DEA, DOCTORS AGREE ON NEW GUIDELINES FOR PAINKILLERS

WASHINGTON - Doctors cannot be arrested for properly prescribing
narcotic painkillers that are the best treatment for millions of
suffering patients, according to new guidelines from pain specialists
and the Drug Enforcement Administration.

The guidelines, written by leading pain specialists and the DEA, come
because many doctors hesitate to prescribe the powerful drugs, which
are heavily regulated because they can be abused by addicts.

The new document for the first time spells out the exact steps doctors
should take to ensure their patients get appropriate medical care
without attracting DEA scrutiny. The idea is to get better pain
treatment for Americans.

"There are many misconceptions about DEA's role... that lead to
unwarranted fear that doctors who treat pain aggressively are singled
out," said Patricia Good, chief of the DEA's drug diversion control
program.

The guidelines, being distributed yesterday to DEA agents and
physicians alike, should help eliminate "this aura of fear," Good added.

The DEA regulates how doctors prescribe drugs that are controlled
substances, such as opioid painkillers - morphine, codeine, fentanyl,
Oxycontin - to ensure they are not diverted for illegal use.

The main message is "pain medicine is not to contribute to abuse, and
law enforcement is not to interfere in patient care," said David
Joranson, director of pain policy at the University of Wisconsin
Medical School, who helped write the guidelines.

Undertreatment of chronic, serious pain is considered a major medical
problem. For example, painkillers known as opioids are considered
standard care for serious pain from cancer, AIDS, and among the
terminally ill, yet about 40 percent are undertreated, said Russell
Portenoy, pain chief at Beth Israel Medical Center.

The new guidelines spell out steps that ensure proper prescribing,
such as records showing the doctor performed a clear medical history
and physical examination to document the need for the painkiller.

Measuring pain intensity and extent of relief over time, and including
the data in a patient's records, "is important evidence of the
appropriateness of therapy," say the guidelines, written as a series
of questions and answers for doctors to keep.