Prescription Drugs Abuse - ASIPP Blog

Prescription drug abuse is not just on the rise – it has become a national crisis, according to a just-released White House study detailing a 400 percent increase in substance abuse treatment admissions for prescription pain relievers between 1998 and 2008.

The report underscores the need for regulation amid a culture that has become increasingly reliant on ever-more-powerful and addictive prescription drugs, say experts.

The non-medical use of prescription pain relievers is now the second-most prevalent form of illicit drug use in America “and its tragic consequences are seen in substance abuse treatment centers and hospital emergency departments throughout our nation,” says Pamela Hyde, administrator of The Substance Abuse and Mental Health Services Administration, in a statement.

The statistics are being released to highlight a problem that has become all too familiar through the high-profile deaths of such celebrities as Michael Jackson and Anna Nicole Smith. But the problem affects all ages and socioeconomic strata, says Dr. Scott Glaser, president of Pain Specialists of Greater Chicago.

From 1994 to 2003, the number of prescriptions for controlled substances rose from 22 million to 354 million annually, says Dr. Glaser. The number of admissions for misuse of prescription painkillers to hospital emergency rooms rose from some 40,000 in 1994 to over 300,000 in 2008, he adds.

“There has been a strong push among doctors in recent years to be more aggressive in addressing pain,” he notes. “This has led to the dramatic increase in opiates such as morphine, but the problem is there hasn’t been a whole lot of science to go along with that.”

The abuse of these strong drugs is an indication of a much more widespread cultural problem, says addiction specialist Clare Kavin of The Waismann Method, a treatment center for opiate dependency, which has treated many celebrity addicts.

“We are in a culture of immediate gratification and nobody will put up with even the slightest discomfort anymore,” she says. This underlying attitude leads many patients to push for stronger painkillers when lower strength – but non-addictive – drugs would have sufficed in the past, she adds.

“We are in a perfect nightmare,” says Andrea Barthwell, who has advised the White House on national drug policies. Many of the factors that have come together to fuel this explosive problem – such as the lack of effective monitoring of prescriptions not just between doctors, but between pharmacies, and from state to state – have been well known for years.

Glaser points out that a federal monitoring program was signed into law in 2005 but funding has languished ever since. Glaser and his colleagues from the American Society of Interventional Pain Physicians are just back from lobbying on Capitol Hill for $55 million to fund the program, which they say will pay for itself in five years.

Currently some 37 states have some form of monitoring, Glaser says, but they are inconsistent and lead to widespread abuse. He points to widespread practices such as:

• Easy access to prescription drugs through the Internet
• Caravans of people crossing state lines – Florida is well known for its open-door clinics with easy access to drugs
• Street sales fueled by lax oversight
• Teens selling prescription drugs to each other

The increasing potency of presciption drugs can lead to what Ms. Barthwell calls a “frightening and unprecedented scenario”: “In the past, the number of people exposed to opiate-level highs was very narrow,” she says. “But now, with a wide cross-section of the population for the first time experiencing this kind of dependency, we are seeing a record number of people turning to heroin when they can no longer afford the more expensive prescription drugs.”

The data released Thursday highlight “how serious a threat to public health we face from the abuse of prescription drugs,” said Gil Kerlikowske, National Drug Policy Director, in a statement. “The spikes in prescription drug abuse rates captured by this study are dramatic, pervasive, and deeply disturbing,” he adds.

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DOC-FIX WATCH – Frustrated with a six-month patch, medical associations continue to push Congress on Medicare payments.

First up: The American Society of Interventional Pain physicians hits the Hill tomorrow pushing for (what else?) a permanent SGR fix – like the AMA, ASIPP is insistent that nothing less will do, even if it’s not political reality.

Their past president and spokesperson, Dr. David Kloth, tells Pulse: “What the House and Senate passed will get us six months but the bottom line is we need a long-term solution or we are going to lose a lot of doctors.”

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By Julian Pecquet – 06/28/10 07:56 PM ET

More than a hundred pain management specialists are in Washington this week to warn lawmakers about the dangers of prescription drug abuse.

The physicians — members of the American Society of Interventional Pain Physicians (ASIPP) — want lawmakers to appropriate $55 million over the next five years to help states collect data on consumers who “doctor shop” and on physicians who over-prescribe or incorrectly prescribe pharmaceuticals.

