Executive Summary
Migraine is one of the few conditions that leave patients in excruciatingly debilitating pain regularly, yet it is not considered to be a sufficient reason for prescribing opioids. The observed lapse in the current policy appears to be highly unfair since patients with chronic and complex migraines suffer intense pain that cannot be alleviated with the help of regular painkillers. Therefore, the Texas Compassionate Use Act, which regulates the process of prescribing opioids to patients, must be altered to cover the issue of chronic and complex migraines as some of the conditions that require opioid-based treatment. The described change will allow improving patients’ quality of life and recognize their dignity and human needs.
This paper will look at some of the crucial benefits of the proposed policy of including migraines into the list of disorders covered by the Texas Compassionate Use Act, as well as an overview of the expected costs associated with the implementation of the said policy. Although the proposed initiative will require a significant amount of cots due to the expenses associated with renting and the purchase of the necessary medications, it is likely to open an opportunity for remedying the drug misuse issue as one of the major public health concerns within the U.S. community.
Background and Significance
Statement of the Issue or Problem
Treatment of conditions that do not allow for complete recovery and involve regular and continuous painful experiences require appropriate treatment involving the use of painkillers and, particularly, opioids as the means of improving the patient’s quality of life. In Texas, the provision of medicinal cannabis as the source of relief for patients that find themselves in constant immense pain applies to the following conditions: “seizure disorders, multiple sclerosis, spasticity, amyotrophic lateral sclerosis, autism, terminal cancer, or an incurable neurodegenerative disease” (“Texas’s Compassionate-Use Program,” 2015, para. 2). While the described provision appears to be reasonable, it fails to cover chronic and complex migraines, which do not fall under the umbrella of neurogenerative disorders (Einstein, 2018). However, since long-lasting, debilitating pain is one of the key symptoms of chronic and complex migraines, failing to include the specified condition in Texas’s Compassionate-Use Program implies failing to address the core needs of a vulnerable group. By introducing a policy that allows prescribing medicinal marijuana to patients with migraine, the Texas state health authorities will be able to address a crucial public health issue.
Background and Significance
There is a doubtless urgency in addressing the existing policies on migraine management by introducing patients to the opportunity to use medicinal marijuana. According to Burch et al. (2018), migraine occurs in one in six Americans. Furthermore, Burch et al. (2018) study clarify that women are particularly prone to chronic and complex migraines, with one in five women suffering from the specified disorder. Nevertheless, despite the extremely high prevalence and incidence of the specified disorder in U.S. citizens, some states, including Texas, do not provide patients with migraine with access to medicinal marijuana as one of the most effective ways of relieving otherwise unstoppable pain (Baron, 2015). The described situation signifies a severe lack of insight and concern for the well-being of patients with chronic and complex migraines, which is why revisiting Texas’s Compassionate-Use Program to include migraine into it is vital.
Information Pertinent to the Issue
For the described purpose to be achieved, a media campaign aimed at promoting the inclusion of migraine into the list of disorders that Texas’s Compassionate-Use Program 2015 covers will be needed. Namely, the creation of new outlets for providing patients with medicinal marijuana will be suggested as a possible solution, which will require taking extra costs for renting a building and purchasing the necessary equipment and tools (Hall & Lynskey, 2016). For instance, the interior of the shop will have to incorporate the necessary items, including stands for products, tools for accurate measurement of the drug in question, and other essential equipment and elements of the interior.
Furthermore, newly hired staff members, who will ensure that patients with chronic and complex migraines are provided with the recommended dose of opioids, will have to be hired. Presently, it is expected that to achieve the set goal, at least five new pharmacists will have to be hired and paid a monthly average salary of $10,000 each. In addition, five assistants, each paid $7,000 per month, and ten other staff members with a median salary of $5,000 per employee will be recruited. Therefore, the total cost for the described project will amount to $103,000.
Finally, it is crucial to establish complete transparency regarding the prescription process, key transactions, and purchase of the product. Thus, the instances of fraud, such as selling or buying cannabis illegally and without the corresponding prescription, will be avoided. The necessity to maintain compliance with the existing legal standards is also dictated by the need to keep the outlets functioning so that patients with chronic and complex migraines could receive regular support and have access to the medication that will relieve them of their debilitating chronic pain.
Policy Options, Position Statement, and Recommendations
The proposed policy options include the opportunity to purchase medicinal marijuana to alleviate the pain that cannot be managed otherwise. The described state of affairs proves to be highly unfair and unethical since it suggests that some instances of unmanageable pain are prioritized over others, which should not be the case given the principles of equal rights and freedoms, including the right to dignity. Indeed, when deprived of the opportunity to manage their pain accordingly and forced to suffer instead, patients with chronic and complex migraines are discriminated against on the basis of the nature of their condition. For this reason, the policy amending Texas’s Compassionate-Use Program 2015 and including migraine into the list of conditions that warrant medicinal drugs is overdue.
In turn, when developing the policy in question, one should consider a flexible approach that allows exerting a significant amount of control over the management of the dispensaries to prevent drug misuse while also providing patients with access to the available recovery options. Furthermore, the position statement of the suggested policy can be summarized as the need to ensure patients’ dignity and the right to receive appropriate treatment that will allow them to maintain the required quality of life. Specifically, for patients with chronic and complex migraines, the specified position statement involves the demand to change Texas’s Compassionate-Use Program 2015 so that it could include chronic and complex migraines as one of the conditions that warrant prescription opioids (“Texas’s Compassionate-Use Program,” 2015). To achieve the specified goal, it is recommended to focus on creating a bill that will recognize the validity of the claim that migraine is a condition with aggravating and excruciating pain that must be managed by providing opioid-based pain relief.
References
Baron, E. P. (2015). Comprehensive review of medicinal marijuana, cannabinoids, and therapeutic implications in medicine and headache: what a long strange trip it’s been…. Headache: The Journal of Head and Face Pain, 55(6), 885-916. Web.
Burch, R., Rizzoli, P., & Loder, E. (2018). The prevalence and impact of migraine and severe headache in the United States: Figures and trends from government health studies. Headache: The Journal of Head and Face Pain, 58(4), 496-505. Web.
Einstein, D. J. (2018). Compassion and compassionate use. Journal of Clinical Oncology, 36(29), 2969-2971. Web.
Hall, W., & Lynskey, M. (2016). Evaluating the public health impacts of legalizing recreational cannabis use in the United States. Addiction, 111(10), 1764-1773. Web.
Texas’s Compassionate-Use Program. (2015). Guides.SLL.Texas.gov. Web.