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Doctors Dish to TheBlaze on Bloomberg’s New Rule Limiting Painkillers in the ER: ‘Ridiculous’

Jan. 16, 2013 8:45am Liz Klimas

Doctors Respond to Mayor Michael Bloombergs New Guidelines for Opiate Painkillers

(Photo: Shutterstock.com)

Last week, Mayor Michael Bloomberg announced that public hospitals in New York City would adopt his new guidelines that restrict emergency room doctors from dishing out opiate painkillers in an effort to curb abuse. But just what do medical professionals have to say about this?

“The fact that Mayor Bloomberg is suggesting that hospitals limit supplies of prescription pain killers in ERs is ridiculous,” Dr. Damon Raskin, a board certified internist and addiction specialist who works with Cliffside Malibu Treatment Center, said in an email to TheBlaze. ”Limiting opiate prescriptions will not change the drug problem and only cause problems with the patients who really need them.”

And that was a common theme among the medical professionals we spoke to.

The problem

A report by the Senate Caucus on International Narcotics Control says prescription painkillers accounted for 20,044 of 26,450 overdose deaths in 2008, more than those from heroine or cocaine combined. DrugFree.org pointed out that 70 percent of people who were abusing prescription drugs got them from a relative or friend.

Map shows an AP analysis of Drug Enforcement Administration data highlighting the increased use of the addictive pain killer oxycodone across the U.S. from 2000 to 2010.

According to the press release from Bloomberg’s office, the rate of opioid painkiller-related emergency room visits nearly tripled in the city between 2004 and 2010.

The new guidelines will be used in all of New York City’s public hospitals. Specifically, the guidelines prevent emergency departments from prescribing long-acting opioid painkillers, like oxycodone, fentanyl patches and methadone. Doctors will be able to prescribe up to a three-day supply of opioids but will not refill lost, stolen or destroyed prescriptions.

“Prescription opioid painkillers can be just as dangerous as illegal drugs,” Health Commissioner Thomas Farley said in a statement. “These new guidelines will help reduce prescription drug misuse while also making sure that patients coming to emergency departments have access to safe and appropriate pain relief options.”

Is government intervention needed?

Dr. Joshua Kugler, the chief medical officer and former chairman of the emergency services department at South Nassau Communities Hospital in Long Island, New York, said he agrees with Bloomberg’s efforts and called it a “necessary evil.”

“I applaud the concept, the philosophy behind it,” Kugler said to TheBlaze in a phone interview. “But also am cautiously optimistic about how this will truly affect patient care.”

Still, Kugler noted that there might be times when the guidelines could leave a legitimate patient in considerable pain. He said, for example, if a patient lost a prescription on a Friday evening after their doctor had gone for the weekend, they could be out of luck until Monday.

He added that although similar guidelines wouldn’t necessarily infringe upon how he or his department practices medicine, he does believe physicians need to have the ability to address patient care on a case-by-case basis.

Dr. Alex Kudisch, the chief medical officer at the Texas-based Origins Recovery Centers, expounded on this sentiment in an email to TheBlaze saying that “medicine must heal itself and without government intervention.”

“Yes, the Oxy for a toothache mentality must end, but the medical community will lose its rights to perform medicine if government intervenes,” Kudisch continued.

And what about the doctor’s roll in providing the drugs in the first place potentially contributing to the problem itself? Glenn Beck earlier this week said that if doctors providing the drugs can’t tell the difference between real pain and a drug addict, “then we have a problem with the doctors.”

Dr. Michael Michael with a rehabilitation clinic in Michigan told TheBlaze in a phone interview that for a long time physicians themselves didn’t do a good enough job managing patients’ use of the drug.

“A lot of it has to do with options — what options the doctor had at managing a patient’s pain,” Michael said, noting that even short term use of opiates as a painkiller is associated with an addiction risk.

He called opiates the “be-all-end-all in pain relief,” but noted there are other treatments now that doctors can use to avoid the drug completely.

“We’ve become better educated about it and are doing better at managing it, but are still not doing well enough,” he said.

Watch Beck share his thoughts regarding Bloomberg’s guidelines and the mayor’s comment that people using the ER as their source of primary care might have to “suffer a little bit”:

Treating the addiction

While Michael, who works specifically with patients suffering from addiction, agrees that something needs to be done to help curb the problem in the short term and that Bloomberg’s guidelines might cut down on overdose situations, he told TheBlaze that he doesn’t think it will have a significant, long-lasting effect.

