Physician groups raising concerns about DOJ opioids letters

Physician groups in the state are sounding the alarm about letters recently sent to doctors by the U.S. Department of Justice.

In early February, the DOJ sent letters to more than 180 physicians, their assistants and nurse practitioners in Wisconsin that were prescribing relatively high levels of opioids.

According to the U.S. Attorney’s Office for the Western District of Wisconsin, these letters are part of a broader federal and state effort to reduce the number of people addicted to opioids.

“We’re very concerned that these letters will alarm prescribers to the point that they may get out of the pain treatment arena altogether,” said Molli Rolli, president of the Wisconsin Medical Society. She says the letters threatened doctors with criminal consequences “even if the treatment provided is medically appropriate.”

In a release from WMS and the Wisconsin Society of Addiction Medicine, it’s noted that the letters don’t take into consideration the different patient groups particular doctors might be treating. The groups say that’s “a critical variable,” as some health care providers spend more time than others treating patients with serious pain.

According to the release, the DOJ letter says the recipient’s prescriptions “may be medically appropriate” and makes no claims about doctors breaking the law.  

Still, WISAM President Matthew Felgus says that disclaimer is “pretty deep into the letter.”

“So essentially the letter is saying ‘you’re not doing anything illegal, but we’re watching you’ — that’s a very new law enforcement attitude compared to what we’ve seen over the last several years, so it’s quite troubling,” Felgus said.

The letters warn recipients that their prescribing practices could be fueling blackmarket sales for unused prescription opioids. The U.S. Attorney’s Office for the Western District of Wisconsin says the names of letter recipients will not be released.

WISAM and WMS both say these letters could result in “negative unintended consequences” for patients who might get turned away by doctors who were spooked by the letter.

“Prescribers receiving this letter may think twice about continuing to see patients who have pain treatment needs — and those patients risk turning to street drugs when they can’t see a physician who is trying to wean them off opioids altogether,” Felgus said.

The letters also tell practitioners they must use the state’s Prescription Drug Monitoring Program to assess patient history before prescribing any narcotics. A recent report from that program found the total number of opioids and other monitored prescription drugs has gone down 29 percent between 2014 and 2018.

“We’re making progress in reducing the amount of opioids being prescribed; at the same time, it’s important to remember that it’s already very difficult for some patients in Wisconsin to get quick access to legitimately needed care,” Felgus said.

Rolli adds that Wisconsin physicians are hoping the DOJ letter’s “punitive stance” is an anomaly, rather than the standard.

In their release, Felgus and Rolli say the state’s Medical Examining Board is in the best position to determine if there’s a problem with how Wisconsin doctors are providing care.

See more on the letters from the U.S. Attorney’s Office: http://www.justice.gov/usao-wdwi/pr/us-attorneys-issue-warnings-opioid-prescribers

 
–By Alex Moe 
WisBusiness.com