‘Pill Mill’ Docs Only Partly to Blame for Opioid Epidemic – US News & World Report

Finally, a study has come out in the journal Addiction, with some real data to counter the hysteria at the Federal and State level that has been shutting down high volume opioid providers, a class of doctor that was created and supported by the very Federal Government that is now shutting them down with no warning. This crisis, which was created because just twenty years ago because the medical establishment was urged to provide opioids as pain relief, now finds itself resorting to lies and raids on doctors that usually have ended up, after years of court time, having the Feds drop all the charges. Rather than treat these physicians and pharmacies like criminals, they should be working cooperatively to rein them in and offer their patients relief.

The study also found that “opioid shoppers” — people who obtain prescriptions from multiple doctors and pharmacies — accounted for just 0.1 percent of opioid users in the study.

Our local physicians here on the Peninsula have often been complicit in this behavior, shunting high pain patients to the one doctor who was willing to work with them, then talking behind his back about how he was somehow “a renegade” and not coming to his defense  when he was raided. They had nothing to say  when the charges were finally dropped.

All prescribers of opioid pain medications — not just high-volume prescribers — play a role in the U.S. epidemic of opioid abuse and overdoses, a new study says.

“This crisis has been misconstrued as one involving just a small subset of doctors and patients,” senior author Dr. G. Caleb Alexander said in a Hopkins news release. “Our results underscore the need for targeted interventions aimed at all opioid prescribers, not just high-volume prescribers alone,” Alexander added.

https://health.usnews.com/health-care/articles/2017-11-30/pill-mill-docs-only-partly-to-blame-for-opioid-epidemic

full abstract and article available at

http://onlinelibrary.wiley.com/doi/10.1111/add.14068/full

Washington state health authority limits quantities of prescribed opioids – Spokesman Review

So this is what happens when know nothing politicians get in the way of medical professionals. First, the pols allow the drug companies to run amok with little or no regulation, telling the medical professionals that opioids like oxycodone are safe to prescribe like candy. That was in the 90s. As it got worse, in Port Townsend, only one doctor would treat the growing pain related issues, the local medical society ostracized him (they didn’t have to worry about the outcomes of their rampant pain prescriptions, they just sent them to him after they were done),  the Feds raided his place, shutting him down, throwing hundreds of patients to the wolves, and never even finding a crime committed. And they did it in Seattle too. Now we find out that it’s at epidemic rate, and the pols  are going to seriously force a cutback on them, without funding more drug treatment beds and money for other treatments. Meanwhile our hospital CEO doesn’t offer help to the sheriff, who is having to often treat these addicts at the jail. Now with the state taking action to stop opioid use, the people with long term pain will likely find themselves drawn to heroin, or other street drugs that are killing thousands just north of us.

A mess, with nothing but finger pointing. Who’s going to take care of low income people with long term pain? Anyone? How?

http://www.union-bulletin.com/local/washington-state-health-authority-limits-quantities-of-prescribed-opioids/article_9c33d6ba-bb3b-11e7-af63-033034e4b32a.html

Washington state awarded $11M to battle opioid epidemic – KREM and others

Thank you President Obama. It was his administration that set it in motion and Trumps can’t deny that there is an Opioid crisis. Now the problem is what are we going to use for the millions of people in real pain who now can’t get opioids?

WASHINGTON STATE – Washington state is set to receive $11 million to combat the state’s opioid epidemic.

The money comes from a grant, totaling $485 million, awarded to states and territories by the Trump Administration.

The funding will be provided through the State Targeted Response to the Opioid Crisis Grants administered by the Substance Abuse and Mental Health Services Administration.

‘I was dead for 10 minutes’: Vancouver’s opioid overdose crisis – CBC

A tale of just how bad it is in Vancouver right now. In Vancouver, on Dec. 13, nine people died of drug overdoses. Those nine deaths in a single night are part of an ongoing trend.

Fentanyl Ground Zero: A night in Canada’s busiest Overdose ER.

http://www.cbc.ca/radio/thecurrent/the-current-for-december-19-2016-1.3900404/i-was-dead-for-10-minutes-vancouver-s-opioid-overdose-crisis-1.3900823

Congress passes bill that could help fight opioid crisis in Washington state -Yakima Herald

Patty Murray supports the bill. Obama supports the bill. Much better than doing nothing. It will support efforts here on the Peninsula and give the power to craft the programs to the State, which is pushing the decision making process down to the regions. It’s a good deal. We may not see the likes of this again for some time.

