The prescription painkiller epidemic has taken the country by storm over the past decade. It is no secret that this problem has caused many overdose deaths. Prescription painkillers cause more deaths than heroin and cocaine combined and have also become the number one cause for accidental deaths, surpassing car accidents. Our country is seeing firsthand how potent and dangerous these medications are when they get into the wrong hands.
Many states have changed their laws to help keep their citizens safe. Prescription Drug Monitoring Programs/Systems (PDMP/PDMS) have become very popular in most states. The PDMS is a system that stops patients from “doctor shopping.” Doctor Shopping is when a patient goes to multiple doctors for the same ailments in order to obtain multiple prescriptions to either use or sell. Before the monitoring programs were put in place, doctors were not aware if one of their patients went to more than one doctor for the same medication. This ultimately puts doctors at risk for over-prescribing the medications and can quickly create an addicted patient. When a patient doctor shops, they can easily flood the black market with these medications. With the value of these medicines going for an estimated $1 per mg on the black market, there is a lot of money to be made. A 30 day prescription of a higher dose opiate can easily go for a few thousand dollars on the black market. Before Drug Monitoring Systems were in place, dealers took advantage of doctors. They would send in multiple “patients” to obtain the medications to resale.
Although many states have created new ways to fight the epidemic, you will still have those people that will try to beat the system. The high majority of doctors take their oath to take care of their patients to the best of their ability. Unfortunately there will always be those few doctors who break the oath usually to make money.
In the state of Texas, the justice system has made it very easy for dirty doctors to prescribe prescription painkillers without criminal charges. Despite a 2010 law to crack down on illegal prescribing, criminal charges were filed against fewer than a third of the 83 doctors punished by the Texas Medical Board in the past three years for drug law violations involving two or more patients. Some doctors with a history of prescribing violations ultimately gave up their license to avoid further scrutiny and freely move on or retire. Still others remain in practice.
One doctor in Texas whose practice was in Houston had three patients die of overdoses from 2010 to 2012. When the board refused his request to operate a pain clinic in 2012, he did so anyway. He operated this facility without the proper license. The disciplinary order says that during a 30-day period last year, he saw 449 patients and prescribed potentially addictive painkillers to all but nine. His numbers of prescribing were far above other doctors in his field. He failed to justify a medical need for the drugs, failed to follow standards of care and failed to monitor patients for drug abuse, the board’s order said. And that was after the three deaths.
As punishment, the board forbade him to treat patients for chronic pain or prescribe controlled substances. He agreed to the order but his prescribing authority will be restored next summer. His license was never revoked and will continue on when his penalty is up. I feel the Texas Medical Board needs to look at the way they handle these situations in order to prevent them from happening again in the future.