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Biomedical subjects

D E Joranson

Publications and source records attributed to D E Joranson.

25 records · Page 2Linked to original sources
PubMed1990

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.

Analgesics, Opioid↗
PubMed1983

delta 9-Tetrahydrocannabinol and therapeutic research legislation for cancer patients.

The Controlled Substances Board evaluated the implementation of the National Cancer Institute (NCI) program in Wisconsin that distributes delta 9-tetrahydrocannabinol (delta 9-THC) to cancer chemotherapy patients with nausea and vomiting refractory to conventional antiemetic drugs. The board concluded that the distribution mechanism for delta 9-THC is appropriate and adequate in Wisconsin. The drug does relieve nausea and vomiting in some cancer chemotherapy patients, but adverse side effects are prevalent. Important questions about its safety and effectiveness remain and should be resolved through scientific research and within the existing framework for testing investigational drugs that are controlled substances. "Marijuana therapeutic research" legislation, similar to that passed in 32 states, was introduced in Wisconsin after implementation and evaluation of the NCI program, but failed to recognize the existing legal framework for approving new drugs and threatened to disrupt the NCI program. With assistance from the American Cancer Society, the State Medical Society, and volunteers and professionals in cancer research, the legislation was adapted to the existing legal and administrative framework.

Antineoplastic Agents↗
PubMedDate not supplied

Pharmacists' knowledge of and attitudes toward opioid pain medications in relation to federal and state policies.

OBJECTIVE: To assess Wisconsin pharmacists' knowledge of and attitudes toward the use of opioid analgesics in the management of chronic cancer and noncancer pain, and to explore the potential for these beliefs to interfere with pharmacist dispensing, the last link of the distribution chain of controlled substances to patients. DESIGN: Mail survey. SETTING: Urban and rural pharmacies, long-term care facilities, hospitals, and outpatient clinics in Wisconsin in 1998. PATIENTS OR OTHER PARTICIPANTS: Representative sample of Wisconsin pharmacists. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Responses to self-administered questionnaires. RESULTS: Although most respondents were knowledgeable about the issues addressed in this study, there were important exceptions. Not all pharmacists knew what constitutes legitimate dispensing practices for controlled substances under federal or state policy in emergencies or for patients with terminal illnesses, and many were unaware of the important distinctions among addiction, physical dependence, and tolerance. Many respondents did not view the chronic prescribing/dispensing of opioids for more than several months to patients with chronic pain of malignant or nonmalignant origin as a lawful and acceptable medical practice; this was especially true when the patient had a history of opioid abuse. CONCLUSION: Pharmacists play a pivotal role in ensuring patient access to medications. Viewed in the context of federal and state controlled substances policies, our findings suggest that the incorrect knowledge and inappropriate attitudes of some pharmacists could contribute to a failure to dispense valid prescriptions for opioid analgesics to patients in pain.

Adult↗
PubMedDate not supplied

Regulatory issues in pain management.

Undertreatment of pain continues to be a serious public health problem. The use of opioid analgesics is considered essential for chronic pain management and palliative care. Pharmacists are encouraged to become involved in initiatives to improve pain management.

Analgesics, Opioid↗