The scope and severity of the opioid epidemic in the United States has prompted significant legislative intrusion into the patient-physician relationship. These proscriptive regulatory regimes mirror earlier legislation in other politically-charged domains like abortion and gun regulation. We draw on lessons from those contexts to argue that states should consider integrating their responses to the epidemic with existing medical regulatory structures, making physicians partners rather than adversaries in addressing this public health crisis.
H.S.Connery, “Medication-Assisted Treatment of Opioid Use Disorder: Review of the Evidence and Future Directions,”Harvard Review of Psychiatry23, no. 2 (2015): 63-75.
3.
21 U.S.C. 823(g) (2012).
4.
21 C.F.R. § 1306.04 (2017); see also R.Rastogi and B.D.Meek, “Management of Chronic Pain in Elderly, Frail Patients: Finding a Suitable, Personalized Method of Control,”Clinical Interventions in Aging8 (2013): at 37 (discussing the use of methadone in elderly populations with chronic pain).
See, e.g., Demint v. State Med. Bd. of Ohio, 70 N.E.3d 21, 29–30 (2016) (reviewing a physician’s treatment of a patient with fibromyalgia, and concluding that a narcotic prescription was inappropriate under the circumstances); T.W.Ruger, “Plural Constitutionalism and the Pathologies of American Health Care,”Yale Law Journal Online347, no. 120 (2011), available at <http://yalelawjournal.org/forum/plural-constitutionalism-and-the-pathologies-of-american-health-care> (last visited March 30, 2018) (noting that medical decision making is legally “devolved to the most particularized level of the delivery system”).
8.
See 21 C.F.R. § 1306.04 (2017) (prohibiting physicians from prescribing methadone for addiction treatment, but allowing prescriptions for pain); 21 U.S.C. 823(g) (2012) (limiting the number of patients to whom physicians may prescribe buprenorphine for addiction treatment).
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12.
R.SDaniels, L.A.Baumhover, and C.L.Clark-Daniels, “Physicians’ Mandatory Reporting of Elder Abuse,”The Gerontologist29, no. 3 (1989): 321-327.
13.
T.L.Chorba, R.L.Berkelman, S.K.Safford, N.P.Gibbs, and H.F.Hull, “Mandatory Reporting of Infectious Disease by Clinicians,”Morbidity and Mortality Weekly Report: Recommendations and Reports39, no. RR-9 (June22, 1990): 1-17.
14.
S.E.Weinbertget al., “Legislative Interference with the Patient-Physician Relationship,”New England Journal of Medicine367, no. 16 (2012): 1157-1559, at 1557.
15.
T.W.Ruger, “Of Icebergs and Glaciers: The Submerged Constitution of American Healthcare,”Journal of Law and Contemporary Problems75, no. 3 (2012): 215-235, at 217-220.
See Federation of State Medical Boards of the United States, supra note 16, at 10.
21.
D.C.Radley, S.N.Finkelstein, and R.S.Stafford, “Off-Label Prescribing Among Office-Based Physicians,”Archives of Internal Medicine166, no. 9 (2006): 1021-1026.
22.
S.Hamel, D.S.McNair, N.J.Birkett, D.R.Mattison, A.Krantis, and D.Krewski, “Off-Label Use of Cancer Therapies in Women Diagnosed with Breast Cancer in the United States,”SpringerPlus4, no. 209 (2015).
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K.A.Neville, D.A.C.Frattarelli, J.L.Galinkin, T.P.Green, T. D.Johnson, I.M.Paul, and J.N.Van Den Anker, “Off-Label Use of Drugs in Children,”Pediatrics133, no. 3 (2014): 563-567.
24.
E.M.Weber, “Failure of Physicians to Prescribe Pharmaco-therapies for Addiction: Regulatory Restrictions and Physician Resistance,”Journal of Health Care Law and Policy13, no. 1 (2010): 49-76, at 58.
25.
E.Marshall, “Uncle Sam is the Worst Drug Fiend in the World,”New York Times, March12, 1911, at SM12.
