Feedback
Pharmacy Times
Specialty Pharmacy Times
OTC Guide
Pharmacy Times

Physicians Pledge to Stop Prescribing Opioids

Published Online: Tuesday, September 6th, 2011
Kate H. Gamble, Senior Editor
Text Size:

When it comes to deaths involving opioid analgesics, one physician has had enough.

Hassan Amjad, MD, an oncologist based in West Virginia, has teamed up with fellow physician Hassan Jafary, MD, and Leonard Clay, a concerned citizen to form an advocacy group to tackle the issue head-on by going straight to the source.

The West Virginia Advocacy Group Inc. is a 501c3-designated organization designed to help curtail the escalating problem of prescription drug abuse within Raleigh County and surrounding communities by gaining refusals to prescribe the addicting compounds.

Dr. Amjad has pledged to stop prescribing addictive compounds, particularly oxycodone and Percocet, and is asking other physicians to do the same, according to an article published in the Register-Herald.

“We are asking other physicians to say, ‘Yes, we see the problem, we see young people dying. We should do everything we can to stop it. We will not write these medications,’” he told the newspaper.

“I do hereby pledge that no prescriptions for oxycodone will be written by me for any patient,” reads line one. Volunteers will actively circulate the agreement among Raleigh County physicians, and Drs. Amjad and Jafary are displaying it in their own practices.

Amjad believes that only certain patients with terminal illnesses should require Oxycontin and its various formulations, and that the lax practices of physicians in prescribing the medications for patients with benign conditions such as arthritis or back pain are contributing directly to the drug problem in southern West Virginia.

“There are patients who had foot surgery 10 years ago and are still getting these pills,” Amjad said in the article. “Even as an oncologist, I am saying there is very little need for oxycodone and Percocet in treating patients.”

A study published online August 23, 20011 in the British Medical Journal supports the limited need for these medications, noting that the number of deaths in the United States involving opioid analgesics increased from 4041 in 1999 to 14,459 in 2007 and are now more common than deaths from multiple myeloma, HIV, and alcoholic liver disease. Opioid prescribing and opioid related deaths—most of them unintentional and of relatively young people—have also increased in other countries, including the United Kingdom, according to lead researcher Irfan Dhalla, MD, of the University of Toronto.

“We know that the risk of addiction for patients who are being treated for chronic pain for several months or longer is 35%,” he told Medscape Medical News, which is significantly higher than the figure of 1% that many believed was accurate. “Physicians need to take a much more cautious approach to prescribing opioids for chronic noncancer pain, and governments and regulatory agencies need to change the way they do business so that physicians can prescribe more safely.”

Dr. Amjad believes that many of the overdose deaths seen in young patients occur as a result of accidental overdose of prescription narcotics, chiefly those who have combined them with Xanax or alcohol.

“There is no way that a patient without a terminal illness needs these medications,” he told the Register-Herald. “You can see people in doctors’ and pharmacy parking lots coming out with prescriptions and selling them right there. If you are going to be socially responsible as a prescriber, then why not come forward and sign this pledge?”

