A grand jury in Suffolk County, NY has issued a 100 page report that represents both a thorough historical analysis of the growth in opioid utilization as well as a stunningly broad solution set for addressing the problem. You can find the full report here.
The grand jury was empaneled as a consequence of a horrific crime committed in the county in June of 2011. Four innocent people were murdered during a pharmacy robbery in which the gunman sought not cash, but Vicodin. The grand jury's task was to "complete an investigation into the diversion and dissemination of controlled substances and issues related thereto."
What resulted, however, was a report that will prove itself useful to all of us fighting the problem of prescription drug over-utilization and, I would argue, a decent blue print for attacking the problem from a legislative and regulatory perspective.
A few highlights (emphasis added):
"As previously noted, prescribers must obtain DEA authorization to issue prescriptions for controlled substances. However, there is no prerequisite of specialized training, board certification or continuing medical education required as a prerequisite at the federal or state level. Prescribers are authorized to issue prescriptions for analgesics, having the same addiction potential as heroin, without any specialized training or certification. This is unacceptable."
"Because, over time, chronic pain has become a commonly accepted diagnosis and condition, prescribers are fearful of malpractice suits and repercussions from professional organizations for under-treating pain; in turn, they have responded by overprescribing to ensure that the patient is satisfied with their treatment. As a result, prescribers are issuing more prescriptions for opioids and in higher doses."
"In essence, this highly addictive class of drugs has been readily prescribed for a condition that is poorly understood by practitioners. The explosion of opioid treatment for a poorly defined medical condition lies with pharmaceutical companies whose aggresive marketing of these drugs has persuaded practitioners of their value."
Add this report to your reading list. Great data, well researched, excellently articulated.
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