Dr. James Patrick Murphy is board-certified in Pain, Addiction, and Anesthesiology. He is President of The Greater Louisville Medical Society and the Course Director for OPIOID.
Dr. Murphy writes…
“What am I supposed to do? I’m over the limit.”
Recently I was visited by a patient “warrior”. I hadn’t known her before, but she had read one of my articles online and wanted to meet me. I was touched. There in the foyer of our surgical center, she motored up in her electric scooter and smiled the genuine smile of a person seeing a long lost friend.
Are there limits to friendship? No.
Are there limits to prescribing opioids for pain? Maybe.
At the vortex of misinformation swirling around pain regulations is the fact that no state has limited what physicians are allowed to prescribe, although some states make it unwieldy to treat legitimate pain patients compared to other states; some set unsubstantiated quantity limits while others require consultation to a pain specialist if a predetermined (yet not scientifically proven) “morphine equivalent dose is prescribed”. Nevertheless, no states unilaterally prohibit a prescription at any dose if the regulations are followed. However, requiring a pain specialist in some cases may become a logistical nightmare because in most instances there are not enough pain specialists to go around.
To be sure they have created thresholds above which physicians are required to do certain obligatory actions like: drug screens, re-evaluations, treatment agreements, and database queries. But these requirements do not represent ceilings to what can be prescribed – as long as it is medically necessary.
Are these regulatory obligations rational, reasonable, fair, or effective? That is a subject for another article. What is true now, however, is that prescribers are drowning.
“OPIOID” is the acronym used in an upcoming seminar that aims to rescue prescribers from the regulatory maelstrom.
“OPIOID” means Optimal Prescribing Is Our Inherent Duty. It is a seminar conceived by physicians, approved by Kentucky’s Medical Board, and produced by the Greater Louisville Medical Society in association with the University of Louisville – February 7 – 9, 2014. The goal of “OPIOID” is to empower prescribers to optimally care for suffering patients and adhere to the governing regulations. Clinicians and support staff can register by email: firstname.lastname@example.org or call: 502-736-6354 or visit online at https://www.glms.org/Home.aspx (and click on the “OPIOID” tab).
My new friend, whose pain had confined her to her motorized chair, wasn’t quite convinced when I assured her that her state’s (Indiana) regulations did not limit what her doctor could prescribe. But in her friendly eyes I saw hope. And her hope gave me strength.
Am I strong enough to climb over the barriers created by these regulations? Are you?
As long as there are patients willing to fight the good fight, then so will I. And courses like “OPIOID” provide us the tools we need to win. Together, the possibilities are limitless.
Please tell a friend about “OPIOID” and feel free to comment on this blog!
…and, a late edition gift from Dr. Murphy
Eagles – Take It To The Limit (Live at The Capital Centre 1977)
James Patrick Murphy, MD, MMM attended medical school at the University of Louisville, interned in Psychiatry at the San Diego Naval Hospital, studied at the Naval Aerospace Medical Institute, and later served as a Naval Flight Surgeon onboard the aircraft carrier U.S.S. Enterprise. He returned to Louisville in 1989 for residency training in Anesthesiology after which he completed a Pain Medicine Fellowship at the Mayo Clinic in Rochester, MN. Dr. Murphy is Kentucky’s first physician to achieve combined board-certification in Pain Management and certification in Addiction Medicine. Dr. Murphy is President of the Greater Louisville Medical Society, Medical Director of Murphy Pain Center, Assistant Clinical Professor at the University of Louisville School of Medicine, and serves on the board of the International Association for Pain and Chemical Dependency. In May 2013 Dr. Murphy earned a Master of Medical Management degree from the University of Southern California Marshall School of Business.