But recently, some states have been taking steps to limit the sort of largesse that drug companies can pass to physicians. In Minnesota, for instance, the state ruled that pharmaceutical salespeople could not give more than $50 in free food to doctors per year. One pharmaceutical sales rep I know in here in Florida sat down and cried buckets when she saw laws changing. “There goes my career!” she cried. “Without freebies, I won’t be able to get my foot in the door at most medical offices.”

Her fears, it must be admitted, were justified. A study has shown that doctors in Minnesota are rejecting pharmaceutical sales visits more than anywhere in the country.

I didn't have to be psychic to  see that pharmaceutical companies would ferret out new ways of making sure their pill is the drug of choice when a doctor sits down to write a prescription. And today, I got my first glimpse of one of those new ways. I just saw a television ad for the Orencia Promise Program from Bristol-Myers Squibb. Orencia is a new drug for people suffering from moderate to severe Rheumatoid Arthritis.

In a nutshell, the Orencia Promise Program is a co-pay program for new Orencia patients with private insurance. The program will pay the full co-pay for Orencia for the first 6 months of therapy. In addition, if you're not satisfied after 6 months, the program will pay your first co-pay of another RA medicine, up to $500 (Some restrictions and exclusions may apply. If you're interested in the Orencia Promise Program click their name to visit their web site.)

On the one hand, I’m pleased to see pharmaceutical companies throwing their money at patients for a change. While they’re at it, how about inviting us to some of those fine restaurants and weekend trips to Disney World for “educational seminars”? I could use a new laptop, too!

On the other hand,  I’m worried that bribing —err, “rewarding” patients could turn out to be an even bigger threat than the old method of rewarding doctors. With the world economy swirling down the toilet,  how many RA patients will be tempted to change therapies just to get their prescriptions—any  prescriptions—free for 6 months?

Doctors are influenced by their patient’s requests.  “Naturally I want patients to be involved in their own health care,” one doctor told me. “If they express interest in a drug with potential benefit and I see no contra-indications, I’m inclined to let them have a trial of it.”

But this tactic of throwing money at people to get your drugs in play is the same old double-edged sword. It’s only that this time, the sword is being passed to the patient. As a pain patient, what’s your take on this issue? Use the comment box below to state your opinion. Meanwhile, I'll be on the phone to Bristol-Myers Squibb to see if that link I provided to their website  is worth a new laptop to them.

### Bonnie Boots recovered from totally disabling chronic pain, but still has occasional days when she feels like hell. That's why she publishes Pain Health News, providing information, motivation and conversation to people challenged by chronic pain.

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What?!!

Well, he may not have said exactly that, but my doctor did point out that my lab tests show I'm far healthier now than I was a year ago…and I say my improved health illustrates that a bad economy can be good for pain patients.

I know that's the opposite of what many people are thinking right now. With the world economy in turmoil and no quick fix in sight, it's easy to let your mind run away with "stinking thinking."

Stinking thinking is what Alcoholics Anonymous labels the type of negative, fatalistic thinking alcoholics often go through when they reach for recovery. It's thinking that says, "Thing's can't possibly get better. They'll only get worse."

People who are challenged by chronic pain can be just as prone to stinking thinking. Lately I've been hearing from pain patients who are terribly fearful of the declining economy and what it will mean for them. While I'm fully aware of the dangers of a world economy in recession, I'm also fully aware that stinking thinking can amplify those dangers-not just in our thoughts, but also in our reality.

Once you let fear get a grip on you, things start looking worse. Before you know it, fear is leading you to make bad decisions, and soon things don't just seem worse. They ARE worse! So let's put the boot to stinking thinking by making a list of all the things that can and will be better because of a shrinking economy. Because believe it or not, there ARE benefits to having less disposable income.

Benefit Number One: Many pain patients will start asking their doctors to help them cut down on prescription medications. I'm already seeing news headlines that indicate the numbers of prescriptions being filled is falling, a clear sign that people hard pressed for cash are cutting back on medications.

