Re: DEA, Doctors Issue Guidelines On Use of Powerful Painkillers

[Guest guest]

In a message dated 14/08/2004 19:19:18 Central Standard Time,

a54@... writes:

, a and all:

I am on a listserv with the people named in this article and many more. Let

me tell you, they do not trust the DEA, and many of them have been

prosecuted/persecuted for helping chronic pain patients. It's a very bad

situation which

affects all of us. Cary

> DEA, Doctors Issue Guidelines On Use of Powerful Painkillers

>

> By Marc Kaufman

> Washington Post Staff Writer

> Thursday, August 12, 2004; Page A04

>

> The Drug Enforcement Administration and top pain specialists yesterday

> jointly issued detailed new 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 clear that doctors have responsibilities to ensure

> that their patients are not abusing prescription opioids such as OxyContin

> and are not doctor-shopping to collect narcotics for illicit sales.

>

> The pain control guidelines make clear that even heavy use of prescription

> opioids, such as OxyContin, can be appropriate. (Toby Talbot -- AP)

>

>

> 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 authors of the new

> guidelines, University of Wisconsin pain studies director E. Joranson.

>

> Getting the agency to publicly declare 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 the steps that ensure proper prescribing, such

> how to diagnose severe pain and keep proper records to justify the

> prescribing of a narcotic painkiller. Written largely in a

> question-and-answer form, the document makes clear to law enforcement

> authorities that even heavy use of prescription opioids can be appropriate

> and that the physical dependence it brings is not the same 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.

>

> Among the high-profile prosecutions of pain specialists is that of

> E. Hurwitz, a nationally known doctor from McLean accused of drug

> trafficking. Hurwitz is scheduled to go on trial this fall.

>

> " In numerous meetings over the past several years, it has become obvious

> that there are many misconceptions about the DEA's role and even the DEA's

> fundamental beliefs about the use of prescription opioids, " said another

> author of the guidelines, DEA diversion control official M. Good.

>

> " Many of these misconceptions lead to unwarranted fear that doctors who

> treat pain aggressively are singled out for enforcement actions, and that

> the goals of protecting the public health from drug abuse have come into

> direct conflict with the goals of promoting the public health through

> effective pain control, " she said. " Undertreatment of chronic, serious pain

> is considered a major medical problem. "

>

> K. Portenoy, another author of the guidelines and a pain specialist

> with New York's Beth Israel Medical Center, said opioid painkillers are

> appropriate treatment for serious pain from cancer and AIDS, as well as

> among the terminally ill. But about 40 percent of those patients are

> undertreated, he said.

>

> " What this document does is make clear [that] we in pain management and DEA

> are on the same page, and that we're willing to endorse the same

> principles, " Portenoy said. " We need to create a culture of respect for the

> policies. "

>

> Joranson, director of the Pain and Policy Studies Group at the University of

> Wisconsin Medical School, said the DEA's written acceptance of basic pain

> management principles could be useful in persuading some states to change

> their laws on prescription opioids. He said his group has found that 20

> states have laws that could be detrimental to pain patients. He added that

> the new guidelines will be sent to officials in those states.

>

> The new document was met with skepticism by some advocates for pain

> patients, who said it will do little to calm jittery doctors or decrease the

> illicit use of prescription narcotics.

>

> " The Department of Justice and other prosecutors are misidentifying quality

> pain management for drug dealing and have apparently convinced academic pain

> medicine that these doctors were 'diverting drugs,' " said Siobhan Reynolds,

> founder of the Pain Relief Network. " The DEA blames doctors as the number

> one reason why pharmaceutical drugs are on the street, when the truth is

> they are smuggled in, stolen from trucks and freely bought and sold all over

> the Internet. "

>

> Fisher, a California doctor who was tried and acquitted on charges

> related to prescribing opioid painkillers, said the new document " is an

> articulation of the status quo in the management of chronic pain. . . . The

> underlying problem is that our national pain policy is an expression of

> social concerns, rather than scientific knowledge. "

>

>

> http://www.washingtonpost.com/wp-dyn/articles/A57933-2004Aug11.html

[Guest guest]

In a message dated 14/08/2004 19:19:18 Central Standard Time,

a54@... writes:

, a and all:

I am on a listserv with the people named in this article and many more. Let

me tell you, they do not trust the DEA, and many of them have been

prosecuted/persecuted for helping chronic pain patients. It's a very bad

situation which

affects all of us. Cary

> DEA, Doctors Issue Guidelines On Use of Powerful Painkillers

>

> By Marc Kaufman

> Washington Post Staff Writer

> Thursday, August 12, 2004; Page A04

>

> The Drug Enforcement Administration and top pain specialists yesterday

> jointly issued detailed new 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 clear that doctors have responsibilities to ensure

> that their patients are not abusing prescription opioids such as OxyContin

> and are not doctor-shopping to collect narcotics for illicit sales.

