AXSchat with Kate Nicholson
Channel: AXSChat
Date: 24/09/2018

Kate Nicholson served in the Civil Rights Division of the U.S. Department of Justice for more than 20 years, practicing health-related civil rights law and securing powerful victories including in the U.S. Supreme Court.  She is currently writing a book about her personal experiences with severe chronic pain.  Kate is also an arts writer and enthusiast who helped found the new non-profit, Tilt West, www.tiltwest.org, recently named by Westword as the “best think tank for arts and culture” in the area.  Kate was a Senior Fellow at Dartmouth College and is a graduate of Harvard Law School.

Kate’s topic is opioid Misuse and the Under-treatment of Serious Pain

“Every news cycle carries a story about the so-called opioid epidemic and the deaths resulting from opioid misuse.  Opioid abuse is a problem that affects 2.5 million Americans and those Americans, many covered by the Americans with Disabilities Act, are not being well served in the current climate.  But there is another side to the opioid issue, another pressing disability rights issue that deals with under-treatment of pain.  According to NIH statistics, 50 million Americans have severe of persistent, every-day pain.  That is 25 times more Americans than abuse opioids. Not all of them need opioids, which are a medication of last resort, but many people in serious pain require pain medicine as a palliative measure or in order to function minimally.  The under-treatment of pain is a serious problem world-wide.

Today in the United States, hysteria about opioid abuse is leading to bad public policy in which doctors, many good quality caregivers, are being prosecuted for providing opioids to people in pain.  And people in pain are increasingly tapered off of their pain medicine – with notable suicides resulting. There is certainly a history of doctors being under-educated about pain, of bad doctors creating pill mills in which pain medicine was too easily disseminated, in which pharmaceutical companies joined in supporting pain studies and encouraging opioid over-prescribing.  But most of that happened in the 1990s, and pain medication prescribing has dropped every year since 2012, while opioid-related deaths are on the rise, mostly due to illicit opioids – especially black tar heroin and fentanyl.   Our public policy is not catching up with this reality – DEA raids of pain doctors and CDC guidance that was designed to compensate for a lack of medical training about pain but is now gaining the force of law are having the effect of chilling pain treatment. “

Kate Says “As a disability rights lawyer for the Department of Justice for 20-years and a chronic pain patient who used opioids, I am concerned that neither group of individuals with disabilities affected by this issue is being well served in the current climate.”