Will Oregon's plan to eliminate opioid prescriptions for chronic pain medicaid patients increase the requests for assisted suicide.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Steven Ariens (Pharmacist)

The National Pain Report published an article by pharmacist Steven R Ariens examining the policy of the Oregon Health Authority to stop prescribing opioids to chronic pain medicaid patients in 2019.

The article outlines the issue:

A proposed policy that would restrict Oregon chronic pain patients on Medicaid access to opioids for chronic pain as reported by the National Pain Report and others have created a stir in the chronic pain community. Columnist Steve Ariens, a retired pharmacist and spouse of a chronic pain patient submitted this opinion.

Oregon is set to eliminate all opiates from being prescribed for all chronic pain and Fibromyalgia patients on Medicaid by 2019. The Oregon Health Authority is considering expanding coverage for alternative therapies like aqua therapy, mindfulness and acupuncture.

Ariens argues that there is not enough data proving the effectiveness of alternative therapy but there is significant data proving the effectiveness of opioid use for chronic pain:

“They” tend to ignore and/or discount studies that have found that patients were found to be functioning quite well after 10 or more years on generally stable opioid dosages, with the vast majority of patients able to care for themselves, drive their cars etc.

“They” also tend to discount the reports that opiate prescriptions are down about 25% from their peak in 2011-2012.  While during the same time opiate OD’s have almost DOUBLED and the typical OD has 4 to 7 different substances in their toxicology report–including illegal Fentanyl analog, Heroin and Alcohol for “starters”. Most likely those ODs are not chronic pain patients who are using the opioid therapy to improve their individual quality of life.

Ariens then makes two points that are crucial to the issue, that being assisted suicide is legal in Oregon and the Oregon budget has a $1 Billion shortfall. Ariens states:

Also, Oregon is one of a handful of states that has a “death with dignity” law allowing terminal patients to elect to end their life with assistance from their prescriber. When pain is not treated, bad things can happen. It can delay healing, decrease appetite, increase stress, disrupt sleep and ultimately cause anxiety and depression While these adverse physical health outcomes may make the patient eligible for using Oregon’s “death with dignity law”. Of course, if a Medicaid patient elects to go down this path, the Medicaid system stands to save untold tens of thousands of dollars in expenditures for these patients if they did not exercise for this option.  

• There is no effective oversight of the Oregon assisted suicide law. 

It is reported that Oregon has a $1-billion annual budget shortfall. Are these bureaucrats in Oregon working under the false pretense that if they curtail the prescribing/dispensing of legal opiates it will cause a dramatic reduction in the demand and addiction to opiates?

I am convinced that ending opioid prescriptions for medicaid patients in Oregon will lead to more requests for assisted suicide. When pain is not effectively controlled, people will experience greater levels of illness which will often lead to people becoming more desparate.

Assisted suicide is a cheaper alternative to treatment. Dead people don't require care.