[Legal and epidemiological aspects of strong opioids]

In spite of the fact that the treatment of pain is highly developed, outpatient care of patients suffering from chronic pain is frequently insufficient. In particular general practitioners often refrain from prescribing the necessary pain therapy with opioids. Because of the contract regarding medical treatment, however, the patient has a legal claim to adequate pain treatment, if necessary by administration of opioids. The failure to meet this claim may not only give rise to a claim for damages towards the doctor, but even to a charge of bodily injury. In comparison, charging the physician with criminal behavior on the basis of the Narcotics Act is rather unlikely. Negligent or incorrect prescription of narcotic drugs does not constitute criminal behavior, but an administrative offence. Even this is hardly something which the physician has to fear. Any medically necessary administration of opioids is covered by the Narcotics Prescription Ordinance. The narcotics prescription form, however, remains indispensable for the safety in the use of narcotics. The doctor's prescription alone is obviously not sufficient to curb the considerable abuse of pharmaceutical products among the population. In the course of the introduction of EDP-readable narcotics prescription form as of 1 July 1995, however, the issuing of this kind of prescription was further simplified. Handwritten particulars will soon be entirely a thing of the past. Now that the legal and administrative conditions for prescribing opioids have been consolidated, the main objective is to exhaust the possibilities of prescription for the benefit of patients suffering from pain in a better way. This is first and foremost, an organizational and technical task of the medical professional group. In particular, training and continuing education in the field of pain therapy must be further developed without delay.