In the past year and a half, according to Rhode Island Department of Health records, seven physicians have been disciplined--some even forced to stop practicing medicine--for improperly prescribing narcotics.
Between them, they're responsible for writing prescriptions for thousands of Oxycontin, Vicodin, Percocet, and other pills, often to people who weren't really their patients, or whom they hadn't properly examined. They prescribed far more than the recommended dose in some cases and allowed early refills in others. And many of them failed to keep adequate medical records on these patients and their prescriptions.
The patients for whom they prescribed these medications may have genuinely needed them. And these physicians may have thought they were making the best decision for that patient at the time - to increase the dose, renew a prescription early, or just prescribe without an examination or even a conversation.
And physicians are busy people, of course. Plus, people who are addicted to or abusing a substance like narcotics can be convincing and manipulative - that' not a judgment, it's what mental health professionals and those who have battled addiction themselves have observed and reported. Their bodies crave that substance and some will do whatever it takes to get it - doctor shopping, pharmacy hopping, and more.
Also, physicians may not have the bigger picture of how many prescriptions or doctors or pharmacies a single patient is using to acquire narcotics. That's not their fault; it's a structural issue in Rhode Island and across the country. Electronic prescription monitoring programs are still in their infancy. What exists in Rhode Island is still voluntary, and not yet widely used.
And yet, it seems difficult to understand some of the more egregious prescribing practices in a state with one of the highest prescription drug overdose rates in the country. Drugs like Oxycontin are incredibly addictive, and, misused, they can be incredibly dangerous. And apparently, they're also incredibly easy to obtain.
So, what's the answer? Many people benefit from narcotics like these to control legitimate pain. And no one wants to take away a good option for easing suffering. But lots of medical professionals--including RI Dept. of Health director Dr. Michael Fine--have told me that prescription drug overdose has become one of the most serious health crises of our time.
I'll be looking into prescription drug monitoring programs in more depth soon. In the meantime, I'd love to hear your thoughts.