Opioid Crisis: Need new American Boarded specialty
The opioid crisis has been discussed by lay people, mayors who want heroin injection sites and more. What we need is a new American Board Specialty in Chronic Pain Management that has specific rules on long term prescribing of narcotic pain meds. Right now, there is no longer term prescribing rules nationally, only recommendations, and the system is totally out of control. Prescribing narcotic medication is part and parcel in a surgery practice and in that setting is generally designed to be short term. According to the CDC and other statistical data is that the sheer number of pills prescribed in the U.S. alone is staggering and has steadily increased. “Health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills”.When the numbers of pills prescribed is analyzed, about 50% of all opioid pills are prescribed by primary care physicians. This massive increase in number of pills prescribed has resulted in overdose and addiction. What can be done to reduce the supply of narcotics to the public? Congress should appeal to the American Board of Medicine with HHS input to create a Board certification for a chronic pain residency program to help increase the numbers of chronic pain specialists nationally. Congress should come up with a grandfathering clause for current chronic pain specialists and the ABM draft minimum new program requirements for a Board Specialty. Congress must give incentives for grads to go into this new specialty like we did for rural medicine. In the meantime, primary care providers who are prescribing for chronic pain must be limited in the first 3 months of prescribing with mandatory referrals to specialists like orthopedics and neurosurgery and neurology as indicated, and no open ended long term prescribing unless those other modalities have been thoroughly exhausted. Can establish a panel of peers made up of mainly 1 year pain specialty providers via the web to review cases NOT for punitive reasons but for outside look at chronic cases that might need new approaches. We also need a Federal narcotic istop program initiated.