Specialists decry DEA drug stance
WASHINGTON — Three medical associations representing pain specialists have sent the Drug Enforcement Administration a joint letter sharply critical of its recently revised guidelines on prescribing pain medicines.
The letter, signed by the presidents of all three groups, called a DEA policy statement published in November in the Federal Register “an unfortunate step backward” that encourages a return to “an adversarial relationship between (doctors) and the DEA.”
Already concerned about what they saw as sometimes over-aggressive prosecutions of doctors, pharmacists and other health professionals who prescribe narcotic painkillers such as OxyContin, the specialists said the new DEA position threatens their ability to provide care to millions of patients.
The presidents wrote that despite the DEA’s assurances that it does not want to discourage doctors from providing proper narcotic medication to people in pain, the new guidelines “will undoubtedly have the exact opposite effect on any practitioner reading them.”
DEA spokesman Bill Grant said in response that the agency “wishes to reassure the public that the withdrawal of the August (statement) does not represent any change in DEA’s investigative emphasis or approach. Physicians acting in good faith and in accordance with established medical norms should remain confident that they may continue to dispense appropriate pain medications.”
He said the DEA is working on a process to gather views of the medical community as it refines its policy.
The letter from the heads of the American Pain Society (APS), the American Academy of Pain Medicine (AAPM) and the American Society of Addiction Medicine (ASAM) is a response to a Nov. 16 DEA statement that repudiated some parts of a jointly negotiated set of guidelines that had been introduced with fanfare in August.
The August guidelines – in the form of answers to 29 frequently asked questions – were the result of two years of discussion and negotiation between pain specialists and the DEA. They were embraced by many doctors as a breakthrough in resolving a deepening conflict between law enforcement and pain management practitioners.
The August guidelines were posted on the DEA Web site and given an enthusiastic review in the Journal of the American Medical Association. But less than two months later, the agency took the document down and replaced it with a notice saying some of the earlier statement was inaccurate and did not represent a DEA policy statement.