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Spokane, Washington  Est. May 19, 1883

Guidelines Studied For Prescribing Painkillers Idaho Board Seeks To Reassure Doctors, Chronic-Pain Sufferers

For dozens of North Idaho residents, the search for narcotics never ends.

But these aren’t drug addicts.

They bounce from doctor to doctor, pleading for medication to relieve chronic pain. The pain that comes from injuries, birth defects and other ailments is debilitating.

Chronic-pain sufferers say their access to medication slowed to a trickle a year ago. That’s when a Silver Valley doctor’s license was revoked by the Idaho state Board of Medicine for prescribing narcotic painkillers to drug addicts.

The board’s action had a chilling effect in the medical community, making doctors leery of prescribing high doses of narcotics even when warranted.

“I’m a prisoner in my own home because the pain is too much,” said Jan Lambert, a Moscow woman who will testify before the Board of Medicine this week in Coeur d’Alene. “My favorite thing to do was to ride my horse. But that was denied me. … I had to stop when I was denied my pain medication.”

A year after yanking 64-year-old DeLamar Gibbons’ license, the Board of Medicine is trying to assure other doctors dealing with chronic-pain patients. Wednesday evening, the board will hear public testimony on proposed guidelines for prescribing narcotics.

The guidelines are modeled after ones recently adopted in California.

But patients such as Lambert don’t like the new guidelines, saying they’ll do little to ensure ample medication is prescribed.

But nationally known physicians who treat chronic-pain sufferers applaud the guidelines, which distinguish between addiction and tolerance, specifying that patients who need high doses of narcotics are not necessarily addicted.

However, that’s a distinction many doctors are uncomfortable making for fear of reprimand by so-called pill-counters who police the use of narcotics.

Dr. John Loeser, director of the University of Washington’s Pain Center, treats Idaho patients who cannot find doctors willing to prescribe high doses of medication. Loeser says the guidelines being considered by the Board of Medicine will help Idaho patients find treatment in their own state.

“Of course, there are addicts who will lie, manipulate and steal to obtain drugs from stupid physicians who are not aware of being manipulated,” Loeser said. “I’m not advocating a candy-store approach to narcotics, … but physicians should be able to use narcotics to treat (long-term) pain.”

He said society has been conditioned, through education and law enforcement efforts, to believe that narcotics are dangerous. So, too, is alcohol, Loeser argues, yet alcohol readily can be obtained by anyone.

Like Gibbons, Dr. William Hurwitz of Washington, D.C., lost his medical license for prescribing too many narcotics.

Hurwitz fought to get his license back and now is president of the National Chronic Pain Outreach Association. He has patients nationwide.

“I have people flying in from all over the country to see me because their own doctors are too paranoid to prescribe medication,” Hurwitz said. He said Idaho’s new chronicpain guidelines - if approved - likely will ease paranoia among doctors in the state.

Dr. Colin Doyle of Lewiston, a state medical board member, also says the new guidelines will help patients.

The board is expected to vote on the new guidelines sometime in March.

xxxx Hearing The Board of Medicine’s public hearing in Coeur d’Alene is scheduled for 6:30 p.m. Wednesday in the Kootenai Medical Center classroom.