Friday, December 15, 2017

Medical Board adopts opioid amendments.

The Mississippi Board of Medical Licensure adopted proposed amendments to regulations that govern prescriptions this afternoon on a unanimous vote  today at a work session.  The Board discussed the amendments but made few changes to them during the 2 1/2 hour session.  A motion to exempt psychiatric patients from drug testing failed on a vote of 5-4.  Video will be posted later.  The amendments will be submitted to the Secretary of State for public comments. After that public comment period expires, the Occupational License Board will review the the amendments and can amend the amendments.  That board meets every quarter.  The amendments will be returned to the Board of Medical Licensure if the Occupational License Board amends the amendments.  Did everyone get that?

36 comments:

Anonymous said...

Going to light up Delbert with some public comments. Drug testing children quarterly is lunacy.

HDMatthias, MD said...

This is an email I sent to all the members of the MSBML. I guess no one cared.


Dear {Board Member}:

Again, I want to thank you for all the time you spend working on the Board, surely at many times a seemingly thankless job.


I’m sorry I can’t attend the meeting tomorrow because of work, but I’m assured there will be video that I can review this weekend.

I’ve spent a great deal of time regarding the opioid/controlled substance regulations, and have had many conversations with various physicians. I learned a great deal at the hearing from listening to physicians in many different disciplines with many different concerns.

I think the best solution at this time is to do the following:

1. Write “general” guidelines based on the CDC opioid/controlled substances recommendations in order to give physicians a reference point. Included could be “non-compulsory” “best practice” recommendations regarding length of prescriptions, PMP monitoring, urine drug testing, maximum morphine equivalents/day, etc.

2. Either allow the Pharmacy Board, MSBML, MBN or another new board set up to monitor the PMP to then monitor the PMP with monthly algorithms, to“tag” outliers, and then proceed with referrals to the appropriate licensing boards for investigations regarding the physician’s prescribing, or to report and investigate a particular patient. If this requires a change or new legislation, then let’s do that.


If one considers the mountains of time spent in the plan first set forth by the board in comparison to the much less time spent only investigating the “outliers” with PMP monitoring, I suspect it would be reduced by 98% and the problem patient and physicians would be easily identified.


After an investigation, the licensing board may consider the treatment within reasonable guidelines, not warranted, illegal, etc. and may then proceed with education, censure, referral to legal agencies, and/or treatment plans for the patient under investigation.

I know that you all have worked on this with diligence, but I think the best solution is the simplest one. Physicians will then understand that they should work under the proposed “guidelines,” have documentation regarding patients and treatment plans/outcomes, and that they will not be burdened with more uncompensated work dictated by government agencies.

I believe that knowing that knowledgeable people are monitoring prescriptions will provide plenty of “incentive” for physicians to be prudent and careful in controlled substances prescribing, and won’t tie them needlessly to computers and endless and needless documentation.

As I said at the hearing, if the purpose is to find providers and patients that are operating outside of “reasonable” medical guidelines for controlled substances, monitoring the PMP is the easiest, most inexpensive, and targeted of all the proposed solutions.

I implore you all to give my solution considerable thought and contemplation. In the end, it will accomplish your purported purpose, allow physicians to practice the “art” of medicine, protect patients and physicians alike, and will strongly “encourage” safe and effective controlled substance prescribing.

Please feel free to call me at any time on my cellphone if you’d like to discuss this at length. I think a more “flexible” and moderate but logical plan is the best solution.

Sincerely,


Heddy-Dale Matthias, MD
One Roses Bluff Parkway
Madison, MS 39110
Board-certified by ABMS-Anesthesiology, Internal Medicine, Critical Care Medicine
601-856-7074 answering service
hdmatthias@comcast.net

“No matter how cynical you get, it is impossible to keep up.”
-- Lily Tomlin

Certified Cynically Clinical said...

I don't know that 'no one cared' Doc; but, It's my assumption that you're finding out just how irrelevant your opinion is. Your assumption that a board member might want to 'call you to discuss at length' is a bit pretentious, don't you think? Anybody who closes an opinion piece by quoting a Laugh-In comedienne can't hope to be considered too seriously.

Anonymous said...

You can bet on a lawsuit.

Anonymous said...

I guess I am going to start getting my shit on the corner.

Anonymous said...

What is the purpose of a work session if they are actually taking votes?

Anonymous said...

My first question, KF, is " What evidence was given of the extent of the' opioid crisis' in Mississippi?"
I have no doubt that we have an increasing drug problem in the entire country, but I have a great deal of doubt about the validity of the media conclusion from anecdotal interviews that the problem was caused entirely by prescription practices.
It is not uncommon for the loved ones of addicts and addicts themselves to attach blame for addiction to others.
If we stop and think, we all likely know those who have been prescribed opioids after serious injuries or surgeries who never developed an addiction.
If we have gone through adolescence and raised children, we have seen that there are those who experimented with drugs and didn't become addicted and those who seemed to quickly become addicted. Indeed, there is some evidence of predisposition to addiction that involves personality traits ,genetic factors and cultural values.
Looking for "quick fix" and "one size fits all" solutions to complex problems by government rarely seems to work out well, does it?
And, to have " conservatives" suddenly do exactly what they have criticized government doing for years is astounding. The only difference is the "base" being placated. It's rather easy to attach " personal responsibility" to others rather than to ourselves.

