The point is- never start prescribing opioids for chronic pain for anyone in your practice. It is the expectation of patients that they will receive opioids that caused the problem in this case. If the office makes it clear up front there will be no opioid prescriptions written, ever, then the problem children will go elsewhere. Getting involved with prescribing opioids for chronic pain is a road to hell for many patients and not infrequently for physicians also. "The only winning move is not to play".
He was shot by the husband of the patient for not prescribing opioids. This doctor did prescribe opioids to some patients. If doctors made it clear up front they do not prescribe opioids and that the patient should go elsewhere if they want opioids, this type of tragedy would not happen.
Opioids should remain schedule 2 or 3 and tighter restrictions imposed. There are way too many docs out there creating long term chemical dependency and never demonstrating improvement in function or pain. If you check initial pain scores before opioids compared with long term opioid pain scores, they are very similar or worse. How many people on disability start working again once started on opioids?
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No one on disability should be started on opiates.
How about restricting to 26 pills from surgeons post-op, 0-10 from ER, and no other Rx can come except from boarded pain physician?
Your ERs are pill mills, in Europe i would estimate that much less that 5% of ER visits are given or prescribed narcotics.