Editorial
Docs and pain

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New guidelines for prescription painkillers represent an equitable strategy for physicians and federal drug enforcement.

The rules balance the need for stronger vigilance of illicit prescription-drug use with doctors' need to aggressively treat pain. Non-medical use of prescription drugs ranks second only to marijuana use as the most commonly abused drug in the U.S. One drug, OxyContin, is blamed in more than 100 deaths. It is appropriate, then, for the Drug Enforcement Administration, by regulating doctors who prescribe opioid painkillers such as morphine and OxyContin, to combat prescription-drug misuse.

But some efforts have had a chilling effect on the medical profession. The arrest of 50 doctors nationwide last year on charges that they prescribed or distributed controlled substances beyond the scope of medical practice led doctors to fear if they prescribed significant amounts of painkillers they would be singled out by law enforcement.

The new guidelines should go a long way toward easing doctors' fears. Created by a team of physicians and the nation's top cops, they help law-enforcement agents and prosecutors distinguish aggressive pain management from drug diversion.

For example, the guidelines warn against automatically assuming malfeasance because a medical practice includes a lot of opioid-taking patients. About 30 percent of Americans suffer from chronic pain, meaning some doctors will have a large clientele of patients taking pain-killers.

The guidelines advise that long-distance prescribing and a large number of premature refills might be better indications of illegal activity.

In addition, by detailing exactly how to prescribe painkillers, the guidelines set uniform standards for doctors.

Doctors are not the culprits in the war against prescription-drug misuse. Most painkillers obtained illegally are stolen from doctors' offices, pharmacies or purchased from Internet pill mills that offer limited or no physician oversight.

Federal controls create a balance between promoting pain relief and stopping criminal activity.