26.
Id.
27.
Harrison Narcotics Act of 1914, Pub. L. No. 63-223, 38 Stat. 785, repealed by Comprehensive Drug Abuse Prevention and Control Act of 1970, Pub. L. No. 91-513, 84 Stat. 1236 (codified as amended at 21 U.S.C. §§ 801–971 (2012)).
28.
See Webb v. United States, 249 U.S. 96 (1919) (finding that a physician could not prescribe morphine to an individual with addiction because it would not “cure” his addiction but maintain his use); United States v. Doremus, 249 U.S. 86 (1919); United States v. Behrman, 258 U.S. 280 (1922).
Mass. Gen. Laws ch. 94C, § 24A (2018); 105 Mass Code Regs. § 700.012(G) (2018).
46.
Mass Gen. Laws ch. 94C, § 18 (2018).
47.
Board of Registration in Medicine, supra note 10, at 8–10.
48.
N.H. Code Admin. R. Ann. Med 502.04 (2018).
49.
N.H. Code Admin. R. Ann. Med. 502.04 to .05.
50.
N.H. Rev. Stat. Ann. § 318-B:41; N.H. Code Admin. R. Med. 502.06 (2018).
51.
NH Rev. Stat. Ann. § 318-B:40 (2018).
52.
N.H. Code Admin. R. Ann. Med. 502; N.H. Rev. Stat. Ann. § 332-B:7- a (granting rulemaking authority to the Medical Board for rules on opioid use and prescribing).
53.
N.H. Rev. Stat. Ann. § 318-B:2 (2018).
54.
Ohio Admin. Code 4731-11-13 (2018).
55.
Ohio Rev. Code Ann. § 3719.061 (West 2018).
56.
Ohio Rev. Code Ann. § 4731.055 (West 2018).
57.
Ohio Admin. Code 4731-21-03 (2018).
58.
Ohio Admin. Code 4731-21-02 (2018).
59.
Ohio Rev. Code Ann. § 4731.052 (West 2018).
60.
R.I. Code R. 31-2-6:4.4 (2018).
61.
21 R.I. Gen. Laws § 21-28-3.18 (2018).
62.
21 R.I. Gen. Laws § 21-28-3.32 (2018).
63.
R.I. Code R. 31-2-6:4.4 (2018).
64.
R.I. Code R. 31-2-6:4.4 (2018).
65.
23 R.I. Gen. Laws § 23-17-26.3 (2018).
66.
W. Va. Code § 60A-9-5a (2018).
67.
W. Va. Code § 30-1-7a (2018).
68.
“Policy on the Chronic Use of Opioid Analgesics,”West Virginia Board of Medicine (Sep. 11, 2017), available at <https://wvbom.wv.gov/download_resource.asp?id=408> (adopting the Federation’s Model Policy) (last visited March 30, 2018).
D.Dowell, T.M.Haegerich, and R.Chou, “CDC Guidelines for Prescribing Opioids for Chronic Pain — United States, 2016,”JAMA315, no. 15 (2016): 1624-1645.
77.
Board of Registration in Medicine, supra note 10.
78.
K.Finklea, L.N.Sacco, and E.Bagalman, “Prescription Drug Monitoring Programs,”Congressional Research Service (2014), at 3, available at <https://fas.org/sgp/crs/misc/R42593.pdf> (last visited April 2, 2018); Prescription Monitoring Program Annual Report, Massachusetts Department of Public Health (April 2016): at 2 (noting that the Massachusetts database was established by regulation in 1992).
79.
Id. (noting that participation in the monitoring program in Massachusetts was until 2012).
R. L.Haffajee, A.B.Jena, and S.G.Weiner, “Mandatory Use of Prescription Drug Monitoring Programs,”JAMA313, no. 9 (2015): 891-892, available at <http://doi.org/10.1001/jama.2014.18514> (last visited April 2, 2018).
See J.M.Keighley, “Physician Speech and Mandatory Ultra-sound Laws: The First Amendment’s Limit on Compelled Ideological Speech,”Cardozo Law Review34 (2013): 2347-2405.
