{"id":31769,"date":"2019-08-08T17:02:30","date_gmt":"2019-08-08T22:02:30","guid":{"rendered":"http:\/\/stateimpact.npr.org\/oklahoma\/?p=31769"},"modified":"2019-08-09T11:08:13","modified_gmt":"2019-08-09T16:08:13","slug":"medical-boards-lack-process-for-opioid-complaints","status":"publish","type":"post","link":"https:\/\/stateimpact.npr.org\/oklahoma\/2019\/08\/08\/medical-boards-lack-process-for-opioid-complaints\/","title":{"rendered":"Medical boards lack process for opioid complaints"},"content":{"rendered":"<div id=\"attachment_29443\"  class=\"wp-caption module image aligncenter\" style=\"max-width: 1920px;\"><img decoding=\"async\" loading=\"lazy\" class=\"size-large wp-image-29443\" src=\"https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/03\/Narcan-1920x1280.jpg\" alt=\"\" width=\"1920\" height=\"1280\" srcset=\"https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/03\/Narcan-1920x1280.jpg 1920w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/03\/Narcan-500x333.jpg 500w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/03\/Narcan-150x100.jpg 150w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/03\/Narcan-300x200.jpg 300w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/03\/Narcan-620x413.jpg 620w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2018\/03\/Narcan-1620x1080.jpg 1620w\" sizes=\"(max-width: 1920px) 100vw, 1920px\" \/><\/p>\n<p class=\"wp-media-credit\">Jackie Fortier \/ StateImpact<\/p>\n<p class=\"wp-caption-text\">Narcan, also known as Naloxone is an opiate overdose antidote.<\/p>\n<\/div><p><span style=\"font-weight: 400;\">The ongoing court case against opioid manufacturer Johnson & Johnson highlighted the role that doctors, and the medical boards who regulate them, have played in the continuing public health crisis.\u00a0<\/span><br \/>\n<iframe loading=\"lazy\" src=\"https:\/\/w.soundcloud.com\/player\/?url=https%3A\/\/api.soundcloud.com\/tracks\/663055331&color=%23ff5500&auto_play=false&hide_related=true&show_comments=false&show_user=true&show_reposts=false&show_teaser=false&visual=false\" width=\"100%\" height=\"150\" frameborder=\"no\" scrolling=\"no\"><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><!--more--><\/p><p><span style=\"font-weight: 400;\">The state is asking a court to <a href=\"https:\/\/stateimpact.npr.org\/oklahoma\/2019\/07\/17\/pain-meds-as-public-nuisance-oklahoma-tests-a-legal-strategy-against-opioid-maker-johnson-johnson\/\">order the opioid manufacturer to pay more than $17 billion<\/a> to \u2018abate the opioid crisis\u2019 in Oklahoma. During the seven-week trial, which wrapped up in July, attorneys for the state claimed that Johnson & Johnson along with other drug giants, waged an aggressive marketing campaign beginning in the 1990s to convince patients and doctors that pain was a vast, undertreated problem &#8211; and that the solution was more opioids.<\/span><\/p><p><span style=\"font-weight: 400;\">Lawyers for Johnson & Johnson argued instead that the state has failed to regulate physician\u2019s opioid prescribing practices properly.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">The court heard video testimony from Richard Zimmer, chief investigator for the Oklahoma State Board of Osteopathic Examiners. The board is responsible for licensing and disciplining 2,500 Oklahoma doctors.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">Zimmer said that there were no written guidelines or common standards for handling an improper opioid prescribing complaint against a doctor.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">\u201cEvery case is different. So there\u2019s a different set of circumstances in every case, and each one of those is looked at by that case review committee,\u201d Zimmer said.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">He told the court that the board is \u2018complaint-driven\u2019 and that complaints must be sent by mail. Zimmer said he then looks through them to see if any are an emergency situation, and if not, sends them on to the review committee, which he also sits on.<\/span><\/p>\n<div id=\"attachment_31770\"  class=\"wp-caption module image aligncenter\" style=\"max-width: 672px;\"><img decoding=\"async\" loading=\"lazy\" class=\"wp-image-31770 size-medium\" src=\"https:\/\/stateimpact.npr.org\/oklahoma\/files\/2019\/08\/Screen-Shot-2019-08-08-at-2.05.22-PM-672x496.png\" alt=\"\" width=\"672\" height=\"496\" srcset=\"https:\/\/stateimpact.npr.org\/oklahoma\/files\/2019\/08\/Screen-Shot-2019-08-08-at-2.05.22-PM-672x496.png 672w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2019\/08\/Screen-Shot-2019-08-08-at-2.05.22-PM-1920x1417.png 1920w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2019\/08\/Screen-Shot-2019-08-08-at-2.05.22-PM-768x567.png 768w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2019\/08\/Screen-Shot-2019-08-08-at-2.05.22-PM-150x111.png 150w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2019\/08\/Screen-Shot-2019-08-08-at-2.05.22-PM-300x221.png 300w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2019\/08\/Screen-Shot-2019-08-08-at-2.05.22-PM-620x458.png 620w, https:\/\/stateimpact.npr.org\/oklahoma\/files\/2019\/08\/Screen-Shot-2019-08-08-at-2.05.22-PM-1464x1080.png 1464w\" sizes=\"(max-width: 672px) 100vw, 672px\" \/><\/p>\n<p class=\"wp-media-credit\">Jackie Fortier \/ StateImpact Oklahoma<\/p>\n<p class=\"wp-caption-text\">Video testimony of Richard Zimmer, chief investigator at the Oklahoma State Board of Osteopathic Examiners played during the state&#8217;s lawsuit against opioid manufacturer Johnson & Johnson.