>

> The pain control guidelines make clear that even heavy use of prescription

> opioids, such as OxyContin, can be appropriate. (Toby Talbot -- AP)

>

>

> 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 authors of the new

> guidelines, University of Wisconsin pain studies director E. Joranson.

>

> Getting the agency to publicly declare 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 the steps that ensure proper prescribing, such

> how to diagnose severe pain and keep proper records to justify the

> prescribing of a narcotic painkiller. Written largely in a

> question-and-answer form, the document makes clear to law enforcement

> authorities that even heavy use of prescription opioids can be appropriate

> and that the physical dependence it brings is not the same 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.

>

> Among the high-profile prosecutions of pain specialists is that of

> E. Hurwitz, a nationally known doctor from McLean accused of drug

> trafficking. Hurwitz is scheduled to go on trial this fall.

>

> " In numerous meetings over the past several years, it has become obvious

> that there are many misconceptions about the DEA's role and even the DEA's

> fundamental beliefs about the use of prescription opioids, " said another

> author of the guidelines, DEA diversion control official M. Good.

>

> " Many of these misconceptions lead to unwarranted fear that doctors who

> treat pain aggressively are singled out for enforcement actions, and that

> the goals of protecting the public health from drug abuse have come into

> direct conflict with the goals of promoting the public health through

> effective pain control, " she said. " Undertreatment of chronic, serious pain

> is considered a major medical problem. "

>

> K. Portenoy, another author of the guidelines and a pain specialist

> with New York's Beth Israel Medical Center, said opioid painkillers are

> appropriate treatment for serious pain from cancer and AIDS, as well as

> among the terminally ill. But about 40 percent of those patients are

> undertreated, he said.

>

> " What this document does is make clear [that] we in pain management and DEA

> are on the same page, and that we're willing to endorse the same

> principles, " Portenoy said. " We need to create a culture of respect for the

> policies. "

>

> Joranson, director of the Pain and Policy Studies Group at the University of

> Wisconsin Medical School, said the DEA's written acceptance of basic pain

> management principles could be useful in persuading some states to change

> their laws on prescription opioids. He said his group has found that 20

> states have laws that could be detrimental to pain patients. He added that

> the new guidelines will be sent to officials in those states.

>

> The new document was met with skepticism by some advocates for pain

> patients, who said it will do little to calm jittery doctors or decrease the

> illicit use of prescription narcotics.

>

> " The Department of Justice and other prosecutors are misidentifying quality

> pain management for drug dealing and have apparently convinced academic pain

> medicine that these doctors were 'diverting drugs,' " said Siobhan Reynolds,

> founder of the Pain Relief Network. " The DEA blames doctors as the number

> one reason why pharmaceutical drugs are on the street, when the truth is

> they are smuggled in, stolen from trucks and freely bought and sold all over

> the Internet. "

>

> Fisher, a California doctor who was tried and acquitted on charges

> related to prescribing opioid painkillers, said the new document " is an

> articulation of the status quo in the management of chronic pain. . . . The

> underlying problem is that our national pain policy is an expression of

> social concerns, rather than scientific knowledge. "

>

>

> http://www.washingtonpost.com/wp-dyn/articles/A57933-2004Aug11.html

[Guest guest]

In a message dated 18/08/2004 08:15:03 Central Standard Time,

Matsumura_Clan@... writes:

> Cary,

>

> So, are you saying that, even with input from Joranson and other pain

> experts, the guidelines are no good?

>

> Do you have a link to the actual document?

>

>

>

>

No-what I'm saying is what the guidelines say and what the DEA is prosecuting

are not on the same page. They say go ahead and prescribe these meds, while

still taking docs to court for doing it. I will find the link, ...I'm

behind on my mail which is why I haven't been posting much and my inbox feels

all

jumbled up! Cary

[Guest guest]

In a message dated 18/08/2004 08:15:03 Central Standard Time,

Matsumura_Clan@... writes:

> Cary,

>

> So, are you saying that, even with input from Joranson and other pain

> experts, the guidelines are no good?

>

> Do you have a link to the actual document?

>

>

>

>

No-what I'm saying is what the guidelines say and what the DEA is prosecuting

are not on the same page. They say go ahead and prescribe these meds, while

still taking docs to court for doing it. I will find the link, ...I'm

behind on my mail which is why I haven't been posting much and my inbox feels

all

jumbled up! Cary

[Guest guest]

Cary,

So, are you saying that, even with input from Joranson and other pain

experts, the guidelines are no good?

