Doctors react to Obama prescription drug initiative
WASHINGTON – The Obama administration unveiled a new initiative to combat prescription drug abuse Tuesday, but some pain specialists say the plan – like the drugs it targets – fails to address the real issue.
Also, physician participation in the training programs will be voluntary – for now.
Proposed solutions for a growing problem
WASHINGTON — Karen Perry’s oldest son, Rich, died of a prescription drug overdose in 2003.
“I was not there to hold his hand on the day that he died,” Perry said. “And that breaks my heart.”
Hundreds of thousands of stories like Perry’s have emerged in the past decade, according to federal health officials. Prescription drug overdoses are increasing at a staggering rate in the U.S., routinely killing tens of thousands of people each year and sending millions to emergency rooms, according to the Centers for Disease Control and Prevention.
The federal government unveiled a new strategy Tuesday that aims to cut prescription drug abuse nationwide by 15 percent within five years.
“We must ensure that patients have access to the medications they need while also preventing misuse and abuse,” said Margaret Hamburg, U.S. Food and Drug Administration commissioner.
To do it, the government is asking you to get rid of your unused medicine by throwing it away in plastic bags filled with coffee grounds or kitty litter.
“As much as 40 percent of all medications go unused which is more than 1.5 million doses a year,” said Michele Leonhart of the Drug Enforcement Administration. “And more than half of teens think that prescription drugs are easy to get from their own parents’ medicine cabinet.”
They also plan to crack down on “pill mill” doctors, or physicians who prescribe drugs for cash.
“Although it’s a very small number of doctors who abuse their prescribing privileges, they are responsible for an immense amount of the addiction, the suffering and the deaths,” said Gil Kerlikowske, President Barack Obama’s drug czar.
It’s good news for Lyle Campbell, assistant clinical director of Howard University Hospital’s emergency department. He said he’s seen the ill effects of prescription drug overdoses too many times, and has noticed an increased number of people asking hospital staff for addictive prescription drugs.
“I think that anytime the government gets involved with the actual health of the community, that’s a good thing,” Campbell said. “So lets see what it does.”
“I am incredibly optimistic that over the next year we are going to make a big dent in this problem,” Kerlikowske said.
— Sylvia Hall
A key element of President Barack Obama’s plan is urging Congress to mandate physician training be a precondition to registering with the Drug Enforcement Agency. This has the American Medical Association on edge.
While they support the plan’s intent, the possibility of mandating training for doctors who prescribe addictive pain killers like morphine and oxycodone is a concern, said AMA President Cecil B. Wilson.
The AMA would not comment further on its concerns until specific legislation was drafted.
“There is an over emphasis in the medical system on medication to deal with pain,” said Dr. Peter Abachi. “We’re missing meat of the problem if we don’t give people the other tools.”
Those tools include physical therapy, psychology and mind-body therapy.
When used together, they address both the mental and physical causes of pain more effectively than medication alone, said Abaci, a clinical instructor at the Stanford Pain Clinic and co-founder of the Bay Area Pain and Wellness Center in Los Gatos, Calif.
This is especially true when that medication is abused.
Accidental overdoses of prescription drugs killed more people that gun shots or heroin overdoses according to the most-recent data from the Center for Disease Control and Prevention.
Oxycodone, morphine, methadone and other drugs commonly prescribed to treat pain are the focus of Obama’s four-pronged plan to reduce abuse of the drugs by 15 percent in the next five years.
One of the major parts of the plan announced by the White House Tuesday requires drug manufacturers to develop and implement a training program for health care providers, teaching them how to properly prescribe the medications.
While doctors definitely need more training on how to use pain drugs, they also need educated on more comprehensive treatment options, Abaci said.
“I see so many problems,” he said. “Patients come in now with a laundry list of [drugs] they’ve tried already and they’re looking at me to clean up the mess.”
Drug Enforcement Administrator Michele Leonhart was confident Congress would back the administration’s effort.
“On prescription drugs they have been behind us all the way,” Leonhart said at a press conference Tuesday.
Legislation or not, patient education is mandatory and pharmacists will be responsible for distributing new medication guides developed by the pharmaceutical companies.
“As the medication experts, pharmacists stand ready to inform and educate the public about the medications they are taking,” said Michelle Fritts, a spokeswoman for the American Pharmacists Association.
Specific training plans and materials are not available yet.
Drug manufacturers making the targeted drugs were notified by the Food and Drug Administration of the agency’s intent to require a Risk Evaluation and Mitigation Strategy in February 2009, according to the agency’s website.
Pfizer spokesman Raul Damas said his company is working with other drug companies to determine how to train health care providers, and how to monitor their participation.
Drugs the FDA said would require the new educational guidelines include Johnson & Johnson’s Duragesic, Pfizer Inc unit King Pharma’s Avinza and Embeda, Actavis’ Kadian and Endo Pharmaceuticals’ Opana ER.
“We recognize our responsibility to physicians and patients and remain committed to being part of the solution to address this important public health and safety issue,” Damas said in an email.
Damas would not comment on the cost to implement the program, but said Pfizer actively participated in developing the recommendations.