NYC Looks to Restrict Prescription Painkiller in Public Hospital ER’s (1/14/13)

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A new city policy will limit the number of prescription pain killers provided in public hospital emergency rooms. 

As part of the city’s efforts to address the national epidemic of prescription drug abuse, Mayor Michael Bloomberg has supported new measures to restrict pain medication within the city’s 11 public hospitals.  Under this policy, patients will only be provided three days’ worth of narcotic painkillers including Vicodin and Percocet.  Other medications such as OxyContin and Fentanyl will also be limited.  Additionally, lost or destroyed prescriptions will not be refilled.

The purpose of this action is to address the growing dependency on painkillers and preventing the easy access of medication by youth that take it out of medicine cabinets or purchase it on the streets.

“Abuse of prescription painkillers in our city has increased alarmingly,” Mr. Bloomberg said in announcing the new policy at Elmhurst Hospital Center, a public hospital in Queens. Over 250,000 New Yorkers over age 12 are abusing prescription painkillers, he said, leading to rising hospital admissions for overdoses and deaths, Medicare fraud by doctors who write false prescriptions and violent crime like “holdups at neighborhood pharmacies.”

However, critics argue that the move could limit the options of doctors to treat patients, many of which are poor or uninsured and utilize emergency rooms as their main source if health care.

“Here is my problem with legislative medicine,” said Dr. Alex Rosenau, president-elect of the American College of Emergency Physicians and senior vice chairman of emergency medicine at Lehigh Valley Health Network in Eastern Pennsylvania. “It prevents me from being a professional and using my judgment.”

While someone could fake a toothache to get painkillers, he said, another patient might have legitimate pain and not be able to get an appointment at a dental clinic for days. Or, he said, a patient with a hand injury may need more than three days of pain relief until the swelling goes down and an operation could be scheduled.

More than two million prescriptions for opioid painkillers are written in New York City each year, the equivalent of a quarter of the city’s population, Dr. Thomas A. Farley, the city’s health commissioner said, and about 40,000 New Yorkers are already dependent on painkillers and need treatment. Painkillers were involved in 173 accidental overdose deaths in New York City in 2010, a 30 percent rise from five years earlier.

Dr. Farley said the city lacked the regulatory authority to impose the new guidelines on its 50 or so private hospitals. But several private hospitals, including NYU Langone Medical Center in Manhattan and Maimonides Medical Center in Brooklyn, said they would adopt them voluntarily.

Source: New York Times