<\/p>\n<\/div><p><span style=\"font-weight: 400;\">Zimmer also testified that there was no standard form of communication between the state osteopathic board and other agencies that do criminal investigations. Zimmer told the court that sometimes he finds out about doctors that the board oversees being arrested in the newspaper.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">The Oklahoma Osteopathic Board did not respond to repeated requests for comment.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">\u201cI mean, it just seems a little more ad hoc then might be appropriate for a board that is supposed to be protecting the public,\u201d said <a href=\"https:\/\/www.networkforphl.org\/topics__resources\/lawyer_directory\/corey_davis\/\">Corey Davis<\/a>, a lawyer and deputy director at the N<\/span><span style=\"font-weight: 400;\">etwork for Public Health Law<\/span><span style=\"font-weight: 400;\">.<\/span><\/p><p><span style=\"font-weight: 400;\">In the U.S., there isn\u2019t much federal oversight of doctors, leaving complaint-driven state medical boards in charge of licensing and disciplining.<\/span><\/p><p><span style=\"font-weight: 400;\">\u201cThe [<\/span><a href=\"https:\/\/www.dea.gov\/\"><span style=\"font-weight: 400;\">United States Drug Enforcement Administration<\/span><\/a><span style=\"font-weight: 400;\">] can take away a person\u2019s ability to prescribe controlled substances but they can\u2019t take away your ability to practice medicine, only the state can do that,\u201d Davis said.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">Over the years, some Oklahoma doctors have been charged and found criminally liable for extreme opioid prescribing. But the lack of communication between agencies means that state medical boards across the country are relying on patients to complain, in order to know that there\u2019s a problem.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">\u201cThere needs to be some process other than just waiting for somebody to complain,\u201d Davis said. \u201cBecause you\u2019ve got to imagine that by that time, it\u2019s probably too late.\u201d<\/span><\/p><p><span style=\"font-weight: 400;\">Doctors have become more aware of their role in overprescribing opioids, said<\/span><a href=\"https:\/\/www.uab.edu\/medicine\/dopm\/primary-faculty-menu\/kertesz\"><span style=\"font-weight: 400;\">\u00a0Stefan Kertesz<\/span><\/a><span style=\"font-weight: 400;\">, addiction specialist professor of medicine at the University of Alabama at Birmingham.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">\u201cThe simplest solution for a doctor concerned about their career is to take everybody\u2019s dose down across the board or to announce that they will not care for anybody who is already receiving opioids, and that\u2019s about 10 million Americans,\u201d Kertesz said.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">That can leave patients without a doctor at all. Rather than cracking down, Kertesz says that medical boards should support and counsel doctors who exhibit opioid prescribing red flags, but who aren\u2019t breaking the law.<\/span><\/p><p><span style=\"font-weight: 400;\">\u201cHealth is actually a more complicated thing, and protecting people is a more complicated thing than whether the pills are just too much or too little and we need to escape that paradigm,\u201d he said.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">But sending a trained health professional to help a physician change their entrenched prescribing practices would be very expensive. Oklahoma\u2019s two medical boards get very little state funding, though that could change if the judge in the Johnson & Johnson case sides with the state.\u00a0<\/span><\/p><p><span style=\"font-weight: 400;\">The judge is expected to announce a verdict in the case in August.\u00a0<\/span><\/p><p>Editor&#8217;s Note: A previous version of this story misspelled Stefan Kertesz&#8217;s name. The story has been corrected to reflect the correct spelling.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The ongoing court case against opioid manufacturer Johnson &#038; Johnson highlighted the role that doctors, and the medical boards who regulate them, have played in the continuing public health crisis.\u00a0<\/p>\n","protected":false},"author":199,"featured_media":31541,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[23],"tags":[12,944,1084,765],"acf":[],"_links":{"self":[{"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/posts\/31769"}],"collection":[{"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/users\/199"}],"replies":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/comments?post=31769"}],"version-history":[{"count":7,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/posts\/31769\/revisions"}],"predecessor-version":[{"id":31780,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/posts\/31769\/revisions\/31780"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/media\/31541"}],"wp:attachment":[{"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/media?parent=31769"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/categories?post=31769"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stateimpact.npr.org\/oklahoma\/wp-json\/wp\/v2\/tags?post=31769"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}