Same Day Multiple Prescriptions
 Why is Our Government Pursuing a War on Doctors?

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Federal
Summary: The Federal Controlled Substances Act (“CSA”), Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, 21 U.S.C. §§ 801 et seq., [DOJ] [Findlaw] $[Lexis] $[Westlaw], regulates the production and distribution of controlled substances. The CSA prohibits the non-medical use of controlled substances and is “the legal foundation of the government’s fight against the abuse of drugs and other substances.” CSA para 1.0.

The CSA classifies federally regulated substances into one of five schedules. See Schedules of Controlled Substances 21 C.F.R. § 1308 [PDF] [LII]. This classification is based upon the substance’s medicinal value, harmfulness, and potential for abuse or addiction. Schedule I classification is reserved for the most dangerous drugs that have no recognized medical use. In contrast, Schedule V classification is used for the least dangerous drugs.See 21 U.S.C.S. § 812. The CSA also provides a mechanism for substances to be added to a schedule, rescheduled, or transferred from one schedule to another. CSA para 2. Under the CSA, Congress has granted authority to the Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) to set the standards of production for certain opioids, stimulants, narcotics, and depressants. See Federal Government for our discussion of government agencies and their roles. These standards must accommodate all legitimate medical and scientific needs.See Prescription Drug Regulations.

The CSA states in part: “many of the drugs included within this title have a useful and legitimate medical purpose and are necessary to maintain the health and general welfare of the American people.” 21 U.S.C. § 801(1). The Prescribing regulation notes, “This section is not intended to impose any limitation on a physician or authorized hospital staff to … administer or dispense (including prescribe) narcotic drugs to persons with intractable pain in which no relief or cure is possible or none has been found after reasonable efforts.” 21 C.F.R. § 1306.07(c) [DOJ] $[Lexis] $[Westlaw].

State
Like federal law, state controlled substance statutes [LII] [HTML], many of which are based on the Uniform Controlled Substances Act 1994 [HTML], prohibit non-medical use of controlled substances. Unlike federal law, many state controlled substance statutes, although they permit prescribing, do not explicitly recognize the pain management benefits of controlled substances.In fact, some state laws and regulations that have been promulgated to focus on drug abuse have the potential to interfere with practitioner decision-making, pain management, and patient care.A few state statutes have expressly addressed the issue of palliative care usually allowing some medicinal uses of marijuana. See generally the National Association of State Controlled Substances Authorities (NASCSA) [HTML].