Mandate Doctor Education to Save Lives

From the New York Times:

Should doctors be required to undergo special education in order to prescribe powerful narcotics? The Food and Drug Administration may soon recommend that they do so, though such a move would most likely prove controversial…
Dr. Rappaport said the F.D.A. was most concerned about potent and longer-acting narcotics like methadone, fentanyl and certain formulations of the drug oxycodone, the active ingredient in OxyContin.
With methadone [when prescribed as a pain med], fentanyl, which is available in patches, has been associated with patient deaths and injuries resulting from physician misprescribing or inadvertent patient misuse…
In the last two years, the agency has sent out alerts to doctors about both methadone and fentanyl, but officials acknowledged that preventable patient deaths were continuing.
“We are putting out communications,” said Dr. Gerald Dal Pan, who directs the F.D.A.’s office of surveillance and epidemiology. “We don’t know why they are failing.”

We have seen “mistakes” in prescribing and talked with prescribing physicians who are very unfamiliar with proper doses and precautions with these meds (e.g. knowledge of drug-drug interactions compounding lethality), although still prescribing them. When I say “we have seen”, I mean folks have died as a result. The “boxed warnings” and informational mailings have failed. I think mandated training is a step in the right direction.