CURRENT ISSUE PREVIOUS ISSUES COMMENTARY RESPONSES SEARCH ABOUT US
VOLUME 2, ISSUE 1
Prescribing Controlled Substances: A Physician's Dilemma, a Patient's Responsibility and the Public's Protection

Advances in pharmaceutical research and production have led to both progress in patient care and increased potential for abuse. This issue seeks to examine the varied hazards of prescribing for psychiatric patients, interventional approaches to chronic pain management, the government's position on physicians' liability and the creation of a standard of care for prescribing controlled substances.

The Journal of Global Drug Policy and Practice, a joint effort of the Institute on Global Drug Policy and the International Scientific and Medical Forum on Drug Abuse is an international, open access, peer-reviewed, online journal with the goal of bridging the information gap on drug policy issues between the medical/scientific community, policymakers and the concerned lay public.

Edited by Eric A. Voth, MD, FACP and David A. Gross, MD, DFAPA, our intended readership includes clinicians, clinical researchers, policymakers, prevention specialists and the interested public.

IN THIS ISSUE
Prescribing Controlled Substances Reconsidered
Thawing the Chill: The U.S. Drug Enforcement
           Administration, Physicians and the Controlled
          Substances Act

Addiction Treatment: A Psychiatrist’s Perspective
Interventional Pain Procedures: Understanding
           their Role in Clinical Practice



COMMENTARY
US Conference of Mayors Entertains
           Drug Policy Reformers

Harm Reduction or Harm Denial?


UPDATES
Medical Research
International Drug Policy
In the News

Prescribing Controlled Substances Reconsidered
Eric A. Voth, M.D., FACP, Chairman, The Institute on Global Drug Policy

Pain management is an important and emerging field of medicine. Appropriately prescribing and managing controlled substances for pain is unfortunately fraught with risk of litigation, regulatory intervention, manipulation by drug abusers, and misunderstanding by the public. Chronic pain is a pervasive and widespread phenomenon which must be adequately treated while at the same time minimizing diversion and abuse of powerful but effective substances. This article outlines useful recommendations for the appropriate use of controlled substances in pain management, and it also defines a legal standard of care.


Thawing the Chill: The U.S. Drug Enforcement Administration, Physicians and the Controlled Substances Act
Joseph T. Rannazzisi, Deputy Assistant Administrator, Office of Diversion Control, DEA

Physicians should not fear administrative or criminal scrutiny from the Federal Government if they are prescribing a controlled substance to a patient for a legitimate medical purpose and in the usual course of professional practice. Federal administrative and criminal action against a physician with controlled substance privileges is rare; however, this action is warranted when a physician practices outside the bounds of established standards.


Addiction Treatment: A Psychiatrist’s Perspective
David A. Gross, MD, Distinguished Fellow of the American Psychiatric Association

This paper will review the clinical, empirical and heuristic observations provided by many years of front line treatment of patients with severe addictive disorders. This discussion would not be complete if it did not include some of the historical challenges facing a psychiatrist trying to serve this unique population. For reasons outlined in this paper, acceptance by the recovering community can be problematic.

Of critical importance is the concept of the multi-diagnosis approach to victims of substance abuse. Essentially gone are the days of the pure alcoholic. Substance abuse comorbid with other major psychiatric disorders has become the norm. Substance abuse and co-occurring bipolar disorder, depression, attention deficit hyperactivity disorder, social anxiety disorder, other anxiety disorders, insomnia and psychosis will be reviewed. The toxic impact of illicit drugs on the brain will be stressed. Clinical cases will be reviewed in throughout this paper with reference to the diagnostic and therapeutic approaches for special patient populations.


Interventional Pain Procedures: Understanding their Role in Clinical Practice
Ian J. Kucera, M.D., Pharm.D., Director of Pain Medicine Stormont-Vail Healthcare, Topeka, KS

Chronic pain is one of the most challenging problems facing physicians today. In recent years it has been recognized that a compartmentalized approach to managing these patients results in unsatisfactory outcomes. A more integrated approach using a multidisciplinary model results in more efficient resource utilization. Interventional pain procedures are one of the tools available to help alleviate chronic pain. Epidural steroid administration and facet injections are basic techniques with a long history in the treatment of chronic pain. Cancer-related pain is also amenable to interventional therapies in select patients. With an ever increasing number of interventions targeting various anatomic structures, interventional pain practitioners continue to refine and explore where these techniques fit into clinical practice.


Medical Research
Chronic use of methamphetamine causes permanent changes in the brain More

Prenatal exposure to cocaine may indicate increased likelihood of adult substance abuse More

Bipolar disorder drug has potential for alcoholic patients More

International Drug Policy
Marijuana is most abused drug in Australia with 11 percent of ages 14 and up using More

Cannabis users getting younger, drug potency getting stronger in Germany More

Drug-related HIV transmission research in South Africa pays immediate benefits More

In the News
Generations of drug use difficult to change in New Mexico More

Nationwide study on HIV/AIDS finds Baltimore infection rate soaring despite 14 year needle exchange program  More

Privacy Policy Terms of Use Contact Us