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Study concludes Florida laws contributed to drop in opioid prescribing

August 18, 2015
by Gary A. Enos, Editor
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A new study suggests that legislative initiatives designed to shed Florida's reputation as a haven for inappropriate opioid prescribing produced some desired results.

Funded by the Robert Wood Johnson Foundation's Public Health Law Research program and published this week in JAMA Internal Medicine, the study found that the state's pill mill and prescription drug monitoring program (PDMP) laws led to decreases in opioid prescriptions between July 2010 and September 2012. The decreases occurred exclusively among those prescribers who had shown the highest prescribing rates, and amounted to a 1.4% decline in the aggregate.

The study examined a database of more than 430,000 prescribers who generated around 480 million prescriptions during the study period, with about 8% of them for opioids. As a basis of comparison, researchers examined prescribing patterns during the same time period in Georgia, which had neither law in place at the time.

Florida's attempt through 2010 legislation to crack down on “pill mill” pain clinics was spurred by data showing that, for example, 90 of the 100 highest-volume physician buyers of oxycodone in the nation that year were located in Florida.

Study authors suggest in their report that states should engage in outreach to their highest-volume opioid prescribers, as well as encourage drug treatment services for individuals at risk of turning to street heroin when access to prescription opioids becomes restricted.

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The recent JAMA for Internal Medicine study regarding the success of Florida's initiative. The study cites a 1.4% decline in the aggregate amount of prescribed opioid medicatins.As an objective professional in both teaching the Florida Pain Management Law and Regulations for the past five years , and consulting with numerous pain physicians and clinics in evaluating their patient's compliance with the Pulido Coates Pain Patient Compliance Protocol and Scale, I have determined that while the Florida legislation has reduced the number of illegal pill mills, the Legislation has rather increased patient NONCOMPLIANCE in even the finest of legitimate pain management clinics and prescriber. In essence, patients are duping the docs! The average clinic level of non compliance including all 5 scale levels we scored in 3200 administrations using the PPCP-S is 60% NON COMPLIANCE. We routinely ask each physician medical director before we begin assessing their patient's compliance how they think their facility rates as to compliance. The response is almost universally, "my patients are 90-95% compliant. Upon showing empiricle evidence of the easily scored PPCP-S, which is a billable procedure, that even many of their most perceived compliant patients are non compliant, the physicians are shocked.

It is one thing to close down a Pill Mill; its a totally different nightmare to know patients are either not educated or diagnosed properly, or the patient has become accustomed and skilled to serve to their reptilian pleasure seeker mentality. Its high time to protect the physician from patient non compliance. its just the right and good thing to do.

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