“There are many states now where there are more young people who die from prescription drug abuse than die from car accidents — and that’s the first time in history,” said David Kloth, past president of the association and a Connecticut pain management doctor.

The physicians want Congress to reauthorize a 2005 bill providing grants to states that collect prescription drug information and share it with physicians and pharmacists — and law enforcement officials when there’s an investigation — while protecting patients’ privacy. Rep. Ed Whitfield (R-Ky.), an original sponsor of the bill, is expected to introduce legislation shortly.

Despite widespread agreement that prescription drug abuse is a serious problem — the 2005 law passed by unanimous consent in the Senate and by voice vote in the House — finding money to fight the scourge has not been easy.

No funds were appropriated until last year, Kloth said, when the Obama administration set aside $2 million in the Federal Omnibus Spending bill for the program, known as the National All Schedules Prescription Electronic Reporting (NASPER).

Kloth said Capitol Hill sources have told ASIPP that Rep. Hal Rogers (R-Ky.) has blocked appropriations for the grants in the past. Rogers, the commonwealth’s former  attorney general, supports a monitoring program that’s more focused on law enforcement and may fear NASPER would compete for funding, Kloth said.

Rogers’s office denied any blocking of grants and defended the lawmaker’s commitment to prescription drug abuse.

“Congressman Rogers has been a leader in the fight against the epidemic of prescription drug abuse for a decade, and while it’s true we disagree with the NASPER approach, to say the congressman has ‘blocked’ funding for the program is simply not true. If that were the case, the millions of dollars appropriated for the program over the years would not be established law today. Congressman Rogers believes NASPER is a duplicative program propped up by the pain physician lobby and six years too late. Instead, he has championed state-sponsored prescription drug monitoring programs, supported by the Department of Justice,” said Rogers’s spokeswoman Stefani Zimmerman.

To date, 41 states have monitoring programs in place, according to ASIPP, although six are not operational.

However, many states do not meet NASPER standards — failing, for example, to monitor prescriptions electronically; only covering certain drug categories; or giving pharmacies more than seven days to submit information.

Only two states — Kentucky and Connecticut — are attempting to share information among states, which ASIPP says is necessary to prevent drugs abusers from stocking up on pills in states such as Florida that have laxer standards.

“Fragmented funding of multiple unauthorized programs will only create confusion among states applying for funding,” ASIPP says in a fact sheet on the NASPER program, “as well as both [the departments of Justice and Health and Human Services] as they try to administer similar programs.”

The group is advocating for other issues as well:

• Healthcare reform: The law incorporates several provisions of the National Pain Care Policy Act, but they need to be appropriated. In particular, ASIPP wants funds allocated for an Institute of Medicine conference on pain next year and a training grant program for medical schools and other entities to educate and train healthcare professionals in pain care.

• Physician payments: A permanent repeal of Medicare’s Sustainable Growth Rate formula.

• Ambulatory Surgery Center payments: ASIPP wants higher reimbursement rates for surgical procedures performed outside of hospitals.

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Even as some of the first pieces of President Obama’s health care reform legislation take effect, Republicans in Congress and conservative activist groups are still working to repeal or at least rewrite major sections of the legislation.

Rep. Steve King, Iowa Republican, is circulating a petition that would force an up-or-down vote in the House of Representatives on repealing the vast bulk of the estimated $940 billion, 10-year legislation the Democratic-controlled Congress passed this spring.

The petition had 80 signatures as of Thursday – the same day the White House formally launched HealthCare.gov, which officials described as a “one-stop shopping” place for health insurance. Other parts of the law, including a new 10 percent excise tax on indoor-tanning services and a new stopgap program to cover Americans with pre-existing health conditions who can’t get private-sector coverage, also went into effect Thursday.

A second House “discharge” petition to force a vote over the opposition of the Democratic majority, offered by California Republican Rep. Wally Herger, calls for a full repeal and the passage of a substitute GOP plan.

Support for Mr. King’s proposal sharply increased this week as House Minority Leader John A. Boehner of Ohio and Minority Whip Eric Cantor of Virginia joined the effort and the conservative Club for Growth informed lawmakers that the group would “score” their position on its influential legislative ranking.

“The American people asked Congress and President Obama not to pass the massive health care overhaul, and they were ignored,” said Mr. Boehner and Mr. Cantor. The two also said they could support Mr. Herger’s alternative.

