Medical Board Cracks Down On Painkillers
Doctors in New Mexico Must Follow New Protocol
SANTA FE — In a hearing room filled with medical professionals hammering out ways to keep physicians from overprescribing painkillers, a 30-year-old former addict wanted to tell his story.
Vince Griego recounted how a hit-and-run car accident more than a decade ago left him with debilitating back pain his doctor treated with the narcotic Fentanyl.
“Three years he overdosed me,” Griego told the state Medical Board on Friday. “I was never an addict. I have never been an addict. He turned me into an addict.”
The medical board — over protest from some
physicians — ultimately approved regulations Friday aimed at combating New Mexico’s high drug overdose death rate, requiring physicians and other licensees authorized to prescribe controlled substances to perform drug testing, check with a prescription monitoring program run by the state Pharmacy Board and consult with pain experts, if needed, in treating patients with chronic pain.
The new rules also require that part of the doctors’ continuing medical education be dedicated to the treatment of pain and problems with abuse.
Some physicians on Friday decried the loss of discretion in dealing with patients and called the new rules “heavyhanded” after the board decided against merely beefing up guidelines in favor of enacting rules.
Dr. Steven Weiner, the board chairman, said in a letter to physicians that the rules would address a “serious public health crisis,” noting that New Mexico has the highest drug overdose death rate per capita in the country.
“Physicians are just simply going to have to be more careful in their prescribing,” Weiner said after the board meeting.
Dr. Jemery Kaufman, a primary care physician and member of the Taos County Medical Society, said in an interview after testifying that she’s on the “front lines” of the drug addiction and overdose problem in northern New Mexico.
She said the prescription monitoring program run by the state Board of Pharmacy is a “Godsend” in furnishing doctors a way to find out what other drugs a patient has been prescribed.
But Kaufman said the board’s decision to mandate what doctors need to do in prescribing narcotics is “very heavy handed.” She and other physicians said most doctors in New Mexico take precautions in writing such prescriptions. But Kaufman said it is sometimes difficult for physicians to discern which patients are merely acting like they need painkillers.
Emergency room physicians questioned how they could perform the required checks on pat ients in acute pain who need drugs immediately.
“This boilerplate approach does not recognize physicians who are doing the right thing,” said Dr. George Kennedy, an emergency medicine doctor and an assistant professor at the University of New Mexico School of Medicine.
To accommodate concerns involving emergency room cases, Weiner said after the meeting, the board applied the new rules to patients who have been prescribed opiates for more than 10 days.
The board already had guidelines on how patients with chronic pain should be treated, but now physicians will have to follow a specific protocol.
Doctors who prescribe narcotics generally must document the treatment plan in the patient record. They will be required to review that plan and the patient’s health at least every six months, and must check the prescription records reported by pharmacies and physicians to ensure patients aren’t taking additional opiates prescribed by other doctors.
The new rules take effect this fall.
Lynn Hart, executive director of the board, said investigations by board staff had shown that some physicians weren’t following the recommended guidelines.
Last year, the board accused two Albuquerque physicians of overprescribing and jeopardizing the public welfare. As a result, Dr. Barry Maron surrendered his medical license last year. Dr. Kenneth Bull, a psychiatrist, was ordered by the board to stop prescribing pain medications.
Two physicians in Las Cruces currently face disciplinary action after the board earlier this year alleged they were endangering patients by overprescribing controlled substances. The medical board has alleged that 17 patients of one of those physicians died of drug toxicity related to his prescriptions.
Griego, of Villanueva in northern New Mexico, told the board he kicked his drug habit more than two years ago “cold turkey,” after also being prescribed 38 Oxycontin pills a day.
“People need to have a hero like me,” he added.