Is Limiting the Use of Painkillers in ERs the Answer?

Without question, prescription drug abuse is a significant problem and we must take serious steps before the problem we’re facing gets even worse.

The mayor of New York City, Michael Bloomberg, believes that limiting the availability of opiates in emergency rooms is something that can be done that will help.  He recently created a new set of guidelines to be used by hospitals all around the city that limit the distribution of opiates.

These guidelines no longer allow emergency room personnel to prescribe drugs like oxycodone, fentanyl or methadone for long-term use.  These are long-acting opiods that are heavy duty painkillers.  If a doctor in an emergency room believes the drugs are medically necessary, they are only allowed to write prescriptions for a 3-day supply of these drugs.

Doctors in these ERs are also not allowed to refill prescriptions where the patient claims the drugs have been lost or stolen.

The team responsible for putting together the new guidelines for Mayor Bloomberg believe they will allow doctors to treat patients they see who need immediate pain relief, but will also add controls that will help curb the misuse of these powerful drugs.

The Pro Opinions

Those who agree with these new guidelines say that something must be done to combat the misuse of prescription drugs.

Prescription opioids can be as dangerous as illegal drugs like heroin and cocaine if they are not used carefully.  These guidelines are designed to stop people who regularly go to multiple emergency rooms, talking about the same pain, in order to get multiple prescriptions for the same drug.  They believe this behavior will be reduced dramatically when those people realize they will only get 3 days worth of drugs (at best) from each visit.

The Con Opinions

Many doctors have been speaking out about these new guidelines because they are not convinced of their effectiveness in combating the drug problem.

One doctor, who works as an addiction specialist at the Cliffside Malibu treatment Center, said that limiting the use of opiates in emergency rooms will cause substantial problems for people who really need them, and it won’t help combat the drug problem at all.

For example, a patient could see their doctor on Friday and obtain a prescription, but misplace it before they can get it filled that evening.  If their doctor is gone for the weekend, they would need to suffer in pain all weekend until their doctor returns.

These guidelines also don’t take into consideration the many people who use the ER as their primary medical source.  In Bloomberg’s own words, those people “might suffer a little bit”.

Doctors who appose the new guidelines tend to believe the doctor who is currently seeing the patient must have the ability to review and treat the patient on a case-by-case basis.

While these doctors don’t want to be restricted in how they can handle their patients, they also do acknowledge that something has to change.  There has been a mentality that has been developed among both patients and some medical professional that the strongest drug should be prescribed, instead of the weaker drugs that can still handle the pain.   You don’t need to prescribe or receive Oxy when you have a toothache.

These doctors also believe they will lose the ability to practice medicine if the government gets involved and starts limiting their treatment options.

There is No One Answer

Unfortunately, no one has yet determined how we solve this growing problem of prescription drug abuse.

It remains to be seen if Bloomberg’s program of cutting off the source of some of the drugs will help, or if it will just punish some of the people who really need the medication.

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