Prescription Mistakes
Are doctors prescribing certain narcotics without fully understanding them? As popular pain medication OxyContin became too expensive for insurance companies to pay for, doctors turned to Methadone, which was previously used to rehab heroin addicts. For some it is working, for others it leads to death. Many doctors are not familiar with the drug, and are prescribing it in too high of a dose, as well as not advising their patients on how to properly use the drug.
A synthetic form of opium, it is cheap and long lasting, a powerful pain reliever that has helped millions. But because it is also abused by thrill seekers and badly prescribed by doctors unfamiliar with its risks, methadone is now the fastest growing cause of narcotic deaths. It is implicated in more than twice as many deaths as heroin, and is rivaling or surpassing the tolls of painkillers like OxyContin and Vicodin.
“This is a wonderful medicine used appropriately, but an unforgiving medicine used inappropriately,” said Dr. Howard A. Heit, a pain specialist at Georgetown University. “Many legitimate patients, following the direction of the doctor, have run into trouble with methadone, including death.”
Issues with this particular drug run deep, especially with the Food and Drug Administration. The FDA actually had the drug listed in “dangerously high dosages” within Methadone packaging until the last quarter of 2006. It took an increase in deaths for the FDA to examine the recommended doses in drug packaging, and now the organization is considering calling for doctors who are going to prescribe the drug to take a special class on the matter to prevent errors and medical malpractice issues.
Tony Davis, a contractor in Victorville, Calif., had just turned 38 in 2004 when, after years of migraines and back pain, he saw a new pain doctor in his Kaiser Foundation Health Plan. The doctor, who had already given him the sedative Xanax, prescribed methadone because of his continued pain.
The second day on the two medications, Mr. Davis said, “I’m feeling really weird,’ ” recalled his wife, Pebbles Davis. The two lay down for a nap and when she woke up, her husband was dead.
Ms. Davis recalled that the coroner had told her, “Given the medicines he was on, his brain forgot to tell his heart to beat and his lungs to pump.” The case went to an arbitrator, who ruled that although Mr. Davis had overused his drugs in the past, the doctor had failed to warn him about the new risks of starting methadone together with Xanax and that the care was substandard. Ms. Davis was awarded more than $500,000. “I never had any idea of the risk nor did my husband,” she said.
The drug may be misunderstood, with the general population believing that any narcotic death would be attributed to patient misuse, but that may indeed not be the case:
As early as 2003, alarmed by the rise in methadone-related deaths, the Substance Abuse and Mental Health Services Administration made an urgent call for more systematic and detailed state and national reporting about opioid deaths — a call that still goes unanswered.
Misuse by abusers was first seen as the problem, but now, said Dr. H. Westley Clark, director of the Center for Substance Abuse Treatment of SAMHSA, “We know that a significant share of the methadone deaths involve doctors making well-intended prescriptions.”
To see a video story on this subject, visit the New York Times video section.
August 21st, 2008 at 8:37 pm
To answer your question; “Are doctors prescribing certain narcotics without fully understanding them?” the answer is simple and disgraceful; YES. Very few have even adequate training or education to dispense these dangerous drugs and worst, have relied on the pharmaceutical companies to provide them with information about the drugs. Ever ask the wolf to gaurd the chicken coop? Regarding your articles title “Prescription mistakes”, the answer is NO. These are not mistakes. I was taught a mistake is when you don’t know better. And it only gets to be used once. Medical agencies and authorities have known since 1999 that an extraordinary amount of death and addiction was on the rise and correlated directly with the obvious lack of training and education given prior to medical graduation. Approx. 8 hours is all the average physician has in pain management, and pain medications ed/instruction. Yet they are given a license to dispense the most dangerous drugs known. Agency’s like the FDA have conducted many, many investigations and hearings on this subject, documenting horror stories from families and even doctors. Yet they failed to act on addressing the contribution that the lack of educ/training had on all these prescription related deaths and addictions. Sadly, and shamefully,nor did the major medical professional or educational institutions make any moves to reduce the destruction and havoc.
The suggestion to address the doctors, who were/are giving these drugs out like candy, could have been advice given by a kindergartener. It was that plainly evident. Why has this taken so long? I wonder; if the drug profits would have reached the Billions, if direct control of the doctors had been exercised back then. Well, no, actually I don’t wonder. The pharmaceutical company’s manipulated the doctors prescriiption practices of opiates, based on self-serving junk science in the early ’90’s. The doctors blindly became more liberal in dispensing opiates for pain. Many of them, like the cases involved in methadone disregarded dosing schedules, which resulted in unwanted overdoses. Or addictions. If a person doesn’t “fully understand” something, mistakes can happen. But when it becomes obvious to those involved that the mistake was based on a lack of knowlege, the ensuing incidents/behaviors are no longer “mistakes”. Those actions are decisive and purposefull. It’s nothing short of a disgrace.