New York City to Restrict Prescription Painkillers in Public Hospitals’ Emergency Rooms

[alp227]

Source: NYT

Some of the most common and most powerful prescription painkillers on the market will be restricted sharply in the emergency rooms at New York City’s 11 public hospitals, Mayor Michael R. Bloomberg said Thursday in an effort to crack down on what he called a citywide and national epidemic of prescription drug abuse.

Under the new city policy, most public hospital patients will no longer be able to get more than three days’ worth of narcotic painkillers like Vicodin and Percocet. Long-acting painkillers, including OxyContin, a familiar remedy for chronic backache and arthritis, as well as Fentanyl patches and methadone, will not be dispensed at all. And lost, stolen or destroyed prescriptions will not be refilled.

City officials said the policy was aimed at reducing the growing dependency on painkillers and preventing excess amounts of drugs from being taken out of medicine chests and sold on the street or abused by teenagers and others who want to get high.

“Abuse of prescription painkillers in our city has increased alarmingly,” Mr. Bloomberg said in announcing the new policy at Elmhurst Hospital Center, a public hospital in Queens. Over 250,000 New Yorkers over age 12 are abusing prescription painkillers, he said, leading to rising hospital admissions for overdoses and deaths, Medicare fraud by doctors who write false prescriptions and violent crime like “holdups at neighborhood pharmacies.”

Read more: http://www.nytimes.com/2013/01/11/nyregion/new-york-city-to-restrict-powerful-prescription-drugs-in-public-hospitals-emergency-rooms.html

[Deep13]

1. Jesus, Bloomberg, leave medicine to the doctors...

...and stop being such a fucking control freak.

[Mojorabbit]

9. Exactly!

What the hell are they supposed to do with patients in pain! Good grief

[area51]

22. +1 n/t

[cstanleytech]

27. Actually some of it makes sense atleast

as far as preventing or atleast limiting people from misusing emergency rooms to gain access to narcotics that they do not need or are just going to abuse though I am not sure if the total ban on replacement prescriptions makes total sense though because people do have theirs stolen from time to time or they lose them.

[christx30]

29. Yeah,

Bloomie got a lot of praise on this board with the soda thing. Got some grumbles about the breast feeding thing. Now prescriptions? Sooner or later he's going to stick his nose into something that any of us are into. And that person is gonna be steaming mad and outraged. The rest of us are gonna say "where were you a year ago?".
What you gotta do is stop this shit cold. Politicians step out of line s little bit on crap like this, or soda, whatever major evil of the world which is not his business, you gotta protest. Even if you don't really care. 16oz sodas yesterday. Healthcare decisions today. What's tomorrow?

[raging_moderate]

32. From a Board Certified Family doc doing Emergency Medicine....

There is no rational or safe reason for Emergency Departments to treat chronic pain, so there is absolutely no place for long acting pain meds (such as oxycontin, MSContin, fentanyl patches) to be be prescribed thru the ED. Period. Chronic terminal pain (end stage cancer etc) should be cared for thru primary care providers and/or hospice care. Unfortunately, we have millions of people with no insurance (until they become medically bankrupt and qualify for medicaid) which makes those options unavailable to many.

For acute pain (fractures, sprains, abdominal pain etc..) patients frequently can not get in to see their own physician or need to be seen in the ED due to the nature of their problem. Their pain should be evaluated and treated appropriately. There are times when three days may be cutting it short (pt can't get in for a recheck of referral within that time frame).

Ideally, medical providers who give narcotics out like candy because it's simply easier than doing their jobs properly (yes, I just said that) would be knocked straight by the DEA and/or medical boards as well as their colleagues and facilities they work at. Unfortunately, up to this point that has not worked.

There is no easy answer.

[datadiva]

2. Unbelievable, all about controlling people. n/t

[Skyline]

21. Well Bloomburg

Did pass the whole no soda over 16oz and women have to breastfeed.

[GeorgeGist]

3. Practicing Medicine without a license.

Oh well. The insurance companies do it, why not the mayor?

[LeftyMom]

4. A family friend had to turn to emergency rooms for pain medication repeatedly

because her terminal cancer was being undertreated by doctors who feared that she would become dependent or die of an overdose.

Read that again if it didn't make you want to punch anybody the first time.

[bettyellen]

6. I could barely walk and it too two visits and an MRI before the fuckers at

NYU hospital gave me a referral to see someone in pain management for a script.
Seriously, they had me wait 5 weeks.

[LeftyMom]

10. She never did get a referral to a pain management specialist.

She had indigent care through the county and they won't cover it, and as a policy her primary care clinic wouldn't refer people out for pain management.

But the good news is that after two years of asking for one her wheelchair was approved two weeks after they declared her terminal. Before that she was told that she could get antidepressants for being depressed about being housebound, and physical therapy to strengthen her legs (which wouldn't have helped with her heart condition, and she was dying anyhow) but no wheelchair.

