Key Implications

Physicians Charged with Opioid-Analgesic Prescribing Offenses
Pain Medicine
September 9, 2008

  • Media coverage of physicians being investigated for improperly prescribing pain medications has made doctors overly-wary of unjustified prosecution or sanctions.
  • Regulators and law enforcement personnel may unintentionally exacerbate the problem by their public comments concerning investigations, disciplinary actions, and prosecutions.
  • Study results suggest that regulators and law enforcement might consider how they craft their public messages around routine investigations of medical practice. Physicians are concerned that publicly-announced investigations may prompt unwarranted settlements and unfairly damage their reputations.
  • News stories that suggest, without firm research evidence, that pain specialists are those most likely to be involved in prosecution and disciplinary cases involving opioid therapy immeasurably intensify physician concerns.
  • As a next step, we now need to determine the numbers of physicians who have been investigated without subsequently being charged. There is little doubt that the number of physicians investigated greatly exceeds the numbers subsequently charged.
  • We were unable to obtain comparable data on the numbers of state criminal and medical board investigations that have taken place, a matter of considerable interest to analgesic-prescribing physicians.
  • Physician characteristics do not include additional, potentially-relevant measures, including years since medical school graduation, years in practice, racial characteristics, or whether there were previous sanctions, warnings, probationary periods, or other signs of potential future problems.
  • Physicians and law enforcement must resolve competing perceptions between treatment for pain and prosecution for drug abuse.
  • All sides must work to achieve balanced medical practices and legal/regulatory policies that support the greater needs of society.
  • How law enforcement, regulators, medicine and the public interpret the tension between the treatment of pain and the effort to prevent drug diversion will almost certainly influence the future climate of pain care in America.
  • Better education regarding the use of opioid-based pain medications is likely to help physicians overcome their reluctance to prescribe them.
  • Less than 5 percent of medical schools today offer courses in pain management. The medical community will have to address inadequate education on pain and safe and effective prescribing of controlled substances, as well as inadequate research on pain and drug abuse.