Pubdate: Sun, 06 Dec 2015
Source: Register-Herald, The (Beckley, WV)
Copyright: 2015 The Register-Herald
Author: Sarah Plummer


In light of local pain clinic doctors facing drug charges, one local 
addiction treatment specialist and psychiatrist believes removing 
cash dealings from the system is key to eliminating the drug epidemic.

Dr. M. Khalid Hasan said greed on the part of physicians, pharmacists 
and patients - manifested in cash dealings - is at the root of the 
prescription opiate scourge.

Hasan explained that patients to Raleigh Psychiatric Services, an 
addiction treatment clinic where patients can receive non-addictive 
drug treatment, have shared their experience at other area clinics.

These patients confessed, according to Dr. Hassan, that some area 
doctors require cash payments. One patient recounted getting service 
but only after paying $500 a month in cash.

Hasan notes that with 100 patents, that's $600,000 a year in cash gains.

"It's a cash cow," he stressed, comparing the few pain clinic doctors 
who operate this way to drug lords.

As a remedy, Hasan would like to see a law that mandates all patients 
be seen under their insurance with no cash payments allowed.

"Why would patients use their insurance for blood pressure medicine 
and other treatment but not pain medication unless it's greed?" he 
asks. "Cash changes the focus from treatment to profit, and patients 
are being charged more than they should be."

Hasan notes that there are a small number of clinics, doctors, 
pharmacies and patients who are "tarnishing the image of others."

Such a change would also affect methadone treatments, which are often 
purchased with cash.

He also expressed concern that a popular addictive drug used in 
treatment, Suboxone, will become as widespread as methadone.

Currently physicians may only subscribe Suboxone to 100 patients 
within their clinic. Those restrictions may soon be lifted, something 
Hasan said would be a mistake.

He believes lifting the restriction could encourage long-term use of 
Suboxone, instead of it being used for a short time as a stepping 
stone to non-opiate treatment.

Treatment at traditional opiate clinics can last for years, Hasan 
said, adding that he knows one patient who has paid $15 in cash a day 
for 11 years.

Hasan also believes that more providers should have mandated pain 
management and addiction certification. Under the Chronic Pain Clinic 
Licensing Act, clinics where more than 50 percent of patients are on 
narcotic pain medication must have a physician with additional 
training and education.

Hasan suggests doctors with more than 25 percent of patents, 
excluding patients with terminal illnesses, should get the additional 

He notes that this issue will need cooperation from everyone - 
patients, doctors, pharmacists, officials and lawmakers.

The culture of opioid prescription persists in southern West 
Virginia, he explained. Opiates are prescribed for injuries when they 
are not needed.

"We are continuing to over-prescribe, and taking these drugs from a 
physician is considered safe, but we need everyone to be held 
accountable for their actions," he said.

That includes evaluation and drug treatment mandated by courts for 
nondrug-related offenses and loss of Medicaid benefits for those who 
subvert the system.

"Medicaid patients who gets addicted have no consequences to their 
action," Hassan said. "They come in and get their drugs for free; 
there's no cut to their income. There have to be consequences to 
their behavior."

Lastly, Hassan stressed education on addiction and prescription drug 
abuse for children and mental health care as a significant part of 
addiction treatment.
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