Am I liable if my patient becomes addicted to opioids or overdoses?

Doctors prescribe pain medications to their patients because they have determined that some of their patients need help managing one or more elements of pain, be it from a recent medical procedure, illness, condition or injury.

To keep their patients safe, doctors can create pain management agreements with their patients, check their state’s Prescription Drug Monitoring Program (PDMP) and follow up with them during office visits. But, what happens between those visits is often where things can unravel.

We know that some patients don’t follow their prescribed treatment plan, some can become tolerant, and some can even become addicted. Even worse, there are some people – approximately 16,000 a year in the U.S. — who overdose on prescribed opioid pain medications and die.

When prescription pain medication addiction, overdose or death occurs, the finger may be pointed squarely at the prescribing doctor. In the most extreme cases, national news stories have spotlighted prescribers who were successfully sued for medical malpractice or more serious charges.

Late last month, a Los Angeles doctor was found guilty of three counts of murder for over-prescribing drugs that caused a fatal overdose in patients, in a case that prosecutors said marked the first such conviction in the United States, according to the Los Angeles Times.

Granted, this is NOT your typical prescriber. This doctor didn’t keep records of patient visits or prescriptions in many instances and faked medical records after she was investigated. In West Virginia, the state Supreme Court ruled earlier this year that prescription pain addicts can sue negligent doctors and pharmacies.

Doctors don’t walk into the office and say, “How can I prescribe less than carefully today?” The truth is, it’s very hard to safely monitor and manage pain patients with current tools available to doctors:

• Documentation is a beast.
• There are dozens of clinical practice guidelines to review.
• Patients often forget they even signed a pain management agreement.
• It’s complicated to choose the right pain, function and risk assessments.
• Access to the state controlled substance prescribing database (PDMP) is a manual process and can take up to five minutes per patient, per visit.
• It requires making many judgment calls to determine if a patient truly is in enough pain to warrant an opioid prescription.
• And, again, doctors don’t know what happens between office visits.

We make it much easier for doctors to do all of the above so they may safely prescribe medications and monitor their patients between visits so they take better care of their patients. And in turn, avoid major liability issues.