5/10/2014, Tennessee docs tightening pain, anxiety prescriptions


The latest action occurred Friday when a committee of physicians appointed by the Tennessee commissioner of health agreed on new guidelines for prescribing opioids in an attempt to curb the state’s addiction problem. The guidelines set limits on daily doses doctors can prescribe to patients, spell out protocols for giving the drugs to women of childbearing age and establish new certification requirements for pain medicine specialists.

They also establish two levels of doctors who can prescribe controlled substances. Most doctors can write prescriptions for daily doses up to 120 milligrams of morphine equivalents. For example, this measure works out to four 30 milligram dosages of hydrocodone a day. Anything above that requires doctors to refer their patients to a pain medicine specialists.

You mean, addiction specialists?

Bottleneck fears

There is concern this rule could create a bottleneck because about 90,000 Tennesseans get pain meds that exceed this daily dosage, and the number of certified pain specialists may not be able to handle that patient load…

Doctors do not have to transfer patients taking more than 120 milligram morphine equivalents a day to a pain specialist, but they do have to refer them to a pain specialist for an least one annual visit.

Dr. James Choo, a pain specialist and committee member, said the 90,000 number should decrease as opioid prescriptions taper off and more patients are referred to addiction experts.

So, are pain patients being referred to pain specialists or addiction experts?  Or are they now one and the same?  Tennessee is going to send 90,000 pain patients to addiction experts to be treated for pain… what could go wrong?

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