GUIDELINES SET ON PRESCRIPTION PAINKILLERS

Purpose To Ease Doctors' Fears Of Investigation

WASHINGTON - New guidelines seek to improve treatment for millions of
Americans with unrelieved pain by spelling out exactly how to prescribe
powerful painkillers such as OxyContin and morphine without attracting
scrutiny by the Drug Enforcement Administration.

Many doctors hesitate to prescribe narcotics, which are heavily regulated
because they can be abused by addicts.

The guidelines issued yesterday, written by leading pain specialists
together with the DEA, stress that the drugs are safe for the proper patient
- -- and pledge that doctors won't be arrested for providing legitimate
therapy.

There is "unwarranted fear that doctors who treat pain aggressively are
singled out," said Patricia Good, DEA's drug-diversion chief.

The guidelines should help eliminate this "aura of fear," she said.

They come at a crucial time, said co-author David Joranson, pain policy
director at the University of Wisconsin-Madison Medical School. Fewer
doctors are willing to prescribe narcotic painkillers, known as opioids,
partly because of the government's high-profile crackdown on
prescription-drug abuse. Some pharmacies won't stock them for fear of
burglaries.

"In some ways, pain management and the use of pain medications has become a
crime story when it really should be a health care story," Joranson said.

The key message: "These are legitimate treatments. They're essential for
good medical care," said Dr. Russell Portenoy, pain chief at New York's Beth
Israel Medical Center and a well-known pain specialist.

With the guidelines, the DEA sanctions that view, and it is distributing the
document to agents and prosecutors to help them distinguish aggressive pain
management from drug diversion.

A lot of opioid-taking patients in a practice shouldn't by itself signal
suspicion, the guidelines advise, while long-distance prescribing and lots
of premature refills might.

The new guidelines stress that when prescribed properly for serious pain,
opioids hardly ever lead to addiction.