Pubdate: Sun, 06 Dec 2015 Source: Register-Herald, The (Beckley, WV) Copyright: 2015 The Register-Herald Contact: http://www.register-herald.com/ Details: http://www.mapinc.org/media/1441 Author: Sarah Plummer HASAN: CASH DEALINGS MUST BE REMOVED FROM OPIATE DRUG TREATMENTS 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 certification. 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. - --- MAP posted-by: Jay Bergstrom