The Republican Study Committee said Thursday at least five other straight repeal bills are in the House, all needing 218 signatures to advance.

The Heritage Foundation’s newly launched independent-advocacy wing, Heritage Action for America, also has a repeal effort. The group notes that most of the legislation’s major changes will not occur until 2013 and 2014 so there is still time to “bring the heat” and tell lawmakers “why you support a full repeal.”

Club for Growth spokesman Mike Connolly said if the repeal effort makes progress, the group would also expect lawmakers who voted against the legislation to “follow through and ultimately co-sponsor legislation in the next Congress.”

Though the economy and jobs will likely remain the key issues during the midterm elections, some Republican candidates – including Senate hopefuls Marco Rubio in Florida and Pat Toomey in Pennsylvania – have made repeal an important part of their campaigns.

Democrats, citing recent polls showing an uptick in popular support for the health plan, have at times appeared eager for a clash over repealing the health program, predicting the GOP blanket opposition will backfire at the polls.

“Some folks on the other side of the aisle … have said theyre going to run on a platform of repeal,” Mr. Obama said last month. “They want to go back to the system we had before. … Would you want to go back to discriminating against children with pre-existing conditions?”

The Democratic National Committee has already aired a 60-second cable television ad titled “We Can’t Afford to Go Back” slamming the repeal effort.

Despite an endorsement from the American Medical Association, many U.S. doctors say they still do not support the legislation.

A coalition of doctors urged Congress on Tuesday to protect them against provisions they fear will hurt their businesses and lower the quality of care of Americans.

Among the group’s primary concerns is that practicing doctors will be excluded from the law’s treatment-recommendation panel and that the new Independent Payment Advisory Board wields too much power and will make decisions based exclusively on cost.

“We’re worried about the [payment] board making decisions without considering a patient’s access to care and the effectiveness of care,” said Dr. Laxmaiah Manchikanti, chairman of the American Society of Interventional Pain Physicians.

The 18-member board, include 15 full-time members, will make recommendations on Medicare and other health care costs without congressional approval. For example, the recommendations go into effect if Congress votes against them, but the president vetoes the vote and Congress cannot get the two-thirds majority vote to overturn the veto.

“We’ll have no recourse in Congress,” Dr. Manchikanti said.

In group’s joint-effort with the North American Neuromodulation Society, nearly 200 doctors came to Capitol Hill to call upon such top Republican Party lawmakers as Louisiana Sen. David Vitter and Minnesota Rep. Michele Bachmann.

However, the most solid promise Tuesday perhaps came from Sen. Sherrod Brown, a Ohio Democrat who voted for the multi-billion dollar reform legislation.

Mr. Brown vowed to circulate a petition asking the House and Senate to put working doctors on the treatment board, officially known as the Patient Centered Outcomes Research Institute. The 40-member nonprofit includes the National Institutes of Health director and 17 appointees by the General Accounting Office.

“A letter doesn’t get it accomplished, but it’s a start,” said Dr. David S. Kloth, a Connecticut doctor and ASIPP director.

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As a pain management specialist, Scott Glaser, MD, works to help patients with chronic pain restore quality of life, increase function and regain wholeness. He has worked with his Pain Specialists of Greater Chicago co-founder Ira Goodman, MD, for over a decade, treating syndromes ranging from common lower back pain to the severe pain associated with nerve damage. The doctors use various minimally invasive techniques to manage pain, including small joint injections, nerve blocks and medication infusion pumps.

Dr. Glaser graduated from the University of Notre Dame and Indiana University School of Medicine and completed his anesthesia residency and fellowship at Northwestern University in Chicago. He has worked as a pain management specialist in the private practice setting since 1990 and was named to the Becker’s ASC Review list of notable ASC physicians in 2009.

Through his work in pain management, Dr. Glaser has become invested in the struggle against controlled substance misuse. He lobbied to ensure passage of the NASPER bill, which aims to protect patients and physicians from substance misuse by setting up prescription monitoring programs. The bill was signed into law in 2005, and Dr. Glaser continues to work to implement a prescription monitoring program in Illinois. He also speaks to physician groups and other health providers about the risks of controlled substance abuse.

