Clearly it would help. They will either stop supplying the abuser, or if they don’t, the next time the patient presents for detox with a clear history of abuse, the addictionologist reports them to the appropriate authorities.

But because we don’t have the guts to police our own, the jack-booted guys are left to do it and do so very clumsily.

We need to initially presume that the opiate prescribing pain docs are tying to practice medicine and do a good job–not slam them behind their backs as quacks. That presumption requires treating them as colleagues and collaborating with them when we think we see addiciton in their patients. Then if they fail trust, we need to bite the bullet and file a complaint with the medical board. Failing to do this, we haven’t a leg to stand on in complaining about the enforcement that comes from outside the profession.

Let’s see…if I’m a pain specialist, I can:
1. Prescribe opiates in a responsible manner (doesn’t pay all that well) and due to my skewed patient population draw a DEA investigation and potentially go to jail when it turns out that one of my patients is selling his oxy or ODs. There are plenty of idiot “expert” witnesses willing to testify to the existence of a “lethal dose” of an opiate…as determined by blood levels (pure steaming BS). And after all, I’m not trained in spying. How can I know for sure what patients are doing at home?
-or-
2. Never prescribe an opiate. No DEA! And guess what, injecting patients pays great…even when there’s little symptomatic benefit.

I’m a PCP, but I can’t fault the choices pain specialists are making under these circumstances.