The United States only holds about 5% of the world’s population yet is consuming 99% of the word’s hydrocodone, 80% of the world’s oxycodone, and 65% of the world’s hydromorphone; all powerful narcotics. Those statistics show themselves in the most disheartening of ways with an opioid epidemic that has 1.3 million Americans needing hospital care for opioid related issues and over 30,000 dying from opioid overdoses in one year alone, with the number climbing every year. The nation’s opioid crisis also costs the U.S. over $70 billion a year when accounting for healthcare costs, productivity loss, addiction treatment and the costs of criminal justice actions and resources. The nation’s epidemic has garnered a federal response in the form of CDC guidelines that are discouraging primary care physicians from prescribing opioids as a first line of defense (or only line of defense) for patients with chronic pain and instead encouraging the use of non-opioid and even non-drug treatments for pain. A DEA response shortly thereafter indicated production quotas would be enforced for Schedule II pain medications, reducing the production of some medications by a quarter or even a third.
In response to the U.S. opioid crisis, one group in particular has been at the center of the DEA’s legal crosshairs: pain management clinics. In an attempt to stem the amount of narcotics causing addiction and being used to supply a street market, multiple state and federal agencies have begun cracking down on rogue pain clinics disregarding DEA regulations and serving as “pill mills” in their communities. Task force raids and subsequent prosecutions of suspect pain management clinics have resulted in the shut downs of such clinics, arrests and criminal proceedings against physicians and staff, suspensions or revocations of medical and drug licenses, substantial fines and even jail time.
States have also responded to the crisis with their own regulations and guidelines. The state of Georgia passed the Georgia Pain Management Clinic Act (HB 178) in 2013 outlining rules and regulations meant to take control of the issue of pill mills by requiring licenses from the Georgia Composite Medical Board (GCMB) for practices whose patient populations receiving Schedule I or II controlled substances are over 50%. Such licenses give the GCMB authority to perform background checks on the physicians and to ensure such clinics are actually owned by a Georgia-licensed physician as required by the law. The law also clarifies that physicians must perform physical exams before the prescription of narcotic medications and a stringent follow up plan to monitor the patient must be adhered to after the prescription of such medicines. Pain management clinics and their physicians and staff face harsh repercussions if they fail to strictly adhere to all rules and regulations set by state and federal agencies in regards to the prescription of pain medications.
The myriad of rules and regulations that healthcare practices and pain management clinics must remain in compliance with can easily be overlooked and bring about a multitude of risks for any healthcare professional. Healthcare providers should always consult with experienced legal professionals to ensure proactive policies and practices are in place in their practices to avoid such legal pitfalls.
Hamil Little PC
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** Disclaimer: Thoughts shared here do not constitute legal advice. Please consult with an attorney to discuss your legal issue.