Move to re­strict painkillers would put onus on doc­tors

Austin American-Statesman - - WORLD & NATION -

In an un­usual move, a state govern­ment is de­vel­op­ing reg­u­la­tions meant to stop doc­tors from pre­scrib­ing higher doses of pow­er­ful — and of­ten dan­ger­ous — painkillers for pa­tients who are not ben­e­fit­ing from them.

The ef­fort, in Washington state, rep­re­sents the most sweep­ing at­tempt yet to stem what some ex­perts see as the ex­ces­sive use of pre­scribed nar­cotics, and it is be­ing closely watched by med­i­cal pro­fes­sion­als else­where. Among other things, Washington would ap­par­ently be­come the first state that would re­quire a doc­tor to re­fer pa­tients on es­ca­lat­ing doses of painkillers for eval­u­a­tion if they were not im­prov­ing.

Ex­perts in pain treat­ment and drug abuse pre­ven­tion say the grow­ing use of long-act­ing painkillers such as OxyCon­tin, fen­tanyl and methadone has been a cru­cial fac­tor in a na­tion­wide epi­demic of over­dose deaths, largely from the abuse of such drugs.

Drug mak­ers and pa­tient groups have said new re­stric­tions would un­fairly pun­ish pain suf­fer­ers who rely on the drugs, while oth­ers, in­clud­ing some doc­tors and reg­u­la­tors, have ar­gued that the drugs are po­ten­tially so dan­ger­ous that they need to be even more tightly con­trolled.

How­ever, the Washington state ini­tia­tive ap­pears to re­flect a grow­ing view that the sta­tus-quo is no longer ac­cept­able. On Fri­day, an ad­vi­sory panel to the Food and Drug Ad­min­is­tra­tion over­whelm­ingly re­jected an agency pro­posal to bet­ter con­trol drugs such as OxyCon­tin as too weak be­cause it did not man­date spe­cial train­ing for doc­tors who pre­scribe such med­i­ca­tions.

The Washington ef­fort is di­rected at con­trol­ling how doc­tors use nar­cotics to treat le­git­i­mate pain pa­tients, not those who il­le­gally ob­tain the drugs for recre­ational use.

The reg­u­la­tions would not af­fect how nar­cotics are used to treat pa­tients with can­cer or those at the end of life be­cause ex­perts agree that such pa­tients should re­ceive as much pain med­i­ca­tion as nec­es­sary.

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