Mandated Pain Management Training for Doctors

Health Policy Analysis Part II

Options Analysis

Mandate Additional Training

In response to this public health crisis, Kentucky policymakers have a variety of options available to them. First, they could pass legislation requiring physicians to complete a certain amount of training on pain management and safe prescribing practices before being allowed to prescribe opioids. The current opioid epidemic in the United States has been labeled as the worst drug crisis in American history. In 2015, over 33,000 people died from an opioid overdose, and the majority of those deaths were caused by prescription opioids. In Kentucky, opioids are a major problem, with 1,404 overdose deaths in 2016. The high number of overdoses is due in part to the fact that opioids are very easy to obtain. In Kentucky, there are no limits on the amount of opioids that a physician can prescribe, and there is no mandatory training on pain management or safe prescribing practices. This lack of regulation has allowed physicians to prescribe large amounts of opioids without any oversight, contributing to the current crisis. Legislation that would require physicians to complete a certain amount of training on pain management and safe prescribing practices before being allowed to prescribe opioids would help to prevent future overdoses and save lives. The training would ensure that physicians are knowledgeable about the risks associated with opioids and how to safely prescribe them. It would also help to create a system of accountability, so that physicians who prescribe large quantities of opioids can be identified and monitored. This type of legislation would be good for public health in Kentucky and would help to reduce the number of overdoses in the state.

Pros

Proponents of mandatory training argue that it is necessary in order to reduce the number of prescription drug overdoses and deaths. They contend that doctors need to be better educated on the risks associated with pain medications and how to safely prescribe them. Additional training could help doctors and nurses, in the long run, to save lives (Scrivani et al., 2021).

Cons

Opponents of mandatory training argue that it is an unnecessary burden on doctors, who are already required to complete a significant amount of continuing education. They also argue that such training would do little to reduce the number of overdoses and deaths, as most of these cases involve patients who misuse or abuse their medication.

Prescription Drug Monitoring Program (PDMP)

Second, they could establish a statewide prescription drug monitoring program to track prescriptions and identify patterns of abuse. Currently, Kentucky is one of only a handful of states in the nation that does not have a statewide prescription drug monitoring program (PDMP). A PDMP is a database that tracks prescriptions for controlled substances, such as painkillers (Fink et al., 2018). It can help identify patterns of abuse and help pharmacists and physicians make informed decisions about prescribing controlled substances. In addition, a PDMP can help to prevent “doctor shopping,” where patients visit multiple doctors to obtain multiple prescriptions for controlled substances (Young et al., 2019). Establishing a statewide PDMP would be good for public health in Kentucky for several reasons. It would help to identify and track individuals who are abusing prescription drugs. Additionally, it would help to prevent doctor shopping and the associated costs, such as emergency room visits. Plus, it would give pharmacists and physicians better tools to make informed decisions about prescribing controlled substances.

Pros

There are several potential benefits of PDMPs. First off, they can help to identify patients who are doctor shopping, which is when patients visit multiple doctors in order to obtain multiple prescriptions for controlled substances. Secondly, they can help to identify physicians who are prescribing controlled substances inappropriately. Thirdly, they can help to identify pharmacies that are dispensing large quantities of controlled substances. Lastly, PDMPs can be used to track changes in prescribing patterns over time, which can be helpful in identifying trends in prescription drug abuse and where more attention needs to be given.

Cons

There are also some potential drawbacks to PDMPs. There is the potential for misuse of the data by unauthorized individuals. Additionally, the data collected by PDMPs may not be accurate or complete. Finally, some have raised concerns about the confidentiality of the data collected by PDMPs. Despite these potential drawbacks, however, many states have implemented PDMPs in an effort to address the problem of prescription drug abuse.

Expand Access to Naloxone

Thirdly, they could work to expand access to naloxone, a medication that can reverse the effects of an opioid overdose. By making naloxone more widely available, policymakers can help to save lives and reduce the burden on our healthcare system. In addition, expanding access to naloxone would also send a strong message that we are committed to fighting this epidemic. Through taking these actions, Kentucky policymakers could potentially help doctors and nurses to reduce the number of overdose deaths in the state.

Pros

On the one hand, there is no doubt that naloxone saves lives. Expanding access to naloxone would make it more readily available to those who are at risk of an overdose, and it could potentially save thousands of lives.

Cons

Naloxone can be expensive, and it requires professional training to administer properly. In addition, some research suggests that expanding access to naloxone may actually increase risky behavior among people who use opioids.

Recommendation

The recommendation here is that legislation should be passed requiring physicians to complete training on pain management and safe prescribing practices. This would help to ensure that opioids are prescribed only when necessary and that patients are aware of the risks associated with taking these drugs. It would also help to reduce the number of unused or unneeded pills that end up in the hands of people who may misuse them. With the proper training and safeguards in place, it is possible to reduce the incidence of opioid abuse in Kentucky.

This is the best option when compared to initiating a PDMP or expanding access to naloxone. In those two cases, there is no direct action affecting the prescribing of opioids. They are more oriented to taking action after prescriptions have been given. The problem is really that safe prescription methods are not being practiced. That can be addressed by way of training. Thus, mandating safe prescribing practices to help reduce opioid abuse is better than initiating a prescription drug monitoring program or expanding access to naloxone.

Mitigating the Cons

One potential way to mitigate the negative consequences of mandating pain management training and safe prescribing practices among doctors in order to reduce opioid abuse is to roll out a public education campaign that rallies the community behind the legislation and helps to bring positive pressure to the medical establishment so that physicians and nurses cannot resist.

It would also help to drive support if policymakers could ensure that these initiatives are well-funded. Many healthcare initiatives are underfunded, which can lead to suboptimal implementation and ultimately decreased effectiveness. Therefore, by allocating adequate resources to these pain management and safe prescribing initiatives, it is more likely that they will be successful in reducing opioid abuse.

Furthermore, it is important to monitor these initiatives closely and gather data on their efficacy in order to make any necessary adjustments along the way. With proper funding and monitoring, these types of initiatives have the potential to be successful in reducing opioid abuse (Ti et al., 2022).

Take Home Message