As I’ve been saying for some time now, the game has changed when it comes to the advisability or inadvisability of long-term opioid prescribing for pain. Here are headlines from as recent as today:
“Treating Pain Without Creating An Addiction”
“Long-Acting Opioids Discouraged by FDA as First Pain Option”
“Opioid Pain Drugs to Get Beefed-Up Warnings”
“FDA Moves to Reduce use of Long-Acting Opioid Pain Drugs”
To repeat my message from earlier posts: The science is changing, and if you are prescribing opioid pain relievers to your patients, you’d better change with the science, or the FDA won’t be your problem but the DEA will. And I’m not talking Diversion Control investigators; I’m talking DEA Special Agents, working with US Attorneys and state and local prosecutors to indict you for drug trafficking or worse.
Providers! The medical societies who tell you that it’s OK to treat people for years and years with increasing amounts of narcotic painkillers, that “100 million Americans suffer from chronic pain,” and that opioids will be safe as long as you follow certain protocols, are giving you bad advice. The advice is outdated, it’s feel-good talk that has no hope of effectively addressing a national public health crisis (pain drugs; not pain itself), and I predict it will soon be all but completely invalidated if not outright dismissed as quackery.
Take it from a criminal defense attorney who does not want to see you get indicted or have your license or your DEA registration stripped:
If you are not in pain management now, don’t get into it unless you become a Board-certified diplomate or specialist. It’s too risky a field and there are too many bad apples in it, putting their patients and peers in danger. If you’re in pain management now, make sure you immediately do a self (or attorney-directed) assessment to ensure that you are complying with state and federal criminal law of prescription painkillers – not just what the advocacy group echo chamber tells you is safe or sufficient. And if you are in pain management and under investigation, be as proactive and preventative as you’d tell your patients to be about their own health. Don’t rest on your laurels or close your eyes to the DEA raid-team deploying right now in your parking lot.
It is not too late to achieve and maintain criminal law compliance. The FDA has echoed what the CDC and AMA have already announced: There are too many narcotic painkillers being prescribed by too many doctors for too many patients. With the science and prevailing policy views advancing so rapidly, there is a window of opportunity for you to get current with and even ahead of the patient safety curve when it comes to prescribing opioids. Don’t let this chance slip by.
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