The American Academy of Pain Medicine

Other Activities

The Academy is involved with the Liaison Committee on Pain and Addiction. AAPM also serves as an associate member of the Rehabilitation Accreditation Commission (CARF) and works with them to develop national standards for pain programs. The Academy also works with the Centers for Medicare & Medicaid Services (CMS), formerly HCF, looking at specialty differentials in payment for the specialty.  Advocacy at the national level is also a year-round endeavor.  Here are some ways the AAPM has been advocating for you:

 

Drug Enforcement Administration (DEA) Regulations

AAPM has been very vocal in working with other organizations on the 2006 proposed federal regulations on Multiple Prescriptions for Schedule II Controlled Substances.  AAPM learned in November 2007 that the changes it recommended have been accepted by the DEA as described in the attached pdf file from the Federal Register (November 19, 2007).  The end result is that the change should reduce the risk of diversion and abuse, as well as increase patient convenience.

The documents below show AAPM’s initial letter to the Deputy Administrator of the DEA, as well as its collaboration on the Pain Care Coalition to comment on the regulations. It also shows its leadership in working with 16 other medical associations to support, modify, and comment on the regulation.  Finally, we have developed a position statement on the new ruling.

 

DEA Listens to Recommendations Proposed by AAPM and Others  (November 2007)

For several years, AAPM has actively been working to ensure that Pain Medicine physicians remain in control of decisions relating to their patients.  In the fall of 2006, a proposed rule on the use of Schedule II medications was promulgated in the Federal Register.  AAPM commented on this rule advocating that multiple “Do Not Fill Until . . .”  prescriptions be authorized for use.  The result is contained in the new ruling that was issued Nov. 19.

Click here to view a letter from the DEA summarizing the rule.
Click here to view the pdf of the rule.

AAPM Reacts to DEA’s 2006 Proposal

Multiple Prescriptions for Schedule II Controlled Substances.   

AAPM DEA Recommendations
This document contains AAPM’s letter to The Honorable Michele M. Leonhard, Deputy Administrator of the DEA regarding the “Clarification of Existing Requirements Under the Controlled Substances Act for Prescribing Schedule II Controlled Substances (70 FR 50408 T).

Pain Care Coalition Response to DEA’s 2006 Proposal

Pain Care Coalition Comments 
AAPM and several other pain groups responded to the DEA’s proposed rule governing multiple prescriptions for controlled Schedule II drugs.  10/31/06.

AAPM Joined 16 Other Medical Associations to Modify, Support  DEA-287N

Consensus DEA Response
These comments to Docket No DEA-287N were proposed to the DEA by the AAPM and 16 other medical associations, including the American Cancer Society and the American Pain Foundation, and the National Pain Foundation.   

 

Contextual Comments on Hurwitz amicus brief  

by Scott Fishman, MD

Attached is the Amicus brief that AAPM delivered to the 4th District Court of Appeals.  The brief focused exclusively on the point of law in the case that, in our opinion and that of the AMA Litigation Center, poses substantial risk to future legitimate physicians who offer appropriate care to patients in pain.  The AAPM brief specifically focused on the jury instructions that misled the jury about their responsibility to establish whether or not a physician charged with violations of the Controlled Substances Act was acting in good faith and within the bounds of medicine.

As you will see in our attached brief, we believe that the instructions offered by the judge in this case confused the well established line between medical malpractice and criminal activity.  Regardless of what any of us may think of Dr. Hurwitz, he was convicted on federal charges of drug trafficking by a jury that was not offered the standard instructions on the difference between prescribing medications as a physician with the intent to help (misguided as it might have been) or dealing drugs as a street criminal.  Without clarifying the "bounds of medicine," any physician who prescribes a potentially addictive medication with a bad outcome may be viewed as a drug dealer.   The AAPM’s efforts did result in the case being re-opened and re-examined for fairness.

Members can view the full brief by clicking here.