Anonymous said...

Kingfish what is the appeals procedure, if any? The doctors could file a lawsuit contesting the regulations maybe? Is there another procedural way?

Anonymous said...

Thank the addiction/recovery movement for all of this. Very analogous to prohibition.

Anonymous said...

Legalize Cannabis and 75% of the Opioid, Meth and Cocaine use will stop.There has been tremendous breah through when it comes to pain reliving strands.

Anonymous said...

10:20, why not legalize all drugs? Wouldn't that work better than just picking your favorite habit?

Anonymous said...

It's okay with me 11:34, talk about saving money, 3/4 of the current jail population should be set free too.

Anonymous said...

All of the people in jail on some drug charges are not there just because they use drugs.
It is the things they do to get the drugs and the things they do when under the influence of drugs that sent them to jail.
I used to marvel at the decisions some friends would make when they were using drugs.

Anonymous said...

Legalize all drugs, turn loose most who are jailed, take the locks off the bank doors, remove all traffic signals and stop arresting whores on 80 and Lynch.

Anonymous said...

How convenient that the FDA just approved a new $1,200 Suboxone shot that only has to be given once a month,which reduced the price of the Suboxone pills to $100 for a month's supply. Easterling and his ilk will be rolling in the dough because there are only a handful of docs who are allowed to presccrtibe it and the Opioid grant will pay for it while the addict is in the 90-day rehab.But what happens when their 90 days are over and the addict who most likely has no insurance leaves rehab??? HEROIN is what will happen

Anonymous said...

Chronic pain patients are 900 times more likely to commit suicide than the average healthy population. Also do you really think someone with chronic pain has the ability to run around to the dr's office, pharmacy and spar with insurance every (7) days??? This just doesn't pass the smell test with the Suboxone monopolists serving on MBML-how in the wortld is this not a conflict of interest? They want to move all chronic pain patients to SUBOXONE...IT'S AN OPIOID TOO AND THE WITHDRRAWALS LAST 6+ FREAKING WEEKS AS OPPOSED TO 72 HRS FOR OTHER OPIOIDS!!!!!!

Anonymous said...

Just so I understand, when Ole Miss had a 45+ year monopoly sanctioned by NIDA on growing the only legal marijuana in the US in an ATTEMPT to discover it's harmful effects and to keep it illegal,that was ok. But when Medical Marijuana has now been proven to lead other states out of their Opioid epidemics, to offer a healthier non-addictive alternative to the deadly effects of opioids,to help alleviate child epilepsy (CBD not THC) just to name a few of the many many benefits of med marijuana, the powers that be won't even consider allowing this natural plant that God gave us dominion over to be used legally by a responsible adult? I'm not talking about recreational use either.

The premise that marijuana is a gateway drug is a totally false statement made by Harry Anslinger to Congress as an afterthought (more like a brain fart) and the Reefer Madness MBN "educators" are still spouting that same false narrative today.MBN Agent Eddie Hawkins is the head of the Methamphetamine unit at MBN and educates law enforcement in 6 states. According to him, Marijuana is a way deadlier problem than Meth and putting Sudafed, etc behind the counter requiring a prescription has eliminated the Meth problem here!! WTH? What world are these shills living in?

Anonymous said...

When I was at Ole Miss they guarded that shitty weed with guard towers,machine guns,razor wire and the brightest flood lights I've ever seen. Then when CNN did a story on how "helpful" they were in providing all the marijuana for research trials and we finally got a look at it, it was full of seeds and stems and looked like ditch weed.Who the hell studies marijuana for 4 decades and doesn't to separate the male plants out? Secondly, the joints they were rolling for research distribution were full of seeds and stems which is like growing tomatoes then making salsa by putting the tomatoes,the vine,the wooden stake and the strips of cloth tied to the stake in a grinder.Yuck, who wants that?
It's becoming more and more apparent that there was some collusion with the Pharmacy school to keep it illegal to protect Big Pharma's deadly racket and the Opioid crises is just one of the catastrophic results.
FREE THE PLANT!!!

Anonymous said...

All of the legalize medical marijuana people seem to forget it isn't the smoke that is the good part of medical marijuana. The smoke is as bad as cigarette smoke.

Anonymous said...

@6:16 I'd invite you to check out "Bong Appetite" which has MS's own Cat Cora making a Delta-Greek fusion meal cooked with cannabis. Also the Gameday Ganja is particularly interesting given that football is king here. It's been said that football is the gateway to opioids due to the lasting effects on the body.Its like being in a 35-mph car wreck each pro game, maybe a little less for college but would you rather Archie,Brett,Eli, Peyton and the other players we've enjoyed watching all these years be on synthetic heroin the rest of their lives?

Anonymous said...

8:35 - Please put down the bong. What the fuck did you just say?

Anonymous said...

8:35...run that by us again but this time in English. Thanks.

Anonymous said...

