Limit prescriptions. Ohio’s new rule limits painkiller prescriptions to 7-day supplies for adults and 5-day supplies for kids and teens.
New Jersey has a 5-day rule, and Kentucky a 3-day rule. The rules usually don’t apply to cancer or hospice patients or people getting medication-assisted addiction treatment. Critics say that these limits shouldn’t over-ride a doctor’s judgement and could hurt patients.
Educate doctors. The Centers for Disease Control recommends physical therapy for common muscle and joint pain — stiff necks, arthritic fingers, bad backs. But doctors refer patients with low back pain to physical therapists in only 10 percent of cases. In a Washington Post-Kaiser Foundation survey of people who had taken prescription opioids for at least two months within two years, 38 percent didn’t hear from their doctor about any option other than drugs.
Doctors have been scolded by their own Surgeon General.
Another solution would be to encourage insurers to let people go directly to physical therapists rather than through their primary care doctor. Insurers, public and private, should also remove other obstacles to reimbursement for non-opioid pain management.
November 02, 2017
Christopher Nystuen, MD, MBA