Progress in Fight Against Prescription Drug Abuse Not Enough - And Response (3)

  • Tuesday, September 6, 2016
TMA President Dr. Keith Anderson of Memphis
TMA President Dr. Keith Anderson of Memphis

A new report from the National Safety Council lists Tennessee as one in just four states “making progress” in the fight against prescription drug abuse.

Tennessee meets five out of six positive indicators, according to the report, while 46 states were ranked as either failing or lagging behind.

The Tennessee Medical Association and other concerned stakeholders in and outside of the healthcare community have helped create rules requiring pain management education for prescribers, issued state-sanctioned opioid prescribing guidelines, and strengthened laws regulating pain clinics or pain management services.

We have made good progress and can point to some measurable results.

The Controlled Substance Monitoring Act of 2002 allowed the state to implement a database to monitor the dispensing of certain controlled substances. Data collection began in 2006 and subsequent laws in 2012 and 2016 have enhanced its capabilities.

In Tennessee, the Controlled Substance Monitoring Database has reduced the incidence of doctor shopping, the practice of visiting multiple doctors to obtain controlled prescription drugs, by 50 percent since 2011. It’s much harder now for addicted patients to fraudulently obtain prescriptions from a legitimate healthcare provider.

Data also shows a nearly 8 percent drop in the total amount of opioid prescriptions for pain, and a more than 14 percent decrease in Morphine Milligram Equivalents (MME) from 2012 to 2015. Among Tennesseans between the ages of 20 and 30, MME prescriptions have declined nearly 55 percent since 2011.

But we still have a lot of work to do.

As the number of prescriptions goes down, the number of overdose deaths continues to rise. The Department of Health reported that 1,263 Tennesseans died from overdoses in 2014, compared to 1,062 in 2011. That’s a 19 percent increase.

Leading physicians in the TMA have long advocated for increased funding for addiction treatment, which is sorely lacking across the state. Opioid addiction is a disease. Without appropriate medical intervention, our efforts are not enough to reverse and eventually end the epidemic.

The need for treatment is perhaps most vivid in the neonatal units of hospitals around our state, where, in 2014, more than 1,600 babies were born addicted to prescription drugs because their mothers abused drugs during pregnancy. According to the Department of Health, the number of babies born in Tennessee with Neonatal Abstinence Syndrome increased 285 percent in the most recent five-year period for which data is available.

We have to continue identifying, educating and even penalizing healthcare providers who are overprescribing, inadvertently or otherwise, and keep “pill mills,” clinics in operation solely to write prescriptions for controlled drugs, out of operation. The CSMD, along with stronger regulations for pain clinics and pain management services, has helped, but the more we can educate and monitor doctors, nurses and physician assistants on safe and proper prescribing, the better we will control the supply of opioids in our state.

Patients also play a role. According to the state’s “Prescription for Success” report, 71 percent of addicts said they get their drugs from a friend or relative, the practice of conversion. More than half the time they are simply given away for free. Government-run take back programs are a safe, convenient way to dispose of unused or unwanted drugs and avoid contributing to this growing statewide and national problem. Many local law enforcement agencies coordinate take back programs throughout the year.

We are making progress in the fight against prescription drug abuse, but we are far from winning. We must stay the course on the things that are working, fix or replace the methods that aren’t, and continue to look for new strategies to combat this public health plague.

Tennesseans’ lives depend on it.

TMA President Dr. Keith Anderson of Memphis

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Dr. Anderson,
The fight against Prescription drug abuse is working. The system is taking the drug seekers, abusers, fakers and others out of the pain management clinics so legitimate pain patients like myself and other can have our pain managed with opioids. The plan has frightened many Pain Specialists and has caused individuals with spinal pathologies to be mismanaged resulting in increased pain, loss of productivity and disability. Most, in not all of us have tried and use some of the alternate treatments. Physical therapy, exercise (if able), injections and spinal stimulators.

