In South Florida, a new pain clinic opened every three days last year. Doctors reportedly distributed up to ten million oxycodone pills that year. The explosion of pain clinics has resulted in the recent arrests of doctors who have been exploiting prescription drug addiction to increase their financial income. Along with these arrests, many pain clinics are being shut down in effort to regain quality control over the pain medicine industry.
What are Pain Clinics?
Pain clinics are doctor's offices that specialize in managing chronic pain for patients. Patients that need pain management suffer from chronic pain related to neuropathic, musculoskeletal, or complex pain.
- Neuropathic pain includes: lower back, fibromyalgia, sciatica, arthritis, shoulder pain, neck pain and sports injuries.
- Musculoskeletal pain includes: postherpetic neuralgia, diabetic neuropathy, complex regional pain syndrome and neuralgias.
- Complex pain includes: cancer pain, refractory angina, facial pain, headaches.
Some pain management clinics require that their patients have referrals from primary doctors stating that they have legitimate pain. Addicts have been known to pretend to have symptoms related to these disorders in order to get referrals from their primary doctors to go to a pain management clinic.
Pain clinics should provide:
- Medication monitoring helps the patient return to a comfortable level of function with minimal pain. Pain clinics should also have options such as oral medication, injections and/or implants, to choose from with regards to medication distribution.
- Physical therapy in the same facility to offer physical therapists to work with patients helping them to learn how to manage painful activities and restore comfortable movement to the affected area.
- Mental health therapy to address the negative psychological effects of chronic pain. Therapists will assist with helping patients learn positive coping skills for depression and anxiety which accompanies chronic pain.
Unfortunately, many pain clinics may offer limited services and their main focus is on the quantity of consumers versus quality of care.
Pain Clinics and Addiction
One pattern found in addiction is that addicts will have several doctors that they frequently see to obtain pain medicine prescriptions. This pattern is referred to as “doctor shopping”. Addicts are able to see several doctors because many non-ethical pain clinics do not require referrals from primary care physicians. This perpetuates the addiction and assists with obtaining prescription drugs in a much easier way. Addicts need only to think about money to supply their habit.
Drug dealers are able to capitalize on pain clinics too. They are driving addicts to and from doctor’s appointments at pain clinics to obtain prescriptions for drugs. They in turn resell them to other addicts. Drug dealers solicit the homeless, halfway house dwellers, and those who were in need of drugs but had no money to go to these appointments.
Some chronic pain patients who have no previous experience with drug dealing are also capitalizing on the indiscretions of pain clinics. They are selling their extra medication for money. Reports were made in Canada of an arrest of a man who claimed he had too many Dilaudid pills. He was receiving over one hundred pills monthly from a pain clinic and began selling them. He reports that he definitely had an addiction to the drugs but also claims, “The doctor was too lenient and overprescribed medication.”
Doctors, drug dealers and patients alike are all benefiting from the prescription drug addiction.
- An addict physically needs to take the medication to function. Pain clinics make getting drugs easy.
- Doctors know a patient’s body will become dependent on the medication and he or she will need to buy more medication to avoid withdrawal symptoms.
- Patients sell their extra drugs to friends, family and/or strangers just because they can.
Pain Clinics in the News
Many references in the news have been comparing pain clinic doctors with street drug dealers. Street drug dealers and pain clinic doctors have similarities in their characteristics:
- Motivated by money
- Violates boundaries
- Risk taking behavior
Doctors who work in pain clinics can earn up to $12,000.00 per week. This is a great incentive to overlook prescription drug addiction and prescribed knowingly to addicts rather than suggesting they get help. Some doctors will overlook lack of factual evidence of chronic pain issues to prescribe medication and receive payment.
The easiness of obtaining prescription medications from pain clinics has increased prescription drug abuse. Some researchers in Florida are attempting to link the many overdoses and deaths related to OxyContin to pain clinics in the area that have already been charged with illegally dispensing these pills.
Some pain clinics operated as ‘cash only’ services attempting to eliminate the quality control of insurance companies. This allowed patients to visit these doctors and receive prescriptions more often without the limitations of insurance. An addict was able to comfortably find their drug of choice perpetuating the cycle of addiction.
Many pain management clinics have been shut down and are still being investigated. Some states, like Tennessee, are requiring that pain management clinics register with the state to ensure quality control. The state of Florida, one of the leading pain clinics destinations, has had three dozen pain clinic licenses revoked since January 2011. Other states continue to work at decreasing the amount of pain clinics in their communities who are operating outside of the limits stated in the Hippocratic Oath.
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