http://www.clarionledger.com/story/news/politics/2017/12/15/medical-regulator-assures-opioid-rule-changes-dont-throw-patients-wolves/955257001/
Susan Norton of Brookhaven attended the Mississippi State Board of Medical Licensure meeting Friday, actively withdrawing from morphine.
Norton, who has been diagnosed with a chronic, painful bladder disease called Interstitial cystitis, was discharged from her pain management specialist in November, just as the state’s medical regulatory agency started mulling increased opioid prescription rules.
“I just feel like the state of Mississippi has thrown me to the wolves and literally to the street to figure this out on my own, and I don’t want to die. But there’s no where to land,” Norton said, just after
board members said their rule changes would not prohibit all opioid use for chronic pain.
“What I’m hearing today is not what’s happening out there with patients like me who have legitimate pain and need something … The doctors are scared.”
Board members assured Norton their
proposed opioid prescription rule changes do not prevent a doctor from prescribing opioids to treat the pain associated with her condition
but that they would require doctors to complete additional documentation.
“If asking someone to jump through a few extra hoops prevents a physician from doing that … shame on them,” said board member Dr. Randy Easterling.
Norton had been on 60 milligrams of morphine and 12 milligrams of Dilaudid for 10 years but she’s been cut off the last five weeks, causing her to experience withdrawals. She said she can see her heart beating through her chest sometimes.
“It’s where you just lay on the cold bathroom floor just to feel something other than pain,” Norton said.
Norton was near finishing nursing school 20 years ago when she was diagnosed with the bladder disease, which changed her life. Opioid users are sometimes labeled “drug seekers,” Norton noted, but she’s tried other pain management techniques with little success.
“If it was Tylenol and that worked I would be so happy, but sometimes it’s going to be more than that,” she said to the board.
In an open work session Friday, the medical licensure board finalized and unanimously passed proposed opioid prescription rule changes, tweaked slightly since its last hearing and pending additional review.
The regulations limit opioid prescriptions to seven days for acute pain, prohibit opioids for chronic pain except where doctors can document it’s the only viable option and require doctors to check the Prescription Monitoring Program and deliver drug tests to patients before writing opioid prescriptions.
The rules do not apply to terminal and cancer pain patients or opioid use in an inpatient setting. The changes are aimed at ramping up prescription monitoring and
discouraging doctors from prescribing opioids
amid an epidemic that kills nearly 100 Americans a day.
“It’s scary,” Norton said of not having access to her medication. “I just feel like I just got thrown out because it was too much for the doctors to want to have to deal with it.”
“Unfortunately, all the doctors won’t read this …
We’re not stopping opioids. We’re not doing anything like that. We’re just for the responsible use
” said board president Dr. Charles Miles, who cites medical literature about the ineffectiveness of opioids for the management of long-term pain. “You can take opioids to the point that the opioid itself causes the pain. It’s ‘opioid hyperalgesia’ and you don’t know that until you start backing off the opioids. then the pain gets better.”
Board members didn’t agree on everything in the nearly three-hour meeting Friday, during which they negotiated mostly specific, technical changes to the language of the new rules.
Board member Dr. Ken Lippincott, a psychiatrist, raised concerns over patient drug testing requirements in psychiatric offices when the patient is being prescribed benzodiazepines, like Valium or Xanax. Some smaller clinics might not have the facilities to do drug testing and, more concerning, it could damage trust between the physician and patient, Lippincott said.
Board member Dr. Claude Brunson, a University of Mississippi Medical Center physician, called for the board to vote whether to exempt psychiatrists from the new rule, saying it may do more harm than intended good.
“If that’s going to deter folks from getting mental help that they need, that’s a public issue,” Brunson said.
The motion failed.
The new rules will go to the Occupational Licensing Review Commission, which the Legislature created during the 2017 session to reign in regulatory boards, for final approval. First, the proposed changes must be filed with the secretary of state’s office to allow for public comment.
Apparently these board members do not listen to what they say or what is put in the proposed regulations.. They are not going to prohibit opiates being prescribed for chronic pain.. BUT.. the prescribers are going to be presented with a whole lot of time consuming administrative tasks in order to do so.. with apparently NO GUARANTEE that in doing so would indemnify the prescriber from being “drug thru the mud” for doing so ?
RULE CHANGES are always subject to interpretation and all too often the interpretation of the rule that is enforced may not meet the letter and intent of the rule.
Just look at what the DEA has done over the last 47 yrs with interpretations of the Controlled Substance Act 1970 and they have generated some NEW INTERPRETATIONS of that law in the last yr +.
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