This can easily bring to mind fears of people suffering because they can't get needed meds.  (And if this is you, check here for helpful resources.)

But let it also bring to mind the number of people who will suddenly find they've been improperly or overly medicated. As I've said before, I was overmedicated for two whole years; time that drifted by as I sat bathed in the blue light of the television, drooling in my own lap. When my insurance benefits finally ran out, the doctors who'd been treating me wished me "Good luck!" as they slammed the door in my face.

I was desperate, afraid and depressed…until the morning I woke up and discovered the last of my medications had worked their way out of my system. For the first time in years, I was thinking clearly. With my brain function restored, I was able to seek out new resources and new methods of treatment and take my first real steps toward recovery.

When I worked as an organizer of self-help recovery groups, I frequently helped people make written lists of all the medications they were taking so that a pharmacist or physician could review it with them. It was alarming to discover how many people were taking 12 or more medications-often a warning sign a person is overmedicated or at high risk for negative interactions. In many cases, this happened because Doctor A didn't know what Specialist B had prescribed, and vice versa.

If the cost of prescriptions is becoming a burden for you, take this first step. Make a complete list of all your medications, including over-the-counter and herbal remedies. Review everything you take with your doctor, your pharmacist or a qualified giver of second medical opinions to make sure all of your meds are necessary, that you have the proper dosage and that there are no negative interactions. You may be pleasantly surprised at what you can save-both in terms of money and your health.

Benefit Number Two of living with a weak economy: Many people will start taking better care of their own health. We all know the rules of healthy living: exercise, don't smoke, drink in moderation, eat lots of fruits and vegetables, and avoid fattening foods and empty calories. 

But knowing those rules is one thing. Following them is another. For most of us, our weaknesses are attempts to help ourselves. Smoking helps some people feel calmer, and they can't motivate themselves to quite if they don't have an alternative resource.

For others, eating empty calories helps them find a little comfort in an uncomfortable world. They'll find it difficult to quit if they can't find another source of comfort.

But with the cost of everything soaring, many people are finding that the pain in their wallet is overriding the comfort of smoking or overeating.

I've felt this myself. My doctor had warned that my cholesterol was creeping up and I might need medication to control it. I was ashamed. I knew my creeping cholesterol was likely related to my fondness for dining out. But a fine meal seemed like such a small pleasure to give myself. Especially, I rationalized, when I work so hard!

A former food writer, I know my way around a kitchen, especially if that kitchen belongs to any of the best chefs in Florida. I've paid a price, especially around my waistline, for writing about all the best restaurants, but I couldn't get myself to slow down until dinner tabs starting resembling the national debt.

One day, I looked at an eye popping check for a dinner I could easily have made at home for just a few dollars and said "enough is enough." Now I'm back home on the range, cooking from scratch, which is benefiting both my wallet and waistline.

My cholesterol level and blood pressure are now something to brag about. And I've rediscovered the pleasure I used to take in cooking, back before I started letting chefs do it for me.

Cutting back on restaurants was always an option I had, but not one that appealed to me until prices crept past my comfort zone. Cutting back on prescriptions was not something I even considered until my insurance benefits dried up. Yet each of these-once I was pushed towards them– had real and instant benefits for me.

This recession will have consequences for everyone.  Let's remember that many of those consequences will be good ones–especially for pain patients. We'll eat healthier. We'll quit smoking. We'll take fewer medications. We'll explore alternatives to high-priced and inadequate medical care and we'll even make all sorts of new discoveries about what we-and the world-are capable of, all because we're being pushed to it.

If you're finding some aspect of your life is improving or you plan to make positive changes because of the recession, I'll welcome your sharing in the comment boxes.  Let's remind each other that even in a bad economy, we can choose to find good news. I'm Bonnie Boots, and that's what I think!

### Bonnie Boots publishes Pain Health News to provide information and motivation to people living with chronic pain.  You can stay in touch with her by typing your email address into the subscribe box in the upper right corner of this page.