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Strict government oversite of opioid medications force physicians to balance the needs of their patients with demands from the government for better control of opioid medications. Fifty years ago cancer patients were denied opioids for their pain because of possible addiction.

Srinivasa Raja, MD, professor of anesthesiology, Johns Hopkins University Medical School, reports that less than 3% of patients with no history of drug abuse will show signs of possible drug abuse when prescribed opioids for chronic pain.

Raja argues that cognitive-behavioral and physical therapies are shown to be effective, but are only part of the solution. In order to address the problem of prescription drug abuse there needs to be a collaboration among the care givers, law enforcement and regulatory agencies, and the pharmaceutical industry. Raja suggest that:

  • Law enforcement and regulatory agencies need to develop standardized state-to-state regulatory control of opioids; including a crackdown on illegal Internet pharmacies and prescription thefts and forgeries.
  • Pharmaceutical manufacturers need to give priority to developing less addicting pain medication.
  • Physicians need to communicate to their patients the benefits and risks of opioids and to screen patients for drug-seeking behavior along with other warning signs of potential abuse.

Raja also suggest patients need to be closely monitored to determine when doses can be lowered.

{ 2 comments… add one }
  • linnietea May 20, 2014, 7:24 pm

    It’s always interesting that physicians who use rats to determine whether humans will benefit from the medication,now have the position of playing God,with people’s lives.14years,my physician attempted everything possible, ten’s unit, biofeedback, physical therapy, N-said, (too many adverse reactions). A pain regime was set, never in those years did I Ask or need an increase in dosing. I was using the prescribed medicine properly, it worked until my physician is transferred, I get a brand new, abrasive, coercive, bullying physician who before I can sit, shoved a pain contract in my face “sign or I won’t treat you”, tapered medicine suddenly became terminated, breakthrough medicine, terminated-why? Because she didn’t like it. I wasn’t given a chance to even explain my needs at the time, she doesn’t converse, only questions. No conversation. Of course, my plan, pt advocate, chief of PC, asking for reassignment. I was told “deal with it”. Patient care suddenly took second place to politics. Without physicians who will work with the pt, there is no where to go. The patient advocate told me she wasn’t there to solve our problems, she is an extension of the director, thus, what she’s told, she just runs to the director. Patient Advocacy is supposed to give voice to the patient unable to get their needs met, NOT AT HAMPTON VA.
    EVEN THE PRIEST, and we don’t have much of a chaplaincy, told me, “every veteran that walks in the front door is now considered either an alcoholic or drug seeker.” This is coming from a staff priest.

    What chance does a veteran have when already before even being screened they’re screwed?

    When a physician has a prescription error and you let them know,they gave you wrong medicine, they say bring it back, I’ll write the correct medication, yet you do, they lie and keep the wrong medication and refuse to replace with the correct script like they promised. How then do you trust this physician, coercive, abrasive, bullying NOW…LYING AND WRITING THE WRONG MEDICINE, NOT KEEPING THEIR WORDS….and you as a pt you’re told to”deal with it.”

    Where is the ACCOUNTABILITY? I have to abide by it why not the STAFF?
    Why can they curse you, yet …raise your voice…the same staff that cussed you will call security. You then can be arrested, a Federal offense.

  • jesse August 5, 2014, 6:24 pm

    i encounter the same treatment at the seattle va i have moderate to severe back neck shoulder pain from my tour and spent years working with doctors to get a pain managment plan that worked for me and a new nursing aid cut all my medications now i have to “deal with it” with out any relief

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