An Open Letter to the Medical Licensing Board of Indiana

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October 7, 2013

Dear Members of the Board,

Opportunity.  Duty.  Trust.

By allowing its Medical Licensing Board latitude to create regulations absent the boundaries of restrictive legislation, the Indiana General Assembly has afforded you a tremendous opportunity – to create regulations that balance access to effective pain care with the imperative to prevent substance abuse.

A physician’s duty is to care for the sick and the suffering, holding fast to the maxim primum non nocere, or “first do no harm.” A physician’s method begins with data collection that leads to an assessment and then to the formation of a plan. Re-evaluation follows, spawning reassessment and modification of plans when indicated. Clinical judgment is enhanced by utilizing a measured approach to prescribing, which includes starting low and going slowly, preventing over-treatment, and staunchly avoiding actions with the potential for irreversible detrimental consequences. Indeed, the most current draft of Indiana’s Emergency Pain Regulations mandates a measured approach when providing pain care, i.e. Where medically appropriate, the physician shall utilize non-opioid options instead of prescribing opioids.

A measured approach to governing our profession is prudent. Regulatory overreach has a chilling effect by making prescribers fearful of jeopardizing their licenses.  This fear can result in physicians abandoning pain sufferers, even forcing some patients to seek black market medications or illicit drugs.  Such has been the unfortunate case in states that hastily passed burdensome pain regulations.  Heroin use in these states has increased dramatically as the supply of prescription pain medications has dwindled.

Ultimately a physician’s obligation, like yours, is to prove worthy of trust. For the Board this means drafting clear and concise regulations that do not overreach nor attempt to address every possible scenario, followed by re-evaluation and modification as necessary.  The “Progress Report Card 2012” from the Pain & Policy Studies Group of the University of Wisconsin School of Medicine and Public Health supports this process and recommends that implementation of any state’s pain policy provide for periodic re-evaluation so that, if necessary, “corrective proposals” can be developed.

The Board’s task is neither simple nor easy and never should be considered a “mission accomplished.” Also, in the future more attention must be given to prevention and treatment of addiction – the root cause of prescription drug abuse – or else our best efforts will be no more effective than a dog chasing its own tail.

I have and will continue to offer my support, passion, and dedication to helping the Board in any way I can. Please contact me whenever I might be needed and expect my support.

Embrace the opportunity. Fulfill this duty.  Deserve the public’s trust.

In earnest,

James Patrick Murphy, MD, MMM

Jeffersonville, Indiana

National Substance Abuse Prevention Month 2013

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Here is a summary of WEEK ONE:

TUESDAY

By the way, since October is National Substance Abuse Prevention Month I am going to message every day this month on TWITTER (@jamespmurphymd). I am inviting you to “follow” me on TWITTER and pass it on to friends and anyone whose life is touched by the plague of substance abuse (i.e. pretty much all of us).

Together we can be the change.  http://www.ncadd.org/index.php/programs-a-services/overview

 

WEDNESDAY

Here’s a goal for DAY 2 of National Substance Abuse Prevention Month… check your VITAL SIGNS. Below is a link to our GLMS publications (all are worthy) but Vital Signs Issue 3 – 2012 “Pain Treatment and Prescription Drug Abuse in Kentucky” is particularly timely this month.  https://www.glms.org/Default.aspx?PageID=139

 

THURSDAY

It’s DAY 3 of National Substance Abuse Prevention Month. Surprised to learn that more than 70 percent of people who abuse pain meds get them from friends or family? YOU can make a difference by LOCKING your meds and DISPOSING of the leftovers properly. Here’s how…  http://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/ucm107163.pdf

 

FRIDAY

It’s day FOUR of National Substance Abuse Awareness Month and THE HEALING PLACE benefit concert with jazzy Sarah Stivers is TONIGHT at Kentucky Country Day’s Performing Arts Center. Chill out and support Louisville’s Healing Place – the most successful addiction recovery program in the USA. Help restore lives! http://www.thehealingplace.org

 

SATURDAY

It’s National Substance Abuse Prevention Month DAY 5. Teens & young adults are most vulnerable to addiction. It’s a brain thing. Learn why. Take action. Is there someone in your life who needs to hear from you?  http://teenbrain.drugfree.org/

 

SUNDAY

Day 6 of National Substance Abuse Awareness Month: “Requiem For A Dream,” is possibly THE most powerful movie EVER about the downward spiral of drug addiction. The trailer alone will give you chills. http://www.youtube.com/watch?v=jzk-lmU4KZ4