FDA Considers Special Training for Narcotics
By BARRY MEIER
By Barry Meier
The New York Times
Should doctors be required to undergo special education in order to prescribe powerful narcotics? The Food and Drug Administration might soon recommend that they do so, though such a move would most likely prove controversial.
“I think it is a good idea, and it is something we are considering,” said Dr. Bob Rappaport, the director of the division of Anesthesia, Analgesia and Rheumatology Products at the FDA. The agency itself does not have the authority to take such a step, Rappaport said.
Typically, state medical boards, rather than the federal government, impose licensing requirements on doctors, including the type of continuing education they must receive. A few states, including California, now provide doctors with education about the treatment of pain patients.
But nationally, state medical boards have shown little interest in mandating added training in the use of potent pain medications or in screening patients for those prone to drug abuse.
Pain experts say they support increased education for doctors, but some fear that mandatory training may harm pain patients by limiting the number of doctors prescribing such drugs.
Under current federal law, doctors need only show they are licensed to practice medicine in order to register with the Drug Enforcement Administration, which will permit them to prescribe narcotics.
An exception is if a doctor wants to prescribe the drug buprenorphine as in-office treatment for narcotics addiction; federal rules require eight hours of specialized training first. Prescribing that same drug for pain treatment, however, does not require such training.
Rappaport said the FDA was most concerned about potent and longer- acting narcotics like methadone, fentanyl and certain formulations of the drug oxycodone, the active ingredient in OxyContin.
With methadone, fentanyl, which is available in patches, has been associated with patient deaths and injuries resulting from wrong prescriptions by physicians or inadvertent patient misuse.
In recent years, the FDA has faced pressure to take added steps on such drugs. Rappaport said recommending additional education was one of the responses the agency might unveil by early next year .
at issue
Pain experts say they support increased education for doctors, but some fear that mandatory training may harm pain patients by limiting the number of doctors prescribing such drugs.
Originally published by BY BARRY MEIER.
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