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Ethical Responsibilities of Physicians in the Opioid Crisis

Published online by Cambridge University Press:  01 January 2021

Mark A. Rothstein
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Type
Columns: Currents in Contemporary Bioethics
Information
Journal of Law, Medicine & Ethics , Volume 45 , Issue 4: Stigma & Health , Winter 2017 , pp. 682 - 687
Copyright
Copyright © American Society of Law, Medicine and Ethics 2017

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References

Centers for Disease Control and Prevention, National Center for Health Statistics, “Provisional Counts of Drug Overdose Deaths, as of 8/6/2017,” available at <https://www.cdc.gov/nchs/data/health_policy/monthly-drug-overdose-death-estimates.pdf> (last visited Sept. 6, 2017). See Katz, J., “New Count of 2016 Drug Deaths Shows Accelerated Rate,” New York Times, Sept. 3, 2017, at 14. It should be noted that the data slightly overestimate the number of deaths by substance because some overdose fatalities were the result of multiple drugs; but the data are based on state reports, which have a completeness of reporting of > 90%, and therefore slightly undercount the number of fatalities. It is not known precisely whether the over-counting and under-counting precisely cancel out. See Provisional Counts, supra at 2, Notes on Data Quality.+(last+visited+Sept.+6,+2017).+See+Katz,+J.,+“New+Count+of+2016+Drug+Deaths+Shows+Accelerated+Rate,”+New+York+Times,+Sept.+3,+2017,+at+14.+It+should+be+noted+that+the+data+slightly+overestimate+the+number+of+deaths+by+substance+because+some+overdose+fatalities+were+the+result+of+multiple+drugs;+but+the+data+are+based+on+state+reports,+which+have+a+completeness+of+reporting+of+>+90%,+and+therefore+slightly+undercount+the+number+of+fatalities.+It+is+not+known+precisely+whether+the+over-counting+and+under-counting+precisely+cancel+out.+See+Provisional+Counts,+supra+at+2,+Notes+on+Data+Quality.>Google Scholar
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Often, this takes the form of telling patients that all painkillers must be prescribed by a pain management specialist. As of January 2017, however, there were only 2,300 physicians who were board certified by the American Board of Pain Management, available at <http://abpm.org/faq> (last visited Sept. 28, 2017), and 6,000 members of the American Academy of Pain Management, available at <https://health-finder.gov/FindServices/organizations/organizations.aspx?code=HR3001> (last visited Sept. 28, 2017). Even if a pain management physician can be located, the added delay, burden, and expense compounds the pain and distress of the patient.+(last+visited+Sept.+28,+2017),+and+6,000+members+of+the+American+Academy+of+Pain+Management,+available+at++(last+visited+Sept.+28,+2017).+Even+if+a+pain+management+physician+can+be+located,+the+added+delay,+burden,+and+expense+compounds+the+pain+and+distress+of+the+patient.>Google Scholar
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Merely adopting a strategy of referring patients to pain management specialists will not work because of the large number of individuals with OUD and the small number of specialists. See note 34 supra.Google Scholar
Many physicians and institutions already have dedicated considerable efforts and resources to help in treating OUD in their patients. On a national basis, however, these efforts are not nearly enough to combat addiction.Google Scholar
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