Physicians for Responsible Opiate Prescribing (PROP)
There is a group, Physicians for Responsible Opiate Prescribing, whose “mission is to reduce opioid-related morbidity and mortality by promoting cautious and responsible prescribing practices.” Their website, http://www.supportprop.org/, talks about the issues with opioid abuse and how they are trying to help. They work in three ways…prescriber education, consumer education, and advocacy.
Prescriber Education: Many prescribers underestimate the risks of opioids, especially the risk of addiction, and overestimate their effectiveness. PROP’s educational materials promote more cautious prescribing by providing clinicians with accurate, evidence-based information about opioid risks and benefits.
Consumer Education. PROP works with a variety of stakeholders to improve access to accurate information about prescription opioids.
Advocacy. PROP advocates for state and federal policies that promote more cautious prescribing practices. PROP also advocates for proper enforcement by FDA of the federal Food, Drug and Cosmetic Act, a law which prohibits marketing of drugs for conditions where risks of use are likely to outweigh benefits. They have appeared before Congress, pressed for changes in labeling, and they continue to monitor opioid-related state and federal legislation and policies.
They are strong advocates for alternatives to chronic pain measurement and management. Their article in The New England Journal of Medicine discusses the currently accepted scale for measuring pain intensity and that it may not be the best way to measure chronic pain. They propose that multiple measures of pain assessment are needed to evaluate a person’s pain and propose multi-focused treatment. http://www.nejm.org/doi/full/10.1056/NEJMp1507136
The following article talks about the current measurement of pain assessment being like a vital sign measurement and the problems associated with that. Treating pain assessment this way, inadvertently encourages the overprescribing of addictive drugs. It assumes all pain is bad and must be treated. This isn’t the case. I am not suggesting pain shouldn’t be assessed and managed, but I am suggesting the current practice is far too often to treat with very dangerous drugs. This over-prescribing has directly contributed to the addiction epidemic plaguing our country today. http://bigstory.ap.org/article/a48f0d9556c3442394da1f5b44e01692/painkiller-critics-take-aim-hospital-surveys-procedures
Follow this link for more on PROP and their journey on combatting addiction in America…http://www.supportprop.org/media-coverage/
PROP is funded by Phoenix House, a nonprofit chain of addiction treatment centers. Phoenix House was founded in 1967 by six heroin addicts who met at a detoxification program in a New York hospital. They were concerned about staying clean after detox. Phoenix House was later made the model for a citywide treatment network. Phoenix House played a role in creating the country’s first correctional treatment unit, a model now widely replicated in prisons throughout the country and abroad. Phoenix House was also an early provider of treatment as an alternative to prison. In 1983, Phoenix House opened its first Phoenix House Academy, a residential high school where teens receive substance abuse treatment as well as daily on-site academic education. Eleven Phoenix House Academies now operate in seven states. The organization is funded mostly by government contracts, but also receives philanthropic support. In addition to residential treatment, Phoenix House’s continuum of care includes prevention and education, outpatient services, sober living and recovery support, as well as specialty programs for mothers with young children, criminal justice clients, and the military community.
Phoenix House makes treatment possible for the poor, the marginalized and the hopeless. While it’s accommodations are a far cry from facilities like Promises, the organization’s mission is to provide free treatment for the country’s oft-overlooked sufferers.
It sounds like I am an advocate for The Phoenix House, I’m not necessarily, but we need a better answer for addicts today. Many can’t afford the treatment they need, many end up in jail, too many end up dead.
I’m glad there is a group willing to look at how doctors prescribe opiates and I’m glad they are working with addiction specialists to accomplish that.
My sister had surgery this week. It was painful. Instead of giving her opiates after surgery, they started with IV Toradol, a nonsteroidal anti-inflammatory drug like ibuprofen. She had good pain relief with it and did not need any narcotics post-operatively…none. My sister is strong, maybe even stronger than most, I’m not sure, but if we TRY non-narcotic drugs first, we will find we don’t need opiates as much as we thought we did. There are alternative treatments for chronic pain sufferers too, and there are doctors willing to work with patients to manage their pain. Doctors that want to see their patients as active members of society, not zombies who die from overdoses or end up in jail due to drug seeking. We need more doctors like that.