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Associated Press investigation highlights opioid crisis

The seven-month investigation focused on efforts by the Pain Care Forum, a coalition that has fought against laws restricting opioid prescription across the country, said Kytja Weir, project manager for the Center for Public Integrity.

In North Carolina, the group donated $500,000 to elected officials and political parties, a relatively small slice of the $63 million in campaign contributions the group has made, considering the size of the state, according to the investigation.

In North Carolina, there are no legal limits on how many prescription opioids can be prescribed by a physician. But Jean Brinkley, spokesperson for the North Carolina Medical Board, which licenses physicians and physicians’ assistants, said appropriate prescribing is one of the board’s biggest priorities.

“The bottom line is that if you prescribe these drugs, you need to do so in a manner that is appropriate concerning current standards of care,” Brinkley said.

Brinkley said the two main ways of doing this are by providing resources about prescribing opioids for physicians to reference and monitoring efforts to make sure appropriate care is being administered. The board regularly investigates physicians to determine whether they are meeting the prescribing criteria.

“This is us being proactive,” Brinkley said. “Being investigated doesn’t mean you’re doing anything wrong in and of itself.”

From 1999 to 2014, more than 165,000 people in the United States died from prescription opioid overdoses, according to the Centers for Disease Control and Prevention. During that same period, the number of drug poisoning deaths in North Carolina increased by 260 percent, according to the North Carolina Department of Health and Human Services.

In 2014, prescription opioid painkillers such as oxycodone, hydrocodone and methadone accounted for more than 50 percent of all medication or drug poisoning deaths in North Carolina.

Brinkley said because of the stigma surrounding opioids in the midst of the current overdose crisis, some physicians are refusing to prescribe these painkillers in an effort to avoid board scrutiny. Some are also turning away patients they have been prescribing opioids to for years.

“There are a lot of doctors out there that are running scared,” she said. “More and more people who are general practitioners who don’t want to deal with pain are referring people to pain clinics.”

Neil Andrews, executive editor of the Pain Research Forum, a project of the Harvard NeuroDiscovery Center, said researchers are working to develop safer and more effective alternatives to opioids.

“Any discussion of the opioid crisis needs to recognize this,” Andrews said. “There’s nothing that really takes care of chronic pain to the degree that many people, especially those with severe pain, need.”

For some patients, treatment options other than opioids are limited.

“There are some people with severe chronic pain who say that they couldn’t get through life without opioids,” Andrews said. “For those people, it’s getting harder to get the medication they need.”

In North Carolina, over-the-counter sales of naloxone, a drug used to reverse an opioid overdose, are legal. Ray Clauson, community relations director at Narconon, a group that combats drug abuse and addiction, said the administering drug can help save lives.

“Now you’re allowed to have a third party like a concerned parent or a nurse at a high school, and they can administer (naloxone) to save a patient’s life, and they wouldn’t be held in jeopardy,” Clauson said.

Weir said in the three weeks since the articles on the investigation were published, there have been two dozen editorials written calling for reform.

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“Right now, we’re just continuing to monitor it,” Weir said. “A lot of people are expressing outrage about the involvement.”

@olivinonaprayer

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