How to Make Change in Chronic Pain Policy

Posted on July 18, 2019 by Amy Coombs

I happened to catch a television interview with Georgia Congressman Buddy Carter on Wednesday. Carter, who is a pharmacist was discussing the Washington Post Story that said six companies “saturated” (their term) the country with 76 billion oxycodone and hydrocodone pain pills from 2006-to-2012.

The Washington Post story is here.

Congressman Carter said that Congress needs to be concerned about overreaction “because we always overreact, and added “some people need these medications—they do work but are highly addictive.”

It caught my interest because I was scheduled to speak with Amy Coombs—who is a lobbyist in Utah who is a licensed social worker/therapist and a chronic pain patient.

We’ve been working on story about why the chronic pain community has been unable to get its point across during the opioid “controversy” which has led us to speak with a number of people who represent groups (or have started groups) that putatively represent the pain patient.

I wanted to find out what Ms. Coombs thought—and she gave some perspective which we’ll discuss in later stories.

She also pointed out pain patients and pain physicians are actually on the same of this issue—government interference in health care and that they should be working closer together.

She also indicated that while there is understandable emphasis on the federal proclamations of the Drug Enforcement Administration, the Centers for Disease Control and the FDA—much of the action is at the state level.

When I suggested—as I have in past articles—that there are really 51 pain strategies (the federal government and each state) she said that sometime it’s more than that given the byzantine way many states and their regulatory boards and commissions dictate pain policy.

But she comes from a point of view that pain advocates need to tell their story better because, by and large, most state legislators and congressional representatives simply don’t understand chronic pain.

“When legislators know, they do better. You can help them learn, but I’ll guarantee you that yelling doesn’t work,” she said.

Coombs thinks there are things that pain patients can do to improve the quality of pain care in their states (and their country)—but first they have to have some basic knowledge.

“Do you even know who your local state representative, state senator or congressional representative is? If not, look them up,” she said.

“If you’re a constituent and live in their district, they are more prone to listen to you,” Coombs said. And by the way, do you know them or do you know people who know them?

“Even better.” She said

“Send them an email.”

First of all, tell them you’re a constituent. That always help make sure they read the email. If there is legislation you are in favor or oppose, tell them.

Be Concise.

Define the issue. Tell them why it matters. And ask for a discussion with the legislator or a staffer. (remember if you are a constituent, you’re more likely to get a meeting.)

Hire a lobbyist

I can hear you now. “How the hell can I hire a lobbyist, I’m broke!”.


But the local AMA, the Pharmaceutical Industry, and others have lobbyists in your state capital—reach out to them. Tell them your story the way you tell your legislator (and copy your legislator)

My problem is not legislation, it is the regulators (Insurance Board, Medical Board etc.)

Even better. Write them a letter of complaint (your physician, your hospital, your insurer) in an email and copy your legislators (and the other way around). The idea here is to create as much discussion as you can with people whose attention you are trying to get.

I’ve got a meeting with my legislator or his/her staff. Now what do I do?

This is important. Tell them your story, not from a point of view of personal “woe”, but from the point of view of you representing other patients. “if this is happening to me, how many thousands of others do you think are having the same problem?”

If it’s legislation—leave a one pager that says why the legislation is good or bad. If you’re just trying to build awareness, let them know how many chronic pain patients there are (100 million) and

I’m not alone.

Prove it. Who are the other pain patients in your legislative/senate or congressional districts? If you don’t know, use the National Pain Report commentary section, contact the U.S. Pain Foundation or ask your pain physician to find other people in your zip code, in your state.

Amy Coombs is there fighting for pain patients (because she is one). There are others, perhaps even in your state. We look forward to introducing you to them.

Amy Coombs, MSW, CSW, CCTP, HRMC

President at Prestige Government Relations & Consulting Group



Amy Coombs, Prestige Government Relations & Consulting Group, Georgia Congressman, Buddy Carter, oxycodone, hydrocodone, Washington Post

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