Painkiller limits: Doctors say NJ shouldn’t ‘practice medicine by legislation’
As part of a plan to combat Jersey’s opioid and heroin addiction epidemic, Gov. Chris Christie wants to limit initial pain prescriptions to five days.
Most New Jersey lawmakers support the idea, but the medical community continues to oppose it.
According to Dr. Joe Costabile, a vascular surgeon and president of the Medical Society of New Jersey, this kind of limitation could cause patients to turn to harder drugs.
He said if a patient in pain runs out of their medication and their doctor’s office is closed they may go to a hospital emergency room and try to get the prescription filled there. But that’s unlikely, so then “they might turn to someone to say 'gee, I’m having this terrible pain in my back.' The friend might say, 'hey, I’ve got some heroin,' or something along those lines.”
“People will go wherever they need to go to relieve their pain, and if it means maybe getting something off of the street they’ll do that. I think it depends upon how desperate the patient is.”
He stressed if doctors are given a time limit on the initial pain prescriptions they are allowed to write, “to be honest with you, I don’t know what that means, because not everybody is going to be the same. I don’t know how long that patient is going to need prescription medication. Five days may not be enough; it may be too much. It’s hard to know.”
Costabile pointed out inconvenience is another factor to consider.
He said if this limit is put into effect and a patient has a serious procedure and is still in pain after five days, and their doctor’s office is closed, “they’re going to have to jackass around to get another prescription."
"Some of these patients are having too much pain to do that, or to drive, they’ll have to get somebody else to drive them.”
The bottom line, he said, is “when you start legislating what physicians can and cannot do, you’re now practicing medicine by legislation."
"I didn’t go to medical school and do nine years of residency training to have my judgment as a physician legislated.”
He also believes this kind of control issue would lead to fewer doctors being licensed to prescribe pain medication.
“It’s because of the hassle factor of having to write more prescriptions,” he said.
He explained every year doctors must renew their controlled dangerous substance certificate, and every other year they have to renew their DEA license.
“If the government is going to make it more and more onerous for the physicians, a lot of physicians will say, 'You know what, I’m just not going to renew my DEA and I’m not going to renew my CDS.'”
That will mean “the patients will have to go elsewhere for their pain medication."
"It’s going to hurt the patients. It’s going to impede on the physician's ability to practice medicine perhaps the way they want to. In the long run we will not be do our patients the service we took an oath to do.”
You can contact reporter David Matthau at David.Matthau@townsquaremedia.com.