Wednesday, January 16, 2013

Bloomberg Limits Emergency Room Doctors from Prescribing Opiates

Mayor Bloomberg of new York City has put prescription drugs in the spotlight once again. This time he is pushing for hospital regulations to restrict the quantity of opiates ER doctors can give to patients. 

The new measure would prohibit ER doctors in public hospitals from giving more than a three day supply of painkillers to patients. Doctors also have to refuse refilling lost or stolen opiate prescriptions and to not write scripts for long-acting, highly addictive and sought after drugs like methadone and extended release oxycodone. The logic behind this policy is that if more opiates are needed, patients can follow up with their primary care physician.

These measures are intended to reduce the overall circulation of painkillers throughout the city in order to cut down on drug abuse and opiate relate crime. New York City has experienced its fair share of robberies of pharmacies along with Medicare fraud for prescription opioids. In addition, emergency rooms have filled up over the past several years with a 143% increase in visits for painkillers between 2004-2010. Adding to these growing statistics, there are 2 million prescriptions written for opiates in NYC every year and an estimated 40,000 New Yorkers with opioid dependence.

As with any policy, there are several predictable and undesirable consequences that can occur as a result. First, for Americans who are poor and uninsured, following up with a primary care physician may be implausible both financially and logistically – as many don’t have PCPs, it can take weeks to get an initial appointment and many can't afford multiple doctors visits. Second, while opioid prescriptions are the preferred drug of choice for many addicts, the lack of available pills isn’t the cure-all for their addiction or drug seeking behavior. Several attempts at curbing prescription opiates has resulted in addicts turning to the lesser preferred opiate – heroin. Third, the void created by this new measure could draw in out of state opportunistic drug dealers, resulting in a new wave of crime.

While measures to cut down on the availability of drugs are often good policies, they are weak without coexisting measures to work on aspects of addiction other than supply. Complimentary policies that will look at how to lower the demand for opiates by offering viable addiction treatment options are needed. Making prescription drug treatment available to addicts is vital, because just cutting down on one supply opens addicts to being supplied by others, or worse, by a stronger version of the drug.

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