Your article and associated pictures on your hyperlinked material give the impression that anyone in possession of a prescription of an opioid narcotic is an addict. This is not true and is a sordid attempt to link to two words to mean the same thing.  The new Surgeon General (40 year old) has weighed in on the matter showing lack of knowledge surrounding pain.  Dr. Vivek Murthy was appointed because he was a minority. Not a US Citizen.

The misinformation you and others are putting out are hurting the lives of many older people that are already crippled and struggle on a daily basis.

I would like for you to visit FDA.GOV and search Chronic Pain-2016 meeting materials, science board to the FDA dated 6-13-2016

Much of the Pain Management area is big business. The dorsal column stimulator business is expected to be worth 16 billion by 2017. It is  business model. A patient cannot make an informed consent based on the information given to the patient about the stimulators. If one digs a little deeper you will find that they only work in 60 % of the cases. The number one problem is infection.

The number 2 complaint is that they do not work like the trial.

The information you and others are putting out is brainwashing the layperson.

The #1 risk for addiction is YOUTH. Opioid addiction in those greater than 55 is almost not existent.

I really thing that many political doctors do not understand what real sustained pain is like. It is like an undertaker saying "I know what it feels like to be dead because I work in a funeral home."

Tim Mason

* * *

Kudos to Tim Mason for a brilliant post regarding pain/management for the over 55 crowd.  Mom was 85 when her arthritis became nearly unbearable.  She couldn't walk, sleep, sit, recline...no position helped her.  Her doc put her on pain pills, one in the morning and one in the evening.  For 3 years she was able to get around better and able to sleep.  Things changed when the script was no longer renewable, I had to pick up a new script from the doc every month which wasn't a problem as long as I could get there before the end of their (and my) workday.  This change was put into effect because of the problems within our state, because of those young folks who were either getting their scripts and then selling them or over dosing.  Mom's doc told me one of the biggest problems were younger folks actually stealing "grandma's meds"!  None of these pertained to Mom but she was at the mercy of the addict she didn't know. 

She passed away recently but wouldn't have had the ability to live more comfortably without the pain meds.  Each and every time I read about some moron getting arrested for doctor shopping and selling their drugs I get red hot mad.  Why?  They're on Tenn Care!!!  Mom was on Social Security and I have to wonder why Social Security is more rigid in their scripts than Tenn Care when it's obvious what's going on here.  If you pay any attention to the news at all you'll see those arrested are all under the age of 55 and all go to numerous doctors to get pain meds.  What's wrong with this picture when you have to show ID and sign for pain meds?  How are these people continuing to get their drugs until their arrest????  Does anyone within Tenn Care know how this is happening?

Sue White 

* * *

To Tennessee Medical Association President Dr. Keith Anderson: 

I read your recent letter about the problem of opioid addiction, but I noticed a glaring hole in your comments. You never mentioned the doctors who are being paid by pharmaceutical companies to push products. 

Wouldn’t it be ethical for all doctors to post in their waiting rooms every pharmaceutical and medical device company that gives any financial incentives to the doctors? Include all trips, golfing junkets, “conferences”, money, stocks, and any other category of benefits that gives doctors incentives to push these companies’ products. That means full financial disclosure from doctors — and not just opioids, but all medical prescriptions. Do you, Dr. Anderson, or anyone believe these companies are passing out big bucks to get nothing in return?  

Don’t you think it’s important that nursing homes, hospitals, surgery centers, pain clinics, and all medical services disclose the financial feasts they enjoy from producers of pharmaceutical and medical device companies?  

Aren’t patients entitled to know who’s buttering their doctor’s buns? Wouldn’t that help you in your “quest” to stop the flow of opioids? Wouldn’t that be the first medically ethical step you could make? Couldn’t you require that of your association members to protect patients from unscrupulous doctors whose place profits above honest care? 

Dr. Anderson, to set a good example you can be the first to post that disclosure in your offices and call the media to show your medical ethics and true concern for your patients. You could ask the State Legislature to pass a law requiring full public disclosure and attach civil and criminal penalties for those medical practitioners who hide such information. 

But we both know that’s not going to happen, is it Dr. Anderson? 

Stephen Greenfield

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