Home > All Posts > F.D.A. Weighs Training To Dispense Narcotics

F.D.A. Weighs Training To Dispense Narcotics


By Barry Meier

August 16, 2008 The New York Times   Should doctors be required to undergo special education in order to prescribe powerful narcotics? The Food and Drug Administration may soon recommend that they do so, though such a move would most likely prove controversial.

“I think it is a good idea, and its something we are considering,” said Dr. Bob Rappaport, the director of the divisions of Anesthesia, Analgesic and Rheumatology Products at the F.D.A. But the agency itself does not have the authority to take such a step, Dr. Rappaport said.

Typically, state medical boards, rather than the federal government, impose licensing requirements on doctors, including the type of continuing education they must receive. A few states, including California, now provide doctors with education about the treatment of pain patients. But nationally, state medical boards have shown little interest in mandating added training in the use of potent pain medications or in screening patients for those prone to drug abuse.

Pain experts say they support increased education for doctors, but some fear that mandatory training may harm patients by limiting the number of doctors prescribing such drugs.

Under current federal law, doctors need only show they are licensed to practice medicine in order to register with the Drug Enforcement Administration, which will permit them to prescribe narcotics.

An exception is if a doctor wants to prescribe the drug buprenorphine as in-office treatment for narcotics addiction; federal rules require eight hours of specialized training first. Prescribiing that same drug for pain treatment,however, does not require such training.

Dr. Rappaport said the F.D.A. was most concerned about potent and longer-acting narcotics like methadone, fentanyl and certain formulations of the drug oxycodone, the active ingredient in Oxycontin.

With methadone, fentanyl, which is available in patches, has been associated with patient deaths and injuries resulting from physician misprescribing or inadvertent patient misuse.

In recent years, the F.D.A has faced pressure to take added steps on such drugs. Dr. Rappaport said recommending additional education was one of the reasons the agency might unveil by early next year.

He said the F.D.A. would probably require that makers of such drugs develop programs to monitor how they are prescribed.

In the last two years, the agency has sent out alerts to doctors about both methadone and fentanyl, but officials acknowledged that preventable patient deaths were continuing.

“We are putting out communications,” said Dr. Gerald Dal Pan, who directs the F.D.A’s office of surveillance and epidemiology. “We don’t know why they are failing.”

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  1. billiesowers
    August 23, 2008 at 8:41 pm

    I totally agree. I think a lot of doctors out there don’t know a whole lot about addiction. They know what they read in a book while in college. I think more education is a good thing.

  2. August 22, 2008 at 10:18 am

    I don’t see how education can EVER be a BAD thing….especially for doctors prescribing these sorts of drugs. I work with Docs a lot and there are some who refuse to believe they don’t “know it all”–which does a huge diservice to their patients and their practices. Because of this group of Doctors, and their training that teaches them to play “god”–I would say it may be NESSECARY to force this sort of training.

    But after the training=let the Doctors do the Doctoring….let THEM decide what is best. Government has too much influence on every part of our lives already!

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