Providing straightforward information pertaining to drugs, drug use & drug policy. The Grey Pages promotes drug-related literacy and advocates a system of viable and tolerant drug policies. This is my personal collection of commentaries, essays, tid-bits, and other such writings on everything ranging from drug use, drug policy and drug-myths, to drug-science, addiction, human behavior, and the workings of the human brain. I started this blog with a particular focus on opioids, and over the past year have found my interest gravitate toward the intriguing, ever-changing world of designer intoxicants (i.e. "research chemicals" or "designer drugs").

Friday, July 15, 2011

Federal Government's Plan to Restrict Opioid Analgesics: Major Changes In the Near Future

Image Source: The Village Voice (villagevoice.com)

Federal Government Plans to Regulate Your Medicine Much Closer. Your health and lifestyle ARE the Government's business: According to the US Dept of Justice, the notions of "personal privacy" and "human liberties" are only important to "abusers" - After all, who needs privacy unless there's something to hide? And why choose how you manage your pain, or even how you live your life, when someone else can make these choices for you?  Only the guilty will resist, the rest will adapt to live as they are told to live. After all, even adults need to be saved from their own choices, right?

Folks, say goodbye to opioid accessability as we know it. USDOJ plans to require an entirely new, additional registration process in order for physicians to prescribe a class of medicine that has been in use for centuries. This will lead to A) Many physicians including those in primary care opting not to go through the trouble of acquiring an "opioid" license, and seeing this as the perfect excuse to refuse opioids or other drugs, and simply expect other physicians to prescribe B) Possibly an emergence of high expense specialty pain clinics; which will also be monitored so tightly that prescribing will be limited to only a limited number of cases.

Opioid analgesia outside of the Hospice setting is likely to be once again a taboo among physicians, and at the least, a legal grey area.
Additionally, hydrocodone compound products will most likely be classified as schedule II, a higher level of restriction than its current C-III scheduling. Broken bones and post dental procedure pain is likely to be treated with NSAIDs or Ultram.

I am deathly afraid to see what the coming years will bring... What is to keep branches of the USDOJ from choosing what we - insert activity or product -? There is a fine line, and it was long ago crossed. It started with the Harrison Act of 1914, and has evolved to the persecution of not only illicit drug use, but medical practice.

While there is no doubt that dependence and accidental ovedose deaths (particularly rx opioids) are among the top causes of morbidity in most states, we have to ask ourselves, are we willing to sacrifice OUR freedom for the protection of negligent/incompetent drug users from the consequences of their carelessness? Especially considering the otherwise safe nature of opioids.
Below is a link to the official White-House Document outlining this plan of action, with major points quoted below.

1) Federal & State Monitoring

The Administration’s desire for Congress to pass legislation to require practitioners to take training on responsible opioid prescribing, use, storage, and disposal before being able to procure DEA registration, 2) plans for federal rulemaking on proper medication disposal, 3) requirement for opioid manufacturers to develop training for prescribers (FDA’s REMS), 4) plans to engage stakeholders on the publicizing of need for the public to use, store and dispose of opioids safely, 5) plans to work with states to implement prescription-monitoring programs in all states and to require prescriber training on program use, and 6) encouragement of federal agencies to increase “take-back” programs. (And yes that's right, 8 years of college/med school + 2-4 years of residency is no longer adequate, MD's will soon have to first take 'drug abuse' courses in order to SPECIALLY register with the DEA to prescribe a vital medicine that has been used effectively for centuries)

"...enhancement and increased utilization of prescription drug monitoring programs will help to identify “doctor shoppers” and detect therapeutic duplication and drug-drug interactions. " US Government Plan to Address RX Abuse (In other words, not only will they regulate the drugs, they will take it upon themselves to mandate proper multi-medication regimens, playing even more of a "Doctor-Cop" role.

"...it is important to provide law enforcement agencies with support and the tools they need to expand their efforts to shut down “pill mills” and to stop “doctor shoppers” " US Government Plan to Address RX Abuse

" ....Evaluate existing programs that require doctor shoppers and people abusing prescription drugs to use only one doctor and one pharmacy. The PMP Center of Excellence at Brandeis University will convene a meeting in 2011 with private insurance payers to begin discussions on these topics. " US Government Plan to Address RX Abuse (ONDCP/DOJ/HHS/SAMHSA)

"...Issue the Final Rule on DEA Electronic Prescribing of Controlled Substances. " US Government Plan to Address RX Abuse

2) Federal Law Enforcement Plans

"...Expand upon DOJ’s pilot efforts to build PDMP interoperability across state lines, including leveraging state electronic health information exchange activities. Work to expand interstate data sharing among PDMPs through the Prescription Drug Information Exchange " US Government Plan to Address RX Abuse

"...Work with the appropriate groups to write and disseminate a Model Pain Clinic Regulation Law taking into consideration: 1) registration of these facilities with a state entity; 2) guidance for rules regarding number of employees, location, hours of operation; 3) penalties for operating, owning, or managing a non-registered pain clinic; 4) requirements for counterfeit-resistant prescription pads and reports of theft/loss of such pads; 5) disciplinary procedures to enforce the regulations; and 6) a procedure to allow patient records to be reviewed during regular state inspections. " US Government Plan to Address RX Abuse

"...Identify and seek to remove administrative and regulatory barriers to “pill mill” and prescriber investigations that impair investigations while not serving another public policy goal. " US Government Plan to Address RX Abuse

"...Use PDMP data to identify “doctor shoppers” by their numbers of prescribers or pharmacies. Encourage best practices such as identifying such individuals to their prescribers and pharmacies, law enforcement and insurance providers. " US Government Plan to Address RX Abuse

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