Doctors, dentists skip proper opioid prescribing training

About one in four Florida health care providers failed to take a two-hour continuing education course on proper opioid prescribing by the required Jan. 31 deadline, according to state officials.

The Florida Department of Health now is preparing to send non-compliance letters advising the providers that they have 15 days to take the mandated course or face disciplinary action, agency spokesman Brad Dalton told The News Service of Florida.

“If the department does not receive a response within 15 days from receipt of the notice, a formal complaint will be initiated,” he said.

The health department does not know how many providers took the course, only the overall compliance percentage, according to Dalton.

In Florida, physicians, podiatrists, dentists, physician assistants and advanced registered nurse practitioners can prescribe controlled substances for the treatment of pain.

But prior to a law passed last year, only physician assistants and advanced registered nurse practitioners were required to take continuing education courses on controlled substances as part of their licensure requirements.

The new mandate impacts an estimated 114,000 Florida health-care providers.

While the state did not have a breakout that showed compliance rates for each profession, Dalton said overall compliance among all professions was 74.2 percent.

The mandate was included in sweeping legislation on opioids that put limits on prescriptions for opioids and required providers check a statewide prescription-drug database before prescribing potentially addictive pain medications to patients.

The 2018 law specifically required all health care professionals registered with the U.S. Drug Enforcement Administration and authorized to prescribe controlled substances to take an education course on opioids. The course covers the current standards for prescribing controlled substances, particularly opiates; alternatives to the standards; nonpharmacological therapies; prescribing emergency opioid antagonists; and the risks of opioid addiction following all stages of treatment in the management of acute pain.

The state sent reminders about the requirement throughout the year to affected providers, Dalton said. The state medical quality division sent 13 emails to all affected practitioners advising they were required to take the course. Nine of the messages were sent in December and January, Dalton said.

The course was required to be offered by a “statewide professional association of physicians that is accredited to provide educational activities” for the American Medical Association or the American Osteopathic Association.

According to research, 80 percent of heroin users first abused prescription drugs, whether their own or someone else’s.

Other studies show that a patient’s chances of addiction increase as the number of days a first prescription for opioids lengthens.

A former neonatal nurse from Ft. Lauderdale, Janet Colbert cared for the drug-addicted infants born to heroin-addicted mothers. She also helped console friends who had lost children to drug overdoses, and eventually helped launch the anti-opioid advocacy group Stop the Organized Pill Pushers Now, known by its acronym, STOPP Now.

Colbert says that she’s disappointed with the continuing education compliance rate but she’s not surprised.

She is hopeful, though, that the state takes enforcement seriously.

“We need to make sure folks keep with this because way too many people are dying,” Colbert said.

While lawmakers lauded most of the changes in the sweeping opioid bill, the continuing-education requirement faced criticism. One legislator accused the bill sponsor of including it in the bill in order to gain the support of the Florida Medical Association, which had balked at imposing prescribing restrictions on doctors.

State Rep. Cary Pigman, an Avon Park Republican who is a doctor, said medical boards could make millions of dollars by charging members between $100 and $200 for the courses. Pigman said that was the reason the continuing education requirement was tucked into the bill.

But Florida Medical Association general counsel Jeff Scott called the accusation absurd and predicted that groups other than the FMA would qualify to offer the course.

He was right.

The Florida Board of Medicine has approved eight different providers — including Informed, a for-profit company based in Jacksonville, and Baptist Health South — to offer the course.

The board also approved the Florida Psychiatry Society,  the Florida Osteopathic Medical Association, the Florida Academy of Family Physicians (FAFP), the Florida Medical Association and the Florida College of Emergency Room Physicians to provide the course.