By Pat Anson, Editor

Nearly two-thirds of health journalists believe the treatment of chronic pain is a major cause of the opioid epidemic, according to a new study that suggests many reporters are biased or ignorant about the true nature of the overdose crisis.

“The CNN Effect: The Mediaization of Pain Policy” was released by the PAINS Project, a coalition of patient advocates and pain management experts that seeks to make chronic pain a public health priority. “The CNN Effect” is a term first used in the 1990’s to describe the impact of 24-hour cable news on public policy.

“One of PAINS’ foundational working assumptions is that the media shapes public perception, public perception translates into votes, and votes equal public policy,” the PAINS report explains. “This theory can also be applied to public health policy related to both chronic pain and the opioid crisis.”

To test that theory, PAINS worked with Mugur Geana, PhD, a professor at the William Allen White School of Journalism at Kansas University, in a survey of over 1,000 health journalists who cover chronic pain or the opioid crisis.

While the response rate was low – only 193 reporters and editors completed the survey – the results do provide some insight into the mindset of journalists and how they cover opioid stories.

The survey’s major finding was that many journalists believe there is a direct relationship between chronic pain and opioid substance abuse – even though studies have shown that it is relatively rare for pain patients to become addicted. Sixty three percent of the journalists surveyed believe that chronic pain was a major cause of the opioid epidemic and over a third (36.5%) believe that overprescribing of opioids by doctors was the primary cause.

Most of those surveyed also believe that opioid abuse is a bigger public health problem than chronic pain, even though pain patients outnumber opioid abusers by a 50 to 1 margin.  Nearly 70% “strongly agree” that opioid abuse was a major problem, compared to less than half who think chronic pain is a major problem.

“Another interesting finding was the very low use of people living with chronic pain as drivers or main sources for stories - compared to medical and academic sources, for example. We keep hearing from patient advocates that their stories seldom make it above the fold (if they make it in the paper at all), and that was reflected in our findings,” Geana said in an email.

Asked what primary sources they used to prepare stories, about 70% of health journalists said they turned to “medical experts” and nearly half said they used local, state or federal agencies. Only about 20% said they used “anecdotal stories from patients” as a primary source.

“Of particular interest to PAINS was evidence that patients are not considered ‘expert’ resources by health journalists. People living with chronic pain seem to be approached only to provide illustrating examples for stories that are driven primarily by information from other published articles/stories, academic sources, and data provided by federal agencies,” the PAINS report found.

“Although the low response rate does not allow conclusive results, this study does imply a bias among healthcare journalists and the need for pain advocacy organizations to help those reporting on these issues to engage with articulate chronic pain patients who can relay their experiences in a way that journalists/reporters find authoritative. Otherwise, reporting on chronic pain and the opioid crisis will continue to be what could be called an ‘echo chamber.’”

The CNN Effect

One example cited by PAINS of the “CNN Effect” was a 60 Minutes report last year that was highly critical of a law passed by Congress that limited the ability of DEA agents to investigate companies that distribute pharmaceutical drugs. After the report aired, Sen. Claire McKaskill (D-MO) invited former DEA investigators who appeared in the 60 Minutes segment to speak at a roundtable discussion on the opioid issue with her Senate colleagues.

PAINS asked Sen. McCaskill and her staff to include medical experts and pain patients in the roundtable and was turned down.

“Initially, we were told that it was simply too close to the date set to extend additional invitations. PAINS sent her staff a list of five highly qualified individuals to participate in the roundtable and offered to facilitate their participation. In response, PAINS’ Director was invited to attend, contingent upon Senator McCaskill’s approval. Two days later the invitation was rescinded,” the PAINS report said.

McCaskill recently released a report that was sharply critical of patient advocacy groups and medical pain societies for accepting nearly $9 million in funding from opioid manufacturers. Among the groups mentioned was the Center for Practical Bioethics, a non-profit closely affiliated with the PAINS Project, which received $163,000 from opioid makers.

“These financial relationships were insidious, lacked transparency, and are one of the many factors that have resulted in arguably the most deadly drug epidemic in American history,” McCaskill's report alleges.

As PNN has reported, McCaskill has received over $6 million in campaign donations from law firms since 2005, including some currently involved in litigation against opioid manufacturers. According to OpenSecrets.org, contributors affiliated with the law firm of Simmons Hanly Conroy have donated over $300,000 to McCaskill, who is running for reelection this year.  

Simmons Hanly Conroy represents dozens of states, counties and cities that are suing Purdue Pharma and other drug makers over their marketing of opioids, and stands to pocket one-third of the proceeds from any settlement, according to reports.