Why? Because treatment of the addition is more than just cutting off the source. Part of the problem is the treatment in and of itself. Michael said the most popular way to wean an opiate addict off the drug is to put them on another, more controlled opiate, which would then be reduced over time. Although Michael said he respects those who provide this type of treatment, he said it’s not only painful for the addict but also not entirely effective as it often leads them to become addicted to this other opiate.

As a doctor at the Eagle Advancement Institute, Michael takes a different, 100-percent non-opiate approach at treating patients. In fact, the Clarity Detox Program was named one of the top five technologies to reduce prescription drug abuse by the Center for Lawful Access and Abuse Deterrence.

Michael said four out of five patients going through their program are successful at overcoming their addiction.

And even if addiction is being addressed, what is to be done about overdoses, which are still bound to occur? Kugler pointed out that Naloxone, an injectable drug used to reverse opiate overdoses, is being distributed to sources beyond emergency responders. New York and a few other states have programs expanding the distribution of Naloxone kits. Reuters reported on a study last year that found it would be life-saving and cost-effective to put the Naloxone kits directly in the hands of known heroine users.

Overall though, Kugler said stifling the problem goes all they way back to parents and schools having a real dialogue with children about the risks associated with prescription narcotics.

In other words, personal responsibility is just what the doctor ordered.

–

Related:

NYPD to Introduce ‘Bait Bottles’ With GPS Trackers to Combat Theft of Prescription Meds

Featured image via Shutterstock.com.

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Comments (53)

Diego Roswell
Posted on January 16, 2013 at 12:05pm
“Kugler noted that there might be times when the guidelines could leave a legitimate patient in considerable pain.” Thats ok with them, they can get all the morphine they want. The elites are excluded from the laws that control the commoner. WAKE UP AMERICA YOU USELESS SHEEP

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perry1980
Posted on January 16, 2013 at 11:40am
I used to think California would be the first state to take total control over their residents.
I now believe New York will be the first state to go Socialists/Communist.
Mayor Doomberg.

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- The_Cabrito_Goat
  Posted on January 16, 2013 at 3:04pm
  This could really be the final straw with New Yorkers.
  
  What, does he WANT people to be in pain, those who really need painkillers?
  
  For the ones that “want to get high”, punish they, the individual, not society.
  
  Report this comment
- ExtremeRight
  Posted on January 16, 2013 at 5:44pm
  Correction: It is a socialist state. Why are so many Jews leftists ? … Serious question
  
  Report this comment
Blazin Glory
Posted on January 16, 2013 at 11:37am
What a hero he will be when the next plane flies into a building and 1000 people are at the E.R.

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VetMike
Posted on January 16, 2013 at 10:28am
As a retired Army Officer and Emergency Physician I’ve sen this problem for years. It was not a problem in the military as we could require people to go through rehabilitation if they had a problem and discharge them if they were recalcitrant. When I first started working in civilian EDs I was astounded at how many people came to the ED seeking pain relief and then you would see them again in a week. A significant number were for dental problems, usually long neglected. Many Dentists will not see patients who cannot pay and dental plans are often beyond the patient’s means. Rarely do you have free dental clinics. On the other hand are the abusers and addicts. Simply not giving them drugs doesn’t stop them from coming to the ED and there are no treatment centers that will take non-paying patients. We’ve been dealing with this problem for two decades and no-one yet has found a solution.

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- HigherRoad
  Posted on January 16, 2013 at 10:47am
  Undoubtedly these problems exist; however, it seems that those in the medical profession, like yourself, are far more qualified to evaluate patients and prescribe appropriate levels of medication. Mayor Bloomberg has overstepped his authority.
  