Share:
IndependentPharmacist   September 13th, 2011 05:09:2005:20:28 PM
"Benign conditions such as arthritis or back pain" ??? These can be extremely painful conditions, and powerful pain medications such as oxycodone can be the difference between a patient having a normal life or being bedridden. There is no doubt that these drugs are misused, but for a doctor to say that he would "never" prescribe them, it unreasonable. There is a middle ground that many physicians have found, of responsibly prescribing these drugs.
Billy, RPh, CAC II   September 13th, 2011 05:09:5005:50:30 PM
I read with great interest the article entitled "Physicians Pledge to Stop prescribing Opioids". Dr. Amjad seems to be interested in decreasing opioid abuse by decreasing the number of prescriptions written for oxycodone in its various forms. He seems to base this on the assumption that we if we can just eliminate the availability of this particular drug, all will be well. Dr. Amjad also seems to believe that people with chronic or acute painful conditions could not possibly benefit from oxycodone and therefore the pain "just can't be that bad". I assure you that there are 100 million chronic pain sufferers alone that would disagree. The fact that a doctor would willfully neglect the suffering of many to prevent the abuse of this drug by the few borderlines on being unethical and certainly is cruel. The article goes on to state that "deaths in the US involving opioid analgesics has incresed from 4041 in 1999 to 14,459 in 2007..." If the author had done the proper research she would have found that a vast majority of these deaths involved methadone and a very small percentage involved oxycodone by itself (most deaths are a result of a combination of alcohol plus other drugs). Dr. Amjad continues his story by saying that "we know that the risk of addiction for patients who are being treated for chronic pain for several months or longer is 35%...". The studies that he references actually changed the definition of addiction, seemingly to appease the study group and included "addiction criteria" that had little or nothing to do with addiction. These included the so-called "aberrant behaviors" sometimes seen in chronic pain sufferers who are not properly medicated. Most responsible and unbiased studies have demonstrated over and over again that the addiction rate ranges from 0.4% to 3%. I too would like to see the abuse of all drugs decrease, but it should never be at the expense of letting people with truly painful conditions suffer without relief. It seems that in today's world we only seek answers that are in the extreme right or left. I hope we can be smart enough to see that we can have effective pain relief for those who need it and at the same time reduce addiction risks. Drug addiction is a complex and horrible disease that affects not only the user but also those around him/her. With the help of everyone pulling together I hope we can slow it down to where fewer people get hurt and more people get help.
Bob,Retired Pharmacist   September 17th, 2011 05:09:0905:09:57 PM
I agree with "Independent Pharmacist" & "Billy,RPH,CacII."I think that Dr.Amjad's
crusade is akin to Rockefeller's Prohibition bill of the 1920s;i.e., eliminate
the drunks by penalizing the entire American population. Not only was it a
ridiculous law, it didn't solve the problem! I also believe that his figures on
"addiction" are grossly exaggerated. The opiates are one of the most effective
pain medications available and millions of people have obtained relief from
the PROPER use of them. It is particularily important for older folks for whom
NSAIDS are countraindicated. I feel PAIN control in the elder is extremly important
and that the physician has an obligation to offer the best treatment available
and that it should be a PRIORITY for him to do so.Too many physicians are
AFRAID of prescribing opiates based on the assumption that their patients
will become addicted. This deprives many folks who really need more pain
relief than lesser potent analgesics.
Dr.Amjad shouldn't prescribe these type of drugs if he feels so uncomfortable
about doing so and leave that to physicians who know how and WHO to
prescribe them to. It's not that hard to recognize an "absurer" and
discontinure them as a patient. I still feel the "Old Folks" who really need
adequate are suffering too much from this type of attitude.
Suzanne   December 5th, 2011 04:12:2604:26:24 PM
I'm a patient caught in the middle of this war on drugs. I have been on Hydrocodone for 10 years due to chronic pain. Last week, I was told by my Doc. of 2 years "I will no longer prescribe these medications". I'm stopping. So, just like that I was given a medication that does not even come close to touching my pain. Why would this happen. I would understand if year after year or less I came in asking for more pills per month. But for 10 years (3) a day has done it for me. Now I'm given nothing. I can barely walk my pain is so bad I don't even know if I'm going to be able to make it to work. Yes, it is that bad. I have never had a drug or alchol addition and never did either when I was a teen. I know I'm addited now but I know where the line is drawn. I know that (3) is all I need. I'm lost as to what to do if all Doctors believe that they must say "no" to these medications. Again, the people that need things suffer because of the people that do the wrong thing!
Your comments are valuable to us. Thank you.



Intellisphere, LLC
666 Plainsboro Road
Building 300
Plainsboro, NJ 08536
P: 609-716-7777
F: 609-716-4747

Copyright HCPLive 2006-2011
Intellisphere, LLC. All Rights Reserved.





Become a Member