PHARMACIST STEVE

America has an opioid crisis. Forty-nine states have authorized a PDMP (Prescription Drug Management Program) in order to get a handle on and control the predicament and Missouri is the lone holdout state. Does the Missouri legislature not care about people who are dying as a result of opioid abuse? Should not physicians and pharmacists be closely watched (in order to reduce the amount of drugs prescribed and dispensed)?

The truth is: America does, indeed, have an opioid problem, however, a PDMP has not been effective in controlling the abuse of prescription drugs in 49 states and a PDMP will not reduce the deaths related to the drugs. The reason: prescription drugs are not the problem.

According to the CDC (Center for Disease Control) in Atlanta, GA, deaths due to the abuse of fentanyl has skyrocketed. Fentanyl, a synthetic opioid, is the culprit for an inordinate number of deaths in recent years, however, fentanyl prescribed by physicians has not been, and is not, the problem.

Illicit (illegal) fentanyl is being produced in makeshift laboratories (predominately in China and Mexico). These producers are concerned only with quantity, not quality (and, of course, the “almighty” dollar). As with the production of the illegal, fake marijuana, K2, illegal fentanyl can have wide variations (as much as 50 % greater concentrations in the same batch) in the potency and its ingestion can have (and has had) fatal results.

Key points:

Illegal opioids is the culprit in the many unnecessary deaths in Missouri and across these United States!
Enacting a PDMP, whether a full-fledged one like the other 49 states have or the well-meaning, but “half-cocked” Executive Order (EO) 17-18 issued by former Governor Greitens has not and will not decrease the deaths caused by illegal drugs!
Illicit fentanyl is an illegal drug!

So, what harm has the PDMP EO 17-18 done? Plenty!

Over 8,000 letters were mailed to Missouri physicians and pharmacists demanding them to curtail the prescription of, and dispensing of, opioids. (Remember, according to the CDC, the rise in deaths due to opioids is not/was not due to the over prescribed drugs!) The result of these letters (this attempt to take away the physician’s ability to treat their patient(s) in a manner deemed best by the doctor) has all but emasculated the physicians receiving the letters. Doctors are afraid of potential discipline meted out, by the state, against them.

The Greitens EO may have been fueled by decisions made by the CDC. In a paper entitled “Prescription Opioids and Chronic Pain” written by Richard A. Lawhern, Ph.D., supports this supposition. Here’s a portion of Lawhern’s writing:

“In March 2016, the Centers for Disease Control released updated guidelines for prescription of opioids in adult, non-cancer chronic pain. Outcomes of these guidelines have been horrific for millions of patients. The CDC guidelines recommended that general practitioners should perform an analysis of risks and benefits before prescribing more than 90 Morphine Milligram Equivalent Daily Dose (MMEDD). Although originally phrased as voluntary, the Guidelines became a statutory requirement on the Department of Veterans Affairs, three months before CDC published its final guideline (emphasis added). Non-VA Hospitals and doctors across America quickly interpreted the Guidelines on safety review as a mandatory maximum dose standard.” (emphasis added)

“Fearing sanctions by the US Drug Enforcement Agency or State authorities if they prescribe opioids to people who need them, doctors are leaving pain management practice in droves. Availability of pain management specialists is dropping in most areas of the US and Canada. Pharmacies are limiting inventories of opioid medications, and challenging doctors’ prescriptions on grounds of corporate policy. Patients with legitimate prescriptions are being turned away.”

“Medical evidence underlying the CDC Guidelines is extremely weak, absent or biased.”

For those of us who may not be reliant upon medicines for pain management, the thought of a PDMP or attempts by the state to control how physicians treat their patients may not mean much. For chronic pain sufferers, however, the inability to obtain the proper medication used to keep in check the pain and suffering caused by long-term ailments can be devastating. And, believe it or not, thanks to the Greitens EO 17-18, chronic pain sufferers are now being targeted for treatment tapering (the decrease of vital medication used to allow them to live a normal life).

Fortunately, many of those identified as “chronic pain sufferers” continue to work. Unfortunately for them, due to the continued enactment of the Greitens EO 17-18, the eventual elimination of the pain-controlling drugs may force them to stop working.

Do we realize that allowing the state to “play doctor” will actually cost taxpayers more money? (When chronic pain sufferers drop out of the workforce due to their inability to control pain, they will be added to the state’s welfare rolls – and we will be required to provide sustenance for them. Forcing anyone to endure pain unnecessarily is inhumane! Creating an atmosphere that purposely compels people to give up their ability to provide for themselves and their families with the only alternative being welfare is the total antithesis to our constitutional republic!

We can do better than this! We must do better than this!

Meetings with Governor Parson has not yet produced any action to rescind Governor Greitens EO 17-18. I believe Governor Parson wants to do the right thing. Perhaps, he will listen to the voices of hundreds, if not thousands of Missourians.

Will you, please take time to contact Governor Parson to request a full rescinding of Executive Order 17-18? Please urge him to restore the physician’s ability to treat their patients in a manner that’s best for the patient. In addition, encourage Governor Parson to focus on (and fund) controlling illegal drugs (wherein the real problem lies).

Governor Parson’s contact information:
Phone: 573-751-3222
E-mail: mo.gov/contact-us
Snail mail: Room 216
201 West Capitol Avenue
Jefferson City, 65101

Please, make the call!

For additional information, please follow this link: http://www.jpands.org/vol23no1/lilly.pdf

 

Filed under: General Problems