The Pulse
12:00 am
Fri October 5, 2012

Meningitis outbreak and pain management clinics

One of the facilities in Rhode Island that received shipments of steroids used in spinal injections happens to be a pain management clinic. The other is an anesthesiology clinic. There were no hospitals or other regulated facilities on the list of places in RI to have dispensed the contaminated steroid. (And if you were one of those patients, the clinic has already notified you or is still trying to, according to the RI Dept. of Health.)

It got me thinking, however, about pain management clinics such as these, and the kind of oversight they’re subjected to. Here’s what I discovered: none. Pain clinics are not licensed in Rhode Island; only three other states do require pain clinics to be licensed. The controlled substances pain clinics dispense are regulated, and doctors, nurses, and other health care professionals are of course licensed. But it struck me that clinics dealing with these substances and providing other kinds of serious, and for many, necessary, treatments, are not subject to state oversight.

Why? Because so many other kinds of operations are subject to state oversight. Crematories. Funeral homes. Salons of all types – for manicures, facials, massages.

If this particular pain management clinic were licensed, if there were more specific regulations pertaining to pain management clinics, could we have avoided dispensing contaminated steroids? Perhaps not. But perhaps clinics would be more likely to buy drugs from more of the same places other health care facilities do. The New York Times is reporting that the pharmaceutical compounding facility the steroids came from has kind of a rap sheet, and that because compounders aren’t as tightly regulated as other pharmaceutical manufacturers, it seems lots of physicians have reservations about ordering from them.

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