses from prescription opioids is 17,087, or
53 percent of the original estimate. Though state laws say chronic pain patients who need medication will receive it, “that’s not what’s happening,” says Lauren Deluca of Worcester, Massachusetts, who founded the Chronic Illness Advocacy & Awareness Group last year after her own challenges getting the opioid painkillers she needed.
The Food and Drug Administration plans a public meeting Monday on chronic pain drug development and the challenges pain patients face in getting the treatment they need.
who knows why they fled from the home country, and the child is in a disadvantageous position to defend themselves,” Toczylowski said.
Meanwhile, the broader legal situation is in flux. A federal judge ordered the White House last week to reunify families within 14 days if the child is under 5 and 30 days if the child is older. The Justice Department has not indicated whether it will appeal. Attorneys involved in the cases said it’s unclear how the order will work in practice and when and how it could take effect.
“We don’t know how the judge’s order is going to play out with reunification of children. What if parents have already been deported?” said Cynthia Milian, a Texas-based attorney at the Powers Law Group.
Given the trauma the children faced in their home countries that led their families to flee, and the pain of being separated from a parent, the expectation that children can mount a legal defense is “unconscionable,” said Benard Dreyer, director of the division of developmental-behavioral pediatrics at New York University School of Medicine.
“It’s certainly grossly inappropriate,” said Dreyer, a member of the American Academy of Pediatrics advocacy committee. “I’m ashamed we’re doing this.”
Leaders at three legal services organizations and a private firm con- firmed that the children are being served with notices to appear in court. They are not entitled to an attorney but rather are given a list of legal services organizations that might help them.
Steve Lee, a UCLA child psychology professor, said expecting the children to advocate for themselves in court is an “incredibly misaligned expectation.”
“That couldn’t be any less developmentally appropriate,” he said, adding that some children may not be mature enough to verbalize a response.
More than 2,000 children who were separated from their parents at the border have been sent to the far corners of the nation to care facilities and foster homes. Officials with the Department of Health and Human Services emphasized last week that the agency is working to unify children with either a parent or a sponsor. But it did not provide a timeline for how long that would take.
“We are working across agencies for reunification of each child with (a) parent or family as soon as that is practical,” Jonathan White, HHS’ assistant secretary for preparedness and response, said in a media call.
HHS representatives said children in facilities run by the Office of Refugee Resettlement receive adequate care, including medical and mental health services, and at least two phone calls a week with family members.
Yet children who are just arriving at care facilities are still not connected with their families, said Megan McKenna, a spokeswoman for Kids in Need of Defense. She said the children arrive at care facilities without a parent’s tracking number, and parents don’t tend to have their kids’ numbers.
After kids arrive in care facilities, HHS officials work on finding a “sponsor” to care for the child, such as a parent, guardian, family member or family friend. Historically, unaccompanied minors — who tended to be teens — found a sponsor in about a month and a half.
But Rachel Prandini, a staff attorney with the Immigrant Legal Resource Center, said finding a sponsor is more difficult now given fears that stepping forward to accept a child could trigger a sponsor’s deportation.
In April, HHS entered into an agreement with law enforcement that requires sponsors and adult family members to submit fingerprints and be subject to an immigration and criminal background check. HHS officials said the process is meant to protect the child.
Immigration lawyers from around the country have been flying into Texas to help represent children and families, said George Tzamaras of the American Immigration Lawyers Association.
It’s impossible to know how many children have begun deportation proceedings, Tzamaras said. “There have been reports of kids younger than 3 years old and others as old as 17.”
Ashley Tabaddor, president of the National Association of Immigration Judges and a jurist in Los Angeles, said unaccompanied-minor cases are heard on a special docket there. She said the judges who take the cases were trained during the last administration on children’s developmental stages, impulse control and making sure the proceedings are understandable to children.
She said in a statement that the court’s work is vital: “This is not traffic court. A mistake on an asylum case can result in jail, torture or a death sentence.”
She said kids seeking asylum tend to make their cases in a non-adversarial office setting with a hearing officer.
But that isn’t always the case, Prandini said. Lawyers might choose a strategy that requires more time in court.
“It’s difficult for adults at times. They go to court and they get nervous before a judge,” Milian said. “Now can you imagine a child having to go before a judge and just explain to them why they’re having to flee their country?”
Toczylowski said her organization is trying to help reunify the families so the children can be tried with the parents.
“The kids don’t understand the intricacies that are involved with deportation and immigration court,” she said. “They do understand that they have been separated from their parents, and the primary goal is to get back with people they love.”