New York City’s public hospitals are adopting new restrictions on prescription painkillers that could make it much harder for pain patients to get access to opioid analgesics.
Under the city’s guidelines, emergency rooms in public hospitals will only prescribe a three-day supply of widely used painkillers such as Vicodin and Percocet. Long-acting painkillers such as methadone and Oxycontin will not be dispensed at all, and the hospitals won’t refill lost or stolen prescriptions.
The move is aimed at curbing what Mayor Michael Bloomberg calls a citywide “epidemic” of prescription drug abuse. Over a quarter of a million New Yorkers over age 12 are abusing prescription painkillers.
“Abuse of prescription painkillers in our city has increased alarmingly in recent years,” said Bloomberg. “We talk about other problems, we talk about narcotics but this is one of the things growing much more rapidly.”
The guidelines are contained in a report from the Mayor’s Task Force on Prescription Painkiller Abuse. They will be used in all eleven of New York’s public hospitals.
“For treatment of acute pain, these guidelines recommend prescribing no more than a 3-day supply (in most cases), and for chronic non-cancer pain, providers are advised to avoid prescribing painkillers unless other treatments have been demonstrated to be ineffective,” the report says.
Limits on opioids will not apply to patients who need prescription drugs for cancer pain or palliative care.
More than two million prescriptions for opioid painkillers are written in New York City annually, according to Dr. Robert Farley, the city’s health commissioner. About 40,000 New Yorkers are addicted to painkillers.
The city lacks the regulatory authority to impose the new guidelines on private hospitals. But several private hospitals have said they would adopt them voluntarily.
Patients with primary care doctors will still be able to get longer 30-day prescriptions for painkillers after leaving the hospital. But critics say many poor and uninsured patients won’t have that option. Poor patients often use emergency room as their primary source of medical care.