[bettyellen]

19. So messed up. Even with insurance I think the whole thing cost me 1K

I went through the tests because my boss insisted I needed to fix it with surgery if needed. So I found out I was not a candidate for surgery AND they recommended no treatment except of symptoms. No advice at all. If surgery was indicated they would have been good, but they are too afraid of liability to do any treatment. The chiro or my GP will be dealing with it from here on in.

[ProgressiveProfessor]

5. Bloomie is now a doctor, who knew?

Its not like the ER docs are passing them out like candy....

[azurnoir]

7. stupid law that will impact the poor and uninsured the most

cause guess what Mr Bloomberg I've seen and have known people who were abusing prescription pain killers and they're not getting them from the ER, they're getting them in clinics from their regular MD's

[jtuck004]

14. +1000. n/t

[unblock]

8. this makes perfect sense

in a world where emergency rooms are used exclusively for emergencies and everyone had easy access to primary care physicians for follow-ups.

unfortunately, even with obamacare we still live in a world where emergency rooms are often used as walk-in clinics or as a substitute for a primary care physician.

so if someone actually needs a week or a month worth of meds, all this does is make emergency rooms even more crowded with patients making repeated visits....

[pnwmom]

17. Obamacare hasn't taken full effect yet, so we don't know how it is going to work out.

The aim is to reduce the number of people seeking primary care in emergency rooms. Expanding the Medicaid rolls should help with that, in the states that cooperate.

[WCLinolVir]

11. This is awful.

It just screws the people who need pain relief. Honestly. Can we get a policy that doesn't penalize legitimate patients?? Now every doctor has to look at all patients as med seekers. Where's my pot. I have a headache.

[Socal31]

12. Aren't we trying to keep .gov OUT of medicine?

Now we are bringing the drug war to people who need pain medicine legally?

Prohibition does not stop a problem. People who need a substance for physical or emotional pain will just turn to something else. Or steal for it.

Here is a headline from 2014. Write this down:

"Record opium crop in Afghanistan floods NYC with high-grade heroin"

I am no fan of street-level drug dealers. I am no fan of BigPharma reps pushing poison onto people who don't need it. But I sure as HELL would rather have 50 people in pain get their medication if that means 5 addicts get their fix by mistake.

Not only does ensuring Doctor contact for refills allow the person to be monitored physically and mentally, it makes the product safer (unless you drink Alcohol with your tylenol-loaded garbage), consistent, and keeps the money out of the illicit market.

[ChazII]

13. My first reaction

Makes me think of the old saying, "Power corrupts"... Bloomy has been corrupted in my opinion.

[catbyte]

15. Jesus Christ. I am sure Tylenol will totally take care of the pain from that gunshot.

Moron. This pisses me off to no end. Shouldn't he be dinged for practicing medicine without a license?

[woodsprite]

34. And good luck finding some Arthritis Strength Tylenol.

It's the strongest OTC Tylenol product you can get, time released, and lasts 8 hrs. It's a godsend for someone who can't take script anti-inflamatories like Voltaran, etc. BUT, try to find it (at least around DE/PA area and you're out of luck.

I went to the ER last year with a 7mm kidney stone trying to work it's way out of the kidney to the bladder. They said it was too small for lithotripsy. We knew it was in there since the docs had been watching and waiting for it to make a move. Talk about painful! It's worse than non-medicated labor/childbirth. After 8 hrs in the treatment area, being catscanned etc, the doc came back and asked how the pain meds were working. I told her "What pain meds?" I don't know if someone filled out my chart wrong or not but I had received no pain meds - oral or IV. Hubby was with me the whole time and could verify that. They sent me home with an envelope with 3 oxy. My 18yo daughter had her 4 wisdom teeth out last year and her oral surgeon prescribed a 30-pill bottle of oxy after the surgery which I thought that was TOTALLY ridiculous for a complications-free procedure. Neither of us used any of them.

[jsr]

16. What an asshole

Bloomberg is out of control.

[LeftInTX]

18. WTF????

[supercats]

20. Bloomberg's Got To GO!

This guy repeatedly over steps his boundaries to suit his own personal morality and here he is doing it once again. This is not right.

[Yo_Mama]

23. The guy has some psychiatric disorder

I don't know what they call it - maybe they should name it after him in DSM XX.

He's got a lunatic need to control the lives and choices of other people. Now he wants to control doctors?

This policy only really affects poorer people who don't pay to see a private MD, so it will fly in NY because the "people who matter" won't be affected. But when some poor schmuck with a bad injury is sent home and starts screaming in pain in a couple of days....

Elitist bastard.

What are they supposed to do at the ER if someone comes in detoxing from heroin if they can't use methadone?

[union_maid]

24. Psychiatric disorder sounds right

I was bewildered by his need to legislate about soft drinks. This is outrageous.

