AMA seeks policy change on prescription postdating

Chicago -- The American Medical Association will call for the Drug Enforcement Administration to reverse its stand on physicians writing multiple prescriptions to be filled on different dates for stable patients taking schedule II medications, under a policy adopted at the AMA Annual Meeting in June.

The DEA published a notice in the Federal Register in November 2004 stating that writing several postdated prescriptions for a patient on the same day was "tantamount to writing a prescription allowing refills." DEA policy states that refills are not allowed for these medications and believes that postdated prescriptions are a tactic used by physicians dispensing these kinds of drugs for illegal purposes.

AMA delegates complained, however, that this situation has become a significant barrier for their patients, particularly those who have to travel great distances for care. Also, the period during which physicians can legally write a refill prescription sometimes falls on a weekend or holiday. This means that treatment disruptions can easily occur.

"It's very difficult to coordinate a 30-day refill based on your availability and their availability," said Thomas L. Hicks, MD, a family physician from Tallahassee, Fla.

The AMA is also calling on the DEA to work with credit card companies and e-commerce entities to develop strategies for reining in the flow of controlled substances over the Internet. Physicians said that the increasingly easy access to these pharmaceuticals is fueling addiction.

"I'm outraged because of all the spam I get saying, 'Buy Vicodin over the Internet,' " said Michael M. Miller, MD, an addiction medicine specialist from Madison, Wis. "This is a new form of snake oil. It's helping people who are addicted stay addicted, and it helps people who haven't gotten addicted yet get exposed to a high volume of these substances in a way that was never intended."

The Association also plans to develop model federal legislation on this topic.