Adhere to Guidelines When Prescribing Opioids

By Osterweil, Neil | Clinical Psychiatry News, January 2012 | Go to article overview
Save to active project

Adhere to Guidelines When Prescribing Opioids


Osterweil, Neil, Clinical Psychiatry News


EXPERT OPINION FROM THE ANNUAL MEETING OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW

BOSTON - The line between proper prescribing of opioids and pill pushing is thin and easily crossed, forensic psychiatrists said at the meeting.

The U.S. Supreme Court in 1975 ruled that physicians who are licensed by the Drug Enforcement Administration (DEA) to prescribe narcotics such as extended-release oxycodone (OxyContin) under the federal controlled substances act are liable to prosecution "when their activities fall outside the usual course of professional practice."

But the decision about what constitutes deviation from normal professional practice might fall to the judicial system, and several high-profile cases of doctors being convicted as drug pushers have made many practitioners who would otherwise consider prescribing opioids leery of the drugs, said Dr. Gregory G. Sokolov, of the division of psychiatry and the law in the department of psychiatry at the University of California, Davis.

"There is a role for opiate medications, and there is a role for OxyContin for severe pain," Dr. Sokolov said. "Some of these cases have really scared people away from treating pain patients and prescribing opiates, and although there are going to be people who are troubled and problematic, there are patients who truly benefit from these medications."

Chronic opioid therapy is more commonly used for control of severe cancer-related pain, but appropriate noncancer uses exist for such agents; the trick is knowing which patients will benefit, and which are malingering, said Dr. Ajay D. Wasan from the departments of psychiatry anesthesiology and perioperative and pain medicine at Brigham and Women's Hospital in Boston.

Dr. Sokolov discussed the case of United States vs. Ronald A. McIver, D.O. Dr. McIver, who ran a pain therapy center in Greenwood, S.C., was convicted in federal court of one count of conspiracy to distribute controlled substances and eight counts of distribution, after the death of a patient with high postmortem doses of opiates in his bloodstream.

Dr. McIver is currently serving sentences of 20 years in federal prison for distribution, and 30 years for dispensing drugs that resulted in the patient's death. His appeals, including one made to the U.S. Supreme Court, have been rejected.

Forensic psychiatrists might be called upon to provide expert opinion in criminal cases asking whether a prescribing physician is guilty of illegally prescribing opioids for distribution or abuse, in civil actions such as malpractice cases, and in medical board investigations, including allegations of physician impairment from opioid abuse, Dr.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
Loading One moment ...
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited article

Adhere to Guidelines When Prescribing Opioids
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

While we understand printed pages are helpful to our users, this limitation is necessary to help protect our publishers' copyrighted material and prevent its unlawful distribution. We are sorry for any inconvenience.
Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.

Are you sure you want to delete this highlight?