Physicians in Pennsylvania and elsewhere in the U.S. will no longer be prescribing opioids.
Due to the barriers put into place for prescribing opioids, an increasing number of doctors in Pennsylvania and elsewhere in the nation are refusing to do so altogether, opting for easier-to-offer options. The risk of not being in compliance is too significant to warrant continued prescribing of potentially addictive medications.
Earlier this month, the Pennsylvania legislature sent SB 432 to the governor for a signature. The measure requires Medicaid managed care organizations to contact the Attorney General and the Department of Human Services if they believe a controlled substance was prescribed or dispensed unlawfully.
“The biggest hurdle for physicians today is fear,” said Dr. Carrie Delone, Medical Director for Geisinger Holy Spirit Medical Group in Pennsylvania. “This is going to the level that now they’re afraid that they’re going to be thrown in jail.”
“There are real examples of doctors getting in trouble for prescribing narcotics,” said Dr. Jordan Klein, Physical Medicine and Rehabilitation Specialist.
Although it means that they are leery of opioid prescribing, many in the medical community understand the necessity.
“The legislature has to put in laws, because there’s an opioid crisis. There’s an opioid epidemic. People don’t realize this is worse than the AIDS crisis,” said Dr. Klein.
The CDC said there are 192 drug overdose deaths every day, and Pennsylvania still has the fourth highest mortality rate in the country.
“I am totally supportive of the new legislation that has been indoctrinated to help with this crisis,” said Dr. Delone. “And we’ve really seen incredible improvements.”
The Canadian Medical Association Journal noted “first time opioid prescriptions are down 54%, but patients accuse doctors of being too strict.”
Another reason physicians are not dishing out these prescriptions any longer is that they have to take the time to educate patients on the associated risks, including addiction, overdose, and death. Chronic pain patients on narcotics are also required to participate in drug screenings once a month.
“It changes how much time they can spend with each patient. Not only the patients on narcotics but the patients not on narcotics. It’s going to be a load for these doctors to see these patients,” said Dr. Klein.
“Even though they enjoy doing chronic pain practices, they don’t know if they’ll continue to do it, because of the stress they have on this,” said Dr. Klein. “The anxiety, the fear of the DEA.”
As it stands right now, anyone can submit a Suspicious Activity Report to the Attorney General’s Bureau of Narcotics and say a physician inappropriately prescribed to a friend or family member. The agency is then required to investigate.
Of course, there has been some erratic patient due to the decision to stop opioid prescribing.
“We’ve had patients come in and tell our docs, ‘I’m going to shoot you. I’m going to find out where you live. I’m going to burn down your house. I’m going to be waiting for you in the parking lot when you get off work,’” said Dr. Delone.
Dr. Klein agreed, stating, “A lot of times these patients have other comorbid psychiatric conditions that need to be addressed and should be addressed.”