"One person dies every 19 minutes from a prescription drug overdose in the United States." "Approximately 80% of the world's pain pills are consumed in the United States, according to 2011 congressional testimony...." This from an article on CNN today. The article talks about a proposal by the FDA to tighten control of our old friend Vicodin (aka Lortab, hydrocodone). It would no longer be possible for docs to prescribe the drug and refills for months. The patient would have to go back to the doctor for refills. Wow...what a concept. It also moves it from schedule 3 drug to schedule 2 drug which would put more restrictions on its use.
Its funny, because a couple of months ago I was having this very discussion with one of our docs about this problem and what could be done about it. Her answer: "Who am I to judge whether someone is having pain or not?" The typical cop out. So I told her that the only way this problem will slow down is for the government to regulate it. An lo and behold...its happening.
How will this affect the ER? Who knows. Might not change much. Docs only give out a small amount by prescription anyway. However, they may be less apt to prescribe it now with the restrictions
What a pathetic commentary on doctors in this country who are responsible for this epidemic (Ain't no one else writing those scripts). They couldn't regulate themselves so the government has to regulate them.
Years ago, when I was nearing the end of my training, JCAHO decided that their new focus would be on pain management. "Treat your patients' pain," we were told over and over. "The only one who knows for sure if the patient is having pain is the patient."
ReplyDeleteWere we given even one second of extra training on non-narcotic methods of pain control? Of course not! Some of us researched it, but most of us just wrote more narcs. And now we have patients who won't even try anything but narcs and docs who give them like candy. JCAHO should have left well enough alone.
I keep seeing things that say how docs give out narcotics like candy. I am used to getting the hairy eye if I say anything about pain to my doc and a look of relief when I say I want more PT rather than narcotics.
ReplyDeleteVicodin always reminds of the series, House, where the lead character struggles with Vicodin addiction. This line from the article seems pretty accurate-"...it is easier for a doctor to write a prescription than to explore other effective options to combat pain." If the FDA does begin to regulate prescriptions it'd definitely be a good thing.
ReplyDeleteAs someone who lives with chronic pain, the increase of doctor's visits don't look like a good idea. Increased cost, higher demand on the doctor's time, and it won't stop the pill-mills.
ReplyDeleteFor me, visiting the doctor is a major commitment - it basicly takes the whole day in terms of preparation and recovery, and I need someone to accompany me, which means a family member taking time off work.
Doctors need to manage themselves, and learn when to say no or suggest alternatives. Increased regulation is going to make things much worse for legitimate pain patients.
You definitely get a tainted view in the ED (I worked there for 10 years, and I hear it is much worse now), but as someone with a legit pain issue who has been on the same meds for 5+ years (at a dose my pain doc and PCP both agree is low), I hate the stigma and I hate the increasing hassles to get scripts filled. I already have to submit paper scripts every time and max 30 days per fill (I think my state regs are ahead of federal). I recently had my mail order pharmacy (that I am required to use to get it covered by my private insurance) decide not to fill a prescription because they thought it was a duplicate. Hello, look at the date. They didn't even notify me; I had to call and inquire why it had not been filled. I agree we can't just hand it out, but there are actually people out there you never see, who use this stuff responsibly.
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