Should initial pain med scripts be limited to five days in Jersey?
I read with great interest David Mathau's story on the pushback by the medical community against Governor Christie's desire to limit initial pain med prescriptions to five days. While most lawmakers are in support, many in the medical field are fighting it. I was mostly blown away by some of the quotes from Dr. Joe Costabile who is a vascular surgeon. He warns that when the five days of pain meds run out a patient "might turn to someone to say ‘gee, I’m having this terrible pain in my back.’ The friend might say, ‘hey, I’ve got some heroin,’ or something along those lines.”
“People will go wherever they need to go to relieve their pain, and if it means maybe getting something off of the street they’ll do that. I think it depends upon how desperate the patient is.”
Is this a realistic scenario for most? Even for a few? If you have no prior drug addiction and you are on pain meds for five days, you are not going to jump straight to the offer of heroin. That's a bit ridiculous. Heroin is something that happens afters months of being addicted to legal prescriptions, doctor shopping, then buying it on the street, and finally buying heroin because you're so deep in the throes of addiction you can't stop and you can buy heroin for much less money.
It seems silly to posit this will happen after only five days. Also, this is assuming a patient didn't think ahead, wasn't paying attention to their level of pain, and didn't contact their doctor on day three or four to avoid running out at 6pm on a Friday. I think people are generally smarter than that. Nothing in Governor Christie's proposal would limit doctor's ability to extend the prescription beyond five days. They simply would have to assess the situation first.
Dr. Costabile also says, “when you start legislating what physicians can and cannot do, you’re now practicing medicine by legislation. I didn’t go to medical school and do nine years of residency training to have my judgment as a physician legislated.” It sounds like the doctor just doesn't want to be questioned whatsoever. But when you have nearly a thousand people a year dying from heroin overdoses and many of them begin with opiate based pain meds I think it's time to check your ego at the door.
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