Executive office update: Colorado in epicenter of non-medical prescription drug abuse

Friday, March 01, 2013 12:07 PM

Alfred Gilchrist, Chief Executive Officer
Colorado Medical Society

Colorado is in the epicenter of the prescription drug abuse epidemic with the dubious distinction of having the second highest rate of non-medical prescription drug abuse in the nation, at 6% of people over the age of 12. As a result, we are squarely in the middle of the emergent national debate on what states should do about it.

As physicians, our members will be integrally linked to the policy proposals that emerge. This is why we are in high gear trying to determine where current practices and policies go wrong and what can reverse these dangerous, even fatal, diversions and misuse, while making sure compassionate, evidence-based care is always there for patients suffering from pain.

Gov. John Hickenlooper and Alabama Gov. Robert Bentley, MD, are co-chairing a seven state pilot project launched by the National Governor’s Association to address this issue. In Colorado, a series of roundtables will involve the entire range of stakeholders in this process, from public health and clinical experts to patient advocates and caregivers.

In a recent letter to the governor (reproduced on page 11 of this magazine), CMS committed itself to this urgent matter, explaining that the threat to patient safety suggests the current methods of pain management and opioid prescribing practices require an exhaustive review and examining the epidemiology of these abuses, whether from street diversion, overprescribing, doctor shopping or any other means of diversion and abuse is of paramount importance in setting a course for reform.

Every policy option ever enacted or contemplated is on the table. Some options will be thoughtful and grounded in painful experience (pun intended). Other options will be punitive, and still others will eventually fall into the been-there-don’t-do-that category. With AMA support, we are already convening the leadership of the other six state medical societies in the NGA pilot to level up our mutual understanding of the best (and worst) practices and to share insights. We are enthusiastically working with Gov. Hickenlooper’s team and our many friends across the spectrum of pain management and addictionology. This work will move from the governor’s roundtables scheduled for March and into the statehouse in 2014.

The time-honored legislative wisdom that “hard cases make bad law” is a risk we will be assuming as the tragedies continue to pour onto the front pages of the Denver Post, other major daily newspapers and prime time television. The coverage has already driven one state legislature to consider and even enact ideas that upon more sober reflection don’t move the needle in the right direction. There is also an often-repeated wisdom to “fix the problem, not the blame,” a value that has in my experience been deeply embedded in the body Colorado politic.

If there is a state that can find the long-term fix, it will be Colorado.