Between a Rock and a Hard Place: Can Physicians Prescribe Opioids to Treat Pain Adequately While Avoiding Legal Sanction?

47 Pages Posted: 13 Aug 2016 Last revised: 3 Oct 2016

See all articles by Kelly K. Dineen

Kelly K. Dineen

Creighton University School of Law

James M. Dubois

Saint Louis University

Date Written: 2015

Abstract

Prescription opioids are an important tool for physicians in treating pain but also carry significant risks of harm when prescribed inappropriately or misused by patients or others. Recent increases in opioid-related morbidity and mortality has reignited scrutiny of prescribing practices by law enforcement, regulatory agencies, and state medical boards. At the same time, the predominant 4D model of misprescribers is outdated and insufficient; it groups physician misprescribers as dated, duped, disabled, or dishonest. The weaknesses and inaccuracies of the 4D model are explored, along with the serious consequences of its application. This article calls for development of an evidence base in this area and suggests an alternate model of misprescribers, the 3C model, which more accurately characterizes misprescribers as careless, corrupt, or compromised by impairment.

Suggested Citation

Dineen, Kelly K. and Dubois, James M., Between a Rock and a Hard Place: Can Physicians Prescribe Opioids to Treat Pain Adequately While Avoiding Legal Sanction? (2015). American Journal of Law and Medicine, Vol. 42, No. 1, 2016; Saint Louis U. Legal Studies Research Paper No. 2016-12. Available at SSRN: https://ssrn.com/abstract=2819462

Kelly K. Dineen (Contact Author)

Creighton University School of Law ( email )

2500 California Plaza
Omaha, NE 68178
United States

James M. Dubois

Saint Louis University ( email )

220 North Grand Boulevard
St. Louis, MO 63103
United States

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