Minnesota Considering Price Hikes On Chronic Pain Prescriptions

April 7, 2023 / Thomas Cohn, MD

opioids If you’re dealing with a chronic pain condition, it’s entirely possible that it has impacted your financial earnings ability or led to increased expenses due to extra medical appointments. In other words, chronic pain can be a significant financial burden for many, and that burden may grow even stronger if Minnesota legislators end up passing HF 1728/SF 2142.

The proposal would add additional fees to opioid prescriptions, and these fees would be passed down to the patient. Legitimate medication has become much harder to get now that the US is really attempting to crack down on the rising opioid-related deaths, but for the patients with chronic pain or those with cancer who truly need their medication, not only are they having a harder time getting their prescription, but it may soon be more expensive. Passing these expenses onto the patients will only cause more strife for patients who are already financially burdened by their medical condition.

The Opioid Price Hike Problem

These price hikes would cause much more harm to legitimate chronic pain patients than it would help in curbing the opioid crisis. This is especially concerning because most chronic pain specialists advise their patients not to rely on pain medications as their main form of treatment. As we’ve preached on the blog in the past, opioids can absolutely be part of a comprehensive treatment plan, but they are not a great stand alone option. Doctors know that opioids alone will not address the underlying issue causing the chronic pain condition, so if they are going to prescribe them, they will be used in conjunction with other treatments like physical therapy, exercise or other active treatments. Making it harder for patients to have access to the medications that can make physical therapy more bearable or simply manage cancer-related pain isn’t the answer.

Lawmakers should seriously consider visiting a pain clinic or a cancer ward before they blindly vote to increase the price of opioids for those with a legitimate prescription in Minnesota. The overwhelming majority of patients use these medications responsibly and have a medically necessary reason for seeking them out. These price hikes will be deferred to them and may make it much harder for them to care for their pain condition. They may have to ration their pills outside of their doctor’s orders to cut down on other necessary expenses just to be able to afford their medications. This bill isn’t the answer, and it will put a bigger financial strain on many chronic pain sufferers across Minnesota.

We’ll keep an eye on the bill when it comes up for a vote, but hopefully Minnesotans aren’t further financially burdened by this potential price hike.

Improving Your Emotional Intelligence Can Help Manage Chronic Pain

March 30, 2023 / Thomas Cohn, MD

Chronic pain is more than just a physical issue. While physical pain is the most obvious symptom of chronic pain, an underlying pain condition can also impact our mental and emotional health. While this may make overcoming chronic pain a little more complex, it also offers us more ways to target the totality of the condition. One way to regain more control over your chronic pain condition is by working to improve your emotional intelligence.

But what is emotional intelligence, and how can we try to improve it? We offer some tips on improving your emotional intelligence in today’s blog.

What Is Emotional Intelligence?

Emotional intelligence is defined as a person’s ability to recognize and manage their emotions and those of others. In other words, emotional intelligence describes your ability to identify your emotions and to react appropriately to maintain a positive or neutral mindset. Needless to say, training your brain to identify negative emotions and to find ways to put a positive or neutral spin on them isn’t easy.

That said, for chronic pain patients, chronic pain is one of the most common sources of negative emotions, so if we can improve how we respond to these stimuli, it stands to reason that we may find more control over our pain condition. But how can we work to improve our emotional intelligence?

Improving Your Emotional Intelligence

There’s no perfect formula for improving your emotional intelligence, but if you consider these tips and try to incorporate them into your daily life, you may find it easier to allow your emotions to control your chronic pain condition instead of having them exacerbate it.

1. Acknowledge Your Feelings – It is common for chronic pain patients to bottle up their emotions and try to handle everything on their own, but this can be harmful to the process. Don’t try to run from your feelings and emotions – acknowledge them. Take stock of how you’re feeling throughout the day, as acknowledging your emotions is the first step in improving your emotional intelligence.

2. What Are Your Emotions Telling You? – Next, try to determine why you’re feeling the way you are. It may be pretty easy to figure out why you’re feeling sad or lonely, but don’t stop there. Try to understand what you need in response to these emotions. Do you need time by yourself? A walk to clear your head? A conversation with a good friend? Figure out what your emotions are trying to tell you, and seek out that need.

3. Get Rid Of Guilt – While this point is often easier said than done, it’s important to acknowledge that you should not feel guilty for your emotions. You’re going to have good days and you’re going to have bad days, but make it a point to not feel guilty when you’re having a tough day because of your chronic pain. You have enough on your plate without being burdened by guilt.

4. Reciprocate – Finally, you also want to be aware of the emotions of other people. You want others to recognize and empathize with your emotions, and you should show them the same respect. Try to understand without judgement, because that’s what you’d want from others.

