Tom, you are so right. It's likely ten times worse in FP than pediatrics, but pendulum swinging is greater in medicine than just about anywhere I can think of.
I think, from reading your post, we kinda think alike as far as the drug police goes. I generally think or say, I can diagnose the pain (I hope), I can treat it, but I can't control what goes on once they leave the door. And, frankly, I don't care. Please don't take that the wrong way. I mean it's not good when a six year old isn't getting their Adderall.
Not sure how it is in every state, but Maine has been declared an epidemic as far as deaths due to overdoses. But, the statistics show that 42% of the overdoses stem from mixing Fentanyl with Heroin. I can't remember the last time I prescribed Fentanyl, and I am pretty sure that Heroin is considered CI. Couldn't send it in EPCS, I know that.
They hired nine new DEA agents. Now, we have to have everyone under 100 MMEs by January 1st unless, like you said, they have cancer. Then, they can have as much as they want. And, the patients at the methadone clinic can have as much as they want.
The numbers are staggering, but how much of it is due to doctor's prescribing habits vs. the horrible economy I don't know. I am sure I have started someone on Vicodin or Oxys who has subsequently turned into Dr. House, but I am rather sure I haven't contributed a ton to Heroin overdoses. I get an email from the Maine Medical Association every Monday, and the lead story has been about the opioid epidemic. The Maine Attorney General (I don't think she is a Surgeon General) has given out 1,000 doses of Narcan to law enforcement agencies. Which I am not sure will help a lot. And, now anyone can get Narcan from the pharmacy so they have it if one of their friends has an addiction.
Of course, before all this started Medicaid already had a seven-day rule. You could only get seven days worth of a narcotic before you had to pay for it yourself. So, now, if a patient needs pain meds, they just go on goodrx.com and get 120 5 mg oxys for $15.00.
