Reinterpreting the controlled substances act: predictions for the effect on pain relief

On November 6, 2001 U.S. Attorney General Ashcroft reinterpreted the Controlled Substances Act in a manner consistent with the Pain Relief Promotion Act, a bill introduced in the last Congress. This reinterpretation criminalizes actions related to the provision of controlled substances (e.g. opioids, barbiturates) in the event that a patient dies and external observers believe the intent of providing the medication was to hasten the patient's death. This paper analyzes the arguments regarding the need for reinterpretation and the potential consequences of such an action on pain relief. The conclusion is that the weight of the data clearly leads to the prediction that this reinterpretation of the Controlled Substances Act will lead physicians to be less likely to provide adequate types and doses of pain medication to patients who may die.