In “Doctor under fire for large prescriptions of addictive painkillers,” Christina Jewett reports on Dr. Edward Manougian, an East Bay physician specializing in chronic pain management – and a few years ago one of the state’s most prolific dispensers of pain medication. Last year, the Medical Board of California stopped his prescribing. To better understand the article and issues around opiate abuse, we’ve created this resource guide. Here you’ll find a glossary of terms used in the article, links to additional reading, and contact information for resources and those involved in the issue.
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narcotic: an opioid-based drug
polypharmacy: the use of multiple medications on a patient
Vicodin: a combination of hydrocodone and acetaminophen; an opioid prescribed for relief of moderate to severe pain
methadone: an opioid prescribed for pain relief, also used to help addicts withdraw safely from heroin
Soma: a compound of aspirin and carisoprodol (muscle relaxant and pain reliever); Soma is a muscle relaxant meant to reduce pain, fever and inflammation
Valium: diazepam, used for treatment of anxiety disorders, alcohol withdrawal, muscle spasms and other conditions; similar to Xanax, this medication is highly addictive
OxyContin: an oxycodone pain reliever, similar to methadone; used for the long-term treatment of severe pain; highly addictive.
codeine: narcotic pain medication used to treat moderate pain; codeine comes in both liquid and tablet form
fentanyl: an opioid used to treat pain in cancer patients, not for use with pain that is not cancer-related, such as headaches; because of its highly addictive nature, this medication is only available through special programs for which patients must register
Xanax: alprazolam, used to treat anxiety and panic disorders; similar to Valium, this medication is highly addictive
Key agencies involved
California's Medicaid program, which is funded by federal and state tax dollars, pays for a variety of medical benefits and services for children and adults with limited means and resources. It covers certain services that federal Medicaid does not, including dental screenings.
- Phone: 800-541-5555 or 916-445-4171 (California Department of Health Care Services)
- Website: www.dhcs.ca.gov/services/medi-cal/Pages/ApplyforMedi-Cal.aspx
Medical Board of California
The regulatory body for physicians and other medical professionals handles complaints about licensees and ensures that the Medical Practice Act is enforced.
- Phone: 800-633-2322
- Address: Central Complaint Unit
2005 Evergreen St., Suite 1200
Sacramento, CA 95815
- Website: www.mbc.ca.gov
Sen. Chuck Grassley (R-Iowa)
Serving since 1981, Grassley is co-chairman of the Senate Caucus on International Narcotics Control with California Sen. Dianne Feinstein. He is currently researching the influence the pharmaceutical industry has on policy with regard to placing limits on opiates.
- Phone: 202-224-3744
- Fax: 202-224-6020
- Address: 135 Hart Senate Office Building
Washington, DC 20510
- Website: www.grassley.senate.gov
Sen. Max Baucus (D-Montana)
Serving since 1978, Baucus is the chairman of the Senate Committee on Finance. A key player in the debates over health care reform, Baucus is also examining the effects of the pharmaceutical industry on medical policy in the United States.
- Phone: 202-224-2651
- Address: 511 Hart Senate Office Building
Washington, DC 20510
- Website: www.baucus.senate.gov
The Substance Abuse and Mental Health Services Administration within the U.S. Department of Health and Human Services has many resources for those with medication addictions and their families, including a map of drug and alcohol abuse treatment programs in your area.
Physicians for Responsible Opioid Prescribing, which promotes responsible opioid prescribing practices, has resources for primary care physicians including prescribing guides and educational videos.
The Centers for Disease Control and Prevention's Vital Signs reports on the rise of prescription painkiller overdoses and the risks of taking methadone as a pain reliever.
And this 2011 analysis of opioid pain relievers deaths from 1999-2008 found that OPR overdose rates have increased so much that they now exceed deaths involving cocaine and heroin.
The National Institute on Drug Abuse has this list of commonly abused prescription drugs.