KOHL EXAMINES EFFECTS OF DEA CRACKDOWN ON NURSING HOME DELIVERY OF PAIN MEDICATION
WASHINGTON - Today U.S. Senator Herb Kohl, Chairman of the Special Committee on Aging, held a listening session on the unintended consequences of the U.S. Drug Enforcement Administration's (DEA) heightened scrutiny of prescribing practices in nursing homes across America. According to many sources within the long-term care industry, vulnerable patients have at times been left to languish in pain as nursing home nurses and doctors strive to adhere to the Controlled Substances Act.
"The hours it may take for a nursing home to fully comply with DEA regulations can feel like an eternity to an elderly nursing home resident who is waiting for relief from excruciating pain," said Chairman Kohl. "It is safe to say that most laws are created to prevent suffering. In the case of the DEA's recent crackdown of nursing homes, it appears that the law exacerbates it."
Panelists detailed a recent enforcement initiative launched by the DEA that has caused many nursing home patients to experience serious delays in receiving the medication they need to control their pain. DEA began its enforcement campaign in Ohio last April, later moving into Wisconsin and other states. DEA contends that the Controlled Substances Act that requires physicians to write out, sign and fax prescription for all pain medications, instead of allowing nursing home nurses to take verbal direction from physicians to order and administer medication, as is done in hospitals.
Until recently, the use of prescriptions for nursing home residents has never been accepted practice in the industry. A number of pharmacies, including several in Wisconsin, are facing tens of millions of dollars in administrative fines from DEA because they dispensed drugs based on doctors' verbal orders, instead of obtaining written prescriptions directly from the physicians.
A Committee investigation has found widespread confusion among nursing home providers, who are trying to change their protocols to adhere to DEA's expectations, with little to no compliance assistance from the agency. More disturbingly, the Committee has received numerous reports from throughout the country of actual harm to nursing home residents who remained in unrelieved pain for hours or even days.
At the session, entitled "The War on Drugs Meets the War on Pain: Nursing Home Residents Caught in the Crossfire," expert panelists discussed pain management for the elderly, the role of nurses in ordering and administering medication, and proposals for possible changes to the regulatory scheme that governs long-term care facilities and pharmacies. Participants included Mike Schanke, owner and administrator of Oakridge Gardens Nursing Center in Menasha, Wisconsin; Dr. Cheryl Phillips, president of the American Geriatrics Society and Chief Medical Officer of On Lok, Inc.; Ross Brickley, president of Continuing Care Rx Inc.; Dr. Robert Warnock, vice president of pharmacy services for Golden Living in Atlanta, Georgia; Dr. Carmen A. Catizone, executive director of the National Association of Boards of Pharmacy; and Joseph Rannazzisi, Deputy Assistant Administrator for the DEA's Office of Diversion Control.
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