Restrictions on the use of powerful painkillers would be loosened for patients with chronic pain under a federal rule proposed Wednesday, allowing doctors to prescribe a 90-day supply of the drugs.
Current law forbids doctors from refilling, without another office visit, painkillers such as Oxycontin and codeine that are heavily regulated as schedule II controlled substances because they can be abused by addicts. But the law is silent on the question of multiple prescriptions for a drug that are issued by a doctor in a single office visit.
The proposed rule, which will go through a 60-day comment period, makes it clear doctors could prescribe up to a 90-day supply without fear of prosecution to avoid multiple trips by a patient. Doctors previously had complained that strict regulation by the Drug Enforcement Administration was forcing them to limit prescriptions and leave patients untreated.
"Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards," said DEA administrator Karen Tandy at a news briefing. "Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged."
The move comes amid a broader debate in recent years about the proper role of federal law enforcement in monitoring doctors' prescription decisions. Earlier this year, the Supreme Court ruled against a Justice Department attempt to use the Controlled Substances Act to punish Oregon doctors who helped patients commit suicide.
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In recent years, the number of physicians charged under that federal law nearly doubled from 38 in 2003 to 67 in 2005. Meanwhile, about 6 million Americans — including one in 10 high school seniors — currently abuse controlled substance prescription drugs, according to the DEA.
At the briefing, Tandy sought to ease distrust of the DEA among doctors, noting that the agency had listened to their concerns in easing prescription rules.
In many cases, doctors had already been issuing multiple prescriptions since the law was silent on the matter. The rule change would give them ease of mind that they won't be prosecuted for doing so.
In addition, the DEA will launch a new page on its Web site called "Cases against Doctors" that will spell out the number of prosecutions each year and the circumstances in which they were charged to avoid an undue chilling effect.
"We believe that the statement and proposed rule will help the medical professional ensure that only patients who need medication for pain relief get it," Tandy said.