Do you have a link to the actual document?

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] DEA, Doctors Issue Guidelines On Use of

Powerful Painkillers

> In a message dated 14/08/2004 19:19:18 Central Standard Time,

> a54@... writes:

>

> , a and all:

> I am on a listserv with the people named in this article and many

more. Let

> me tell you, they do not trust the DEA, and many of them have been

> prosecuted/persecuted for helping chronic pain patients. It's a very

bad situation which

> affects all of us. Cary

>

>

> > DEA, Doctors Issue Guidelines On Use of Powerful Painkillers

> >

> > By Marc Kaufman

> > Washington Post Staff Writer

> > Thursday, August 12, 2004; Page A04

> >

> > The Drug Enforcement Administration and top pain specialists

yesterday

> > jointly issued detailed new 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 clear that doctors have responsibilities to

ensure

> > that their patients are not abusing prescription opioids such as

OxyContin

> > and are not doctor-shopping to collect narcotics for illicit sales.

> >

> > The pain control guidelines make clear that even heavy use of

prescription

> > opioids, such as OxyContin, can be appropriate. (Toby Talbot -- AP)

> >

> >

> > 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 authors of

the new

> > guidelines, University of Wisconsin pain studies director E.

Joranson.

> >

> > Getting the agency to publicly declare 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 the steps that ensure proper

prescribing, such

> > how to diagnose severe pain and keep proper records to justify the

> > prescribing of a narcotic painkiller. Written largely in a

> > question-and-answer form, the document makes clear to law

enforcement

> > authorities that even heavy use of prescription opioids can be

appropriate

> > and that the physical dependence it brings is not the same 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.

> >

> > Among the high-profile prosecutions of pain specialists is that of

> > E. Hurwitz, a nationally known doctor from McLean accused of drug

> > trafficking. Hurwitz is scheduled to go on trial this fall.

> >

> > " In numerous meetings over the past several years, it has become

obvious

> > that there are many misconceptions about the DEA's role and even the

DEA's

> > fundamental beliefs about the use of prescription opioids, " said

another

> > author of the guidelines, DEA diversion control official M.

Good.

> >

> > " Many of these misconceptions lead to unwarranted fear that doctors

who

> > treat pain aggressively are singled out for enforcement actions, and

that

> > the goals of protecting the public health from drug abuse have come

into

> > direct conflict with the goals of promoting the public health

through

> > effective pain control, " she said. " Undertreatment of chronic,

serious pain

> > is considered a major medical problem. "

> >

> > K. Portenoy, another author of the guidelines and a pain

specialist

> > with New York's Beth Israel Medical Center, said opioid painkillers

are

> > appropriate treatment for serious pain from cancer and AIDS, as well

as

> > among the terminally ill. But about 40 percent of those patients are

> > undertreated, he said.

> >

> > " What this document does is make clear [that] we in pain management

and DEA

> > are on the same page, and that we're willing to endorse the same

> > principles, " Portenoy said. " We need to create a culture of respect

for the

> > policies. "

> >

> > Joranson, director of the Pain and Policy Studies Group at the

University of

> > Wisconsin Medical School, said the DEA's written acceptance of basic

pain

> > management principles could be useful in persuading some states to

change

> > their laws on prescription opioids. He said his group has found that

20

> > states have laws that could be detrimental to pain patients. He

added that

> > the new guidelines will be sent to officials in those states.

> >

> > The new document was met with skepticism by some advocates for pain

> > patients, who said it will do little to calm jittery doctors or

decrease the

> > illicit use of prescription narcotics.

> >

> > " The Department of Justice and other prosecutors are misidentifying

quality

> > pain management for drug dealing and have apparently convinced

academic pain

> > medicine that these doctors were 'diverting drugs,' " said Siobhan

Reynolds,

> > founder of the Pain Relief Network. " The DEA blames doctors as the

number

> > one reason why pharmaceutical drugs are on the street, when the

truth is

> > they are smuggled in, stolen from trucks and freely bought and sold

all over

> > the Internet. "

> >

> > Fisher, a California doctor who was tried and acquitted on

charges

> > related to prescribing opioid painkillers, said the new document " is

an

> > articulation of the status quo in the management of chronic pain. .

. The

> > underlying problem is that our national pain policy is an expression

of

> > social concerns, rather than scientific knowledge. "

> >

> >

> > http://www.washingtonpost.com/wp-dyn/articles/A57933-2004Aug11.html

[Guest guest]

Cary,

So, are you saying that, even with input from Joranson and other pain

experts, the guidelines are no good?