In 2008, Dr. Glaser was elected by his fellow specialists to serve as a director on the national board of the American Society of Interventional Pain Physicians. He also became a diplomat of the American Board of Interventional Pain Physicians —acknowledged to be the highest level of credentialing in his field — the first year it was offered.

Dr. Glaser is an instructor for the American Society of Interventional Pain Physicians, a society that provides training for interventional pain management specialists and promotes excellence in the field of pain management. He teaches other physicians minimally invasive procedures and lectures on continuing medical education at ASIPP meetings.

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Your back is throbbing and has been for weeks. You can barely move from your bed, but you are not getting any sleep because of the intense pain.

This is a pretty common scenario, explains David Neumeyer, MD, the associate director of the Sleep Disorder Center at the Lahey Clinic Medical Center in Burlington, Mass.

“Pain and sleep are integrally connected,” he says. “Chronic pain is very common in the population and even more common in people who have poor sleep, and it sort of becomes a vicious cycle.” Pain affects your ability to sleep, and the lack of sleep makes the pain seem worse.

The Link Between Pain and Sleep Problems

Exactly how the two conditions are connected varies from person to person. “You have to determine what is the chicken and what is the egg,” he says. “Is pain a manifestation of, or made worse by, a sleep disorder or is pain causing the poor quality of sleep?”

Charles Bae, MD, a neurologist in the Sleep Disorders Center at the Cleveland Clinic in Ohio, puts it this way: “Pain can be the main reason that someone wakes up multiple times a night, and this results in a decrease in sleep quantity and quality, and on the flip side, sleep deprivation can lower your pain threshold and pain tolerance and make existing pain feel worse.”

“If you have arthritis and roll or turn while you are sleeping, pain can wake you up,” says David S Kloth, MD, the founder, medical director, and president of Connecticut Pain Care in Danbury, and a past president of the American Society of Intervention Pain Physicians.

The first step is to figure out if the lack of sleep is causing pain or if the pain is causing a lack of sleep, and then you treat whichever came first, he says.

The Pain-Reducing Benefits of Better Sleep

Pain may not be the only problem interfering with your sleep. Some people may also have an underlying sleep disorder, such as sleep apnea. Neumeyer recommends an evaluation by a sleep specialist to be sure there is not underlying sleep disorder.

Once you’re correctly diagnosed, sleep experts say good treatment can significantly help those living with chronic pain.

Getting better quality sleep — and more of it — may improve your pain threshold so you will ache less, says Neumeyer.

“People in pain don’t sleep, and people who sleep have less pain,” agrees Michael Breus, PhD, author of Beauty Sleep and the clinical director of the sleep division for Arrowhead Health in Glendale, Ariz.

Treating Pain-Related Sleep Problems

Improving sleep in people with chronic pain such as low back pain, arthritis, fibromyalgia, and diabetic nerve pain is difficult because these individuals often don’t want to take any more drugs, says Breus.

These individuals are often already taking several medications to treat their pain disorder. What’s more, certain prescription sleeping pills may interact with their pain medications, so they couldn’t take them even if they wanted to, says Breus.

In essence, Breus becomes the Sherlock Holmes of sleep problems. He looks at each individual’s sleep habits and bedroom environment. “I have to investigate how old their mattress and pillows are, and make sure they are offer proper support,” he says. He asks about their diet and habits. Do they avoid beverages with caffeine after 2 p.m.? Do they exercise regularly? Do they use the bedroom only for sleep and sex? All these things may also help people in pain get their ZZZs.

The bottom line, according to Cleveland Clinic’s Bae, is “if you have chronic pain and trouble sleeping, bring it up to your doctor to see if anything can be done to help your sleep while getting your pain treated.”

ASIPP

They’re often called doctor shoppers, border hoppers, pharm-aholics and even hit-and-runners. They count on states’ lack of communication and exploit professionals whose job is to heal, hurting themselves and feeding others’ addictions through such feats.

They’re prescription painkiller addicts and, like other drug addicts, often go to extreme measures to get their fix. It’s not a new problem, just one that’s recently become more visible with high-profile celebrity deaths being caused by prescription pill overdoses.

“The least fun part of my job is managing medications,” said Connecticut-based pain physician Dr. David Kloth, who referred to Michael Jackson — formerly the King of Pop — as the King of Drug Popping. “You are suspicious of everybody — it’s sad, but everyone is painted with the same broad brush.”

