The Food and Drug Administration announced July 9 that it would not require doctors to have special training before they could prescribe long-acting narcotic painkillers, saying the power to mandate it rested in Congress. This post is brought to you by Physician Disability Insurance.
The announcement arrives after years of deliberations by the FDA into the growing problem of prescription painkiller abuse. According to the Center for Disease Control, prescription painkiller overdoses were responsible for more than 15,000 deaths in 2009. Nonmedical use of prescription painkillers costs more than $72.5 billion each year in direct health costs. And for every overdose from prescription painkillers, there are about 130 people who abuse or are dependent on them.
Major doctors groups such as the American Medical Association fought the idea of mandatory training, saying the programs would be burdensome and could limit the number of physicians to treat pain patients. Add that to the looming physician shortage, and the number of available physicians only shrinks. The FDA will require drugmakers to provide voluntary physician training to teach physicians appropriate opiod use.
It is incredibly difficult to gauge an individual’s level of pain to determine if prescription painkillers are needed. Training programs for doctors are designed to help them identify deceptive behavior by people likely to abuse prescription painkillers. Dr. Michael F. Fleming at Northwestern University’s Feinberg School of Medicine designed an interactive video game with “actor” patients, profiled in the New York Times. Doctors are put through various patient scenarios and trained to look for warning signs such as a history of family problems, and nonverbal indicators such as nervousness, breaking eye contact, fidgeting and finger-tapping.
Proponents of mandatory training say that it would reduce the abuse of prescription painkillers. Others argue that it would be a huge burden to doctors. It is a subjective battle, and blanket changes, opponents argue, could raise the risk of under-medication for patients who truly need the medication.
As a physician, what is your opinion on regulating painkillers? Should it be left to the doctor’s jurisdiction, or the drugmakers? Are stricter regulations necessary? Join the discussion today.
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Source: New York Times