State, medical schools teaming up to address prescription opiate abuse

Massachusetts doctors deciding whether to prescribe painkillers for their patients – and how much, at what dose – may soon have new guidance from state medical leaders.

Gov. Charlie Baker met with the deans of the state’s four top medical schools Wednesday to talk plans to update curricula for medical students and create a set of statewide standards on prescribing painkillers, powerful drugs that can be a gateway to addiction.

“I view this as something that is multi-factorial, multidisciplinary and there is no single silver bullet,” Baker told reporters. “We’re going to have some very important leaders in the health world working with us on this.”

The effort comes as part of Baker’s action plan on opiate abuse, one element of which seeks to bring new training to doctors, who are essentially the gatekeepers of the powerful medication.

“We know that most physicians have been prescribing in ways that are reasonable, but we also know that there have ben some issues where too many opioids have been prescribed and allowed to get into our community,” said Dennis Dimitri, president of the Massachusetts Medical Society.

The MMS published a new set of pain management guidelines for doctors earlier this year.

Treating pain can be especially challenging for doctors because it is hard to measure, said Monica Bharel, state public health commissioner.

“Pain is a subjective interaction between the caregiver and the patient, so that the level of subjectivity, that takes training,” Bharel told reporters Wednesday.

Mike Duggan, who runs a resource called Wicked Sober, which connects addicts with treatment, said in an interview nearly every opiate addict he has worked with got their start the same way: abusing painkillers.

“They all started with prescriptions,” Duggan, himself a recovering addict, told Metro. “Some took the medication legally, but others got it off the street, off the medicine cabinet or at a party.”