It may be sad, but it’s what doctors face every day. Pain pill-related deaths have risen significantly over the years, with overdose deaths becoming the second leading cause of unintentional injury death in 2002, just behind motor-vehicle injuries, according to a Centers for Disease Control and Prevention (CDC) study. This increased death rate stems from prescription drugs known as opioid analgesics — powerful, addictive drugs like OxyContin and Vicodin that produce heroin-like effects — that were increasingly prescribed in the 1990s to treat pain.

“Their potential for misuse was underestimated, and opioid analgesics quickly became the most popular category of abused drugs,” the CDC report stated.

In an attempt to track patients’ prescriptions and prevent double dipping between doctors — and states – many states have created prescription drug monitoring programs through federal funding sources. As it stands, 41 states have passed laws to create some type of program, but some states with multiple nearby neighbors — like Maryland, Arkansas and Nebraska — don’t have any such law or bills pending.

“You need to know this information when you have a patient you’re concerned about,” Kloth said, adding that prescription drug abuse can often contribute to social ills such as divorce, child abuse and neglect. “The stories are endless.”

Under the National All Schedules Prescription Electronic Reporting Act (NASPER) — signed by President George W. Bush in 2005 — more than $50 million has been given to states to enact programs that allow doctors and other authorized users, like police, to access patient records. Though the NASPER legislation called for $50 million in funding, to date it has received $2 million as a result of denials by the Appropriations Committee.

The law’s aim is to have a coordinated national system that monitors an array of controlled substances — all those in Schedules II, III and IV (e.g., cocaine and anabolic steroids), as defined by the U.S. Drug Enforcement Administration and the U.S. Food and Drug Administration. It permits states to exchange sensitive data with each other to deal with border hoppers, doctor shoppers and the like.

“Patients moving from one jurisdiction to another (as in cases involving Virginia, the District of Columbia and Maryland) will typically be able to obtain multiple prescriptions by merely crossing state lines,” a NASPER fact sheet stated. “The conscious and more prevalent unconscious misuse of Schedule II, II and IV controlled substances, are a national problem that cannot be effectively addressed on a state-by-state basis.”

But states are making progress toward implementing such monitoring programs, said Joanee Quirk, who runs the Nevada Prescription Drug Monitoring Program. “[States] have a common bond, but we all run our systems a bit differently,” she said.

Those differences can sometimes create strife between states, she said. For example, unlike many other states, Vermont doesn’t allow outside law enforcement agencies to access its system,

NASPER proponents are preparing to file for reauthorization of the bill with Congress, the effects of which should allow states to create (if they haven’t already) and standardize their programs, said American Society of Interventional Pain Physicians CEO Dr. Laxmaiah Manchikanti. “We are progressing toward better monitoring and it’s becoming more doctor-friendly,” he said.

Right now, Manchikanti, whose practice is in a small Kentucky town, has to tap into other states’ databases to get information on a patient, he said. While a national database is becoming a reality for Manchikanti, its full implementation could take up to 10 more years, he said.

The U.S. Government Accountability Office in 2002 reported that state monitoring programs do indeed provide an effective tool to stem the growing problem of illegal diversion of prescription drugs, and noted that they offer quick access to comprehensive information, which often deters abusers from doctor shopping within the state.

“Further, only a few programs operate proactively, while most operate reactively,” a NASPER fact sheet stated. “Incidents of drug diversion, however, are on the rise in neighboring states, indicating the problem is proliferating or shifting to states without monitoring programs.”

Such a program recently came in handy for Kloth, who, after hearing a litany of excuses from one patient — from running out of medication early, losing the bottle and saying his wife accidentally washed it — checked the state database and found the patient had seen 35 doctors and was prescribed medications at 25 pharmacies. “It’s very easy to get addicted to these medications,” Kloth said. “The drugs … will take hold of you.”

In Nevada — a typically transient state — the state prescription drug monitoring program is run by the state board of pharmacy and anyone who prescribes a controlled substance is required by law to report that information to them, said Quirk, who runs the program.

“The real key here is it is just a tool,” Quirk said. “We don’t want a doctor to base prescribing or not prescribing on these reports, but to look at the big picture.

“We don’t know the big picture, but the doctor may,” she said. “That’s why we have this incredible tool they can use.”

