Opioid-related deaths continue to be an epidemic of crisis proportions. But federal and state agencies are focusing on the wrong target – legitimate prescribing of opioids – and have insinuated themselves into the doctor-patient relationship as never before.
The foundational facts remain undisputed. Opioid-related deaths continue to be an epidemic of crisis proportions. More than 72,000 opioid-related deaths occurred in the US during 2017. (Final results for 2018 are not in yet, but the death rate from opioid overdose is expected to remain relatively flat.)
The opioid epidemic has gained widespread notoriety. And politicians sense an opportunity to gather some easy votes. But the solutions being considered in legislatures across the country impose draconian limitations on the discretionary judgment of prescribing physicians.
For example, the Oregon Health Authority recently proposed to taper the opioid use of all Medicaid patients suffering from chronic pain down to zero.
Dr. Beth Darnell of Stanford University was invited to address the commission considering that proposal. In her remarks, she noted that: “The debate has turned into an argument of opioid yes or opioid no. But it’s not a black-and-white issue. A forced taper to zero may destabilize an individual both medically and psychologically.”
The media is now acknowledging some of the problems that will result from such governmental interference between patients and their doctors.
A Fox News opinion recently asked: “Since when does the government write prescriptions?”. The article goes on to assert that:
New laws are being proposed by more strident politicians. But they overlook the fact there’s a big difference between dependency and addiction. Addiction is substance abuse. It’s compulsively using a drug despite significant negative results.
But dependency does not qualify as addiction. Patients can be dependent upon opioids and still lead normal, productive, and happy lives. There’s no reliable evidence that opioid dependence necessarily produces negative outcomes.
In any event, the federal government has been consistently unable to effectively regulate pharmaceuticals. The federal agency with jurisdiction over prescription drugs is the FDA. The mission of the FDA is to keep unsafe drugs off the market, not to regulate the sale and use of approved drugs.
The only post-approval aspects of pharmaceutical drugs over which the FDA has direct control are labeling and marketing. And even making meaningful changes in those limited areas has been difficult for the FDA.
It took several years, from the late 70s to the early 80s, for the FDA to make relatively insignificant changes in how drug labels describe when a tranquilizer should be prescribed. And labels, of course, don’t really control how a drug is finally used.
One-size-fits-all laws may sound good in a campaign speech. But in real-life applications those laws fail to recognize crucial distinctions. And until the FDA is given some effective means of controlling post-approval distribution of pharmaceuticals, its remedial powers will remain negligible.
It’s clear that no all-encompassing governmental control over how physicians prescribe for their unique and individual patients can ever provide a solution. The 2016 CDC opioid prescription guidelines confirm this principle. Those guidelines strongly encourage physicians to reconsider when and how they prescribe opioids.
But those same CDC guidelines also state that opioid therapy should be continued when opioids provide “clinically meaningful improvement in pain and function that outweighs the risks to patient safety”. In the final analysis, this basic calculus can only be resolved between a doctor and a patient, one patient at a time.
We approach our work armed with tried and true medical techniques and state-of-the-art regenerative strategies bred from sports medicine and the neurological sciences.
The Nuvo team of medical professionals is solely dedicated to minimizing or eradicating pain by resolving the underlying conditions that cause the pain. We are proud that we consistently achieve that goal and successfully enhance our patients’ overall quality of life.
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Read the full article at: www.foxnews.com
