Supreme Court Refuses to Expand Criminal Liability in Opioid Prescribing Cases
The U.S. Supreme Court has unanimously held that physicians who are authorized to prescribe controlled substances can only be convicted for violating the Controlled Substances Act when they intentionally or knowingly prescribe in an unauthorized manner. Furthermore, they cannot be held criminally liable simply for failing to prescribe in accordance with current medical standards if they lacked the aforementioned mental state.
This decision comes as a relief to many in the pain management community—not just for patients who depend upon opioid analgesics as a part of their pain treatment plan, but also for the clinicians who treat them, who have often been deterred from prescribing controlled substances to their patients who need them for fear of unwarranted prosecution. In the decision, Justice Breyer wrote that requiring a culpable mental state “helps to diminish the risk of ‘overdeterrence,’ i.e. punishing acceptable and beneficial conduct that lies close to, but on the permissible side of, the criminal line.”
DoD Discusses “Golden Hour” Response, Pain Control, and Medic Training
The Department of Defense (DoD) is getting candid about battlefield medicine, writing about the challenges posed by today’s large-scale and dispersed military operations, changes in medic training, and the “golden hour” — a critical time window for trauma patients to receive a series of life-saving interventions.
DoD explains that past wars were often centralized, meaning there was often a short distance between the battlefield and a fully-stocked military hospital. However, in decentralized operations, service medics, special operations medics and independent duty corpsmen will “need a lot of skills, such as in administering pain medications, long-term pain control, airway management, and nursing skills,” according to Air Force Col. Stacy Shackelford, chief of the Joint Trauma System in San Antonio, Texas. To meet these needs, all branches of the armed forces are significantly overhauling their medic training programs.
CMS recently published an updated Behavioral Health Strategy that outlines five major goals, one of which is ensuring effective pain treatment and management. The agency aims to expand access to evidence-based treatments for acute and chronic pain, expand the workforce, and increase coordination between primary and specialty care through payment episodes, incentives, and care and payment models.
AHRQ has released an update of its systematic review on Opioid Treatments for Chronic Pain. This review is a part of AHRQ’s larger collection on treatments for chronic pain, which also includes Nonopioid Pharmacologic Treatments for Chronic Pain and Noninvasive Nonpharmacologic Treatment for Chronic Pain: A Systematic Review Update.
CDC has developed resources to help providers better understand and treat the many symptoms and complications of Sickle Cell Disease (SCD). As pain is the most common complication of SCD, the resources include opioid information for SCD patients, a daily pain tracking sheet, information about pain in the emergency room, and warning signs that pain may indicate a more severe problem, such as blood clots, leg ulcers, and more.