How Lucid Lane Helps Reduce Doctor Liability in Prescribing Opioids

Doctors prescribe opioids for many reasons: to manage acute pain stemming from an injury, to help with cancer-related pain, or as one tool among many to manage chronic pain. At Lucid Lane, we estimate that opioids are prescribed to 50 million people each year.

Unfortunately, few MDs are able to provide a plan for managing or safely tapering the use of opioids. A contributing factor in the opioid epidemic is that doctors are not trained on how to prescribe, monitor, and safely taper opioids for their patients — not to mention that this process takes time that most physicians lack.

This lack of training means that doctors often take on a lot of risk when prescribing opioids. While regulatory mandates aim to lower this liability, these guidelines can actually complicate matters. Here are some of the risks that doctors face when prescribing opioids — and how Lucid Lane can help.

What is a doctor’s liability for prescribing opioids?

Doctors face a number of risks when deciding whether or not to prescribe opioids to treat a patient in pain. Doctors who overprescribe opioids face review by state regulators and health insurance companies, not to mention the reputational risk that can result from a patient’s death. MDs also face medical malpractice lawsuits, restricted hospital privileges, and medical board disciplinary action for negligent prescribing.

A small but increasing number of physicians are starting to face criminal liability, too. Take the extreme case of Dr. Hsiu-Ying Tseng in 2016. Dr. Tseng was sentenced to 30-years-to-life in prison after being found guilty of second-degree murder for three patient drug overdose deaths. “This marked the first time in American history that a physician was held criminally liable for the murder of a patient by means of extreme recklessness in opioid prescribing,” according to a commentary piece by the Mayo Clinic. In total, Dr. Tseng played a role in at least 12 patient opioid deaths.

While well-intentioned, regulatory mandates or health system guidelines also complicate matters. As the CDC sought to stem the growing opioid crisis in 2016, it recommended that physicians avoid using opioids to treat chronic pain and prescribe lower doses — with tapering plans for those already prescribed high doses. For acute pain, the CDC recommended limiting opioid treatment to three days.

These recommendations are based on limited research and were never meant to become policy. However, many states have misinterpreted them and have since implemented regulations based on these limits.

“Unfortunately, since 2016, the CDC’s efforts to guide consistent practice have been transformed into an inconsistent patchwork of rigid regulations, fuelled partly by political pressure to tackle the public-health crisis more aggressively — even when such policies go beyond specialist advice,” wrote one expert in Nature. “At least 35 U.S. states have laws that regulate opioid prescriptions, most of which were passed after 2016 and formalize strict limits on dosage and treatment duration that differ from each other and from the CDC guidelines.”

Today, doctors are sometimes required to make opioid prescriptions contingent on patient education programs or prior attempts at non-opioid pain management. The upshot of that requirement is that many doctors don’t learn how to prescribe (and de-prescribe) safely.