If you can do these four things and recognize how your emotional intelligence can contribute to or fight back against your chronic pain sensations, we’re confident that you’ll be able to gain more control over your pain condition. For more information, or to talk to a specialist about how you can tackle different physical, mental or emotional aspects of your pain condition, reach out to Dr. Cohn and his team today at (952) 738-4580.

Law Change Helps Patients Fighting Chronic Pain In Minnesota

August 8, 2022 / Thomas Cohn, MD

A number of new laws went into effect on August 1, but one law in particular could be a godsend for certain chronic pain patients in Minnesota. The law clarifies and updates how doctors can prescribe medications to patients battling chronic pain, which will make it easier for some patients battling complex pain problems to receive the medications they so desperately need.

The new law came after some concerns developed in the wake of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain. Those guidelines really attempted to reduce opioid addiction and overdose deaths by placing limits and restrictions on the types of medication that patients with chronic pain could receive. However, as we’ve talked about on the blog in the past, chronic pain is highly individualized, so attempting to paint all pain patients with a broad brush stroke and subject them all to the same restrictions was bound to cause problems for some patients.

The 2016 guidelines featured specific numeric thresholds for opioid prescribing, which were later adopted widely and used in regulations and state laws to police opioid prescribing. But these restrictions also had an unintended effect – patients who could no longer get the crucial medication they needed to help with their pain would sometimes turn to the streets for painkillers.

“Many have turned to the streets out of desperation,” said Laura Johnson, a chronic pain patient who spoke to the Minnesota Senate during a spring hearing. “Many more have ended their lives.”

Both the American Medical Association and the Minnesota Medical Association backed up Johnson’s testimony, sending letters in support of a proposed change.

The New Guidelines

The updated guidelines essentially allow doctors more freedom to continue prescribing opioids past the previous threshold so long as they are doing so with a clear purpose and accurate documentation. The revised statute provides new or updated definitions for treating problems like intractable pain, palliative care and other rare conditions. Here’s what they say:

No physician, advanced practice registered nurse, or physician assistant shall be subject to disciplinary action by the Board of Medical Practice or Board of Nursing for appropriately prescribing or administering a controlled substance in Schedules II to V of section 152.02 in the course of treatment of a patient for intractable pain, provided the physician, advanced practice registered nurse, or physician assistant keeps accurate records of the purpose, use, prescription, and disposal of controlled substances, writes accurate prescriptions, and prescribes medications in conformance with chapter 147 or 148 or in accordance with the current standard of care.

No physician, advanced practice registered nurse, or physician assistant, acting in good faith and based on the needs of the patient, shall be subject to disenrollment or termination by the commissioner of health solely for prescribing a dosage that equates to an upward deviation from morphine milligram equivalent dosage recommendations or thresholds specified in state or federal opioid prescribing guidelines or policies, including but not limited to the Guideline for Prescribing Opioids for Chronic Pain issued by the Centers for Disease Control and Prevention and Minnesota Opioid Prescribing Guidelines.

Prescribers are prohibited from tapering a patient’s medication dosage solely to meet a predetermined dosage recommendation or threshold if the patient is stable; is experiencing no serious harm from the level of medication prescribed, and is in compliance with treatment plan and patient-provider agreement.

No pharmacist, health plan company or pharmacy benefit manager shall refuse to fill a prescription for an opiate issued by a licensed practitioner authorized to prescribe opiates solely based on the prescription exceeding a predetermined morphine milligram equivalent dosage recommendation or threshold.

Prescribers and patients are required to enter into an agreement that includes the patient’s and prescriber’s expectations, responsibilities, and rights according to the best practices and current standard of care with agreement to be signed by the patient and the prescriber, and a copy of the agreement included with the patient’s medical record and a copy to the patient, to be reviewed at least annually and when there are any changes to treatment plan.

Absent clear evidence of drug diversion, nonadherence with the agreement must not be used as the sole reason to stop a patient’s treatment with scheduled drugs.

These updated guidelines should ensure that patients and providers who are doing everything in their power to correctly address a chronic pain issue won’t run into problems with access to medications that they need. Hopefully we see these intended results in the near future. And if you need help with a pain issue in the greater Twin Cities area, reach out to Dr. Cohn and his team today at (953) 738-4580.

How Can We Do More For Chronic Pain Patients?

July 7, 2022 / Thomas Cohn, MD

Chronic pain affects more than 50 million people in the US alone, and yet it doesn’t seem to be an issue that is getting the attention it deserves. We need to be doing more for the millions of people who battle a chronic pain diagnosis on a daily basis, but how can we provide better care?

We don’t pretend to have all the answers, but we’re going to use today’s blog to talk about some of the ways that pain care in America and across the globe could be improved.