Do you have a link to the actual document?

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] DEA, Doctors Issue Guidelines On Use of

Powerful Painkillers

> In a message dated 14/08/2004 19:19:18 Central Standard Time,

> a54@... writes:

>

> , a and all:

> I am on a listserv with the people named in this article and many

more. Let

> me tell you, they do not trust the DEA, and many of them have been

> prosecuted/persecuted for helping chronic pain patients. It's a very

bad situation which

> affects all of us. Cary

>

>

> > DEA, Doctors Issue Guidelines On Use of Powerful Painkillers

> >

> > By Marc Kaufman

> > Washington Post Staff Writer

> > Thursday, August 12, 2004; Page A04

> >

> > The Drug Enforcement Administration and top pain specialists

yesterday

> > jointly issued detailed new 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 clear that doctors have responsibilities to

ensure

> > that their patients are not abusing prescription opioids such as

OxyContin

> > and are not doctor-shopping to collect narcotics for illicit sales.

> >

> > The pain control guidelines make clear that even heavy use of

prescription

> > opioids, such as OxyContin, can be appropriate. (Toby Talbot -- AP)

> >

> >

> > 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 authors of

the new

> > guidelines, University of Wisconsin pain studies director E.

Joranson.

> >

> > Getting the agency to publicly declare 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 the steps that ensure proper

prescribing, such

> > how to diagnose severe pain and keep proper records to justify the

> > prescribing of a narcotic painkiller. Written largely in a

> > question-and-answer form, the document makes clear to law

enforcement

> > authorities that even heavy use of prescription opioids can be

appropriate

> > and that the physical dependence it brings is not the same 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.

> >

> > Among the high-profile prosecutions of pain specialists is that of

> > E. Hurwitz, a nationally known doctor from McLean accused of drug

> > trafficking. Hurwitz is scheduled to go on trial this fall.

> >

> > " In numerous meetings over the past several years, it has become

obvious

> > that there are many misconceptions about the DEA's role and even the

DEA's

> > fundamental beliefs about the use of prescription opioids, " said

another

> > author of the guidelines, DEA diversion control official M.

Good.

> >

> > " Many of these misconceptions lead to unwarranted fear that doctors

who

> > treat pain aggressively are singled out for enforcement actions, and

that

> > the goals of protecting the public health from drug abuse have come

into

> > direct conflict with the goals of promoting the public health

through

> > effective pain control, " she said. " Undertreatment of chronic,

serious pain

> > is considered a major medical problem. "

> >

> > K. Portenoy, another author of the guidelines and a pain

specialist

> > with New York's Beth Israel Medical Center, said opioid painkillers

are

> > appropriate treatment for serious pain from cancer and AIDS, as well

as

> > among the terminally ill. But about 40 percent of those patients are

> > undertreated, he said.

> >

> > " What this document does is make clear [that] we in pain management

and DEA

> > are on the same page, and that we're willing to endorse the same

> > principles, " Portenoy said. " We need to create a culture of respect

for the

> > policies. "

> >

> > Joranson, director of the Pain and Policy Studies Group at the

University of

> > Wisconsin Medical School, said the DEA's written acceptance of basic

pain

> > management principles could be useful in persuading some states to

change

> > their laws on prescription opioids. He said his group has found that

20

> > states have laws that could be detrimental to pain patients. He

added that

> > the new guidelines will be sent to officials in those states.

> >

> > The new document was met with skepticism by some advocates for pain

> > patients, who said it will do little to calm jittery doctors or

decrease the

> > illicit use of prescription narcotics.

> >

> > " The Department of Justice and other prosecutors are misidentifying

quality

> > pain management for drug dealing and have apparently convinced

academic pain

> > medicine that these doctors were 'diverting drugs,' " said Siobhan

Reynolds,

> > founder of the Pain Relief Network. " The DEA blames doctors as the

number

> > one reason why pharmaceutical drugs are on the street, when the

truth is

> > they are smuggled in, stolen from trucks and freely bought and sold

all over

> > the Internet. "

> >

> > Fisher, a California doctor who was tried and acquitted on

charges

> > related to prescribing opioid painkillers, said the new document " is

an

> > articulation of the status quo in the management of chronic pain. .

. The

> > underlying problem is that our national pain policy is an expression

of

> > social concerns, rather than scientific knowledge. "

> >

> >

> > http://www.washingtonpost.com/wp-dyn/articles/A57933-2004Aug11.html