To Reduce Prescription Drug Abuse, Focus Less on Patient Satisfaction

Pain management education must help prescribers focus less on patient satisfaction, and more on their functional improvement, according to Sherry Green, the CEO of the National Alliance for Model State Drug Laws (NAMSDL).

Current pain management education is largely based on the concern that people in chronic pain are not receiving adequate relief, Green says. “More and more emphasis has been placed on patient satisfaction. With doctor ratings available online, some physicians are concerned that if they don’t give patients what they want, they will drive them away and receive unsatisfactory ratings. That may make them less willing not to give someone the drug they’re asking for.” The pressure to satisfy patients may also come from hospitals, whose own ratings are influenced in part by patients’ satisfaction with doctors, she adds.

Improving prescriber education was one of the topics at the recent meeting convened by NAMSDL for state and local professionals from around the country to identify legislative and policy options for addressing “pill mills” and safeguarding the legitimate practice of pain management.

Participants included doctors, law enforcement officials, medical board representatives and addiction treatment specialists. They crafted a preliminary set of proposals which NAMSDL will distribute in early 2013 to a wide variety of stakeholders for further review and comment. The goal of the multi-step, multi-disciplinary approach is to provide policymakers with practical solutions to preventing prescription drug abuse, addiction and diversion while safeguarding legitimate access to prescription drugs.

Participants at the meeting agreed patient satisfaction may be receiving too much emphasis. “There’s a concern we’ve gone too far down that road,” notes Green.

They also discussed how pill mills have fueled the prescription drug abuse epidemic. “Pill mills do not necessarily refer to a specific location, but rather to a set of practices that is not legitimate medicine,” Green says. “Pill mills’ entire focus is on prescribing drugs, without taking medical histories, performing physical exams or providing followup. There is no individualized care, and the same kinds of pills are given across multiple types of patients.”

Legitimate pain management involves practices diametrically opposed to pill mills, according to Green. “Pain management is more holistic – it looks at other ways of treating pain in addition to pills,” she notes.

Prescription drug monitoring databases as a tool for combating prescription drug abuse will be a big focus on the state level in 2013, she adds. There are many details that states must consider, including whether to require doctors and other prescribers to use the databases.

“Our goal is to see what are the best kinds of policy and regulatory changes that are needed to reduce prescription drug abuse. Once we agree, our stakeholder groups can move forward and make these changes,” she says.

9 Responses to To Reduce Prescription Drug Abuse, Focus Less on Patient Satisfaction

  1. beverlie dunlap | December 11, 2012 at 12:13 pm

    It is about time. I have a friend that is 55 years old,she is a hypochondriac and through that mental health issue it has brought her to prescription drug addiction. Her doctors have prescribed and prescribed medications and now she is so addicted that it is destroying who she is. She has the same issues as anyone else addicted to drugs, rationalization, justification and an added one, she reels righteous in her addictions because it is “medicine” that her doctors are giving her.Something really needs to be done.

  2. Stewart B. Leavitt, MA, PhD | December 11, 2012 at 12:30 pm

    What was the source of this article? A press release (we could find none)? An interview with Ms. Green? Certainly, many patients with chronic pain would vehemently dispute the notion that their needs are being overly satistied.

    • Roxanne | December 11, 2012 at 2:33 pm

      Thanks for checking that out,Stew. I had never heard of her and not all pain can be controlled by “holistic measures”,as we both know. As we are all different nothing is “One Size Fits All” when it comes to Medicine. Any kind of Medicine! As a chronic pain patient and well established Advocate for Medication Assisted Recovery I talk to patients on a regular basis.

      Thanks Stew
      Rokki

  3. Sandra Bartee RN,BS,RAS | December 11, 2012 at 12:39 pm

    It is a ludacrious idea to focus less on satisfaction for clients. That leads to untreated pain. Focus on spending the money you are on all of this, to EDUCATE THE DOCTORS and POLICY AND REGULATIONS. Beleive we have enough of the government in our lives. Put the money towards mental health, addiction treatment, early education. There will ALWAYS be addiction, there will always be pills, heroin, crack etc…. Use money where it counts insted of cutting the MH and addiction programs to nil. Addiction does not get helped by policing the doctors, and more regulation. Treatment works if it wasn’t getting cut to shreds.

    • Roxanne | December 11, 2012 at 2:34 pm

      PATIENTS Not “Clients”

      Language Police

  4. PWKaplan | December 12, 2012 at 9:03 am

    Ms. Bartee is absolutely correct. This is just the most ludicrous thing I’ve ever heard! I just went through 5 weeks of utter agony because my surgeon refused to properly medicate me post-surgery. This was acute pain, not even chronic–and all he could say (besides lying to me about the drug laws) was that I shouldn’t need more or stronger medication because the pain shouldn’t be so bad (this was major throat surgery, and let me tell you, it was incapacitatingly agonizing). I have worked with addicts and chronic pain patients for many years and the problem of underprescribing is far greater than the problem of overprescribing pain-killing meds.

  5. linda vandeveer | December 12, 2012 at 9:45 am

    Tell the stakeholders that they need to stop taking away our rights and stop playing ruler over us all, The compassion and mercy seems to be gone, They need to learn the meaning of walking a mile in anothers shoes and stop putting everyone in their new founded categories. the stakeholders are the ones changing the criteria in the DSM that recommeds the doctors put our children on all kinds of drugs as quickly as possible, seems to me they are making some really bad choices concerning the people of the U.S. They want to control the behavior of us all and they are doing it by giving drugs and than they will punish you for being addicted. These kind of people are not good for our country.

  6. Tom L | December 14, 2012 at 3:21 pm

    Many replies appear to be anecdotal. I am an Addictions Counselor of 17 years. The overprescription of pain medications is reaching epidemic proportions. My understanding of the message is to focus on measurable physical achievements, instead of the difficult to measure human satisfaction. And if you take away the addicts pills, of course they will be dissatisfied, but possibly a lot healthier. Or just keep treating them in the emergency room, thats so much cheaper.

  7. Jan C | May 31, 2013 at 5:51 pm

    Doctors can have both satisfied and non-addicted patients by engaging them in a conversation about options, offering expert feedback and ultimately helping the patient make the best decision. This entire article is based on the doctor assuming the same dynamic of fixer. *sigh*

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