California Doctors Alarmed by State Letters Linking Opioid Prescriptions to Patient Deaths

California doctors are alarmed by state letters being sent to them, linking patient overdose deaths to opioid prescriptions they have written. These letters are part of the California medical board’s Death Certificate Project, a response to the current opioid epidemic that is sweeping the nation.

The board typically investigates doctors in response to patient complaints. However, with the Death Certificate Project, the board proactively collected nearly 3,000 death certificates of people who died of opioid overdoses. The board then cross-referenced the certificates with the state’s drug prescription database. Rehab Near Me: San Francisco is leading the charge when it comes to high levels of care for addicts.

Many physicians in California are crying foul over the new project after receiving letters from the state medical board. “I was horrified,” says Dr. Ako Jacintho of San Francisco, who received this type of letter about a year ago. The letter explained that a patient he had treated died in 2012 from taking a toxic cocktail of methadone and Benadryl. It was Jacintho who wrote the patient’s last prescription for methadone. “I became overwrought with sadness. And I was really just surprised that this had happened to this patient.”

Doctors Responding to ‘Accusatory’ State Letters in quick fashion.The letter was one of more than 500 sent to doctors in recent years throughout the state. The board’s goal was to identify doctors who may have prescribed the drugs inappropriately, even if it was not the fatal dose. If a reader lives in San Francisco and is seeking drug or alcohol treatment, click the link.

They then sent the letters explaining the situation and requiring the doctors to respond with a written summary of the care they had provided, as well as a certified copy of the patient’s medical record. Doctors would face fines of $1,000 per day if they did not comply.

Doctors who are found to have violated state law face public reprimands, probation, or even revocation of their medical licenses.

Many California doctors complied, but also took issue with the wording of the said letter, saying it was accusatory. The letter seemed to presume that the doctors did something wrong—whether or not they did provide prescriptions inappropriately. The letter used words like “complaint,” “overprescribing,” and “allegation” even for doctors who had patients with intractable pain.

It wasn’t until 2016 that the Centers for Disease Control and Prevention (CDC) issued guidelines for prescribing opioids. CDC told doctors to start with low dosages and increase slowly, and when possible, use ibuprofen instead.

Doctors also complained about the fact that the medical board is using death certificates from 2012 and 2013 to discipline doctors and encourage them to limit the prescription of opioids. However, in recent years, many physicians have already made the necessary adjustments, considering that there is an opioid crisis affecting the nation. This means that older cases of opioid-related deaths could not be related to a doctor’s current way of prescribing medication. A few years ago, when the opioid epidemic wasn’t as widespread, giving opioids for intractable pain is the standard and recommended procedure.

Jacintho, for example, has completely revamped his practice in the six years since his patient died. As a family doctor, he saw the opioid epidemic coming because patients started asking for stronger drugs, even though their pain stayed the same. This caused him to switch gears and go back into training. Eventually, he got certified as an addiction specialist. “If they're looking for clinicians who are overprescribing, I'm the wrong doctor,” he said.

Meanwhile, Kim Kirchmeyer, executive director of the medical board, says that medical investigators are taking career changes into account. The medical board is reviewing medical records according to the standard of care that was in place at the time. “We understand that just because a patient has overdosed that that doesn't mean that the care and treatment provided was not appropriate,” she says. “But anytime there may have been a violation of the law, we do need to look into it.”

So far, the investigators have completed investigations for about half of the first 500 doctors originally identified as possibly deviating from the standard of care. While the majority was cleared of any wrongdoing, the board has also filed formal accusations against 25 doctors.

Hundreds of doctors are still waiting to learn their fate. The medical board stands by the Death Certificate Project, as they say, it is prioritizing consumer’s safety over the comfort of medical doctors, hoping to save lives by investigating possible violations.

If someone in the family is struggling with opioid addiction, it is important to seek help. A combination of medical detox and behavioral therapy can go a long way in the fight against drug abuse. But because every individual is affected by addiction differently, a comprehensive program tailored to their specific needs is necessary. Look for a nearby addiction treatment facility today and find out how drug treatment programs work.