The number of Oklahomans dying from prescription drug abuse has more than doubled over the past 12 years.
State leaders and health officials have grappled with — and argued over — how to best address what’s been dubbed an epidemic in the state.
During the past legislative session, a bill failed to win legislative approval that would have required doctors to check an online database before writing narcotic prescriptions.
Many members of Oklahoma’s medical community did not support the bill, although many voiced support of an ongoing conversation to address prescription drug abuse in Oklahoma.
Dan McNeill, clinical professor at Oklahoma City University, is the president of the Oklahoma Academy of Physician Assistants. He answered a few questions about the organization’s efforts to curb prescription drug abuse in Oklahoma.
What authority, under Oklahoma law, do physician assitants have in writing prescriptions for painkillers?
McNeill said PAs are able to prescribe non-scheduled drugs and scheduled drugs III through IV. A PA can also be registered with the Drug Enforcement Administration to write a prescription for schedule II drugs in a hospital setting, but is not to write such a prescription to be filled at a retail pharmacy.
Schedule II narcotics include oxycodone, hydromorphone, methadone and fentanyl.
McNeill said pain is a common condition that PAs see, and thus, it makes up a large part of their practices.
Recently, the DEA changed hydrocodone combinations from schedule III to the more stringent schedule II of the Controlled Substances Act. The rule went into effect Oct. 6.
“That has some unintended consequences for PAs and nurse practitioners that work in emergency rooms throughout Oklahoma and being able to appropriately manage modest to severe acute pain,” McNeill said.
Did your organization support recent legislation that would change requirements to check the state’s prescription drug monitoring program?
Representatives from the Oklahoma Academy of Physician Assistants were part of Gov. Mary Fallin’s task force examining prescription drug abuse in Oklahoma.
The organization did not take an official stance on a law that would have required medical professionals check the prescription drug monitoring program, a database of controlled dangerous substances prescribed in Oklahoma, drugs that include oxycodone and hydrocodone.
“We certainly support the PMP program,” McNeill said. “The mechanism that was proposed originally about checking on it every patient, … with scheduled drug, we do (that) could be burdensome, but we do support the use of the PMP and continuing discussion to come to a compromise.”
What is your organization doing to address prescription drug abuse?
Since the 1990s, PAs have been required by the state medical board to take a continuing medical education course with a lecture hour on substance abuse treatment or about recognizing when someone might be chemically dependent.
“Making the profession aware that prescription drug abuse is a huge problem in Oklahoma and proper prescribing techniques is a common feature of our annual conferences,” McNeill said. “…The academy is constantly trying to educate providers on proper prescribing, not only narcotics but all medications.”
Does your organization support a legislative or medical education approach to providers using the PMP?
“A little of both,” McNeill said. “I think requiring (providers) to use the PMP, I don’t have a problem with that,” he said. “It’s just — I don’t think that requiring us to access the PMP on each and every prescription that’s written is necessary. We know our patients best and periodic and even frequent checking of the PMP, I could go along with, but on every patient, I think that’s probably overly burdensome.”