Painkillers: Too Much, Too Easy
Sept. 7, 2006 — -- The Drug Enforcement Agency unveiled a new proposal on Wednesday intended to make certain powerful painkillers more easily available to patients with legitimate medical needs.
The new plan would extend the maximum prescription length for some pain medications from the current 30-day supply to a 90-day supply.
Speaking at a press conference, DEA administrator Karen Tandy called the announcement "a good news day for people who are in chronic pain and need these drugs."
Experts in the field see the proposal as a long-awaited change that would update problematic regulations.
Rollin Gallagher, director of the Center for Pain Medicine, Research and Policy at the University of Pennsylvania, told ABC News, "These new rules will enable many more patients with severe pain to obtain proper treatment and prevent the consequences of pain."
Current laws do not allow prescriptions for Schedule II drugs, such as Oxycontin and Vicodin, to be refilled. This means patients must visit the doctor every month to obtain a new 30-day prescription. Such frequent visits can be a burden on patients and physicians alike, and also prove costly.
Plus, the current system doesn't indicate if doctors can issue multiple prescriptions during one office visit. This creates a potential for doctors to violate DEA regulations and possibly lose their licenses.
The new plan clarifies the rules, allowing doctors to issue multiple 90-day prescriptions for these drugs at one office visit. To prevent abuse, the new proposal controls the number of doses issued with each trip to the pharmacy. It allows for the 90-day prescription to be filled in three stages, with a month's supply available immediately, and then again after 30 days, and again after 60 days.
"The ability to prescribe a 90-day supply will greatly improve our ability to manage pain without forcing the patient to repeatedly make unnecessary doctor visits and trips to the pharmacy," Dr. Fredrick Burgess of Brown University Medical School told ABC News.
Doctors and patients alike have bemoaned the current system, complaining that the restrictions on these prescriptions make it too difficult for many patients, who suffer from chronic pain, to receive the drugs they need.
"This is a statement that the DEA recognizes, and it respects the legitimate needs of patients suffering from pain conditions and diseases," said Gallagher. "The old rule requiring monthly visits for medications for no legitimate medical reason restricted their access to treatment."
The new plan was formulated after the DEA took into consideration more than 600 comments from physicians, patients, pharmacists and medical boards on how to create a policy that would offer patients the best care.
Tandy called the new policy "balanced," saying it addresses the needs of both the medical community and law enforcement agencies.
The proposed plan is subject to a 60-day comment and review period and, if approved, is expected to go into effect in three to four months.
The new DEA plan comes at a time when law enforcement is increasingly concerned about widespread prescription drug abuse. According to the DEA, roughly 6 million Americans admitted to abusing prescription drugs in a 2004 survey, including one in 10 high school seniors.
In an effort to curb increases in such abuse, the DEA is also releasing a policy statement to the medical community to educate physicians and pharmacists about these drugs. It also provides pointers -- for doctors diagnosing a patient or prescribing medicine -- on how to spot potential drug abusers or those who may be seeking to resell the drugs.
Physicians in the field recognize the potential for abuse of powerful medications but say the changes are necessary.
According to Dr. Tim Lubenow at Rush University Medical Center, "The change is likely to result in increased risks for a small but important subpopulation. ... Bottom line, it needs to be done."