Plan would let doctors issue 90-day supply

Some doctors already have been issuing multiple prescriptions.
WASHINGTON (AP) -- People taking Oxycontin, codeine and other powerful painkillers for chronic pain could get a 90-day supply, under a proposal Wednesday that would let patients avoid repeated doctor visits to get more than 30-day prescriptions.
Unless a patient makes another office visit, doctors now cannot refill the schedule II controlled substances because they can be abused by addicts. Current law is silent on the question of multiple prescriptions for drugs that are issued by a doctor in a single office visit.
The new proposal, subject to 60 days of public comment, makes clear that doctors could prescribe up to a 90-day supply without fear of prosecution. Doctors have complained that strict regulation by the Drug Enforcement Administration forced them to limit prescriptions to a 30-day supply and leave patients untreated.
"Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards," the agency's chief, Karen Tandy, said at a news briefing. "Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged," Tandy said.
Raising questions
A broader debate in recent years has questioned the proper role of federal law enforcement in monitoring doctors' prescription decisions. The Supreme Court this year ruled against a Justice Department attempt to use the Controlled Substances Act to punish Oregon doctors who helped patients commit suicide.
The number of physicians charged under that law has risen from 38 in 2003 to 67 in 2005. Meanwhile, about 6 million people -- including one in 10 high school seniors -- abuse controlled substance prescription drugs, according to the DEA.
At the briefing, Tandy sought to ease distrust of the DEA among doctors, noting that the agency had listened to their concerns in easing prescription rules.
In many cases, doctors had already been issuing multiple prescriptions since the law was silent on the matter. The rule change would give them ease of mind that they won't be prosecuted for doing so.
Offering statistics
In addition, the DEA's Web site will offer a new page that will spell out the number of prosecutions each year and the circumstances in which they were charged to avoid an undue chilling effect.
"We believe that the statement and proposed rule will help the medical professional ensure that only patients who need medication for pain relief get it," Tandy said.
The American Medical Association said the proposal was a step toward improving patient care without the added inconvenience and cost of repeated office visits.
"Relieving suffering while doing everything we can to prevent the abuse of controlled substances reflects appropriate patient care, a standard which is easier to achieve when a strong patient-physician relationship exists," said Dr. Rebecca J. Patchin, an AMA board member. "We need to provide access to pain relief for patients with legitimate needs, and the DEA proposal would help in doing this."
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