Drug Addiction

Pain Clinics See Criticism for Encouraging Patient Drug Addictions

In many states, patients come in to a pain clinic seeking medical help and walk out with a prescription for a painkiller – even if they are already addicted to a painkiller or similar drug. Some say patients are actually treating pain clinics as places to feed their addictions.

Doctors who give prescription medications to people who already have drug addictions could face more scrutiny and restrictions as groups like the American Society of Addiction Medicine strive toward tighter regulations.

The problem is made more complex by the reality that some physicians, like several in Florida, actually work in both realms – they work with people suffering from drug addictions and also help patients manage chronic pain by giving them prescriptions for painkillers like Oxycontin and Vicodin. It’s a delicate matter, say addiction professionals, because the practice can encourage people struggling with drug addictions to move from pain clinic to pain clinic in search of prescriptions while veering away from treatments that could bring them to recovery.

According to University of Miami Miller School of Medicine’s Dr. Ihsan Salloum, a specialist in addiction psychiatry, pain clinics may create a situation where a person with an addiction can have increased access to the drugs.

Other pain clinics are actually undercover drug stops, fueled by black market drug trafficking. Concerns are also increasing toward some pain clinics who may strive to keep patients dependent on anti-addiction drugs in order to increase business.

Efforts to close illegitimate pain clinics can be slow. Federal law offers protection to physicians who are approved to provide prescriptions for narcotic drugs, and law enforcement agents must acquire an order from a judge before beginning an investigation of a pain clinic or physician.

In Florida, a series of pain clinics have opened up along a large stretch near Miami, numbering well over 100 in just one county. Data from the U.S. Drug Enforcement Administration says South Florida has the physicians who prescribe the nation’s highest levels of oxycodone. Outspoken marketing campaigns for the clinics, including coupons, newspaper ads and special information for clients from other states have added to the complexity of the situation. Some ads list prescription withdrawal medications by brand name, especially those available on an outpatient basis.

Many addiction experts have expressed serious concerns over pain clinics’ use of pill-based forms of treatment for addictions, rather than a whole-picture approach that includes counseling and lifestyle changes. In some states, such as New Jersey, only physicians who are board-certified in the field of managing pain can administer addiction treatment medications like Suboxone. Expert-level status in addictions is not required for physicians to give prescriptions for anti-addiction medications like Suboxone, in which a physician can be ready to prescribe after completing a course offered online.

Several fatalities from drug overdose are also believed linked to pain clinics over-administering medications, prompting law enforcement officials and drug research organizations to push for stricter regulations for pain clinics nationwide.