Into The Vault: Dr. No Pain

As promised here is the article in it's entirety. You should check out the Banner website. Thebannercsi.wordpress.com Vin Forte posted some funny stuff today.

So with that I give you, Dr. No Pain, M.D.

Dr. No Pain, M.D.

Prescription Drug Abuse is just a doctor’s visit away

By Ian K Feldman

As of 2008, 6.2 million Americans were reported for prescription drug abuse. Combine that with the high volume of controlled prescriptions written by Staten Island doctors and it raises the question: Who needs a drug dealer when you have your friendly neighborhood physician?

The 2008 National Survey on Drug Use and Health (NSDUH), which was released September 2009, reported that 2.5% or 6.2 million Americans over the age of 12 had used prescription drugs for non-medical reasons. Of those prescriptions, 1.9% were classified as opiate painkillers, such as OxyContin and Vicodin. With all of the prescription drug abuse cases that have occurred in Staten Island, the accessibility of these drugs concerns doctors and pharmacists alike.

Marissa Maurino, a Physician Assistant in the Pain Management Center at the Health Care Associates of New York Medicine, writes about 8-10 prescriptions for painkillers daily.

“I treat a lot of young people who come here after seeing their primary doctor,” said Maurino. “It should not be left in the hands of the primary doctor to decide to give the patient these drugs but should be left for pain management to make that decision.”

Pain management centers like Health Care Associates take certain measures to attempt to prevent prescription drug abuse. They include urine toxicology report before medicine can be dispensed. Other methods of prescription drug abuse prevention include the push for physical therapy, exercise, psychological evaluations and non-controlled anti-inflammatory prescriptions.

Many of the patients that are sent to a pain management center have already become addicted to painkillers because of their primary doctors. This makes things tougher for pain management clinics as they struggle to find ways to wean patients off the medications. “Unfortunately, some doctors want to get rid of the patient and their complaining, so they’ll just write the prescription,” said Dr. Maurino.

Dr. Ramachandran Nair, a doctor who specializes in infectious diseases at the Staten Island Medical Center told a slightly different story.

“Teens and gangsters are stealing it from the parents,” said Dr. Nair. When the doctor sees patient, it’s a one to one thing and the doctor is not responsible whether or not the patient chooses to take the medicine.”

The Drug Enforcement Agency (DEA) keeps records of every prescription written by every doctor and the DEA deserves every right to investigate a doctor if suspicious activity is suspected. A statement, which proves that the doctor is partially responsible for the patient’s decisions and can result in serious consequences for a physician.

Dr. Mathew Mani, an internist at Heartland Medical Center, refuses to write controlled prescriptions for his patients. “You want my honest opinion,” said Dr. Mani, “They should ban it all together like marijuana and cocaine.” The value of prescription drugs on the streets don’t compare to other illicit drugs. “On the street, Oxycontin goes for about $50 a pill and Vicodin is about $10 to $20,” said Dr. Mani. “One bottle of Oxycontin is equal to five joints of marijuana.”

Pharmacists are concerned about the accessibility of these prescription drugs. Chain pharmacies, such as Walgreens, CVS, and Rite-Aid and private pharmacies try their best to prevent prescription drug abuse.

Peter Sabados, a pharmacist who owns Woodrow Pharmacy in Rossville, comes across 15-20 controlled prescriptions a day in his pharmacy. “This is definitely an issue and we constantly have to investigate it,” said Sabados. Woodrow Pharmacy runs into problems with fake prescriptions four-five times a week, with most of the people being males between the ages of 18 to 30.

One step, which seeks to limit prescription drug abuse, requires all scripts, including non-controls, to require a bar code that must be scanned. This would help prevent the over-prescribing of controlled medications. Some doctors deem that insufficient.

“We try our best to prevent these problems,” said Sabados. “You have to make your own judgments when filling these prescriptions.”

The 2008 NSDUH shows a slight decrease from the 2007 report, which concluded that 6.9 million Americans abused prescription drugs. The Substance Abuse and Mental Health Services Administration, (SAMHSA) predicts that the number will not stay down for long and the DEA must take further actions to put a stop on this crime.

“[We] as a whole [have] to be careful when writing, filling and taking prescriptions,” said Dr. Maurino. “We all share the responsibilities of this issue and must remain aware of it.”

Doctor Learned His Lesson
Doctors have to be aware when they write controlled prescriptions because if they are not careful then they could run into trouble with the law. Just ask infectious disease specialist, Dr. Ramachandran Nair.

Dr. Nair happened to practice internal medicine until August 2003, when he was arrested and charged for selling a controlled prescription to an undercover DEA agent. As a result, Dr. Nair’s license was suspended for a total of three years and could not practice internal medicine.

Dr. Nair is not the only doctor that has been guilty of this crime and the DEA has been trying to keep a tighter grip on these physicians.

Six years later, you can find Dr. Nair, who practices in his office at the Staten Island Medical Center, doing what he loves best. However, he has remained wise when it comes to prescribing medications. “It’s all about keeping proper record keeping,” said Dr. Nair.

This has been Ian Feldman speaking words of wisdom.