Experts agree that one of the best ways to tackle the growing opioid crisis
is to crack down on opioid overprescribers. Unfortunately, a new report
suggests that the federal government is not doing a good job at determining
who those doctors are.
Pain Prescriptions Fueling Opioid Addiction
As we have
previously discussed on this San Diego Injury Blog, several factors have contributed to the rapid increase in opioid-related
overdoses, including a rise in prescriptions for the potent painkillers.
Since 1999, the amount of prescription opioids sold in the U.S. nearly
quadrupled. However, there has not been an overall change in the amount
of pain that Americans report.
In 2013, providers wrote nearly a quarter of a billion opioid prescriptions,
which is enough for every American adult to have their own bottle of pills.
Opioids are also increasingly prescribed for chronic pain. Although they
may provide short-term relief, the medications have not proven to be an
effective long-term solution.
New GAO Report on Opioid abuse
In a new report, the Government Accountability Office (GAO) concluded that
the Centers for Medicare & Medicaid Services (CMS) need to gather
more overprescribing data from payers and providers to identify potential
“We found that CMS does not identify providers who may be inappropriately
prescribing large amounts of opioids separately from other drugs, and
does not require plan sponsors to report actions they take when they identify
such providers,” the
GAO report states. “As a result, CMS is lacking information that it could use to assess
how opioid prescribing patterns are changing over time, and whether its
efforts to reduce harm are effective.”
The GAO report notes that CMS’s existing data effectively identified
more than 33,000 Medicare beneficiaries at risk for opioid abuse. However,
it concludes that the existing criteria CMS uses to detect possible opioid
abuse fails to capture all of the risk indicators set forth in
guidelines developed by the Centers for Disease Control and Prevention (CDC).
“Because neither the CMS criteria nor the patient safety measures
include all beneficiaries potentially at risk of harm from high opioid
doses, we recommended that CMS should gather information over time on
the total number of beneficiaries who receive high opioid morphine equivalent
doses regardless of the number of pharmacies or providers, as part of
assessing progress over time in reaching the agency’s goals related
to reducing opioid use,” the GAO said.
Holding Negligent Prescribers Accountable
While there is nothing unethical or negligent about prescribing opioid
medications to help patients manage pain, medical professionals have a
legal obligation that their treatment of a patient and their prescription
practices are performed in accordance with the acceptable standard of
care. That means that doctors must carefully evaluate a patient’s
health, as well as the risks and benefits of any prescribed narcotics.
In some cases, the failure to weigh the benefits of pain treatment with
the risk of addiction can rise to the level of medical malpractice.
prove medical malpractice, the plaintiff must be able to show that the physician breached the duty
of care. To determine what a "reasonably prudent physician"
would have done in the same situation, courts often look to whether the
doctor followed relevant opioid-prescribing guidelines. For instance,
the CDC Guidelines for Prescribing Opioids for Chronic Pain state that
doctors should discuss the risks of opioids directly with patients and
reevaluate patients every three months to assess for risks in relation
to benefits. Courts may also find negligence when doctors fail to maintain
accurate records of opioids prescribed and fail to take any action to
limit opioid prescriptions for known-addicted patients.
If you or someone you care about has suffered serious harm due to negligent
prescriber, you may be entitled to compensation, such as pain and suffering
damages and reimbursement of medical expenses. For more information, please contact
a San Diego medical malpractice lawyer at the Law Offices of Robert Vaage for a free consultation.