Mutiple Positions on Multiple Prescriptions

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Yesterday the DEA announced that, contrary to the position it took two years ago, doctors may give patients suffering from chronic pain multiple prescriptions for narcotic painkillers instead of making them come back every month for a new prescription. The DEA's announcement that the common practice of writing prescriptions in advance was illegal provoked a flood of complaints from doctors who said the one-prescription-per-visit requirement was medically unnecessary and a major hassle for patients and physicians. Now the DEA has reversed its position, and Admistrator Karen Tandy says, in essence, "Yay for us!"

"Think about how hard it is for anybody to go out publicly and say, 'We think this is probably prohibited by law,'" Tandy told The Washington Post. "And then you listen to people and then you say, 'You know what? You're right,' and we're going to propose a rule that interprets this correctly. And that's what we've done." In other words, the DEA misinterpreted the law, causing needless anxiety and inconvenience for doctors and patients, and now it wants credit for admitting its mistake two years later. As painful as it may be for the DEA to correct itself, I suspect it does not compare to the agony of patients left without their medication because they couldn't get back to the doctor in time.

Meanwhile, the DEA made it clear that it reserves the right to determine when a doctor is writing "appropriate" prescriptions and "acting in accordance with accepted medical practice." Lest that knowledge deter doctors from treating pain, the DEA has launched an online rogues' gallery of physicians who have been prosecuted or disciplined for stepping over the DEA's fuzzy line. The lists ostensibly are meant to show that doctors who are acting in good faith need not worry about getting into trouble. The reassurances are somehwhat undermined by the government's argument that doctors who are acting in good faith can nevertheless be convicted of drug trafficking.

[Thanks to Jeff Schaler for the tip.]

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  1. Let me just say as a son of a man who suffers daily from incredible pain that this is long overdue. Many times have I had to run to the doctor’s office to obtain a meaningless prescription to cover the paperwork. To tell you the truth, since my Dad is such a good customer for the pharmacist, many times he would advance us medication (schedule II, oxycotin, etc) without the prescription. Illegal? Perhaps, but also humane.

  2. Great. Right now my doc can’t even phone in a 5mg percocet prescription, although he can do so for a much larger dose of vicodin.

    They both seem about the same to me.

  3. As ignorant as the original interpretation may have been, it really is a big deal for an agency to reverse itself like this.

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