Congress on Wednesday passed a bill that would allocate $1 billion over the next two years for state-level responses to the opioid epidemic, which is killing tens of thousands of people every year between heroin and prescription painkillers.

http://www.yakimaherald.com/lifestyle/health/congress-passes-bill-that-could-help-fight-opioid-crisis-in/article_fbccee86-bd12-11e6-97ed-636b6d259c27.html

Desperation and death after Seattle Pain Centers close: ‘The whitecoats don’t care’ – The Seattle Times

Last summer, the state decided that they would summarily close down Seattle Pain Centers,  a chain of pain clinics throughout Washington State, by  suspending the medical license of it’s chief director (and owner) with no advance notice to patients. That the state would do this, assuming that the medical community had the capacity to pick up the 8,000 patients of these clinics, could almost, in and of itself, be described as an act of  gross negligence.  The crackdown on pain med prescribers has, in fact, been happening  around the state, including in Port Townsend a couple of years ago. No charges have been filed in the case of Dr. Li (who denies the allegations) and I could not find and any public record that Dr. Rotchford was charged with a crime. In fact, Dr. Rotchford’s  clinic has reopened since this story in 2011.  However, Li’s patients have been left in  limbo, which this story, by the Seattle Times, clearly shows.

A 58-year-old former patient of Seattle Pain Centers committed suicide last month, leaving notes claiming he could find no help for his chronic pain after the chain of clinics closed in July following state sanctions.

 

As described by the Times, and reported to me over the last few years by local medical providers, there is a reticence by primary care physicians to take on patients in severe chronic pain, such as the person in this article. The possibility of random raids by the State (as has happened to Dr. Li) and the Department of Drug Enforcement, which manages the licensing of medical providers to prescribe opiates, and the state’s own guidelines which are mentioned in the article, have told providers to send these patients to specialty clinics. Some providers don’t seem to have a great deal of sympathy for addicted patients, because they can’t tell which ones might be faking it, they know some might be reselling the meds on the black market, and the providers don’t get paid enough for these patients to make it worth their while to spend a lot of time on them. Reimbursement rates are falling everywhere for medical providers. Now, because a small number of these patients have died (12 out of 25,000) the state has decided that this is negligence on behalf of Dr. Li. While I don’t pretend to be an expert in the statistics behind these numbers, it does not seem out of line that 12 patients, being treated for chronic pain, (ongoing unrelenting pain) would end up overdosing. Are we really saying that if our medical providers don’t get a zero number of people dying that we are going to shut them down? It seems that the State owes the public an explanation of what they really are trying to achieve in this case. Isn’t there an assumption that by closing these clinics, that patients may take to more dangerous drugs, like heroin? Or that they may turn to crime to feed the habit?

A sad reality is that the medical prescription for severe chronic pain is usually opiates. These by their very nature are addictive, and the providers know this. It makes them very leery of taking on patients who they know will become addicted. So specialists, like Dr. Li and others here on the Peninsula, take great risks  by taking them on.  Some of these patients are going to become seriously addicted, and some will likely overdose on their own. Getting them off opiates does not guarantee that they will become pain free. And where do they go to get help if the pain is chronic and doctor’s don’t have options?  This appears to be the case with some of Li’s patients that the State has discussed. Is that the Doctor’s fault? Or the patients? Or society for setting up this situation that appears to have a built in failure mode? It seems that this story points up that there needs to be a serious re-evaluation by both the state, the DEA and the medical community of how these patients are going to be treated.  

Read the following story. For any of you that have not had to deal with a patient, loved one, or even your own pain after a surgery or aftermath of an injury, this might be an eye opener. I appreciate that the Times did a very evenhanded and thorough approach to this.

“The whitecoats don’t care” one mans desperation and death when pain clinics close

Previous article by the Seattle Times in 2011 reporting on the build up to this situation. 

Gov. Inslee issues order on fight against opioid abuse – PDN

This is good news for drug addicts, counties and cities.

Gov. Inslee issues order on fight against opioid abuse. The order calls for efforts to prevent overdose deaths, including expanding access to naloxone, a medication used to counter overdose effects.

http://www.peninsuladailynews.com/news/gov-inslee-issues-order-on-fight-against-opioid-abuse/

And a followup:

Peninsula health officials applaud governor’s interest in stemming opioid abuse

Gov. Inslee’s executive order on preventing opioid addiction and overdose deaths is praised by local leaders.

http://www.peninsuladailynews.com/news/peninsula-health-officials-applaud-governors-interest-in-stemming-opioid-abuse/