Pubdate: Thu, 12 Aug 2004 Source: State, The (SC) Copyright: 2004 The State Contact: http://www.thestate.com/ Details: http://www.mapinc.org/media/426 Author: Marc Kaufman, The Washington Post Bookmark: http://www.mapinc.org/oxycontin.htm (Oxycontin/Oxycodone) PAINKILLER GUIDELINES DESIGNED TO AID DOCTORS DEA tries to satisfy pain specialists WASHINGTON - The federal Drug Enforcement Administration and top pain specialists Wednesday jointly issued detailed guidelines designed to reassure worried doctors that they will not be prosecuted for prescribing high doses of powerful, morphine-based painkillers for patients who need them for intractable pain. The guidelines also make it more clear, however, that doctors have responsibilities to ensure that their pain patients are not abusing prescription opioids like OxyContin and are not doctor-shopping to collect narcotics for illicit sales. The new document, which will be distributed to law enforcement agencies and all doctors who apply for DEA approval to prescribe controlled drugs, is an effort to resolve a controversy that has bedeviled pain specialists. An earlier consensus paper failed to clarify the issues, leading to a situation in which many patients with severe pain have been turned away by doctors and pharmacists concerned that prescribing and dispensing opioid painkillers would get them in trouble with the law. "We hope this is a step in the right direction, to reverse an increasingly unfriendly environment for pain management," said one of the authors of the new guidelines, University of Wisconsin pain studies director David Joranson. Getting the agency to publicly describe its position on prescribing opioids "will make more clear that the DEA understands good medicine and would be avoiding it in their investigations," he said. "A lot of people don't feel now that's the case." The new guidelines spell out steps that assure proper prescribing, such as how to diagnose severe pain and keep proper records to justify prescribing a narcotic painkiller. Written largely in a question-and-answer form, the document makes clear to law enforcement that even heavy use of prescription opioids can be appropriate and that the physical dependence it brings is not the same thing as physical addiction. The DEA and other law enforcement agencies stepped up their prosecutions of doctors, pharmacists and some of their employees after the prescription narcotic OxyContin became widely used and abused in the late 1990s, resulting in numerous overdoses. With hundreds of doctors charged in recent years, pain patients and doctors who treat them have complained of a growing climate of fear - adding to what is widely seen as a serious nationwide problem of inadequate pain treatment. - --- MAP posted-by: Josh