  Report this comment
- SLEAZYHIPPOs ILLEGITIMATE OFFSPRING
  Posted on January 16, 2013 at 12:02pm
  As a surgeon myself, I regret this action by an elected official. I believe it is a sign of things to come. First it was banning soft drinks for your good, then guns, then limiting numbers and types of pain medications. I believe it stems from this elitist, “I know better than you how to run your life” arrogant jerk. This is the same man who got a ban passed on idling your car in the summer with A/C running while he got caught doing that very same thing himself. While drugs are certainly a problem I want to clue everyone in one a little medical secret. Most physicians I know working the ER get so worn out by the same addicts coming in with their lame excuses holding up the ER that often they will give them what they want just to get them out of their ****. They are a nuisance and they now it, it’s part of their game to get what they want. The problem is eventually your doctor wont be practicing anything he will simply be following dictates and guidelines handed down from the government of what he must do for you. In many ways we already do. We have become a nations of cowards and Kings. The power grab in the name of safety is astounding. All the while no mention of how many of these frequent flier ER addicts are subsidized by the government and state medical aid that truly makes it all possible while you and I foot the bill. Why shouldn’t they pay something for their irresponsible behavior? Liberals don’t believe in personal responsibility, I forgot.
  
  Report this comment
- DebateMe
  Posted on January 16, 2013 at 12:33pm
  @HigherRoad
  Perfectly stated. This is just par for the course with today’s politicans meddling in things they don’t care to fully understand. Their meddling will just make a great photo op, sound bite, or bumper sticker to promote their next election with. There’s no doubt that people can be addicted to pain killers. But it is the doctors who are best suited to managing each individual patient’s needs. What bloomberg has done is put a band-aid over a problem while the underlying causes continue to fester. In the meantime, important matters politicians should really be spending their time on go unaddressed. /golfclap
  
  Report this comment
- Former11BRAVO
  Posted on January 16, 2013 at 2:22pm
  I agree with HigherRoad. Who better to judge than the doctors and nurses who work in these emergency departments?
  
  Hey Mr Mayor! Have you ever been in extreme pain? No? Then who the HELL are you to judge what it’s like – or to condemn patients to “suffer” a bit, before they get relief? Unbelievable!!!! :-(
  
  Somebody should drop a 16 oz bottle of soda on his head – from atop the Empire State Building! Maybe THEN he’d get a clue! Hey boys and girls . . . can you spell J A C K A S S ?
  
  Report this comment
- Wisdom7
  Posted on January 16, 2013 at 2:44pm
  ” A significant number were for dental problems, usually long neglected. Many Dentists will not see patients who cannot pay and dental plans are often beyond the patient’s means. Rarely do you have free dental clinics.”
  
  You are so very right about this. I could expand on this for an entire page. Honestly, we can rant and rave over Obamacare, but in my opinion it is one of the reasons the GOP lost because they came up with nothing. It made them seem uncaring toward the very people you speak about. They need help the most and no one is helping them. One can also see by comments on this site they are continually placed into the category of loser and addict. If you are between jobs with no insurance and cannot afford insurance, a dentist isn’t going to help you either. We have one free clinic, a Christian Mission, in a three county area where I live that has around a two year waiting list for dental work because no dentists will offer their time. I think they have a single dentist that is basically retired providing services presently.
  
  Report this comment
leasecommander
Posted on January 16, 2013 at 10:26am
Bloomberg thinks he’s a doctor, no he thinks he’s a dietitian, no he thinks he’s Mr. Obama, no he thinks he’s a King, no this man doesn’t know how to think!!!!!!

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loafer4952
Posted on January 16, 2013 at 10:10am
The people of New York elected this idoit. So guess they are getting what they asked for.

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brigott
Posted on January 16, 2013 at 10:07am
Dr. Michael Michael – what parents in their right minds would do that to their child?

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rockymtngal
Posted on January 16, 2013 at 9:53am
Most hospitals know which people are “pain-pill” seekers. I have a real problem with how this Obama healthcare reform is having an impact on those of us who have employee or gov’t insurance. Insurance companies have already raised premiums and are offerring less benefits. People on these plans, in most cases, are required to get their scripts via mail order to save on costs. Now, many of the medications people received on a 90 day basis, are now on a month to month basis. Obamacare not only treats those who can’t get insurance, it has taken over ALL insurance companies (except gov’t and union) and how they now operate. Higher premiums, higher out of pocket expenses, higher deductibles, fewer benefits and total control of our medications.

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HigherRoad
Posted on January 16, 2013 at 9:48am
It seems that New York is not a good place to live with people like Mayor Bloomberg and Gov. Cuomo putting ridiculous constraints on individual freedoms. Whoever heard of a mayor determining the level of prescription pain relievers an ER doctor can prescribe? Come to think of it, whoever heard of a mayor determining the size of a soft drink an individual can have? Now Gov. Cuomo is taking it upon himself to single handedly destroy the 2nd Amendment. Good luck, New Yorkers!

