A state law barely two months old is wreaking havoc for doctors and their pain patients.
AB 474 was designed to curb opioid overdoses. The violations carry stiff penalties and something as simple as a clerical error could threaten a physician’s license.
8 News NOW spoke with pain specialist Doctor Dan Laird last fall. Now with the new regulations — we checked back in to see how its impacting his practice and his patients.
“Really, I think that this law, while well intended, it’s just has created a mess,” Dr. Dan Laird said.
A mess of confusion and controversy. The law has morphed into mountains of paperwork for physicians and pressures for pain patients uncertain if their prescriptions will be honored.
Dan Laird is a Las Vegas attorney and a doctor at Flamingo Pain Specialists.
“So, the patients are sensitive and hurting and in pain to begin with and then put in this environment where under fire, hassled virtually everywhere they go. A lot feel shame, feel like they’re being treated like a criminal at the pharmacy,” Dr. Laird said.
Some patients complain the crackdown has led to pharmacy overreach with some skipping the full amount of pills or refusing to supply them at all.
“They start wondering when I go today is it going to be the good pharmacist or the bad pharmacist? Is it going to be the one who hassles me or the one who fills the prescription? It really causes a lot of suffering for them and worry,” Dr. Laird said.
AB474 targets Class 2 drugs, like Adderall, Ritalin, which treat Attention Deficit Hyperactivity Disorder. Pain suppressors like hydrocodone, Vicodin, Lortab, oxycodone, Percocet, Demerol, and more. The law also impacts Class 3 and 4 drugs: Ambien, used for insomnia. benzodiazepines, used for anxiety like Xanax and Valium. and testosterone products, like AndroGel.
So, prescribers must take numerous steps before issuing any pain medications, sleeping aids, ADHD, testosterone, and migraine medications. Steps that are time consuming and cumbersome.
Just days after the tighter restrictions went into effect, doctors gave an earful to the state medical board warning them it’s gone too far by forcing doctors to become detectives spending more time shuffling papers than taking care of people.
Pharmacies are feeling the squeeze too by making decisions on who should and should not get their meds. Dr. Laird suspects some of his African-American pain clients are being profiled.
“I can tell you that I have about 10 percent of my patients who are African-American, maybe 20 percent. Eighty percent of problems I have at pharmacies are with African-Americans and I don’t think that’s a coincidence.”
Not only is it inappropriate, its unlawful to discriminate against patients. Another concern is exactly what the AB 474 is trying to prevent — people dying. If patients are unable to get adequate pain control, they may be pushed to the brink and consider taking their own life.
“I ask every patient about suicide every visit because I’m very concerned about the possibility that people who have limited coping skills and they’re given severe pain they see their options as very limited. So, one of them is suicide unfortunately,” Dr. Laird said.
AB 474 is the law, but outspoken doctors are urging the state board of pharmacy to not carry out the tough enforcement and even repeal the issue all together.