Public Wants Doctors to Talk More with Patients about Dangers of Opioids

Andrew Kitchenman | March 17, 2015 | Health Care
Poll finds wide support for legislation as another piece of anti-addiction package advances

Tom Allen talks about his fight to overcome opioid addiction.
After a gym injury 13 years ago left Tom Allen with two ruptured discs in his neck, a doctor laid out his options: undergo cervical fusion surgery, which the doctor recommended, or the alternative of pain medication and physical therapy.

But Allen’s conversation with his doctor didn’t focus on the danger present by that second option – the potential for becoming addicted to opioid pain medications.

Allen opted against surgery because he didn’t want a disruption from law school.

But that choice led him down a dark path of suffering throughout a years-long addiction that he said ruined his life.

Now he’s working to ensure that future patients know more than he did about opioids by advocating for a bill, S-2366/A-3712, that would require doctors to talk with patients about the addiction potential of drugs before prescribing them.

Allen has turned his life around. He serves as CEO of Summit Behavioral Health, an addiction treatment provider.

And his position has wide support among New Jersey residents. A recent survey by Fairleigh Dickinson University’s PublicMind poll showed that 91 percent agreed that doctors should be required to tell patients their prescription is addictive. In addition, 64 percent of residents believe that discussing the potential for addiction will reduce the number of people who become addicted.

The bill is one of two that would make doctors more responsible for preventing addictions. A separate measure that the Senate passed yesterday would require doctors, before issuing an opioid prescription, to check a state registry to see whether patients have already been receiving the drugs from other providers.

Allen said the bill mandating a doctor-patient talk about addictive medications is as much about ensuring that doctors are informed about the medical science of addiction as it is about warning patients about the risks.

The primary-care doctors of Summit Behavioral Health patients generally don’t have “a good grasp of addiction and what it entails — the brain chemistry behind it,” Allen said. But by having to prepare for talks with their patients, they would become better informed, he said.

The poll was sponsored by the Partnership for a Drug-Free New Jersey, a nonprofit that receives state and private funding.

“In New Jersey, a simple conversation between a patient and a doctor can be life-saving,” said Angelo M. Valente, the organization’s executive director. “It can mean the difference between living a happy and healthy life and embarking on a long and sometimes deadly path of substance abuse.”

The bill mandating the doctor-patient discussions has been met with opposition from major physician groups. Representatives of the Medical Society of New Jersey and the New Jersey Academy of Family Physicians agreed that patients should be kept informed, but they oppose government mandates that affect the time that doctors spend with patients and the ability of doctors to use their own discretion.

“The abuse and misuse of prescription medications is a very difficult and emotional issue for physicians, patients and their families, but unfortunately mandating a state-scripted conversation between a physician and patient is just not the solution,” said Claudine Leone, government affairs director for the academy.

Not all doctors are opposed. Dr. Shuvendu Sen of Raritan Bay Medical Center in Perth Amboy said doctors have shown “a certain nonchalance” about the adverse effects of opioids. He said that while doctors shouldn’t be blamed for the problem, the solution must start with them because “we have been the point of entry.”

Bill sponsor Sen. Joseph F. Vitale (D-Middlesex) said he wants to make sure that patients have “full and complete knowledge” about the addictive potential of opioids before they receive a prescription. Sen. Loretta Weinberg (D-Bergen) also is a primary sponsor for the legislation.

The Senate passed the discussion mandate by a 36-1 vote in December. The Assembly version, sponsored by Assemblyman Herb Conaway Jr. (D-Burlington) and Assembly Joseph A. Lagana (D-Bergen and Passaic), has been referred to the Assembly Health and Senior Services Committee.

Vitale noted that the bill is just one of 21 in a legislative package intended to bolster drug education, prevention, treatment and recovery. Vitale noted that many of these bills – which he has supported — are making their way through the legislative pipeline, including the requirement that doctors check the Prescription Monitoring Program (PMP) to see if patients are shopping for prescriptions with multiple doctors.

The Senate passed that PMP bill, S-2119/A-3129, by a 36-0 vote yesterday. The Assembly version has been referred to the Assembly Appropriations Committee.

“We’re getting closer and closer to the goal line,” Vitale said.

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