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* From a press release…
The Illinois State Medical Society (ISMS) released a comprehensive plan today to address the misuse and abuse of powerful opioid prescription medications. Due to their high potential for addiction, opioids are classified as Schedule II drugs. ISMS developed the report, Recommendations for Deterring Improper Use of Opioids, for the Illinois House Task Force on the Heroin Crisis, chaired by House Democratic Majority Leader Lou Lang (D-Skokie), as a framework for Illinois legislation.
Illinois physicians suggest taking a pro-active approach to maintain our state’s good standing in the appropriate prescribing of opioid medications. Illinois’ low rate of oxycodone prescribing exemplifies physicians’ cautious use of a powerful medication. Of the total oxycodone prescriptions issued nationwide in 2013, Illinois had a per capita use of only .05, ranking 50th in the United States. By contrast, Tennessee had over six times as much utilization of oxycodone per capita, ranking at third in the nation with a .31 utilization rate per capita.
* Full details are here. A few of the dot points…
· Expanding and strengthening Illinois’ Prescription Monitoring Program (PMP), a statewide data base that prescribers can check to prevent “doctor shopping.”
The PMP is a valuable resource for prescribers to identify patients seeking medication for illicit use. ISMS has identified several strategies to expand the PMP’s use and effectiveness.
Presenting new opportunities for continuing medical education for opioid prescribers.
ISMS supports increasing prescribers’ access to educational opportunities and information by developing the PMP as a vehicle for sharing such material.
Increasing access to naloxone, a medication used to counteract opioid and heroin overdose.
Several Illinois communities have initiated programs to promote naloxone availability; however, it is not readily available without prescription in most areas. Illinois must make naloxone more accessible to law enforcement, family members of at-risk patients and other first responders.
Promoting safe medication disposal sites.
Opioid abusers commonly obtain medication from a friend or family member’s medicine cabinet. Expanding patient education and options for medication disposal will help keep addictive medications out of abusers’ hands.
Most are just common sense. I’m not sure how effective this plan will be. I don’t see any penalties for docs. Your thoughts?
* Somewhat related…
* Docs in the medical pot business can’t recommend their patients to use it
posted by Rich Miller
Monday, Feb 23, 15 @ 10:33 am
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Previous Post: A look at some of the governor’s proposed Medicaid cuts
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This seems to be a pre-emptive strike. Is there a tougher proposal coming down the line?
Comment by Wordslinger Monday, Feb 23, 15 @ 10:48 am
===Illinois had a per capita use of only .05, ranking 50th in the United States.===
We’ve seen a lot of ranking with Illinois fairing poorly compared to other states. Glad to see we’re ranked very well in this category.
What’s going on in Tennessee though? Sheesh, that’s a lot of dope being sold, and it’s all (perfectly legal) drug pushers making the money, as in doctors, pharmacists and drug companies.
Get caught selling heroin in Chicago and you’ll be going to prison. Over-prescribe oxy in Knoxville and your CVS pharmicist will get promoted.
Comment by 47th Ward Monday, Feb 23, 15 @ 10:49 am
From a quick glance I don’t see anything about expanding education about Suboxone, a drug that can ease the withdrawal from opioids while also sending the user into withdrawal if they use opioids simultaneously.
A close friend of mine was able to get clean after years of Oxycodone abuse using this, but I’ve heard of doctors not knowing about this treatment when asked. I’m not a healthcare specialist, but I’d like to hear more from that community on that option.
Comment by Anonymous Monday, Feb 23, 15 @ 10:52 am
People in pain will have a harder time getting their painkillers. A lot of them will sit around, pain limiting their moving around much. This lack of exercise is bad for them in the long run. Pain patients very rarely become addicts.
Drug addicts will still find a way to get drugs, getting heroin and likely an early death from an overdose.
Comment by DuPage Monday, Feb 23, 15 @ 10:55 am
we should legalize all drugs and be done with this goofiness where certain people with access to a doctor and money can get highly refined legal drugs, but targeting drugs that tend to be used without the same levle of resources. Kegalize, regulate and tax. Just like we did with the numbers rakcet (state lottery), liquor and tobacco.
Added bonus of reducing prison population substantially and reducing incentives to violent crimes related to drugs.
Comment by Ghost Monday, Feb 23, 15 @ 10:56 am
==powerful== is an understatement for some of these opioids.
This ==plan== is like handing someone a napkin when they need a trip to the ER.