[RandiFan1290]

25. Yeah! Get your drugs like Rush does!

At the Denny's parking lot on Belvedere Rd!

https://maps.google.com/maps?hl=en&ll=26.690916,-80.0731&spn=0.001095,0.002064&t=h&z=20&layer=c&cbll=26.690916,-80.0731&panoid=On4kSOgR8HDG4SLHpfiiCA&cbp=12,339.69,,0,-3.74

[Odin2005]

26. Yeah, screw everyone in NYC with chronic pain!

This popular notion that people with horrible pain must suffer because they MIGHT get addicted is disgusting.

[randome]

37. It's about emergency room procedures.

I'm not saying Bloomberg is a saint but see raging_moderate's post #32 above. Dispensing narcotics from emergency rooms is not a good thing.

[WooWooWoo]

28. ugh

[img][/img]

[TheKentuckian]

30. Wouldn't live in NYC for love or money. I don't even want to visit with the stop and frisk shit.

Bloomberg should be run out on a rail but crazy fuckers keep voting for him.

[southern_belle]

31. That's Bullshit!

Leave the practicing medicine to doctors, you jerk!

[randome]

36. See raging_moderate's post #32 above.

This is related to emergency room procedures. There is no need to dispense narcotics this way. It's a process that has been abused.

[irisblue]

33. similar restrictions in Ohio

A semi official push by state level government to inhibit doctors from writing narcotic prescriptions has had some small good effects ( a few pill mills in the Appalachian areas have been shut down) but mainly chronic pain patients have limited choices for pain control. If the state limits a physicians ability to prescribe, the state effectively limits that person in being and acting as a physician. Control of chronic pain shouldn't be just a hospice situation or limited access to pain management physicians.

[Rhiannon12866]

35. Kicking

[Freddie Stubbs]

38. The Golden Rule: Those with the gold get to make the rules

This only applies to public hospitals, so a patient can go to a private hospital if they are unhappy. Federal law requires any hospital with an ER which accepts Medicare (there are very few that do not) to evaluate, treat, and stabilize a patient regardless of whether or not the patient has insurance.

[lynne]

39. But, But, But, it's all to make us better and healthier people!

First it was the large sodas and now it's pain medication. What's next?

Once government gets on a roll of telling us what we need to do to be "healthy", it's hard to get them to stop. Better hide your whiskey, beer, sugar, coffee, white flour, etc. Because one of them will be next.

[randome]

40. Does no one read past the first couple of sentences of a post?

This is about emergency rooms dispensing narcotics. The process is abused. No one is trying to make anyone healthier, they're trying to stop the abuse of narcotics in emergency rooms.

If it's Bloomberg, it must be something to hate, right? The guy is no saint but this is not something to rail against, IMO.

[rainbow4321]

41. Just means they will ER hop

So they can get a handful from several ER's.

Been working as a nurse for 20 years...if people with a drug addiction are wanting drugs, they will do whatever it takes. My former and current co workers see this daily. Patients who clock watch for their next dose of narcotics..we had one patient who the doc told she could have morphine every 2 hours for chest pain (wasn't cardiac related, forget the actual diagnosis, it was a few years ago) so guess who pushed the call button literally every 1 hour and 58 minutes with "chest pain"? Around the clock. I could have set my watch by her.

Just recently we had someone who was trying to frame nurses by saying the nurses were not opening the vial of pain medicine in front of him and he didn't think that he was actually getting the pain medicine. Yet I go into give him the pain medicine and OPEN the vial in front of him (he had tried the stunt on me earlier) and he wouldn't take his eyes off the TV to watch me open it. Um, excuse me, I need you to LOOK at me while I OPEN this since last time you were not looking at me open it and you got upset that you didn't SEE me open it. What had changed his demeanor between the two times? He saw that I had brought a nurse co worker into the room with me and he knew that any shit he pulled would not just be between me and him. So he was trying to play cool and as if nothing was a big deal to him anymore. He even made the comment "oh, you didn't need to bring someone with you". Well, yeah, I did....when word spreads that you are trying to frame nurses over narcotics, we start to bring witnesses in the room with us. This is the same guy who wanted me to QUICKLY push the large amount of narcotic dose I as giving him. Quick push = a "buzz"/immediate high feeling. He was pissed because I was pushing it very slowly and taking away his thrill. He went as far to ask a co worker when I was leaving..sure enough, he delayed his next dose til he knew I was getting off shift. What he didn't realize is nurses share important info like his behavior during shift change report so everyone coming on to take care of him is well aware of what he is trying.

Bottom line, drug seekers know how to try and work the system. In this guy's case, he thought if he claimed a nurse didn't give him his narcotic dose, everyone would think he was right and just go ahead and give him a second dose of it..to hell if he fucked the nurse over under a cloud of suspect of taking a patient's narcotics.