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.

A key element of 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 on President Barack 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 four-pronged 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.

  • johncole

    I agree as well ChickFight. “Alternative” medical treatment to accompany our “alternative” energy usage being federally mandated is an affront to me. The “bent” of the media is such that if state medical boards are screaming, we won’t hear a sound. I was dumbfounded by the rigamarole at each step along the way in my last medical procedure. The check-out for pharmaceuticals was the most complicated stage. Seven full pages of description for the drugs prescribed, and additional words of caution from the dispensing pharmacist.

  • empiresentry

    Destructive. Worthless waste of time and money. (Picture of Obama flailing his arms around claiming he has actually accomplished something.) Already us ‘pain med users’ have our names in national databases with everyone counting our pills at the end of the month to see how much is left over. Regulations have not changed a thing.

    Please please: can I personally meet the doc that says that OTHER tools should be used? I want to kick him in the nuts and hit him with a baseball bat so that he knows what surgery and migraines feel like. I promise to wait one hour before I castrate him sans meds so that he will know what a hysterectomy feels like. I wonder how well he will wish that away.

  • Tess_Comments

    Why am I not surprised that another of Obama’s planned policies fails to address the real issue.

    Do Not Destroy the hard work good doctors have done regarding Pain Management.

    Doctors do not need more training. In order to combat prescription drug abuse, the doctors that over prescribe addictive drugs need to be stopped.

    The American Medical Association needs to follow-up on doctors that over prescribe and abuse their rights to write prescriptions.

  • Callie369

    In 2009 the copay on my preferred-generic pain med was $7.00.
    In 2010 the copay was $8.00, and endocet was the ONLY generic allowed.
    Now, thanks to Dumbamacare, there is NO preferred-generic available at all, and to get the “non-preferred” generic, the copay is $60.00.
    Remember when Dumbama said “give them a pill?’ I’m in pain 24/7, cannot afford surgery, and now $60.00 copay? Thanks to the W.H. a-hole!!! (By the way, preferred-generic just means its the generic medicare “PREFERS” we use.)

  • dallas yankee

    The AMA is upset? Aren’t they the idiots that backed Obamacare, over the protests of most doctors

  • maggie8

    Does that bunch of idiots in the White House stay up nights thinking up more wasteful and crazy things to do? They think they know more than any MD…
    Can’t stand this much longer………..come on 2012, they have to go.

  • jmk1502

    I live in Florida, the “pill-mill” capital of the US. Only 8 people a day die here from prescription drug abuse. Why not wait until it’s 15 or 20, like our fine newly-elected teabagger crook Gov. Rick Scott wants? That’s right! We really can’t, because other states applied a tremendous amount of pressure for us to set up a drug-tracking database. Plus, I’m sure Rush Limbaugh would advise you how innocent prescription opiates are – right after he’s done railing about the evils of them :)

    • Rich Matarese

      Nothing in the measures proposed by Barry the Stoner (that was his nickname among his adolescent Punahou School “choom gang” of smokers and tokers) is likely to reduce death rates from prescription drug diversion in Florida or any other venue, and that’s got to be recognized. The War on (Some) Drugs is actually a war on human nature itself, and like all other such morally bankrupt efforts to mess with the individual’s proclivity to go to hell in his own personal handbasket, it’s simply never going to work. Getting between drug abusers and their chosen self-destructive psychoactive substances is simply spectacularly stupid.

      But then “spectacularly stupid” gives us the perfect characterization of government policy in all regards, doesn’t it?

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  • texan59

    Oh come one now. Our dear leader is the smartest man in the room. If he says we need to do this, we need everyone to jump on board, be a team player. There are no nefarious intentions here. This could not possibly be the first step in the re-education process for the medical profession. There is no way that this could be the first step in requiring doctors to follow the leader down that path to complete control over each and every thing they do. I see no way possible that this could lead to a mandate such that any doctor who has ever prescribed any of these medications at any time would have to be trainedto do things the right way. Oh, and by the way, if you don’t do this, you probably will be phased out of the healing arts in fairly short order. As well, if you don’t take this step in your re-education, you will no longer be allowed to accept any Federal dollars for treating patients. And another thing, if you don’t accept Federal funds you will probably not be allowed to practice medicine in this Country for much longer. Not to worry doctor, not to worry.

  • ChickFight

    All Useless bureaucratic BS! This just makes life more difficult for Doctors, Pharmacists and Pain Patients, who must all suffer because of the bad apples, who will, incidentally, continue to be bad apples. Extra ‘education’ and preachy condescending pamphlets will only end up in a landfill, and Doctors will have to waste their valuable time being re-trained for what they already went to school for ten years to learn. These intrusive laws also create a tense atmosphere among professionals and patients, in addition to treating everyone concerned like suspects. People on drug therapy are there because all other alternatives have already failed. Forcing patients through them again in order to satisfy the Federal government is reprehensible. Controlled substances are already controlled, and rightly so. All this superfluous Obamacare rubbish is just empty feel good nonsense used to micromanage our lives and generate power and money for Democrats.

    • raveman7

      Well said ChickFight.. there is already enough regulation and laws in place. They are missing the point, if there is an addict out there, they are going to find ways to get the medication. Just look at Alcohol, nearly 17.6 million adults in the United States are alcoholics or have alcohol problems. I dont see anyone putting Budweiser on notice or telling bartenders they have to take extra education classes so they can spot a drunk.. Come on. its just more bureaucratic BS