The federal government has made no secret of its concern over what is invariably described as an “opioid epidemic” sweeping the country. Nor is it a secret that the government sees prescribing physicians—especially primary care physicians—as the best choke point for slowing the flow of opioids.
Virtually every day another federal department, agency, or commission joins in the effort to assist—or further regulate—prescribers. Last week the Food & Drug Administration announced a new rule requiring stronger warnings on immediate-release opioids. The rule puts the onus on manufacturers to provide the new warnings. But one clear effect of the warnings is to charge prescribers with a higher level of knowledge about the drugs they prescribe. And with the higher level of knowledge comes a higher level of responsibility.
Earlier this month the Centers for Disease Control & Prevention published a new “checklist” for use by physicians in prescribing opioids for chronic pain. Like the new FDA rules, these CDC guidelines have the effect of increasing prescribers’ knowledge and responsibility. (The guidelines appear in in the March 18 issue of the CDC’s cheerily titled publication, Morbidity & Mortality Monthly.)
Even the normally paralyzed Senate managed a rare near unanimous (94-1) vote to pass S. 524, the Comprehensive Addiction & Recovery Act (CARA) to “address the national epidemic of prescription opioid abuse and heroin use.” One section of CARA (§101) calls for “Development of Best Practices for the Prescribing of Prescription Opioids.” When issued by the government, best practices tend to become required practices.
Clearly, the federal government is intent on placing responsibility for addressing the opioid epidemic on the shoulders of the prescribers.