To what extent, if any, should restrictions be placed on prescribing powerful painkillers that are increasingly linked to abuse and overdose deaths? That issue is being debated in the state of Washington, where regulations are being developed to prevent docs from prescribing higher doses to patients who are not benefiting, The New York Times reports. Instead, docs would be required to refer patients for evaluation if no improvement is shown.

Nationwide, fatalities from prescription drug overdoses are the second-leading cause of accidental death after car accidents and, in some states, are the leading cause, according to the Centers for Disease Control and Prevention. Last year, narcotic pain killers accounted for 7 percent of all prescribed drugs, and the number of patients annually taking long-acting versions has increased about 30 percent over the last decade, the Times writes. Among the meds is OxyContin and fentanyl.

While many patients benefit from pain killers, there is growing evidence from studies, including one in Washington State, that patients suffer significant side effects, such as lethargy, increased sensitivity to pain and, sometimes, potentially fatal overdoses. “This is not just about addicts but little old ladies with arthritis starting to die because of this kind of medical practice,” Alex Cahana, a pain specialist involved in devising the regulations, tells the paper. “There is a dissonance in not recognizing the nexus between poor pain management and the hyperconsumption of opioids.”

The move comes just as an FDA advisory panel rejected an agency plan for controlling such drugs as insufficient because it did not require special training for docs who prescribe these drugs. But what would be the consequences for failing to follow the proposed rules? A doc who ignores the regs could face sanctions from state licensing boards, including potentially losing the right to practice.

However, patient groups and drugmakers complain that new restrictions would unfairly punish pain sufferers who rely on the drugs. Purdue Pharma, which makes OxyContin, lobbied against the restrictions. This is the same the company that, along with present and former execs, three years ago agreed to pay $634.5 million to settle charges related to deceiving docs about the potential for abusing its painkiller (background).

pic thx to mothersagainstmedicalabuse.org