Tennessee's pain doctors are being inundated with calls from patients needing a specialist to prescribe opioids. The combined impact of a new state law and closure of a dozen pain clinics has created a pinch for pain patients.
The new state law makes it difficult to prescribe any more than three days' worth of opioids to many patients, and physicians have said it will make them more likely to just refer patients to a pain clinic.
"We are seeing — left and right — referrals on acute pain issues," says John Schneider, a pain doctor in Murfreesboro who leads the Tennessee Pain Society.
He says he's had referrals from surgeons and orthopedic doctors, gun shy about testing the new state limits.
"You couple that with 25,000 patients that just got discharged from Comprehensive Pain Specialists, and it's just kind of a nightmare," Schneider says.
Comprehensive Pain Specialists, whose former CEO was indicted for Medicare fraud, started closing down its clinics last month, and many of those patients are now reportedly running out of their medication.
The number of pain clinics was already dwindling in Tennessee as problem prescribers have been forced out of business. In 2015, Schneider says there were more than 300 pain clinics in the state. The figure is now closer to 100.
A spokesperson for the Tennessee Department of Health says the agency has contacted CPS leadership and reminded them of their legal obligation to make sure patients can find another prescriber.
"Our primary concern is for patient safety. In our role in regulating pain management clinics in the state, TDH has contacted both CPS leadership and the medical directors of CPS facilities to remind them of their duty and responsibility under Tennessee state law."
If they can't find a new doctor, opioid experts are concerned some could turn to the black market for their pain pills or even heroin.