An effort to ease tensions between physicians who specialize in treating pain and the Drug Enforcement Administration over the use of morphine-based painkillers has backfired, says the Washington Post. The result leaves many pain doctors and patients more fearful than before that they could be arrested for practicing what they consider good medicine. The DEA caused the new impasse this month when it published a statement clarifying its position on a number of issues central to pain medicine. The document discusses when a doctor is at risk of being investigated for alleged prescription drug diversion, whether patients with known drug problems can be prescribed narcotic painkillers, and whether doctors can give patients prescriptions to be filled on a future date.
On each issue, the new DEA position is at odds with a set of guidelines negotiated over several years by DEA officials and a group of leading pain-management experts. Those guidelines were posted on the agency’s Web site in August as part of an effort to reassure doctors who properly prescribe narcotics. Several weeks later the document was abruptly removed and described by the agency as inaccurate and unofficial. Pain-management experts say the new DEA position may result in the denial of pain relief to millions of sufferers. Howard A. Heit, a pain and addiction doctor in Fairfax County, Va., said that “over 90 percent” of patients and doctors could face investigation under the new guidelines.