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SeekerEmerald
Posted on January 16, 2013 at 9:40am
I hate to nitpick, but if TheBlaze wants to be taken seriously, PLEASE PLEASE PLEASE hire an editor to read all these stories BEFORE they get posted!

Or, if the idea is to let the writers post quickly, then somehow ensure the writers are having another set of eyes ready these stories. I don’t always re-read my comments here, but I’d never post a story without carefully proofreading it.

“And what about the doctor’s roll in providing the drugs…”

This should be “And what about the doctor’s ROLE in providing the drugs…”

I’m not LOOKING for these errors, some of them just jump out at me.

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- firstHat
  Posted on January 16, 2013 at 9:59am
  you missed where they typed “addition” instead of “addiction.” I have long thought that the Blaze should set up a special email account for typo reporting and then give it to some of us who read fairly regularly and are good at catching such things. Of course they should check us out to make sure that we aren’t whack jobs and/or have some background that suggests they’d make good editors, but then they should let us report errors. They could have a free editing service if they wanted. At least I know I’d do it just to help the Blaze look better!
  
  Report this comment
firstHat
Posted on January 16, 2013 at 9:38am
I think whoever made that map for AP was testing out the stuff of the topic. Did anyone else notice that Minnesota replicated itself and is pretending to be New Mexico?

I guess it takes a dyslexic to see it in others :-)

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MrKnowItAll
Posted on January 16, 2013 at 9:36am
Those Opiates. You just Can’t eat just one.
Pharmacists today think they are Dr.’s and God! Fill my Scrip Idiot!
Get OFF any Opiate…..Three Glasses of Medimucle a day. AND CO Q 10 Once a Day.
Thank Me in Three Days.

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- Tachy320
  Posted on January 16, 2013 at 1:26pm
  Right on. I switched pharmacies when they wouldn’t fill an scrip because it was a few days early. He said he needed to talk to my Dr. even though he received a scrip signed by my Dr. I was so mad, my wife had to talk to him. I was not happy. I asked him if he was a Dr. and he said no. I said then quit acting like one and fill it. A*****e.
  
  Report this comment
pagraywolf
Posted on January 16, 2013 at 9:28am
Anyone else notice that New Mexico has become Minnesota????? Gotta love our government at work…

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- firstHat
  Posted on January 16, 2013 at 9:43am
  Heh…you beat me to it! I just posted then came back and found yours. However, that map was produced by AP not the government and I probably shouldn’t point to the typos in the article itself, for instance, it should be “role” not “roll” and in one case, “addition” should be “addiction.”
  
  All this coming from the typo queen herself :0)
  
  Report this comment
rabblechat
Posted on January 16, 2013 at 9:25am
So every three days you will need to pay for another Rx and most likely another office visit as most Doctors wont write a prescription for medication especially pain meds without seeing you first.

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Wisdom7
Posted on January 16, 2013 at 9:21am
I have to say that map is interesting. Perhaps they should try to find out WHY there is such high use in those high use areas. Many of them seem to be very low population rural areas. Perhaps more physical labor and farming that causes injuries?

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AndiAndiAndi
Posted on January 16, 2013 at 9:19am
Doctors don’t refill narcotics if they are lost or stolen. That’s a policy that’s been around forever. If there is proof that somebody had their pain medicine stolen,for example in a burglary, then it is at the doctors discretion to refill it, not Bloombergs. I hope Bloomberg starts getting chronic migraines and kidney stones. I’m sure that if he goes to the emergency room, he will get more than a 3 day supply. Jerk.

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Al J Zira
Posted on January 16, 2013 at 9:09am
So last January, when I was diagnosed with cancer and had to have surgery, I was on morphine and Dilauded, a high potency kind of morphine that acts quickly, my 2 weeks in the hospital. When I was released I was given a prescription for both drugs but had a hard time getting them filled by the pharmacy without approval by my health care provider. While waiting at home for the scripts to be filled the opiates wore off and I experienced the full brunt of the pain from surgery and cancer.

Let me tell you: it feels like someone is trying to rip you stomach out through your nose. The pain was excruciating! Maybe the village idiot needs to experience something like that to feel the full effect of his ill conceived edict.