I want to say so much but as I’ve disvovered my breath is wasted on the issue of CBD oil and medical
Marijuana especially in my home state of MS. I grew up there for 25 years, spent 5 years in Colorado and now live in Florida. I love MS but damn y’all...backwards hardly describes 80% of the “opinions” and “facts” shared by Mississippians on the subject of marijuana. Too many minds spoiled and opinions made by the media. Don’t be a sheep.

I’ll keep providing my mother cbd oil for her shingles, glaucoma, debilitating headaches, no appetite, etc..

Y’all do what you want!

Anonymous said...

Post nasal drip and seasonal allergies are a living hell because of these people. One of the worst states for allergies, too. Dental work is about to become real “fun”. Might as well just get a root canal on every tooth to avoid the nerve pain.

Anonymous said...

@9:43 - it's like the Republican leadership in this state is not even remotely clued into what Western states are doing (with great success) after changing marijuana laws. They can continue to ignore it, but there is a gigantic economy springing up around cannabis, and MS as usual is getting left in the dust. Not to mention losing out on a vastly safer pain/ailment remedy for its people.

Anonymous said...

In the western states everything is not roses and marijuana.
The legalization of marijuana is not the miracle some people would like to think.
Problem is many of those who are in favor of legalizing marijuana are too smoked up to realize what is happening when their dream does come true.

Anonymous said...

@10:36 - you can claim that all you want, the reality is that marijuana legalization has led to an economic boom in Colorado, especially in the tech sector. Not unlike how the automakers in Detroit had many ancillary businesses spring up around them. All in all, it has been a massive success. And you're revealing yourself to be quite ignorant on the subject.

Anonymous said...

10:36, I’m the 9:43 poster. I’m a Tesla Certified powerwall installer as well as a photovoltaic systems designer and technician. I also hold a part 107 license to commercially fly a drone for my small business as well as contracted out work.

I’m in favor of legalization. With that comes regulations. A few western states have already paved the way, laid out plans and guidelines and...ohh wait....been successful.

I wasn’t too smoked up when I decided marijuana was much safer (for my body) than alcohol (yes I know inhalation of any smoke is terrible) but that’s not the only way to ingest and benefit (be it a buzz or be it purely cbd and medically used with NO euphoria). I was actually making my OWN rational, educated, calculated decision based on research over decades and my own body’s reaction. I’m sorry your opinion is created by FOX news.

Let the “too smoked up” fall in line and in “rehab” with the “too liquored up”. Your argument is vague, biased, and totally Deep South bible beatin’ Republican crap:

No substance.

Anonymous said...

I’m a Tesla Certified powerwall installer as well as a photovoltaic systems designer and technician. I also hold a part 107 license to commercially fly a drone for my small business as well as contracted out work.

So what? Think that your anonymous opinion somehow carries greater weight? You ain't more worthy buddy than anyone else here.

Anonymous said...

When should we be expecting Randy Easterling to come out as a BIG government, Bernie Sanders democrat? He just got done running for office on a platform that stands for less government. How in the hell is this less government? The addicts are going to get the drugs regardless if these new regulations actually go into effect. The people who will suffer are the legitimate patients. Republicans and Democrats are no different when it comes to regulations. The ONLY party that truly stands for limited government is the Libertarian Party. Patients who are prescribed controlled substances for legitimate medical reasons should not have to suffer because of the POS worthless addicts.

Anonymous said...

@Kingfish, when will these new regulations actually go into effect? Do they have to be approved by the Secretary of State and Occupational Board first or what?

Zac said...

@12:51, no, I never thought I was. I simply included my occupation as a possible base to show not all people advocating and supporting and calling out the idiocracy over marijuana laws are “stoners” or”dope smokers” or “hippies”.

I’m glad my post ruffled your ole feathers so much you could only muster a lack luster and purely negative response to my post by telling me I’m not worthy. No where did I say or think I was.

Good day thread!

Anonymous said...

8:07, are you trying to tell us that every stoner is Tesla Certified powerwall installer as well as a photovoltaic systems designer and technician. I also hold a part 107 license to commercially fly a drone for my small business as well as contracted out work.

I know a woman who had 3 children. She collected SS on those 3 kids but she smoked a lot of dope. Every month she would get smoked up and spend the SS check on something stupid. Once enrolled all 3 kids in a karate school that cost nearly the same each month as the SS check she got each month. During this time she and the 3 kids lived on a picnic table at a park.

Anonymous said...

12/26 2:21, you realize in your rant that only one of those instances would have a victim, right?

I'm sure this has nothing at all to do with all the trial lawyers needing a new cash cow. Nothing at all.

No moral panic, no cash cow.

Anonymous said...

@11:07 - there are people who do that with Smirnoff. What's your point?

Anonymous said...

@ 11:07, I am the 8:07 poster.

That’s quite a..story?

Not sure how you can misconstrue things so badly..but after reading your tale of a karate enrolling, park living, dope smoking (crack, heroin, meth, oxy, etc?) mom that relates in no big way to my post..I now understand your mental capacity. I just hope you smoked “dope” before you posted because otherwise that’s a sad state of affairs in your mind.

Merry Christmas all ye Mississippians!

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