Clearly, there's more to be done, right? We as a profession have to own that, and we are owning that. We're saying that we need to do a better job.
As in all of these discussions, it's much more complex on the front lines if you have a health care practitioner or a primary care doctor who has only five or 10 minutes with a patient. It would be much better if they had a long time to sit down and talk through all the different alternatives for pain management. They often have a very compressed period of time and they feel very pressured to provide or renew a prescription instead of talking about the other types of alternatives that are available.
As well, these front-line physicians feel that they're under a lot of pressure to provide these prescriptions. You have people coming in demanding access to medication and saying they need it and that if they don't get it, they'll go into withdrawal. The physicians are feeling stuck between a rock and a hard place.
What we're seeing sometimes—and I see this in my practice—is that family doctors are saying that this takes too much of their time, it's too difficult, and they feel under pressure from the regulatory authorities on one hand and the patients and their families on the other hand, so they're just not going to prescribe narcotics anymore. That will be their solution. From their standpoint, they've handled things with their patient population, but those patients just go elsewhere. We need to do a better job of equipping that group of physicians with the tools they need to make the proper decisions, as well as the prescribers, who need more help and guidance in terms of the proper dosing and de-escalation.
There's no question that there's a lot more work to be done.