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Recent O.D. of Brittany Murphy and J&J Heiress Casey Johnson Underscores Need For Tougher Drug Monitoring

NEW YORK– January 15, 2010 – There is a grim fact that ties together the recent deaths of Clueless actress Brittany Murphy and heiress Casey Johnson, as well as last summer’s passing of “King of Pop” Michael Jackson and before that actor Heath Ledger.  You could even go back to the real “King” Elvis Presley’s death (he’d have turned 75 this month if he were alive) – despite recent studies suggesting a decrease in non-medically administered prescription drug use, the number of Americans who die as a result of abuse is still alarmingly high.

And it’s no coincidence that it seems like another high profile person in this country is dying of matters related to the mismanagement of prescription drugs such as OxyContin, Xanax and Propofol – each and every week.

The American Society of Interventional Pain Physicians (ASIPP), the organization which proposed the National All Schedules Prescription Electronic Reporting Act (NASPER), a bill that allows for nationwide drug monitoring to help stem the tide of rampant prescription drug abuse, is calling for much tougher drug monitoring, training and testing on a national level.

“Prescription drug abuse in this country is out of control and I can safely predict the list of high-profile deaths like Brittany Murphy and Casey Johnson is only going to get longer because too many people including regular citizens have had fairly easy access to this excess for far too long,” remarked Dr. David Kloth, ASIPP past president and board member. “Americans have to wake up and realize that we are facing a national epidemic that is killing our loved ones every day – not just celebrities and socialites.”

“The problem is not the medication alone, but rather those prescribing the drugs without adequate control and training and patients who abuse the medication and do not follow their doctors’ orders. That’s why we propose more rigorous standards and certification for physicians dispensing pain medication otherwise, patients will continue to abuse and the overdoses and deaths will continue to mount,” added Kloth.

According to the U.S. Drug Enforcement Administration, nearly 7 million Americans are abusing prescription drugs — more than the number abusing cocaine, heroin, hallucinogens, Ecstasy, and inhalants, combined and twenty-five percent of drug-related emergency department visits are associated with abuse of prescription drugs.

ASIPP says that physicians who prescribe pain medications need to be properly trained. These medications can only be prescribed by a physician with an active DEA license in the state within which they are working or prescribing. Additionally, patients must be informed about the dangers of over medicating, which can lead to a potentially fatal overdose.

About The American Society of Interventional Pain Physicians
ASIPP’s mission statement is to promote the development and practice of safe, high quality, cost-effective Interventional Pain Management techniques for the diagnosis and treatment of pain and related disorders, and to ensure patient access to these interventions.  Founded in 1998 by current CEO Laxmaiah Manchikanti, MD, ASIPP is a rapidly growing not-for-profit organization that supports the needs of physicians who practice Interventional Pain Management across the country.

Since its inception, the organization has had substantial impact on the practice of interventional pain medicine, resulting in an impressive list of major achievements.  In 2005, ASIPP succeeded in passing The National All Schedules Prescription Electronic Reporting Act (NASPER), which provides and improves patient access to quality care, and protects patients and physicians from the deleterious effects of controlled substance misuse, abuse and trafficking.  ASIPP is headquartered in Paducah, KY and currently has over 5,000 members.  For more information, visit www.asipp.org, call 212-843-8073 or email amazur@rubensteinpr.com.

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WSJ Health Blog

By Shirley S. Wang

It’s no joke for doctors that today marks the day that Medicare’s 21% reimbursement pay cuts were to go into effect.

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Congress left for its Easter recess without voting to delay the scheduled April 1 start of lower payments to docs. The agency that oversees Medicare has effectively delayed the cuts by deciding not to pay claims for the first 10 business days in April. When Congress returns, it’s still expected to adopt another law to delay the cuts for longer, as it has done annually for years now.

So what does the delay in paying claims mean for doctors? In the short-term, their cash flow shouldn’t be disrupted much, according to the Centers for Medicare and Medicaid. Typically claims are paid no sooner than 14 calendar days anyway, so doctors shouldn’t see a dip in their income unless Congress fails to act with a new delay in the next two weeks, the agency says.

But the long-standing threat of Medicare cuts are weighing on doctors, say medical societies.

“It’s tough,” Andrew LaMar, spokesman for the California Medical Association, told the Health Blog. “Imagine if every month you didn’t know what your paycheck is going to be.”

