Just a week or so ago, I was asked about the new education requirements for physicians who wanted to prescribe certain opioids. I checked and found that in most places, there still aren’t any.
That surprised me, because I’ve noticed increased caution among the practitioners I work with, not just for opioids but for benzos such as Valium and Xanax. But I guess that was due to media coverage, or concern over potential liability.
Meanwhile, the battle over painkillers rages on. Despite the collateral damage, Big Pharma seems determined to preserve the market for its products, through sophisticated lobbying. In today’s politics, that means large infusions of cash, old-fashioned political pressure, and employing surrogates– often advocacy nonprofits formed for that purpose. It’s these surrogates who carry the message to an increasingly skeptical public.
Here’s a fascinating article that appeared just recently, courtesy of the Associated Press.
I’ve rarely criticized big for-profit corporations for doing what they’re intended to do– which is make money for their investors, large and small. I get that, and I certainly wouldn’t expect them to abandon their mission in favor of what I happen to think is the public’s best interest. But it does seem as if there are steps we could be taking, that for some reason– we still haven’t.
I liked the plan laid out in this article. A brief summary:
- Avoid using opioids for acute pain unless indicated.
- Limit the number of pills
- Make a time-limited plan for use
- Reevaluate before refilling
- Revise outdated policies at the state level
- Track trends, including prescribing, ODs, and SUDs
- Talk with the patient at every refill visit.
- Use a gradual taper to discontinue medication.
- Consider taxing painkillers to raise funds for addiction treatment.
OK, that last one will raise some eyebrows, but do you see anything at all among the rest that seems terribly unreasonable?
Neither do I.