Very recently in our community , two very busy health care  providers lost their medical license over unregulated  prescriptions of narcotics . It was a very unfortunate incident

The community where it happened largely consists of under served  population . Patients have chronic pain disorders  and almost every body has behavioral health issues, not to mention being the biggest victim of  economic recession .

But it seems it is a vicious cycle that has been going on for ever . As physicians , we are not blame free . When narcotic naive patients are initiated into this cycle ,somewhere in the ER or in the primary care physician’s office,  patients are not educated enough about safer alternative  options or the addictive potential of these controlled substances .Once their bodies get used to the effects of these medications , it becomes a must have for these patients

In community health centers , where we have a large chunk of these patients , regulations are not easy to practice .Most of the physicians are on their visas ,waiting for their green cards and job insecurity always looms on the horizon . Most of these CHC[ community health center ] ,are dependent on grants , which are drying up fast . There  is a constant pressure to perform well as compared to the moneyed players in the fields as most of these big players are accepting all kinds of insurances currently

Administrative coercion , patients’ pressure , economic hardships of CHCs  all play a vital role in this doctor patient narcotic cycle .

In the end either the doctor gets to loose his license or patient, his quality of life .Stricter regulations need to be spelled  out to save the  small pool of qualified health care providers and also patient’s safety.