NPR's Montana Opioid Refugee Piece

[drusso]

http://www.npr.org/sections/health-...efugees-leave-state-to-get-prescribed-opioids

http://leg.mt.gov/content/Committee.../March-2016/march2016-casey-brock-pain-pp.pdf

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[Extralong]

http://www.npr.org/sections/health-...efugees-leave-state-to-get-prescribed-opioids

http://leg.mt.gov/content/Committee.../March-2016/march2016-casey-brock-pain-pp.pdf

"Be clearly advised that the anti-opioid movement is well-funded by such financial interests as interventional pain physicians, surgeons and surgical hospitals, mental health professionals, and the heroin cartel. "

Wtf!!!! Are you serious! That's the quote from the PowerPoint slide. They place heroin cartels next to mental health professionals and interventional pain physicians. First off, I didn't know heroin cartels are lobbying to decrease the opioid epidemic. Secondly, I'm at a loss of words. Sighhh

 

[SeniorWrangler]

Who's Forrest Tennant? They quote him a lot.

Also of interest, this article from 2015 also about "narcotic refugees" in Montana:
http://nationalpainreport.com/monta...al-license-for-narcotic-refugees-8825472.html

 

[lonelobo]

Tennant is editor of some monthly Pain medicine throwaway journal, who has never met a symptom that he doesn't think an opioid will help

 

[Ducttape]

Tennant is editor of some monthly Pain medicine throwaway journal, who has never met a symptom that he doesn't think an opioid will help

He is renowned for believing that there is no upper limit of opioid dosing, and the primary important factor for determining appropriate dose is when pain is gone.


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[lobelsteve]

He is renowned for believing that there is no upper limit of opioid dosing, and the primary important factor for determining appropriate dose is when pain is gone.


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Breath goes away minutes before the pain does.

 

[craigkes]

Interesting. I do practice pain in Montana. Trust me...the crap that is inappropriate prescribing is still out there. If you look hard enough here you will find it. I still see young people on methadone. Oxycodone doses that are mind boggling for sure. If I had a dollar for every patient put on inappropriate doses of opioids who showed up on my door wanting me to continue their ridiculous doses because "my doc doesn't feel comfortable writing it anymore" I wouldn't have to work nearly as hard. I have no issue putting it back on the referring doc. I will even hold their hand while they titrate them off (that is always my favorite conversation).

The bill of rights is a big issue for me because there is nothing in there that we don't already know (most of us). My idea of "prescribing opioids at a level deemed appropriate" is much different than what the patient thinks....shocker. There is nothing new here. I do find it interesting how "spinal taps" may be a treatment option. Maybe I missed that on in fellowship. Ok, ok...Prialt. Fine. Not really a tap...which I thought was for diagnostic purposes...but I am just an anesthesiologist. Oh....but I should be aware that there are side effects and possible complications from my epidurals. Maybe I should read up on those. I don't see any mention about the long term complications of opioid therapy in the bill of rights or the lack of long term evidence supporting its use. It must be on a slide that was deleted.

It is no more difficult to write medications in this state than any other.

 

[Ducttape]

https://projects.propublica.org/checkup/providers/1720278252
look it up. i was going to post it, since it is public information, but after reading the stats, i see such, um, wrongness...

1337 scripts, for $633K in 2013.

90% of his patients got an opioid. 40 patients got 1337 prescriptions. thats elite (pun intended).
his top 8 drugs are all opioids - oxycodone, hydromorphone, methadone, hydrocodone, morphine, fentanyl, oxycontin.

 

[lonelobo]

https://projects.propublica.org/checkup/providers/1720278252
look it up. i was going to post it, since it is public information, but after reading the stats, i see such, um, wrongness...

1337 scripts, for $633K in 2013.

90% of his patients got an opioid. 40 patients got 1337 prescriptions. thats elite (pun intended).
his top 8 drugs are all opioids - oxycodone, hydromorphone, methadone, hydrocodone, morphine, fentanyl, oxycontin.

This guy is a dealer masquerading as a legitimate Pain Physician

 

[hyperalgesia]

Typical NPR. They always pick the wrong victim with the wrong cause.

 

[Extralong]

This is just ridiculous. I just don't understand how physicians(they should not/don't deserve to be called pain physicians) just start sliding further down the rabbit hole.