Thursday, November 02, 2017

Opioid panel's final report recommends more drug courts, prescription monitoring, doctor training

"President Trump's commission on the opioid crisis called Wednesday for a nationwide system of drug courts and easier access to alternatives to opioids for people in pain, part of a wide-ranging menu of improvements it said are needed to curb the opioid epidemic," Lenny Bernstein reports for The Washington Post. The President's Commission on Combating Drug Addiction and the Opioid Crisis, led by Republican Gov. Chris Christie of New Jersey, was created by Trump in March. It issued an interim report on July 31.

Fewer than half of all federal court jurisdictions have drug courts; the commission wants them in all 94. The bipartisan group made 56 recommendations in its final report, including a requirement that opioid prescribers check prescription-monitoring databases to make sure patients aren't "doctor shopping" for opioids. Doctors would also have to show they've received special training on safe opioid-prescription practices.

The commission also recommended changing the way insurance rates are set, so doctors will be encouraged to try physical therapy or other non-drug treatments before prescribing opioids. And it recommended that the Centers for Medicare and Medicaid Services "eliminate questions about pain from satisfaction surveys that are used rate hospital performance. Physicians have said they feel pressure to treat pain aggressively, often with drugs, so they are not penalized on such surveys. The start of the opioid epidemic in the early 2000s is widely blamed on the over-prescription of opioid medications," Bernstein reports.

What the commission didn't recommend: marijuana for pain management, or safe injection sites like those in Canada where intravenous drug users can inject drugs while under medical supervision.

The White House's press shop offered a noncommital response to the report, saying that "We are grateful for the Commission’s extensive work since March, and look forward to reviewing these recommendations as the entire Administration continues to work to lessen drug demand and the opioid crisis."

The commission's draft report was released the same day as a Government Accountability Office study that recommended accountability measures for the Department of Health and Human Services to respond to the opioid epidemic.

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