The head of the US Food and Drug Administration, Dr. Scott Gottlieb, believes that the nation’s physicians should undergo mandatory training on pain management and the prescribing of opioid analgesics.
In an interview Wednesday with CNN Chief Medical Correspondent Dr. Sanjay Gupta, Gottlieb said that because current physician education on opioids is not mandatory, too many doctors continue to treat patients based on outdated training.
“I think doctors were trained … that pain is the fifth vital sign, so there was more liberal prescribing of these medications,” Gottlieb said. “We now recognize that wasn’t appropriate, so I think that there needs to be some effort to try and re-educate a generation of physicians.”
Gottlieb suggests that training occur at the point when a doctor obtains a DEA license, a registration required by the US Drug Enforcement Administration to prescribe controlled substances. He also told Gupta that the education could go further and include treatment for addiction.
“So at the very time you’re educating them about the appropriate prescribing of opioids, you’re also educating them about how to spot signs of abuse and treat it If they do have a patient who becomes addicted to opioids,” Gottlieb said.
Though supportive of physician education, the American Medical Association has previously opposed federally mandated training that is “one size fits all.”
In a December letter to the FDA, the association argued against the idea. “We instead encourage the FDA to work to increase information about, use of, and dissemination of all of the effective strategies for treating pain and reducing the risk of opioid use disorders.”
Gupta sat down with Gottlieb in advance of the FDA leader’s address to the National Rx Drug Abuse & Heroin Summit this week in Atlanta.
In those remarks, Gottlieb also called upon the nation’s internet providers to police illegal offers of prescription opioids and illegal drugs that are feeding the nation’s growing drug crisis.
“Internet firms simply aren’t taking practical steps to find and remove these illegal opioid listings,” Gottlieb said, according to an advance copy of his speech. “There’s ample evidence of narcotics being advertised and sold online.”
Gottlieb pointed to a recent three-month congressional investigation of online sellers of fentanyl, one of the most powerful opioids. The undercover investigators identified 500 financial transactions with 300 people in 43 states, totaling over $230,000 in sales.
“I’m concerned that social media companies, internet service provider firms that host websites and others in the internet ecosystem haven’t been proactive enough in rooting out these illegal offers to distribute opioids from their respective platforms,” Gottlieb said in the speech. “I think we can work with them to do much more to address this public health danger.”