99.
Tex. Med. Providers Performing Abortion Servs. v. Lakey, 667 F.3d 570, 578 (5th Cir. 2012); see also Haupt, supra note 96, at 1300 (discussing the mandatory ultrasound cases).
100.
Stuart v. Camnitz, 774 F.3d 238, 256 (4th Cir. 2014).
Id. at 1313 (quoting Sorrell v. IMS Health, Inc., 564 U.S. 552, 578-79 (2011)).
116.
R.Anderson-Watts, “The Failure of Breast Cancer Informed Consent Statutes,”Michigan Journal of Gender and Law14, no. 2 (2008): 201-222, at 206.
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Id. at 215.
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Id. at 212.
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A.B.Nattinger, R.G.Hoffman, R.Shapiro, M.S.Gottleib, and J.S.Goodwin, “The Effect of Legislative Requirements on the Use of Breast-Conserving Surgery,”New England Journal of Medicine335, no. 14 (1996): 1035-1040.
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P.M.Lantz, N.K.Janz, A.Fagerlin, K.Schwartz, L.Liu, I.Lakhani, B.Salem, and S.J.Katz, “Satisfaction with Surgery Outcomes and the Decision Process in a Population-Based Sample of Women with Breast Cancer,”Health Services Research40, no. 3 (2005): 745-768, at 753.
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Id.
122.
Id.
123.
See “New York State Confidentiality Law and HIV: Public Health Law, Article 27-F Questions and Answers,”New York State Department of Health, available at <https://www.health.ny.gov/publications/9192.pdf> (last visited April 2, 2018); N.Y. Civ. Rights Law § 79-l (McKinney).
124.
See Webb v. United States, 249 U.S. 96 (1919) (finding that a physician could not prescribe morphine to an individual with addiction because it would not “cure” his addiction but maintain his use); United States v. Doremus, 249 U.S. 86 (1919); United States v. Behrman, 258 U.S. 280 (1922).
125.
J. R.Schottenfeld, S.Waldman, A. R.Gluck, and D. G.Tobin, “Pain and Addiction in Specialty and Primary Care: The Bookends of a Crisis,”Journal of Law, Medicine & Ethics46, no. 2 (2018): 220-238.
126.
E.g., E.Llorente, “New Jersey’s New Opioid Law Raises Concerns among Doctors,”Fox News Health, May9, 2017, available at <http://www.foxnews.com/health/2017/05/09/new-jerseys-new-opioid-law-raises-concerns-among-doctors.html> (last visited April 2, 2018) (quoting the New Jersey Attorney General arguing that “a bad doctor is worse than a street corner drug dealer – a doctor is someone who is shrouded in the public trust. A doctor has to be treated more harshly than a street drug dealer.”).
H.J.Chaudhry, J.D.Gifford, and A.S.Hengerer, “Ensuring Competency and Professionalism through State Medical Licensing,”JAMA313, no. 18 (2015): 1791-1792 (describing the continued importance of state medical boards in protecting modern medical standards).
HIV and Hepatitis B — Infection Control Standards and Training, 1992 N.Y. Sess. Laws 2157 (codified at N.Y. Educ. Law § 6530(47) (McKinney 2018)).
131.
“Methadone Diversion Control,” in R.A.Rettig and Y.Yarmolinsky, eds., Federal Regulation of Methadone Treatment (Washington D.C.: National Academy Press, 1995).
132.
S.E.McCabe, C.J.Teter, and C.J.Boyd, “Medical Use, Illicit Use and Diversion of Prescription Stimulant Medication,”Journal of Psychoactive Drugs38, no. 1 (2006): 43-56.
See M.A.Yokell, N.D.Zaller, T.C.Green, and J.D.Rich, “Buprenorphine and Buprenorphine/Naloxone Diversion, Misuse, and Illicit Use: An International Review,”Current Drug Abuse Reviews4, no. 1 (2011): 28-41.
