Thursday, May 10, 2012

Something Rotten in the State of Opioid Prescribing

There's something rotten in the state of opioid prescribing...
The New York Times reported yesterday that the Senate Finance Committee has launched an investigation into the financial ties amongst pharmaceutical manufacturers of analgesics, pain "experts," advocacy groups, and organizations that set guidelines for the use of these drugs. 

Tired of partisan politics in Washington?  The letter that went out announcing the investigation was signed by Max Baucus (D-Montana) and Charles Grassley (R-Iowa).  This is a bi-partisan slam dunk.  While I don't have any direct evidence of malfeasance, I'm not the least bit surprised that the committee has chosen this as an area of focus. 

As a quick aside, the Times article quotes Dr. Andrew Kolodny, a psychiatrist in New York.  I mention this for two reasons: 1) I've met Dr. Kolodny and think highly not only of his stance on these issues, but also of the way he communicates his perspective;  2) He leads the Physicians for Responsible Opioid Prescribing, the web site of which is an outstanding resource to get educated on the topic of opioid over-utilization.  We use the videos here at PRIUM for training and we recommend the site as a resource to our insurance and employer clients looking for free, web-based education tools.  Excellent stuff. 

Back to the investigation...

I recently had occasion to discuss the issue of opioid over-utilization with leaders from a couple of these companies.  I brought up the topic of evidence-based medicine and clinical guidelines.  I further explained the growing role of these tools in work comp. I was surprised by two things:
1) The concept seemed completely new to them; 2) the looks on their faces were priceless: it was as if I had committed some unforgivable offense.  Monitor, influence, or perhaps even CHANGE a physician's prescribing habits based on peer-reviewed medical evidence?  Who would do such a thing?

This is an industry that needs to be investigated.  I'm encouraged the Senate is taking action.  This is a public health crisis and it demands this level of scrutiny. 

If nothing else, we're all going to get a really good peek at how this industry really operates.

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1 comment:

  1. They might want to look at what is going on in the urine drug testing industry as well.