Solving Chronic Pain On An Individual Level

Let’s first look at the problem on a local level. What can a pain care physician do to help solve chronic pain? They need to focus on what they can do to provide the best level of care to the patients they are seeing in their office. This involves:

Taking the time to listen – Everyone’s pain is different, and there are no one-size-fits-all solutions to chronic pain. Doctors need to take the time to really get to know their patients and their condition so that they can help them find a treatment that works for them.

Don’t go for the quick short-term fix – Opioids can help mask the symptoms of chronic pain, but they won’t treat the underlying issue. As we’ve said on the blog countless times in the past, prescription medications can play a pivotal role in a comprehensive treatment plan, but they should not be the only form of treatment. Doctors should not rush to medicate without pursuing more active treatment methods.

Be ready to pivot – If one treatment isn’t working, it means that doctors need to be ready to pivot to another treatment. As we’ve mentioned, pain is highly individualized, so what works for one person isn’t guaranteed to work for another, and providers need to be flexible in their approach.

Continue to learn – Pain care is always evolving, and pain physicians need to keep furthering their understanding of chronic pain and how to best treat difficult cases. Doctors need to continue to seek out highly credible research in order to provide patients with the highest level of care.

Solving Chronic Pain On A Global Level

Solving chronic pain on a global level will take a more concentrated effort. Obviously there is no simple solution, but there are two main areas we should be focusing on. For starters, chronic pain prevalence needs to become more mainstream. Roughly one in five Americans deal with a chronic pain condition, so odds are a number of your family and friends are fighting an invisible fight each and every day, and many of them aren’t talking about it. We need to combat the stigma of chronic pain and find ways to talk about it so that more people are willing to take the necessary steps to treat their issue head on. Chronic pain patients shouldn’t have to live in the shadows, hiding their pain from those around them.

The other main way to work towards an effective solution to chronic pain is to increase funding for research. As we mentioned above, 50 million Americans battle a chronic pain condition on a regular basis, so there is clearly an audience ready to jump towards more effective treatments. We just need to find them, and the best way to do that is to invest in research programs dedicated to better understanding chronic pain.

If you want to speak to a pain management specialist who will work hard to accomplish those individual tasks and champion the idea of tackling chronic pain on a larger scale, trust your care to Dr. Cohn and his team. For more information or to set up an appointment, give his office a call today at (952) 738-4580.

Four Things Chronic Pain Patients Wish They Knew Earlier

February 25, 2021 / Thomas Cohn, MD

Many people describe their chronic pain management as a journey to find relief, and like any journey, there are things we wish we would have known earlier in the process. In today’s blog, we highlight four things that we’ve heard from some of our patients and others in the pain community that they wish they would have known earlier during their pain journey.

What Patients Wish They Would Have Known Earlier

Here’s a look at four sentiments that many patients say they wish they would have know earlier in the chronic pain management process:

1. It’s Not Just Physical – Chronic pain manifests itself in the physical form, but the underlying cause or contributing factors are not all physical. Chronic pain has strong emotional and psychological roots, so you need to make sure that you’re caring for more than just your physical health. If you’re under a lot of stress or you’re suffering from another mental health issue, it could be playing a role in the onset of your physical pain. If you only focus on the physical contributors to chronic pain, you may be ignoring promising treatment options.

2. You’re Not Alone – Chronic pain can leave you feeling isolated from the outside world, but it’s important to remember that you’re not alone. There are a number of ways to connect with others about your condition to help treat it and fight back against feelings of isolation. You can:

Connect with a pain management specialist for professional help.
Reach out to friends and family members for help or to talk, or to just take your mind of your condition.
Connect with others who are going through a similar situation in an online support group.

Know that you’re not alone in this process and that you should be relying on other people for support.

3. Your Mindset Matters – It’s also important to know that how you approach your chronic pain treatment can have an impact on its success. When you improve your mindset, you improve your outcomes. It’s obviously easier said than done, but try to focus on everything you’re doing to help you conquer your chronic pain, instead of looking at all the ways your chronic pain is affecting your life. You can start to take back control over your condition by approaching treatment with a positive and determined mindset. Talk to your pain specialist if you want extra help improving your mindset when it comes to your pain condition.

4. It’s About The Small Wins, Not Absolutes – We can never say with absolute certainty that we’ll be able to completely cure all aspects of your chronic pain condition, and while that is our goal, that’s not how you should always view your end goal. If you’re only ever focused on the existence of pain and not the fact that it’s getting better or you’re having fewer flareups, you’re only going to be discouraged in the face of progress. This discouragement can negatively impact your treatment and your long-term success. Instead, focus on small wins and celebrate them, and you’ll find it easier to keep on working hard to treat your chronic pain condition.

For more information, or for help with any of the above tips, reach out to Dr. Cohn’s office today.