Much is being proposed to help reduce the prescription drug abuse problems in New York State. NYSAFP and MSSNY have both made suggestions. The American Society of Addiction Medicine is preparing a position paper that will address provider education and prescription monitoring programs. The New York Society of Addiction medicine is bring forth two other suggestions which we hope will be considered as solutions are sought for this problem in our state.
1. NYSAM encourages the development of quality indicators related to the prescribing of controlled substances. For example, some doctors never do urine drug screens, Insurance companies and Medicaid know this but never suggest it. The same can be said of other important quality indicators. Physician organizations, insurance companies and other payers should develop these indicators, provide education around them and use them t help improve patient care.
2. Physicians should receive adequate reimbursement for the evaluation and management of patients on controlled substances. It takes just a minute to write a prescription and the patient usually leaves happy. It takes more time to evaluate whether a patient is a good candidate for a potentially addicting medication. For the optimal management of chronic pain patients, old records need to be reviewed, and there is a need for patient education and careful follow-up. These services are not adequately reimbursed. Insurance companies pay for expensive injections and for opioid prescriptions but they often do not pay for counseling or comprehensive multi-disciplinary team approach, even though studies show that this is often the most effective approach to chronic pain problems.
