Prolific Prescribers Of Controlled Substances Face Medicare Scrutiny : Shots - Health News In the face of abuse concerns, Medicare covered more prescriptions for potent controlled substances in 2012 than in 2011. Top prescribers often have faced disciplinary action or criminal charges.

Prolific Prescribers Of Controlled Substances Face Medicare Scrutiny

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RENEE MONTAGNE, HOST:

Prescriptions for narcotic painkillers and stimulants are rising quickly in the Medicare program. In just one year from 2011 to 2012 prescriptions of very strong painkillers, like OxyContin and morphine, plus stimulants, like Ritalin and Adderall, grew by almost 10 percent. That's the finding of a new analysis by the nonprofit investigative journalism organization ProPublica. The rise is happening despite a widening crackdown on prescription drug abuse. David Greene spoke with ProPublica senior reporter Charles Ornstein.

CHARLES ORNSTEIN: The alarms have been sounding now for several years about the use of powerful painkillers and the overuse of them, in fact, and how they've been linked to overdose deaths. And so the fact that we're seeing this go up at all is a sign that some of these efforts to crack down have not yet really taken hold - at least in 2012, which is the year covered by this number.

DAVID GREENE, BYLINE: And who were the doctors? That seems to be a part of this that is the most troubling. The top 20 prescribers here, you found many were under investigation by law enforcement or faced discipline in the past? Give me some more details about that.

ORNSTEIN: Sure. Well, some of these doctors have subsequently surrendered their licenses. They have been terminated from their state's Medicaid programs. They've faced actions from the DEA. They're under investigation or indictment for both issues involving drugs, but also in some cases sexual conduct with patients. So it appears that some of these were under investigation or had already been disciplined in 2012 - so the time covered by this data. Medicare, though, has historically been pretty slow to respond to such information.

GREENE: And what might that suggest to us if we have, you know, a dozen or so doctors who have faced disciplinary action or are under investigation who are prescribing these types of painkillers at a pretty high rate?

ORNSTEIN: What I think it means is that the tide is beginning to turn. I think that if a doctor is out there and is prescribing a whole lot of pain medication, it's very likely that this is going to catch the eye of Medicare, which has subsequently changed its practices. They're looking for this sort of thing. State medical boards are now on the lookout for this. So I think there's less cover for doctors to prescribe anything they want without fear of any consequences.

GREENE: Sounds pretty bad on its face to have doctors who, you know, have faced legal action, who are prescribing painkillers and narcotics. I wonder if there's been a response from the doctors who you've named here.

ORNSTEIN: Well, some doctors that we talked to said, you know, that data in itself can be misleading. And what I mean by that is they say that their numbers may include numbers from nurse practitioners or physician assistants who work under them, and so it's not just a single doctor prescribing all of this medication. Most doctors, though, did not return our phone calls or attempts for comment.

And I think that what we heard from other experts is that, you know, most doctors want to do the right thing. Pain is a very real problem, and if you're in pain, you just want relief from that. And so doctors are trying to help provide that relief. But I think what we're learning more and more is that pain and treating pain can also lead to abuse. It can lead to addiction, and it can lead to dependence. And there's a lot of questions about whether or not these narcotic painkillers actually relieve the pain.

GREENE: Charles Ornstein, thanks very much.

ORNSTEIN: Thanks, David.

MONTAGNE: Charles Ornstein is a senior reporter at ProPublica. You can go to propublica.org to look up how much your doctor prescribed within Medicare in 2012.

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