Pain Doctors’ Limit: 150 Rx/day

17 Oct 2010 | SOURCE: Health News Florida

Doctors who work in Florida pain clinics should write no more than 150 prescriptions a day for potentially addictive and dangerous drugs, a state panel decided.

The proposed rule, aimed at curbing pill mills that make Florida a magnet for drug abusers, is based on an average of three prescriptions per patient for a physician seeing 50 patients per day. A part-timer’s limit would be lower, pro-rated on the same formula.

Some organizations had pushed for a higher limit of four or five prescriptions per patient. But doctors on the panel decided on three: two for painkillers–one for quick relief and one for the long term — plus one for the anti-anxiety drug alprazolam, which goes by the trade name Xanax.

“That’s how we came up with three,” said Dr. Lisa Tucker of Pensacola. “It really did seem reasonable.”

But Paul Sloan of Sarasota, owner of a chain of pain clinics, said the proposed rule needs more flexibility. For example, what if one doctor gets sick and another in the clinic has to see more patients that day to cover for him? And what about patients who can’t afford to fill the whole month’s prescription at a time? (Pharmacies can’t hold back part of a prescription for filling later if the drug is a controlled painkiller, he said).

“They didn’t address these things,” Sloan said. “They want to throw these doctors to the wolves.”

Dr. Steven P. Rosenberg, a panel member from West Palm Beach, said following the meeting that Sloan has a point about the rule lacking needed flexibility. Rosenberg said there is little the panel can do about that because of the way the Legislature wrote the law.Doctors who work in Florida pain clinics should write no more than 150 prescriptions a day for potentially addictive and dangerous drugs, a state panel decided today.

The proposed rule, aimed at curbing pill mills that make Florida a magnet for drug abusers, is based on an average of three prescriptions per patient for a physician seeing 50 patients per day. A part-timer’s limit would be lower, pro-rated on the same formula.

Some organizations had pushed for a higher limit of four or five prescriptions per patient. But doctors on the panel decided on three: two for painkillers–one for quick relief and one for the long term — plus one for the anti-anxiety drug alprazolam, which goes by the trade name Xanax.

“That’s how we came up with three,” said Dr. Lisa Tucker of Pensacola. “It really did seem reasonable.”

But Paul Sloan of Sarasota, owner of a chain of pain clinics, said the proposed rule needs more flexibility. For example, what if one doctor gets sick and another in the clinic has to see more patients that day to cover for him? And what about patients who can’t afford to fill the whole month’s prescription at a time? (Pharmacies can’t hold back part of a prescription for filling later if the drug is a controlled painkiller, he said).

“They didn’t address these things,” Sloan said. “They want to throw these doctors to the wolves.”

Dr. Steven P. Rosenberg, a panel member from West Palm Beach, said following the meeting that Sloan has a point about the rule lacking needed flexibility. Rosenberg said there is little the panel can do about that because of the way the Legislature wrote the law.

The panel, which met in Tampa, includes representatives of both the boards of Medicine and Osteopathic Medicine. Their charge is to create rules that implement new laws aimed at reining in the sea of drugs flowing to addicts and street dealers, some of whom drive in from other states because of lax regulation.

The panel’s vote now goes to the respective boards for approval. But all the rules will likely face legal challenges.

The panel, which met in Tampa, includes representatives of both the boards of Medicine and Osteopathic Medicine. Their charge is to create rules that implement new laws aimed at reining in the sea of drugs flowing to addicts and street dealers, some of whom drive in from other states because of lax regulation.

The panel’s vote now goes to the respective boards for approval. But all the rules will likely face legal challenges.

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