Move to restrict painkillers would put onus on doctors
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.