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- biohazard23
  Posted on January 16, 2013 at 9:18am
  His policy wouldn’t apply to him, only to the little people and you, my friend, would still be SOL. And just as there are people who are able to scam the system now, there will be patients who will find a way to work around these restrictions, too. All this does is make it more difficult for patients with a legitimate need suffer while the pill junkies get their fix elsewhere just like they do now. There are plenty of Dr Feelgoods out there and the pill poppers know it. Doomberg has no idea what he’s doing but that isn’t surprising in the least.
  
  Report this comment
- blanco5
  Posted on January 16, 2013 at 9:29am
  He is in the category of “more equal than others.”
  
  Report this comment
- whatsallthisthen
  Posted on January 16, 2013 at 9:37am
  Sorry to hear of your pain going without treatment. Everything the govt. gets involved in means less and less positive results. The so-called war on drugs is a complete failure and always will invite the criminal element. Several years ago I heard a well known MD suggest free opiates for addicts. I used to purchase drugs for a medical facility and was very much surprised at the low cost for phar. grade opiates. 0.1% of average street value. Imagine giving away $1.50 drug and 2, $.20 syringes a day to an addict and see the resulting crime numbers go down. Not recommending it, Just imagine!!
  
  Report this comment
Uechi
Posted on January 16, 2013 at 9:08am
People of New York vote with your feet, turn NYC into the new Detroit.

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- kaydeebeau
  Posted on January 16, 2013 at 9:47am
  Uh- I think NYers should be allergic to Tennessee – try Illinois – we don’t want the cancer spreading in the south thank you
  
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biohazard23
Posted on January 16, 2013 at 9:06am
So Doomberg is now a physician who specializes in pain management and emergency treatment? The gall of this guy… Now he knows better than medical doctors… What an arrogant putz! He almost makes dear leader look relatively humble.

Almost, but not quite.

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- RJJinGadsden
  Posted on January 16, 2013 at 9:22am
  Morning BIOHAZARD, Yep, almost…..
  
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- biohazard23
  Posted on January 16, 2013 at 9:39am
  Good morning, RJ! Yeah, no one can top dear leader in the arrogance dept. If someone did, he would just find some way to be beat them into submission to make him king of that hill again.
  
  Report this comment
Southernsoul
Posted on January 16, 2013 at 9:04am
The leftist morons in NY voted for this guy, they got him, they deserve him. Just stay in NY and don’t bring your crap to Florida. You made your bed, now sleep in it.

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jakartaman
Posted on January 16, 2013 at 9:00am
Bloomy’s arrogance is only surpassed by his stupidity.
He now thinks he has a Medical degree. What a Nanny!
But the New york liberal voters love to be told what to do, when to do it and how to do it.

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- starman70
  Posted on January 16, 2013 at 9:13am
  Next he will be dictating the amount of toilet paper one can use after a bathroom visit and will require dispensers metered to dispense only a certain amount at each “Sitting”.
  
  He should realize that anyone who gets these drugs will just transfer the contents of the container to an old pill bottle and the marked containers will just wind up in the trash. His legion of government trackers will have a ball tracking all those trash containers.
  
  Bloomberg is a complete idiot!!!! I just can’t believe that New Yorkers just don’t have a recall election and heave this numbskull out of office. He is the epitome of what wrong with America.
  
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- oldguy49
  Posted on January 16, 2013 at 9:27am
  only 3 minitue showers ……….soon
  
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Taurnil
Posted on January 16, 2013 at 8:58am
It astounds me people of NY City think so low of themselves to have elected such a tyrannical, dictatorial and petty individual as Bloomberg.

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RightUnite
Posted on January 16, 2013 at 8:57am
Bloomberg needs to have his sorry *zz forcibly removed from office. He is a disgrace to the country.

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dustbunnieskill
Posted on January 16, 2013 at 8:53am
And we thought there was already too much govt. interferance.God save the ‘Kings

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Snowleopard {gallery of cat folks}
Posted on January 16, 2013 at 8:50am
Government intervention is not needed in the nanny state dictatorial method of Bloomburg.

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- barber2
  Posted on January 16, 2013 at 9:47am
  SNOW: Think Bloomberg is suffering from the 16oz. Soda Syndrome.
  
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- M13
  Posted on January 17, 2013 at 2:53pm
  I think he just suffers from liberal stupidity.
  
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