The American Medical Association and others urged repeatedly for a permanent repeal of Medicare cuts throughout the health-care bill legislative process, but it wasn’t included as part of the final bill.

David Kloth, past president of the American Society of Interventional Pain Physicians, told the Health Blog that private insurers base their rates on those set by Medicare, so a cut in Medicare payments would likely result in reimbursement cuts across the board. And if their revenue drops significantly, docs may reduce the number of Medicare patients they see or have to lay off employees, he says.

“If they’re not careful, they’re going to drive doctors out of Medicare and Medicaid,” says Kloth.

Photo: Associated Press

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FOR IMMEDIATE RELEASE

NATIONAL SOCIETY OF PHYSICIANS RAILS AGAINST OBAMACARE’S COMPARATIVE EFFECTIVENESS RESEARCH

Practicing Doctors Warn About Increased Government
Control of Private Medical Decisions

PADUCAH, KY, APRIL 9, 2010 – A leading national medial society with thousands of physician members is again speaking out against the newly passed healthcare reform legislation, particularly the creation of a single panel that will be charged with determining insurance carriers’ coverage decisions for treatment of patients nationwide.

ASIPP, The American Society of Interventional Pain Physicians, is strongly opposed to a provision in the law for the creation of the new non-profit organization called the Patient-Centered Outcomes Research Institute. The institute, comprised of a 19-member board of directors chosen by the U.S. Comptroller General, is expected to begin meeting within the next six months and will be comprised of methodologists and statisticians rather than actively practicing clinicians. Current plans do not include the use of physician experts or medical societies related to the field under review.

Dr. David Kloth, board member, past president and national spokesman for ASIPP says, “This is perhaps the prime example of how the government will come between patients and their doctor.”

ASIPP says this will result in continued and increased healthcare rationing and that the Patient-Centered Outcomes Research Institute will wield too much control over the private medical decisions of individuals, including determining both the clinical and cost effectiveness of procedures, treatments, drugs and medical devices. The society believes this will be extremely damaging to the cutting-edge developments across the entire spectrum of medicine. Such government guidelines and authority in health care will result in a centralized decision-making process, ASIPP says. The scenario is similar to the counterproductive and flawed system practiced in the United Kingdom for decades and where many common chronic pain treatments are now denied coverage.

“The most important aspect of establishing any type of guidelines is that there are practicing physicians who have the hands-on knowledge working in tandem with those who understand and can analyze the research (methodologists),” added Dr. Kloth. “Without the expertise of both, based on our recent experience, the guidelines will be overly restrictive and not in the best interest of our patients.”

ASIPP agrees that health care reform is mandatory for the country but is very concerned with many aspects of the new laws. Rather than exercise a monopoly over health care coverage decisions, ASIPP believes that the government should encourage and incorporate input from practicing physicians, researchers and policy makers alike.

ASIPP says that if the government’s goal is to ultimately reduce the amount of waste, fraud and abuse in the U.S. healthcare system, the answer isn’t the rationing of medicine by an appointed panel but to work with actively practicing doctors who know the treatments and can help create ethical and appropriate treatment coverage guidelines.

For interviews with David Kloth, MD, national spokesman for the American Society of Interventional Pain Physicians (ASIPP) please call (212) 843-8073 or email amazur@rubensteinpr.com.

About The American Society of Interventional Pain Physicians

ASIPP’s mission statement is to promote the development and practice of safe, high quality, cost-effective interventional pain management techniques for the diagnosis and treatment of pain and related disorders, and to ensure patient access to these interventions. Founded in 1998 by current CEO Laxmaiah Manchikanti, MD, ASIPP is a rapidly growing not-for-profit organization that supports the needs of physicians who practice Interventional Pain Management across the country.

Since its inception, the organization has had substantial impact on the practice of interventional pain medicine, resulting in an impressive list of major achievements. In 2005, ASIPP succeeded in passing The National All Schedules Prescription Electronic Reporting Act (NASPER), which provides and improves patient access to quality care, and protects patients and physicians from the deleterious effects of controlled substance misuse, abuse and trafficking. ASIPP is headquartered in Paducah, KY and currently has over 4,000 members. For more information, visit www.asipp.org or call 270.554.9412. Ext. 215.