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A Serious Catch-22 for Clinicians Prescribing Pain Meds


 

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Recently, the West Virginia Supreme Court ruled that patients can sue doctors if they became addicted to a medication the doctors prescribed even if the patients have committed crimes, such as doctor shopping, to get there.

Apparently, no one can be held responsible for their own actions anymore.

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This is a serious catch-22 for providers. On the one hand, we have ethical considerations, and oaths, to help others and relieve suffering. Now, on the flip side, doing just that can open us to legal action.

I prescribe narcotics. I try to use them judiciously, and only in people for whom other options have failed or are contraindicated. I suspect most clinicians are the same. Every drug has its risks and benefits, and we try to make a calculated decision for each patient. I ask for the patient’s input, too, since he or she is the one who’ll be taking it.

I also have to depend on patients’ honesty. Patients who sell drugs to others, take more than I’ve prescribed, or use other methods of getting them (doctor shopping, buying them off the street) are all committing serious offenses. The development of monitoring databases where I can check on such behaviors has helped me catch those who’ve abused the medications.

One person quoted in an article about the court decision said, “I lied to everybody. I would steal. I pawned my grandma’s wedding rings. I was breaking into houses, doing anything and everything to stay high.”

So, obviously, that was all the provider's fault. He was trying to help her, and apparently led her to commit theft and burglary. I suppose the next step in such insanity is that he could be charged as an accomplice in her crimes. After all, it’s not her fault that she decided to steal from others.

This opens up a gold mine. Crooks obtaining narcotics through illicit means can now sue the clinicians who were originally trying to help them.

How will it affect me?

I’ll likely further decrease my writing for controlled pain meds. I really can’t give up my DEA number entirely, because I need it to write for several epilepsy medications. But the use of narcotics in my practice will decline. Other docs will probably do the same.

Sadly, this only hurts those who legitimately need pain relief. It will be harder for them to find providers willing to prescribe narcotics, and even if they do, it’s possible those clinicians won’t take their insurance.

Some will say my reaction to the ruling means I don’t care, which isn’t true. I do care. I signed up for this job to help people. But I also have a family to support and protect, and have to think of them, too.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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