DEA seeks comments on pain med question

Pain medicine experts seek balance in policies on prescribing controlled substances.

By Andis Robeznieks — Posted Feb. 7, 2005

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The U.S. Drug Enforcement Administration is preparing a document that will address its role as defined by the Controlled Substances Act. The DEA has invited physicians and others to submit comments on what they would like the document to address.

According to the announcement, published in the Jan. 18 Federal Register, those interested have until March 21 to submit comments.

The announcement was the latest in a series of notices about a frequently-asked-questions document on prescribing controlled substances for pain treatment that was posted on the DEA Web site in August 2004 and then withdrawn in October.

The document took more than two years to finish and was co-authored by the DEA, the University of Wisconsin Pain & Policy Studies Group and the Last Acts Partnership, with Russell K. Portenoy, MD, serving as the panel's lead expert on pain treatment.

Dr. Portenoy, chair of the Dept. of Pain Medicine and Palliative Care at New York's Beth Israel Medical Center and faculty member for the AMA online series on pain treatment, said he had little enthusiasm for going through the process again.

But PPSG Director David Joranson said it appeared that there were new people at the DEA working on prescription drug diversion, and they need to be educated on the issues. "I think everyone in the pain field -- clinicians, administrators and patients -- should take the DEA request very seriously," he said.

Joranson said the FAQ document was valuable in that it educated clinicians on law enforcement's drug diversion concerns, and it informed law enforcement about medical issues.

The president-elect of the American Academy of Pain Medicine, Scott Fishman, MD, said he would mention this in a letter to the DEA. "It will reiterate the position of balance, assert that aggressive pain medicine is possible without perpetuating addiction, and caution regulators about policies that try to solve the problem of drug diversion by restricting access to pain medicine of those who legitimately need them," he said.

The DEA said it had no comment.

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External links

U.S. Drug Enforcement Administration's solicitation of comments on dispensing of controlled substances for the treatment of pain, Federal Register, Jan. 18. (link)

U.S. Drug Enforcement Administration/Dept. of Justice's interim policy statement on the dispensing of controlled substances for the treatment of pain, Federal Register, Nov. 16, 2004 (link)

University of Wisconsin Pain & Policy Studies Group's Nov. 24, 2004 response to the Drug Enforcement Administration's Nov. 16, 2004 interim policy statement, in pdf (link)

AMA position on pain management using opioid analgesics (link)

AMA online continuing medical education series on pain management (link)

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