Alexander DeLuca, M.D.
Addiction, Pain, & Public Health website  
[Home] [Library]  [Slides]  [Search]  [Medline]  [Links]
Statement of Purpose; Privacy policy; Email Confidentiality Policy; Statements of Ownership & Sponsorship; Advertising policy

DEA Called Unqualified to Set Standards On Pain-Killing Drugs

from: Older Americans Report; 28(45); pg 355; 11/19/2004. Originally posted: 11/25/2004; [www.doctordeluca.com/Library/WOD/DeaUnqualifiedToSetStandards.htm].

[Older Americans Report (entire issue); 28(45); 11/19/2004 in PDF format]

Laudable as it might have been for the Drug  Enforcement Administration (DEA) to provide guidance on the proper use of  narcotics, it is not the place of a  law enforcement agency to get involved in setting standards of care, according to a lawyer in Portland, Oregon. 

Eli Stutsman is president of Death with Dignity, which has been resisting attempts by Attorney General John Ashcroft to preempt Oregon’s assisted-suicide law (OAR, Nov. 12, p. 352). He also  represents physicians and pharmacists in other  states who have been charged by the DEA with  abusing their prescribing privileges. But whether the issue is terminal illness or chronic pain, the problem is that the DEA is arguing with practitioners over what constitutes proper medical care,  Stutsman said. “In both instances, the DEA is looking over  the shoulder of practitioners,” he told OAR. “The standard of care is an issue for state law and not  federal law.”  

The DEA withdrew the guidelines shortly after  posting them on its website Aug. 11 and this week published a notice in the Federal Register giving a few of its reasons. But Stutsman  said the statement is disingenuous because it does not mention that at least one physician [Hurwitz] facing DEA charges has attempted to use the guidelines in his own defense. 

To convict practitioners, known as registrants, under the Controlled Substances Act, the DEA must prove that a doctor or  pharmacist knowingly or intentionally distributed a controlled substance outside the course of professional practice. In short, the agency must prove that such individuals “weren’t practicing medicine,” Stutsman said. “It’s a specific-intent crime.” But that is hard to prove. In fact, the DEA never alleged that diversion was taking place when it challenged the assisted-suicide law, Stutsman  said. “What they did instead is they disagreed with  the standard of care — they said, ‘You can’t do this.’”    

Stutsman said he does not fault the doctors who have tried to get DEA to provide them with guidance. But he warns that any such attempt is risky, because the DEA itself is split on how to handle the issue of pain medications, as its abrupt withdrawal of the guidelines made clear. “It backfired horribly — the left hand didn’t know what the right hand was doing.”   

Contact: Eli Stutsman, (503) 274-4048
-------------------------------------------------------
Siobhan Reynolds
Family Member of a Chronic Pain Patient
President, Pain Relief Network

[Older Americans Report (entire issue); 28(45); 11/19/2004 in PDF format]