I-Team: Telemedicine helps chronic pain patients avoid COVID-19 exposure

I-Team

LAS VEGAS (KLAS) — The coronavirus can infect anyone, but millions of chronic pain patients are especially vulnerable. In Nevada and elsewhere, regulators have eased some of the strict rules that govern how pain medications can be dispensed during this health crisis.

Tens of thousands of Nevadans are among the 20 million chronic pain patients in the US who are terrified of the COVID-19 virus because their immune systems are already compromised due to deadly diseases, severe injuries, or other ongoing conditions. 

Because of the opioid crackdown started by the CDC in 2016, pain patients have been denied care, tapered off their medicine, kicked to the curb. Millions have suffered in silence. Others have taken their own lives as a last resort. Some have turned to illicit street drugs, which has caused overdose deaths to spike even higher.

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Dr. Dan Laird. (KLAS-TV)

Dr. Dan Laird, a pain specialist and attorney, said this about the risk factor for his patients.

“These are patients who live under constant stress due to their pain and because of the discrimination they receive from the health care system, pharmacies, and government.  Many have serious illnesses and complex medical histories, so we see them as being at increased risk” to infection from the coronavirus.

Drug Enforcement Administration agents. (Joe Burbank/Orlando Sentinel via AP)

For pain doctors, it’s almost as bad. Threats of DEA raids and pressure from state medical boards in the last four years have caused many pain doctors to retire or change to another specialty. The end result is, there are far fewer pain clinics and pain specialists  in the US than four years ago. But severe pain caused by accidents or diseases has not taken a holiday.

A typical pain patient is required to show up every month at pain clinics often packed with other patients. They interact with medical staff, undergo exams, and even take monthly urine tests. As the coronavirus spreads, this system is highly risky — for patients and for medical staff.

Pain doctors recognize that offices packed with immune deficient patients is a recipe for disaster. So, as of this month, they have initiated changes in how they do business.

Pain specialist Dr. Dan Burkhead, president of the Clark County Medical Society, told the I-Team  that physicians “must do everything we can to minimize a high concentration of people in waiting rooms.”  

Another prominent pain physician, Dr. Stephen Gephart, said that his practice stopped requiring in-person visits earlier this month in favor of telemedicine — that is, interacting with patients by phone so they don’t have to report to a clinic during the viral pandemic. “We are doing our best to keep both our patients and our employees safe,” Gephart said.


HELPFUL LINKS:
Clark County Medical Society
American Medical Association
Drug Enforcement Administration (DEA)
Pain News Network


The American Medical Association issued an advisory opinion in March, stating that under the circumstances, telemedicine is advisable for pain physicians because it is consistent with social distancing guidelines.

To the utter amazement of pain patients, the DEA issued a similar statement.  On its website, DEA granted exemptions to its strict rules about opioid prescriptions, authorizing the use of telemedicine for as long as the health emergency is in effect. For pain patients and physicians, it’s the first good news they’ve heard from DEA in years. 

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