Comment by Formerly Known As... Monday, Feb 23, 15 @ 10:58 am
Definitely a pre-emptive strike. Doctors want mandates on insurers and new guidelines for PMPs, but don’t want to be subjected to continuing education requirements for themselves, don’t want to be required to “continuously monitor” patients that have opioid prescriptions, and don’t want to be liable if they make a mistake. The Med Society is trying to carve themselves out of the conversation by “taking the lead”. Who knows if it will work or not..?
Comment by out of touch Monday, Feb 23, 15 @ 11:02 am
A lot of tough talk, but the “Opposition to Policies that Will Interfere with the Doctor-Patient Relationship” section stands out to me. Has a few points that basically get out of jail free cards for docs.
Comment by Precinct Captain Monday, Feb 23, 15 @ 11:03 am
DuPage, according to CDC, overdose deaths from Oxy and Vics are about three times that of heroin. Prescription drug abuse is a much more serious problem.
Comment by Wordslinger Monday, Feb 23, 15 @ 11:13 am
2015 Golden Horseshoe for best typo:
Kegalize
If we go that route we cannot stop and start. Keep it flowing!
Comment by LizPhairTax Monday, Feb 23, 15 @ 11:16 am
So if Illinois is amongst the lowest abuse states, why is this a priority?
Nothing else to worry about?
Comment by plutocrat03 Monday, Feb 23, 15 @ 12:05 pm
“Most are just common sense. I’m not sure how effective this plan will be. I don’t see any penalties for docs”
————-
Two points….
First, can the proposed changes result in being any less effective than what we are already doing? Doubt it.
Second, adding more penalties means in reality that we’re going to expand an already obese enforcement establishment that is seriously in need of a diet.
We don’t have the money to expand enforcement, or add more people, so where’s the money going to come from? A new tax on pharmaceuticals? You mean they aren’t expensive enough?
We’re to the point budget wise her in IL where if you can’t back up the cost savings (without resorting to use of ‘magic fiscal beans’, than you), the proposal should be DOA.
Comment by Judgment Day (on the road) Monday, Feb 23, 15 @ 1:02 pm
I wouldn’t mind tougher controls on dispensing opioids if there were a better, faster civil remedy for causing sick and dying people needless pain and suffering. However, all of the “enforcement” attention seems to go toward unlawfully providing the medicine, not unreasonably withholding it.
Most people have no idea, until they hear the panicked moaning of their loved one in between working the phones and racing around to different pharmacies, how inhumanely difficult it can be to get lawfully-prescribed and necessary meds urgently required on a certain schedule for a pain-debilitated person — even with the assistance of a fully able-bodied, pain-free, haze-free, well-educated, documented, never-arrested adult.
If you’re a sick person on your own, forget it. At a certain point you can’t drive to the 5th Walgreens, hobble in (sorry, our policy is that we can’t talk to you about this drug at the drive-thru!), and wait 20 minutes to be “helped” (denied: “we won’t get another shipment of that for 3 days because we aren’t allowed to keep very much onsite” “can you call another branch to see who has it in?” “no, you’ll have to go there, we’re not allowed to call around to find out who has it”). You’ll soon end up choosing the ER or suicide. Luckily (but expensively), most people end up choosing the former, where they are treated even more shabbily as pill-seekers.
And where, if you are on a 3-hr pain prescription schedule, your busy nurses will only begin an hour-long process of requesting opioids from the basement pharmacy after the 3-hour point.
It’s completely horrifying, the number of hours a person in their last months/year of life can be made to writhe and suffer because people are justifiably afraid of losing their job/going to prison (and are clueless about what is appealable “policy” and what is “law,” such that pushing back on any stupid thing you’re told means you’re treated like a criminal).
Comment by crazybleedingheart Monday, Feb 23, 15 @ 1:06 pm
So yeah. We’re number 50. 50!
Anyone who wants to create additional hurdles for the sick had better be okay with paying out when those hurdles harm the innocent.
Comment by crazybleedingheart Monday, Feb 23, 15 @ 1:09 pm
Doctor shopping for narcotics is a real problem.
It is also a problem when some providers are too “generous” with prescriptions as many get hooked on pain medications unintentionally. Helping ensure that doesn’t happen is part of the provider’s responsibility and some don’t do their part.
Anyone employing a provider, should be tracking the prescriptions of controlled substances issued by their providers and the distance those patients travel to ensure they’re not part of the problem.
Comment by logic not emotion Monday, Feb 23, 15 @ 3:51 pm