NCPA Urges Return to Common-Sense Policy for Providing Long-Term Care Residents Pain Medications

Alexandria, Va. - March 24, 2010

The National Community Pharmacists Association (NCPA) submitted a written statement today for the U.S. Senate Special Committee on Aging hearing "The War on Drugs Meets the War on Pain: Nursing Home Residents Caught in the Crossfire" recommending the Drug Enforcement Agency (DEA) cease enforcement of its current interpretation of the Controlled Substances Act (CSA) until a reasonable compromise can be achieved. Community pharmacies, which provide prescription drug services for more than 50 percent of long-term care beds in America, are being constrained by the DEA's policy of disregarding the "nurse-as-agent" paradigm that expedites the approval process for controlled substance pain medications. 

"We believe that the DEA is undermining the ability of pharmacists to address controlled substance pain medications needs in long-term care facilities in a timely manner, which can led to unnecessary suffering for residents with serious health challenges," said Bruce T. Roberts, RPh, NCPA executive vice president and CEO. 

According to NCPA the problem has arisen because, "The DEA has recently started enforcing an interpretation of the Controlled Substances Act that has made it more difficult to provide needed prescription medications to long-term care residents in a timely manner. For years, it has been standard practice in long-term care facilities to allow the nurse to relay information between the physician and the pharmacist." 

However, NCPA believes this is no longer the case despite the fact that, "Long-term care facilities serve a resident population that is chronically ill with multiple concurrent disease states requiring medication treatment. The fragility of these residents requires the timely administration of medications. A resident's need for medications, including those used to treat severe pain, can arise at any time." 

DEA's new interpretation of the Controlled Substances Act in long-term care facilities means that physicians must contact pharmacists directly when a change in a controlled substance pain medication is necessary. Because the pharmacist always needs a hardcopy prescription and the nurse is not allowed to communicate the physician's orders with the pharmacist directly, the pharmacist is forced to tracking the physician down to get a faxed copy of the prescription. 

NCPA believes this puts pharmacists in a precarious position in which they are, "Reduced to threatening prescribers with DEA notification for noncompliance. On one hand, pharmacists risk damaging vital collaborative relationships if they report a physician to the DEA for failing to write the required prescriptions; on the other, they risk losing their right to practice pharmacy if they don't report noncompliant prescribers." 

NCPA recommends the DEA immediately suspend further actions against pharmacies trying to balance the ethical and legal dilemma of not filling a prescription for a resident in pain and violating practice standards or violating the DEA's interpretation of the Controlled Substances Act. "We would welcome the opportunity to work with the DEA in creating a workable solution for all parties involved that balances the need for quality patient care, while adequately preventing fraud and abuse," added Roberts. 

The entire statement submitted by NCPA can be viewed here

The National Community Pharmacists Association (NCPA®) represents America's community pharmacists, including the owners of more than 22,700 independent community pharmacies, pharmacy franchises, and chains. Together they represent an $88 billion health-care marketplace, employ over 65,000 pharmacists, and dispense over 40% of all retail prescriptions. To learn more go to www.ncpanet.org or read NCPA's blog, The Dose, at http://ncpanet.wordpress.com.

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