When I was in the Army, we did not always have the ability to choose the medical treatment that worked best for us. Soldiers’ treatment options were shaped by military rules, approved medication lists and layers of review. It was not always ideal because those decisions did not always reflect individual needs. But in a combat environment, the military depends on uniform rules, clear command and quick decisions.
That kind of top-down system may be necessary in war. But it makes far less sense here at home. Yet that’s what is happening with the Nevada Board of Pharmacy. State lawmakers are being asked to consider the board’s recommendation to place natural compounds made from the kratom plant in Schedule I, the most restrictive category under state law.
One compound affected by this recommendation is 7-OH, which, like many people in Nevada, and especially veterans, I use to manage chronic pain.
The Board of Pharmacy has an important role. Lawmakers need technical advice when they are dealing with complicated public health questions. But the board’s word should not be treated as a final verdict. Before lawmakers attach criminal penalties to products people use to manage pain, they should look beyond a behind-the-scenes recommendation from an appointed regulatory board. They should hear from the people who rely on these products, examine the evidence and consider less extreme options.
I have lived with chronic pain since my deployment to Afghanistan in 2011 and 2012. Today, I work in construction. The work is long and physical. Pain is part of the job, but mine does not stop when the workday ends. It is there when I bend, lift and climb, and it’s still there when I drive home and try to sleep.
I went to the doctor and tried the prescription opioids I was given. They helped for a while but made me foggy and tired in a way that did not work for construction, where I need to stay sharp and steady.
Eventually, I found a product containing natural 7-OH that helped me manage my pain without making it harder to do my job. I still have bad days and still have to pace myself. But it helps bring the pain down enough that I can work a full day, come home and provide for my family.
The Centers for Disease Control and Prevention found that 8.5 percent of U.S. adults have high-impact chronic pain, meaning pain that frequently limits life or work activities. Applied to Nevada, that suggests more than 200,000 adults here may live with pain severe enough to limit work or daily life. Veterans such as me carry an even heavier burden. CDC data show that 31.5 percent of veterans reported chronic pain in 2019, compared with 20.1 percent of nonveterans. Nevada also faces provider shortages and access barriers, and prescription opioids are not a workable answer for everyone.
That should make lawmakers cautious about narrowing the options available to people living with pain, especially without a plan for what comes next.
The Board of Pharmacy’s process is built for technical consideration by professionals. Those voices matter, but they are not the same as hearing from the people who will live with the outcome. Most people do not know what this organization is, let alone when its meetings are happening or how to participate in them. By the time its recommendation reaches lawmakers, it can look settled even though many of the people most affected were never heard. That’s not good enough.
Lawmakers should require a public process, hear directly from patients, veterans, workers, retailers and health experts, and compare criminalization against regulatory options before banning. Nevada chronic pain patients deserve more than a ban on something they rely on, based on a recommendation from a process that never heard from them.
Randy Gardner is an Army veteran who deployed to Afghanistan in 2011 and 2012 and now works in construction in Reno. He lives with chronic pain.
