DEA Ruling Allowing Multiple Prescriptions For Controlled Substances

Main Category: Pain / Anesthetics
Also Included In: Regulatory Affairs / Drug Approvals;  Alcohol / Addiction / Illegal Drugs
Article Date: 20 Nov 2007 - 6:00 PDT

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The American Academy of Pain Medicine (AAPM) supports today's Drug Enforcement Administration (DEA) ruling, which allows multiple prescriptions for controlled substances when appropriate. This DEA Final Ruling, "Issuance of Multiple Prescriptions for Schedule II Controlled Substances," was published in the Federal Register on Monday, Nov. 19, 2007.

AAPM considers this ruling to be a positive indication of recently improved communication between the medical community and law enforcement. Under protest from pain physicians, the DEA had previously disallowed "Do Not Fill Until…" prescriptions for several years. The agency's Final Rule has been eagerly awaited by these concerned physicians who must provide legitimate pain control.

Although not in effect until 30 days from the date of the final ruling on "Issuance of Multiple Prescriptions for Schedule II Controlled Substances," this rule change allows physicians to write three separate prescriptions with staggered fill dates. Patients can still be given the equivalent of a 90-day prescription for schedule II controlled substances when medically appropriate. Schedule II drugs are those that have recognized medical uses as well as a potential for dependence and abuse. Consequently, these drugs are carefully controlled and regulated by the DEA.

This welcome policy reversal by the DEA has eliminated the burden previously imposed on patients with cancer or chronic pain who were forced to visit their physician every month for new pain medicine prescriptions when there was no medical necessity to do so. The DEA now allows physicians to use their professional judgment to carefully control the amount of a controlled substance issued to a patient at one time. "Do Not Fill Until…" prescriptions offer increased control, safety and convenience, and may be issued in small increments for at-risk patients, or by the month to comply with insurance reimbursement regulations.

With today's Final Rule, the DEA has recognized the need for policies that support effective control of potentially abusable drugs that do not unnecessarily hinder the appropriate treatment of pain. On behalf of all legitimate patients with pain, AAPM continues to address and debate policies that address the dual crises of prescription drug abuse and undertreated pain. AAPM is committed to safe and effective treatment of pain and to effective policy on prescription drug abuse.

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The American Academy of Pain Medicine was a contributor to the Federation of State Medical Boards Model Policy for the Use of Controlled Substances in the Treatment of Pain and has developed educational programs for physicians on pain assessment, opioid usage, detection of addiction, and prevention of diversion. The American Academy of Pain Medicine is the organization representing physicians who specialize in treating complex pain disorders.

Source: Amy Jenkins
American Academy of Pain Medicine

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