Kohl Seeks to End Pain Medication Delays in Nursing Homes

WASHINGTON - U.S. Senator Herb Kohl, Chairman of the Senate Special Committee on Aging, has introduced legislation to address the unintended consequences of the U.S. Drug Enforcement Administration's (DEA) heightened scrutiny of pain medication prescribing practices in nursing homes across America. As a result of the DEA policy, vulnerable patients are sometimes left to languish in pain as nursing home nurses and physicians strive to adhere to the Controlled Substances Act (CSA).

"The law should prevent suffering, not make it worse," Kohl said. "Unfortunately, DEA's crackdown has left elderly nursing home residents waiting for hours or even days for relief from excruciating pain. This legislation would help end these needless and avoidable delays."

Under Kohl's Nursing Home Resident Pain Relief Act of 2011, a physician may authorize the administrator of the long-term care facility to designate nurses and other appropriately licensed health professionals to act as facility designees. On the physician's oral instruction, the facility designees mayorder and administer pain-relieving controlled substances to residents whose medical conditions warrant immediate pain relief. The bill also requires written records documenting each step in the process, and provides strong criminal and civil penalties for diverting drugs or violating the recordkeeping requirements. 

Last year, Kohl held an Aging Committee hearing calling attention to the unintended consequences of DEA's heightened scrutiny of prescribing practices in long-term care settings. Kohl has been working closely with U.S. Attorney General Eric Holder and stakeholders to find a solution that satisfies the law enforcement goals of the DEA and meets the needs of ailing nursing home patients.

Historically, nurses were able to call urgently needed prescriptions into pharmacies upon a physician's order over the phone. Pharmacies would fill the order; residents would get their pain medication; and, physicians would follow up with written confirmation of the prescription. However to comply with the CSA, DEA now requires physicians to directly issue prescriptions in writing for all pain medications before they can be dispensed, even in emergency circumstances. 

Last year, DEA issued a policy statement to provide a way for nursing home residents to access some kinds of medication more quickly. Under the new policy, a nursing home's licensed health care professionals may, on a physician's behalf, transcribe the physician's oral prescription for Schedule III, IV or V medications to a pharmacy to be filled. Kohl's legislation would amend the  CSA, to provide the agency with the statutory authority needed to allow licensed health care professionals to transmit prescriptions for Schedule II controlled substances, the category under which nearly all pain medications fall.