Federal and state regulation of opioids

Federal and state policy governing opioids is discussed in relation to achieving balance between efforts to control drug abuse and maintain drug availability for legitimate medical purposes. Federal controlled substances law affirms the essential medical value of many drugs that are controlled substances, and states that opioids may be used for extended periods in treatment of patients with intractable pain. Providing opioids to addicts is otherwise unlawful unless the physician is separately registered to treat addiction. State laws, while they permit prescribing of opioids for pain, do not provide affirmative recognition of the medical value of controlled substances. Imprecise legal definition of terms allows patients to be confused with addicts. In addition, some states require physicians to report opioid-dependent patients to the government, regulate prescribing of Schedule II opioids more strictly, and limit the quantity of controlled substances that may be prescribed at one time. Recommendations are offered to revise state laws and to improve communication between health care professionals and regulators.