Don’t criminalize doctors for prescribing opioids

As Americans continue to die from drug overdoses at a increasing rate, policymakers are seeking interventions to reduce reckless medical practices that put patients at risk of addiction. Many of them Recommended the law want To limit the number of times patients can use prescription opioids from their physicians. But as for us New researchPublished this week Yale Law and Policy Review Inter aliaArguably, prescription opioids are not responsible for today’s crisis.

Laws that are set arbitrarily duration or Amount Restrictions for opioid treatment methods are based on the belief that increased access to prescription opioids has led to increased addiction and ultimately overdose deaths.

However, while opioid deaths continue to rise, so do opioid prescribing rates decreased Every year since 2012. Furthermore, non-medical use of prescription opioids remains relatively low stable Over the past two decades. As we indicated in our research, popular spike The rate of nonmedical opioid use reported between 1998 and 2002 is likely due to major changes in survey methodology. And if there was a real increase in non-medical opioid use, it might be because of it Codeine, not overprescribing a common pain reliever like OxyContin. The claim That the introduction of OxyContin in 1996 “fueled” prescription opioid use is not supported by data.

Such claims about Purdue Pharma were echoed during last week’s House Energy and Commerce the hearing In the fight against fentanyl overdose. Rep. Tony Cardenas (D-Calif.) Foreword “His questioning with Purdue, the Sackler Family, and crime pays—still one of the wealthiest families in the world…who are a big part of where we are today.” Rep. Marianette Miller-Micks (R-Iowa) shared a similar one emotionality: “As we know, post-operative care and pain management, a lot of opioid addiction is triggered by pain relief.”

But it’s illegal opioids like heroin and fentanyl, not prescription pain relievers, that initially responsible for today’s opioid crisis. By reducing access to legal channels of prescription, laws that limit the use of prescription opioids only increase the likelihood that a pain patient will have to turn to the black market to meet opioid demand with dangerous illegal drugs.

And yet, academics and policymakers continue to push for reforms that will exacerbate the problem. For example, Loyola Marymount University law professor Rebecca Delfino Recommended That Congress passes the Prescription Abuse and Prevention Act (PAPA), a law that would make it easier to prosecute physicians for violations. Controlled Substances Act (CSA). No legislation specifying PAPA has yet been introduced, but policymakers have shown the hunger Criminalizing doctors for prescribing opioids in the past.

Under the CSA and the law It follows, that it is unlawful for a physician to “knowingly or intentionally” prescribe a controlled substance unless the prescription is “for a legitimate medical purpose…in the ordinary course of his professional practice.” Like CSA, PAPA provides an objective or knowledge Still for sale standard, but allows a “presumption of knowledge” to be established by a “physician’s expert knowledge, practice experience and specialized medical training.”

Simply put, if a patient overdoses on a medication prescribed by a physician, the event itself may be sufficient to convict the prescriber of second-degree murder. This is because the doctor’s skill should have prevented the patient from such a risky situation in the first place.

While it shouldn’t be expected that prosecutors will go after every physician whose patient overdoses under PAPA, this phenomenon will likely concern many physicians because of the automatic conviction upon charge. Furthermore, PAPA gives prosecutors the discretionary authority to imprison any physician whose patient overdoses while under his care. Such potential liability shall be further reduction on prescriptions across the country, which will only increase illicit opioid deaths.

Supreme Court in the last term clarify inside Rouen v. United States That to be liable under the CSA, a physician must “knowingly or intentionally act in an unauthorized manner,” rather than merely intending or knowing that he or she is prescribing some controlled substance. Although the CSA regime is not perfect, the regime is there Ruan Provided much-needed clarity on the standard of liability under the CSA and protected physicians from being prosecuted for merely acting as authorized.

Criminalizing doctors is not the way to end the opioid crisis. As much as the literature indicates, opioid prescriptions rarely lead to addiction when treated. intense or lasting Pain Given that more than 88 percent of opioid overdose deaths now involve heroin or fentanyl, targeting prescriptions is not an effective way to combat mortality. The way forward is to expand access for both addiction and pain patients, so that those who most need a safe environment to consume opioids can do so legally.