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Since 1999 efforts to recognize distinct population groups and the differences between them, when using opioids to treat non-cancer chronic pain and efforts used to combat opioid abuse, have had few if any recognizable differences. Patient populations for both groups have been lumped under a single category for combating opioid abuse and addiction. Chronic pain treatment being an after thought with little regard for the actual impact on patients and the consequences they might suffer.

Reducing the supply side of opioids has been an almost singular perspective in the efforts to slow abuse, addiction and overdose deaths, but such actions have unintended consequences. With prescription opioid production now cut by 50% since 2013, critical care facilities now have routine shortages of essential medications needed to treat injuries and disease, combined with law enforcement efforts to curb prescribing for chronic pain conditions, it's rare to find anyone treated with opioids who's not experienced a forced taper or termination of essential medications.

The results have been horrific with millions of American's suffering a wide range of difficult consequences. Loss of functionality resulting in decreased quality of life, loss of employment and earned income, with some individuals becoming home bound or bed bound and still others, committing suicide rather than face the day to day existence of constant and unbearable pain.

The other component of these efforts has been directed at physicians, but since law enforcement has no jurisdiction on how medicine is practiced, law enforcement has pitted doctor against doctor by using paid consultants to judge the efforts of other prescribing doctors. Those deemed to be high prescribers are prosecuted to the full extent of the law, instilling fear of prosecution and loss of assets through asset forfeiture in those that remain. This latter approach has been wildly successful over the last 20 years and has eliminated as many as 60% of the doctors who once prescribed opioids for chronic pain conditions. The other phase of these efforts was to provide falsified data and opinion through the CDC on treating long term chronic pain, providing justification for State Medical Boards to override FDA prescribing guidelines by setting fixed limits based on Morphine Milligram Equivalents, regardless of patient age, sex, body mass or other comorbid conditions which complicate treating chronic pain.

With the financial support of DPPR members, now more than 12,000 individuals, DPPR is broadening it's efforts by establishing this web sight, The Doctor Patient Forum, to further the mission of helping doctors and patients return to a balanced approach of treating chronic pain. Methods which do not have as their primary or only goal of preventing opioid abuse and addiction. While acknowledging this as a possible complication, DPPR is seeking to restore the rights of physicians to practice pain management based on individual need, without the fear of undue legal complications of treating chronic pain advocated for by the 2016 CDC guidelines. The adoption of these guidelines by State Medical Boards for use by pain specialist as well as all other medical specialties, is a misapplication of the stated purpose of the guidelines.

To these ends, starting in 2020, DPPR will begin developing its legislative action plan to support the following mission goals.

  • Helping Americans deal with chronic and consistent pain without undermining efforts to deter opioid abuse and overdose.
  • Devise a legislative outreach plan to
    • Open a dialogue with federal agencies such as CDC and DEA
    • To recognize the proper use of pain medication on an individual basis and in those conditions where opioids provide a better outcome or fewer risks.
  • Meet with pertinent congressional members to get an idea of what is happening in Washington.
  • To identify and promote legislation which recognizes the greater benefits and lower risks associated with physician autonomy, in weighing treatment choices for chronic pain conditions.
  • To reduce the stigma of fear currently hanging over prescriber decision making, regarding the use of opioids or amounts needed, when treating individuals.

Below is a letter from the Mayforth Group which has been retained by DPPR for these purposes. This letter represents the continued collective efforts of DPPR membership.

January 10, 2020
Presented to:
Claudia Merandi
Dr. Friedman


The Mayforth Group has been active in government relations at both the state and federal level for twenty years. Throughout the years, our core mission has remained the same: provide the best service possible using the communication skills, experience and extensive network of contacts to ensure the client’s message is heard. We are not a law firm that has internal government relations division that dabbles in lobbying and politics; we are exclusively a government relations firm that uses an integrated approach to identify the client issues and seek out the most efficient and successful strategies to resolve them. The client will not be overwhelmed with an account team that is assigned to the work needed; the client will deal directly with Mayforth executives from the start of a contractual relationship right up until the end. Our accessibility is paramount to providing quality service.

Simply put, our strategy is to put the client in touch with the right people, with the right message, at the right time.


Due to the rise in hospitalization and deaths because of the opioid addiction in this country, elected officials, health and community groups, have worked to curtail the use and prescription of many effective pain medications. While the cause has been debatable by many people in this area, there is no debate that the effect has been a loss of option for millions of Americans living with chronic pain.


The Mayforth Group will work with members of the Don’t Punish Pain Rally Organization and national medical personnel to develop an action plan for strategic and targeted federal government relations activity that supports and promotes the organization’s goal of helping Americans deal with chronic and consistent pain management We will work with the organization to devise a legislative outreach plan that will result in getting dialogue with federal agencies such as CDC and DEA to recognize the proper use of pain medication for millions of Americans. We will also identify and promote legislation which recognizes the need for proper pain management and control.

Scope of Work


The plan will include meeting with pertinent congressional members to get an idea of what is happening in Washington as they deal with the improper management of opioids by Americans.

In addition, Mayforth Group will set up meetings with CDC and DEA officials to discuss how their policies have greatly affected those living with chronic pain AND how its effected medical providers fearful of retribution from prescribing pain medication.

Finally, we will use DPPR’s national database to influence legislation that has a direct impact on Americans living with chronic pain. Once we know what legislative initiatives affect us (both in a positive and negative way) we can act accordingly in supporting or defeating proposals.

Lobbying services also include the following: (1) monitoring and tracking of legislative activity relating to pain management and opioid use; (2) reviewing, analyzing and reporting on legislation or administrative proposals of impact, (3) attending, and if necessary, providing testimony at General Assembly committee hearings.


Advocacy organizations like Don’t Punish Pain Rally must be able to effectively identify and communicate with key leaders and stakeholder groups that are connected in some way to their mission. An important first step in communicating is developing a consistent and focused message. Upon working with the DPPR’s leadership team, the Mayforth Group will work in coordination to schedule meetings with key legislative leaders, policymakers, and fellow advocates in order to establish an open line of communication that will facilitate and foster constructive dialogue. The goal of building and maintaining these external relationships will be to promote less restrictive pain medication for those diagnosed with chronic pain.


The Mayforth Group will work closely with the designated representatives of DPPR to devise a lobbying outreach strategy. In doing so, The Mayforth Group will set forth a direct line of communication and shared documentation of activity, outreach and intelligence in order to best determine a strategy to ensure legislative success

In addition, a consistent message will be a vital component of the campaign to ensure legislators are being presented with the most effective and persuasive talking points that will resonate with them and their constituencies. The message development will be a key element to a successful campaign and will be the result of work done previously by DPPR.


The Mayforth Group proposes the following annual fee structure for the scope of work outlined in the section entitled Strategic Plan:

  • $15,000 for legislative work which would commence immediately through March 31st, with a mutually agreed upon extension for the same amount through June.
  • The fee will be payable at the signing of the.
  • The fees referenced above are inclusive of all professional and clerical services as well as any miscellaneous expenses incurred while provided the services set forth in the scope of work.
  • The fee will also cover all travel and lodging.