September 24, 2008

Few Physicians Face Drug Charges


A study shows that doctors needn't fear prescribing pain medicine.

Many physicians underprescribe pain medications for patients who need them out of fear of prosecution, but a national study shows that few of the nation's doctors ever get in trouble for prescribing narcotics improperly.

The study, which appeared in the Sept. 9 edition of the journal Pain Medicine, shows that only one-tenth of 1 percent of the nation's nearly 700,000 practicing physicians were prosecuted or sanctioned between 1998 and 2006 for prescribing opioid-analgesics improperly.

Oklahoma Attorney General Drew Edmondson is one of nine authors of the study and was the only state attorney general involved.

"The overriding purpose of the study was to see what a typical prosecution of this type looked like, if there was any such thing," he said.

"The big surprise to all of us was that the largest group prosecuted were family practice physicians," he said.

Few were pain medicine specialists.

The perception that physicians are often prosecuted for prescribing opioid narcotics improperly has left many people suffering with chronic pain, Edmondson said.

"This is a very significant problem in that 30 million to 50 million people are in chronic pain that could be relieved but are not," he said.

As many as 40 percent of U.S. nursing-home residents are not being treated adequately for pain, he said.

According to the study, few medical schools offer courses in pain management.

"A doctor knows that if he prescribes Oxycontin, it's going to raise more eyebrows than Tylenol 3," Edmondson said. "We don't want doctors to shy off from the best medication available."

He said he doesn't believe that the small percentage of physicians sanctioned or prosecuted indicates a lack of law enforcement.

According to the study, the number of investigations by Drug Enforcement Administration officers of physicians who have been suspected of prescribing violations has risen in recent years.

But prosecutions remain infrequent.

"Most doctors do follow the rules," Edmondson said. "Very few will prescribe without seeing a patient."

He said his hope is that the study will provide physicians "a comfort level that what they're doing is appropriate" so that patients who need pain management get it.

"When you look at end-of-life care, people want to know, 'Will my pain be managed?' 200a(unknown)" Edmondson said.

Kim Archer 581-8315

[email protected]

Study findings

725 physicians were prosecuted or sanctioned for such violations between 1998 and 2006. That averages 81 doctors a year. Put another way, only about one in 1,000 practicing physicians was tried or sanctioned for such offenses between 1998 and 2006.

Among the 725 physicians involved in these cases, only 25 have been pain medicine specialists or have self-identified as such. In contrast, general practice/family medicine physicians account for 285.

Combined criminal and administrative cases have shown an increase over the study period, from 17 cases in 1998 to 147 in 2006.

Source: Center for Practical Bioethics

Originally published by KIM ARCHER World Staff Writer.

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