A brand new article called:
by Mark A. Rothstein and Julia Irzyk
Are physicians liable if they abandon or force taper a patient who is on opioids and that patient takes his life? This is an excellent article to share.
"Abstract: The precipitous and medically contraindicated reduction or “tapering” of opioids for patients with chronic pain due to serious medical conditions has caused needless suffering and, increasingly, suicide. Physicians could be liable for wrongful death based on negligent tapering of opioids."
Some quotes from the article:
"Patients treated for chronic pain with opioids are highly vulnerable. They have medical conditions with severe pain that cannot be controlled by other treatment modalities or less potent analgesics. Their underlying medical condition, their pain level, and the opioids they take all may interfere with their cognitive or reasoning abilities. They are dependent on their physician’s renewal of their prescriptions; there are no safe and effective alternatives. Significantly, they bear the stigma of requiring drugs often associated with personal immorality or criminal activity. As a price for access to a substance that allows them to lead the semblance of a normal life, patients with chronic pain are often required to sign contracts pledging compliance with terms imposed on them, to submit to periodic or random urine testing, and to bear humiliation by a society that is frequently fearful, suspicious, and intolerant. Few other patients are subject to such indignities."
"Vulnerable patients should not be abandoned or have their treatment unreasonably delayed when they are at risk of accidental or intentional overdosing."
"A plaintiff must prove that the defendant-physician failed to meet the appropriate standard of care, which almost always requires expert testimony. An important issue is whether the standard may be established by the introduction of nonbinding professional guidelines or recommendations. In In re Jankowski, a state licensing agency brought disciplinary proceedings against a physician for, among other things, prescribing excessive levels of opioids without medical justification. The appellate court, in affirming sanctions against the physician, held that the 2016 CDC Guideline was the standard of care for a pain management physician, notwithstanding the statement in the Guideline that it applied only to primary care clinicians."
"America’s opioid crisis is well into its third decade. There are many causes of this problem and resolving them will take a variety of measures over an extended time. Unfortunately, some past efforts to reduce the morbidity and mortality associated with improper use of prescription opioids have been ineffective and led to
disastrous unintended consequences. One such attempt to limit the supply of prescription opioids involved the issuance of prescribing guidelines. Between 2012 and 2020, the number of opioid prescriptions declined dramatically from 255 million to 142 million, but the number of overdose deaths soared from 41,000 to 100,000. One of the most tragic consequences of curtailing the use of opioids for managing severe, chronic pain has been an increase in suicides, which now account for an estimated 30 percent of drug overdose fatalities. It is not known how many suicides result from a physician’s negligent, aggressive tapering of opioids."
"Many physicians are concerned that prescribing opioids could lead to criminal prosecution, license revocation, loss of employment or hospital privileges, or malpractice litigation. On the other hand, legal jeopardy for failing to continue prescribing opioids to existing patients, even when the standard of care requires it, does
not seem to be a widespread concern."