Could we soon be leaving behind the assumption that anyone wanting opiate painkillers is or could soon be an addict? President Obama’s new director and deputy director of the White House Office of National Drug Control Policy (ONDCP) and are saying some things that make me optimistic.
The director is R. Gil Kerlikowske, and he says the “war on drugs” is over. That doesn’t mean we won and there’s nothing left to fight — he’s trying to end the war-on-drugs mentality that drug addiction is a criminal matter, and instead focus on the public health issues of identification, prevention and treatment of addiction.
The deputy director is A. Thomas McLellan, PhD, and he has 35 years experience in researching addiction treatment. In a recent JAMA interview, McLellan said some things that make me hopeful for pain patients:
“There are some very good, clear indicators that addiction has an at-risk period. It is basically adolescence, somewhere between age 10 and 21. If you don’t become addicted to tobacco, alcohol, cocaine, or opiates by that time, you probably are not going to be.”
Doctors need to know this, so they’ll stop denying pain medications to those of us who are well north of the drinking age and have never had a substance abuse problem!
“One of the things we’re going to be doing is urging medical schools, nursing schools, and pharmacy schools to devote courses to substance use disorders. It’s very important to be clear that substance use disorders are public health problems. . . . This is one of those areas that physicians, nurses, and pharmacists are not adequately trained in.”
Finally, someone’s talking about the proper role of the medical community — an educated group that can recognize and head off substance abuse in the early stages, rather than a law enforcement watchdog group that creates a barrier between patient and treatment.
JAMA asked McLellan specifically about opiate abuse, which is currently the second leading cause of death in the U.S. While lowering the rate is obviously a major concern, he says the goal is to do so without compromising pain treatment. To come up with policies, the ONDCP is working with the Department of Health and Human Services, the National Institute on Drug Abuse, the FDA and large medical societies.
McLellan outlined 3 areas that need improvement:
- Patient education: making sure patients know the low risk of addiction and proper use of these medications, to alleviate fears of becoming addicted.
- Doctor-patient contracts and communication about medication management and storage, and also about the risks of sharing their pain meds with other people.
- Prescription drug monitoring through electronic health information systems to prevent doctor shopping.
He adds that there is a role for law enforcement when it comes to doctors who are willfully violating the law. However, he says most doctors aren’t doing anything illegal and that clearly outlined policies will help them prescribe these drugs without fear of legal or professional repercussions.
I hope these changes come swiftly and that doctors start getting the message that responsibly prescribing pain medications won’t create untold numbers of addicts, get their license to practice revoked, or land them in jail. It could also help change the public perception that anyone who takes opiates long term “must” be an addict.
What do you think about these policies? Are they a good place to start, or too little too late? What else do they need to do to ensure pain patients get proper treatment, while keeping drugs away from abusers? Leave your comments below!
Source: JAMA, The Journal of the American Medical Association
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New Drug-Control Policy Could Benefit Fibromyalgia Patients originally appeared on About.com Fibromyalgia & Chronic Fatigue Syndrome on Monday, March 8th, 2010 at 06:00:06.
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