Lately there has been a lot of noise in the news media about the Medical Board of California and question of whether doctors are over-prescribing pain medications. As California administrative law attorneys representing doctors in accusation hearings, we are concerned when the public focus turns to blaming doctors and physician assistants for the lack of treatment and control of drug addiction, rather than looking to the source of the problem or lack of resources in the community.
In May 2013 dozens of parents whose children overdosed on prescribed pain medications attacked the Medical Board at a Senate hearing. The parents blamed physicians for failing to identify drug-seeking, addicted patients (their children) and to take action to prevent drug abuse and overdose. The Board had earned the ire of these parent advocates when it refused to increase doctors license fees by $9.00 to fund increased monitoring of prescribing and drug use. Attorney General Kamala Harris entered the fray, asking for significant expansion of the state’s CURES (Controlled Substance Utilization Review and Evaluation System) program.
Now legislation is moving to address these prescribing issues. SB 62 (Price) would require county coroners to report a finding that a cause of death was determined to be the result of prescription drug use to the Medical Board, thus triggering a potential physician investigation and accusation. SB 670 (Pres. Pro Tem Darrell Steinberg) would speed up suspension of doctors suspected of overprescribing. Finally, SB 809 (DeSaulnier) sponsored by Attorney General Kamala Harris, would increase fees paid by most California health care providers (physicians, pharmacists, dentists, veterinarians, nurses, optometrists, and podiatrists) in order to fund increased surveillance and monitoring of prescribing and drug distribution under the state’s CURES program (Controlled Substance Utilization Review and Evaluation System).
Doctors already face serious scrutiny relative to prescribing of dangerous or addictive drugs. Referral to a Pain Management Specialist has become commonplace. Prescribing to an addict is against the law (there are exceptions for treating addicts). (Bus. & Prof. Code Section 2241)
Back in 1994 and again in 2002, the Legislature and Medical Board focused on allowing humane prescribing to control pain. As a result the Medical Board adopted policies and procedures addressing pain management. Now, apparently, the pendulum has swung the other way.