Thank you. The editorial you've linked to* suggests - shall we say - some context against which to evaluate the assertion, above, that:

The younger [doctors] today, are a bit more afraid of C-II abuse than the more experienced ones.

Afraid of being pilloried by the DEA, et al may be more like it. Not unlike the problems Planned Parenthood and other groups find themselves in when seeking to find young OBGYN practitioners willing to become abortion providers in, say, Wichita, where their predecessor was gunned down for his efforts.

And as to the statement that:

If a pharmacist has been sanctioned for an error or involved in a legal problem with anything including pain meds, they will tend to be guarded with everyone after that.

I certainly don't consider myself biased, but I have refused a few on occasions.

To see the problems that are implicit in such a statement, in light of well documented disparities between White and minority communities gaining access to prescription analgesic medications in the United States, needs look no farther than the marvelous "Topic Brief" presented by American Pain Foundation, PAIN MANAGEMENT & DISPARITIES, November, 2008, http://www.painfoundation.org/learn/...isparities.pdf, and the 20 studies cited therein. As set forth in something of an executive summary to the Topic Brief:

RESEARCH ON DISPARITIES IN PAIN CARE HAVE SHOWN:

• Blacks were less likely than whites to receive pain medication and had a 66% greater risk of receiving no pain medication at all.
• Hispanics were twice as likely as non-Hispanic whites to receive no pain
medication in the emergency department (55% of Hispanics received no pain
medication vs. 26% of non-Hispanic whites).
• Minority patients were less likely to have pain recorded relative to whites, which is critical to providing quality patient care.
• Only 25% of pharmacies in predominantly nonwhite neighborhoods had opioid
supplies that were sufficient to treat patients in severe pain, as compared with 72% of pharmacies in white neighborhoods.
• In a study of minority outpatients with recurrent or metastatic cancer, 65% did not receive guideline-recommended analgesic prescriptions compared with 50% of nonminority patients (P < 0.001). Hispanic patients in particular reported less pain relief and had less adequate analgesia. [Footnotes omitted.]

It was perhaps an awareness of these issues that led the Wisconsin Pharmacy Examining Board to adopt the following position on December 7, 2005:

A survey of Wisconsin pharmacists’ knowledge and attitudes about dispensing opioid analgesics for chronic cancer and non-cancer pain was published in the March/April 2001 issue of the Journal of the American Pharmaceutical Association. http://www.medsch.wisc.edu/painpolic...k/01japhak.htm The study found that not all pharmacists knew what constituted legitimate dispensing practices for controlled substances under federal or state policy in emergencies or for patients with terminal illness. Also many pharmacists were unaware of the distinction between addiction, physical dependence, and tolerance. The Board encourages pharmacists to re-educate themselves with current literature on pain management. Appropriate pain control can improve or at least maintain a patient’s quality of life. It is the pharmacist’s duty to provide medications along with proper counseling to ensure pain control. The PEB considers refusal to fill a Schedule II prescription based on speculation or ignorance unacceptable. [Emphasis added.]

http://www.aspi.wisc.edu/wpi/Documen...mentofPain.pdf

Mike

* In the event that the link expires, I have copied the editorial, Claude A. Curran: Physicians and the problem of pain, The Providence Journal Co., October 30, 2009 as a text file. For ease of reading, go to "Format" in the bar across the top of the page, and then click on "Word Wrap."

Attached Files

Physicians and the problem of pain.txt (5.7 KB, 168 views)