The Corner

Health Care

Sacrificing Pain Patients to Prevent Opioid Abuse

Bottles of prescription painkiller OxyContin sit at a local pharmacy in Provo, Utah, April 25, 2017. (George Frey/Reuters)

We certainly have an opioid addiction epidemic in this country that requires government action. But I worry that we may sacrifice the legitimate medical needs of patients in severe pain to protect people who abuse these powerful drugs from themselves.

That seems to be happening in California where the medical board has launched aggressive investigations into doctors whose patients died of an overdose — even if the drugs that caused death were not prescribed by that physician. Many doctors worry that this will create a significant chilling effect, leading to legitimate pain patients remaining untreated. From the California Healthline story:

Using terms such as “witch hunt” and “inquisition,” many doctors said the project is leading them or their peers to refuse patients’ requests for painkiller prescriptions — no matter how well documented the need — out of fear their practices will come under disciplinary review.

The project, first reported by MedPage Today, has struck a nerve among medical associations. Dr. Barbara McAneny, the American Medical Association president and an Albuquerque, N.M., oncologist whose cancer patients sometimes need treatment for acute pain, called the project “terrifying.” She said “it will only discourage doctors from taking care of patients with pain.”…

The crackdown on doctors has created fear, said Dr. Robert Wailes, a pain medicine specialist in Encinitas and chair of the California Medical Association’s Board of Trustees. “What we’re finding is that more and more primary care doctors are afraid to prescribe and more of those patients are showing up on our doorsteps,” he said.

As I reported here last year, the same chilling phenomenon seems to be happening in Nevada.

This is most unfortunate. Doctors should not be allowed to use their M.D. license as a cover for drug pushing. But responsible physicians should also not be punished for prescribing aggressively when there is no other practical means of providing effective medical relief. Surely, the benefit of the doubt in judging should go to alleviating pain.

And how’s this for a bitter irony? The same California doctors who could face punishment for prescribing pain pills to a patient outside the standard of care, can prescribe opioids to the terminally ill for use in suicide without worry since the only legal standard for death doctors is to act in “good faith.” Good grief, patients who can’t obtain adequate pain medication because of this aggressive enforcement action could conceivably be driven to seek such lethal prescriptions as the only readily available way out of their pain.

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