25 Rhode Island Doctors and Workers Prescribed Oxycodone 5,000+ Times
Tuesday, May 05, 2015
Twenty five physicians and health care providers in Rhode Island prescribed Oxycodone more than 5,600 times in one year under Medicare, according to a breakdown of physician activity by ProPublica.
The top prescriber, Dr. Jerrod Rosenberg, who was listed as having 384 Medicare claims for Oxycodone HCL in 2012, was reprimanded by the Rhode Island Department of Health in 2014 for the "off-label" use of another drug, and for "poor record keeping."
The third highest prescriber, Dr. Dennis Moonan, was reprimanded in 2014 for "not maintaining sufficient safeguards against diversion of controlled substances in his prescribing practices."
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTCombined, the top three physicians for Oxycondone prescriptions in Rhode Island were one fifth of the top twenty five prescribers -- and had a totail retail cost for all prescriptions filled under Medicare Part D in 2012 of over $1.7 million dollars.
SLIDES: See the Highest Oxycodone Medicare Prescribers BELOW
Oxycodone is a federally classified Schedule II drug, defined as "drugs with a high potential for abuse...with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous."
In Rhode Island, regulations recently went into effect outlining the responsible prescribing of prescription pain medication.
"[The] regulations went into effect [on March 16], which represent a significant effort at codifying responsible prescribing of controlled substances," said RI Department of Health Spokesperson Christina Batastini.
In the regulations, the Department of Health wrote, "It is recognized that controlled substances including opioid analgesics may be essential in the treatment of acute pain due to trauma or surgery. Use for chronic pain carries significant risk and the risks of chronic opioid use need to be weighed against limited benefits. Practitioners should always consider the many facets of pain and strongly consider an interdisciplinary or multidisciplinary approach to management of pain, (acute, episodic or chronic). Practitioners shall recognize that tolerance and physical dependence are normal consequences of sustained use of opioid analgesics and are not the same as addiction."
Addressing the Issue
First dubbed as a epidemic by the CDC in 2011, the problem has only increased.
“Deaths from prescription painkillers have also quadrupled since 1999, killing more than 16,000 people in the U.S. in 2013. Nearly two million Americans, aged 12 or older, either abused or were dependent on opioids in 2013 (the most recent year of full data),” wrote the CDC.
GoLocalProv reviewed data collected by the non-profit, media watchdog group, ProPublica who has been collected and organized federal data available. The data collected by ProPublica and reviewed and categorized by GoLocalProv comes from new federal reporting requirements impacting the Centers for Medicaid and Medicare (CMS).
A National Survey on Drug Use and Health found that Rhode Island ranked 13th in the nation in abuse of prescription drugs. The survey found that 5.18% of Rhode Islanders 12 years and older used painkillers for a non-medical purpose each year.
Nationally, a recent national study involving researchers at Rhode Island Hospital and the Miriam Hospital found that opioid overdoses were the cause of over 100,000 ER visits in 2010 -- more than two-thirds of all emergency room department visits for overdoses that year. According to the study, subsequent hospitalizations cost nearly $3.2 billion.
“Opioid overdose takes a significant toll on the health care system in the United States, both in terms of finances and resources,” says Traci Green, PhD, MSc, an epidemiologist at the Department of Emergency Medicine at Rhode Island Hospital and a senior researcher on the study. “To date, there have been minimal studies and related national data about opioid overdoses in emergency departments.”
"It's a culture shift. The [opioid] pendulum has swung back and forth, going back to the Civil War," said Dr. Jody Rich, Professor of Medicine and Epidemiology at Brown University, who said that the medical community's most recent efforts to address "chronic pain" were the precursor to the current epidemic.
"Chronic pain snuck in on the heels of addressing cancer pain and the push to address chronic pain became 'this is important, we need to measure this." Doctors were graded on how well they dealt with pain -- it was the fifth vital sign. They thought they'd get in trouble unless they treated pain," said Rich. "So it was 'let me give you some pills, let me give you some more' - it didn't help that big pharma was pushing, pushing, pushing. They gave out a lot of misinformation and shameful marketing practices, and that's what leading to this current situation. A culture of doctors overprescribing opioids, and addicting a generation."
National, Local Responses
Congress has recently been hearing from members of the medical community on how "physicians need better training in how to manage pain as well as how to treat addiction to opioids," according to MedPage Today.
"[We need] to develop better strategies for the management of chronic pain," said Nora Volkow, MD, Director of the National Institute on Drug Abuse, in Bethesda, Md., while testifying last Friday at a House Energy & Commerce Oversight and Investigations Subcommittee hearing on government efforts to combat the opioid abuse epidemic. "Physicians are forced -- their patients are suffering, they don't know what to do and give an opioid, even though the evidence does not really show us they're effective for chronic pain, but there are not very many alternatives."
Rich said that hoped that by requiring tracking of prescriptions, that those addicted might be helped into recovery.
"People don't understand [opioid] dependence...it attacks the part of the brain that's needed for survival," said Rich. "If physicians can see that a patient has gone to multiple doctors for pain medication, instead of be wary of treating them for being addicted, they should try and help them into recovery. There are many good programs currently out there."
Related Slideshow: RI Doctors - Who Prescribed The Most Oxycodone?
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