New crusade for loathsome nanny-state mayor: Limiting painkillers in public hospital ERs

The only redeeming virtue of this bit of paternalistic sadism is that it’ll make great oppo in case this tool tries to be a national player in 2014 or 2016. Lord knows he has the bank to do it, as well as a political brand carefully engineered to make soft-headed centrists and media types swoon. He’s a Democrat who pretends to claim the partisan high ground by identifying as a no-labels independent, a man of “solutions” who’s on the case when it comes to poor people limping home from the emergency room with an extra day of painkillers but not when it comes to preparing the country’s biggest city for hurricanes.

There are new reasons every week why I’m glad he left the GOP, and now here’s this week’s. Imagine a card-carrying Republican instituting this policy and then defending it by shrugging and saying, “So you didn’t get enough painkillers and you did have to suffer a little bit. The other side of the coin is people are dying and there’s nothing perfect.”

Under the new city policy, most public hospital patients will no longer be able to get more than three days’ worth of narcotic painkillers like Vicodin and Percocet. Long-acting painkillers, including OxyContin, a familiar remedy for chronic backache and arthritis, as well as Fentanyl patches and methadone, will not be dispensed at all. And lost, stolen or destroyed prescriptions will not be refilled.

City officials said the policy was aimed at reducing the growing dependency on painkillers and preventing excess amounts of drugs from being taken out of medicine chests and sold on the street or abused by teenagers and others who want to get high…

City health officials said the guidelines would not apply to patients who need prescriptions for cancer pain or palliative care, and drugs would still be available outside the emergency room. They said that in this era of patient-satisfaction surveys, doctors were often afraid to make patients unhappy by refusing drugs when they are requested, and the rules would give those doctors some support when they suspected that a patient might be faking pain to get drugs.

“There will be no chance that the patients who need pain relief will not get pain relief,” said Dr. Ross Wilson, senior vice president and chief medical officer of the Health and Hospitals Corporation, which runs the city’s public hospitals.

Of course there’s a chance. Bloomberg’s quote about people possibly having to suffer accepts it as a price of preventing addiction. But I don’t see the point of denying painkillers to ER patients but not patients elsewhere in the hospital. The thinking is, I guess, that impoverished addicts are more likely to try to game the ER for their fix than other wings of the hospital, but I’d bet it’s also true that the average ER patient is more urgently in need of painkillers than patients in those other wings. As with the gun-control debate, he’s letting the worst actors drive policy for society at large regardless of how many law-abiding people are inadvertently punished by its overbreadth — except that this is worse because most addicts, unlike most aspiring mass shooters, will ultimately hurt only themselves. He could, of course, simply let doctors judge whether a patient is trying to game them and deny painkillers on a case by case basis, but while that might make for sounder policy, it would deny Bloomy the opportunity to Do Something about a social problem which he thinks deserves more attention. So if you’re a New Yorker laid up at home with back pain because the prescription from the city hospital’s ER just ran out, take comfort in that. Your mayor Did Something.

Exit question: If painkillers will be available in the rest of the hospital, won’t sympathetic ER doctors and nurses simply “borrow” drugs from other wings for their patients who really need them?

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