A bill introduced this week in the Senate to ease rigid Drug Enforcement Administration (DEA) restrictions under the Controlled Substances Act (CSA) does not address the key issue, according to long term care industry insiders at the American Health Care Association (AHCA), who are looking to change the way DEA interacts with nursing facilities over dispensing of controlled painkillers.
AHCA Vice President of Public Affairs Greg Crist said the proposal by Sen. Herb Kohl (D-Wisc.), chairman of the Senate Special Committee on Aging, “misses the mark” by adding more layers of recordkeeping without getting to the core problem of some patients being forced to wait long periods without much-needed pain medication.
“When a patient is suffering, caregivers need to be focused on treating the pain, not filling out more paperwork. We tried working with the senator’s staff to improve this measure, and apparently our recommendations were not included,” Crist says. “AHCA cannot support the bill in its current form.”
Under the CSA, physicians must submit prescriptions for certain classes of painkillers in writing before giving them to residents. Before strict DEA enforcement came into practice, facility nurses had been allowed to call into pharmacists for urgently needed medications on a doctor’s order over the phone.
Kohl’s proposal, called the Nursing Home Resident Pain Relief Act of 2011, demands written documentation of all steps of the drug ordering and dispensing process. Penalties would be incurred for recordkeeping mistakes.
The long term care community, in the form of its Quality Care Coalition for Patients in Pain, wants the CSA amended to recognize the long term care nurse as an “agent of the prescriber” and “chart orders” as valid prescriptions.
Until that fix is made, the coalition would like DEA to retreat from its strict enforcement so that pharmacies can continue to dispense narcotics/controlled medications in a timely fashion, allowing nursing facility, assisted living, and/or hospice patients to not have to endure suffering while the pharmacy tracks down the doctor for a prescription.
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